cardio vascular disease

心血管疾病
  • 文章类型: Journal Article
    钠-葡萄糖协同转运蛋白2(SGLT2)和胰高血糖素样肽-1受体激动剂(GLP-1RA)抑制剂的发现显着改善了2型糖尿病的管理。大规模临床研究表明,SGLT2抑制剂和GLP-1RA均可增强心血管健康。好处包括降低心血管疾病风险,死亡率较低,更少的心力衰竭住院(SGLT2抑制剂),和中风预防(GLP-1RA)。此外,这些药物可以减缓慢性肾脏病的进展.这种综合治疗以血管事件为目标。尽管存在差异,这两种药物都至关重要。GLP-1RA主要降低卒中风险,而SGLT2抑制剂缓解心力衰竭。我们的发现,根据文献综述,将解决SGLT2抑制剂和GLP-1RA对糖尿病患者和非糖尿病患者的肾脏和心脏影响,强调它们对心脏病的综合益处。
    The discovery of inhibitors for sodium-glucose cotransporter 2 (SGLT2) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) has significantly improved type 2 diabetes management. Large-scale clinical studies have shown that both SGLT2 inhibitors and GLP-1 RA enhance cardiovascular health. Benefits include reduced cardiovascular disease risk, lower mortality, fewer heart failure hospitalizations (SGLT2 inhibitors), and stroke prevention (GLP-1 RA). Additionally, these drugs slow chronic kidney disease progression. This comprehensive treatment targets vascular events. Despite differences, both drug classes are crucial. GLP-1 RA mainly reduce stroke risk, while SGLT2 inhibitors alleviate heart failure. Our findings, based on a literature review, will address the renal and cardiac effects of SGLT2 inhibitors and GLP-1 RA in both diabetics and non-diabetics, highlighting their combined benefits for heart conditions.
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  • 文章类型: Journal Article
    血压升高是心血管疾病的主要危险因素之一。关于血压的身心医学(MBM)技术的现有证据尚无定论,并提供了相互矛盾的结果。当前系统评价和荟萃分析的目的是评估MBM技术对心血管疾病患者血压的影响。在2000年至2020年之间进行的关于心血管疾病的随机对照试验(RCT),使用MBM技术,如冥想,通过电子数据库搜索基于正念的减压和放松技术,如PubMed,护理和相关健康累积指数(CINAHL),EMBASE和Cochrane图书馆。三位作者独立进行文章选择,数据提取和验证。使用随机效应模型和标准化平均差(SMD)进行荟萃分析,对效应大小进行95%置信区间(CI)估计。15个RCTs,927例患者被纳入荟萃分析。对于所有分析,研究之间的异质性非常高(I2>94%)。为了比较收缩压,与常规治疗相比,MBM干预措施显示出显着(p=0.01)效果,SMD的总体估计效应大小为0.78(95%CI:-1.36,-0.20)。为了比较舒张压,与常规治疗相比,MBM干预没有显着效果,SMD的总体效应大小为-0.26(95%CI:-0.91,0.39)。荟萃分析的结果表明,MBM干预措施可以改善心脏病患者的收缩压。纳入研究的异质性高,质量低,在提示MBM作为降低心血管疾病血压的有效治疗方式之前,需要更有力的证据.
    Elevated blood pressure is one of the major risk factors for cardiovascular diseases. Available evidence on mind-body medicine (MBM) techniques on blood pressure is inconclusive and provides conflicting results. The objective of the current systematic review and meta-analysis is to evaluate the effect of MBM techniques on blood pressure in patients with cardiovascular disease. Randomized control trials (RCTs) done between the years 2000 and 2020 on cardiovascular disease, using MBM techniques such as meditation, mindfulness-based stress reduction and relaxation techniques were searched through electronic databases such as PubMed, Cumulative Index to Nursing & Allied Health (CINAHL), EMBASE and Cochrane Library. Three authors independently performed article selection, data extraction and validation. Meta-analysis was performed using a random effect model and standardized mean difference (SMD) with 95% confidence interval (CI) estimated for the effect size. Fifteen RCTs with 927 patients were included in the meta-analysis. Heterogeneity among the studies was very high for all analyses (I2>94%). For studies comparing systolic blood pressure, MBM interventions show a significant (p=0.01) effect when compared to conventional treatment, an overall estimated effect size of SMD - 0.78 (95% CI: -1.36, -0.20). For studies comparing the diastolic blood pressure, MBM intervention did not show any significant effect when compared to the conventional treatment, an overall effect size of SMD -0.26 (95% CI: -0.91, 0.39). The findings of the meta-analysis suggest that MBM interventions may improve systolic blood pressure alone in patients with cardiac diseases. With high heterogeneity and low quality of the included studies, more robust evidence is required before suggesting MBM as an effective treatment modality for reducing blood pressure in cardiovascular diseases.
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  • 文章类型: Journal Article
    心血管疾病(CVD)继续构成全球健康挑战,证明了不同人群之间发生的显著差异。大量研究表明,与美国当地人口相比,南亚移民的心血管疾病患病率更高。提高移民心血管效益的需求越来越大,这需要对更大、更多样化的人口样本进行进一步研究。这项研究将调查这种变化的主要原因,其中包括研究人群群体的遗传多样性特征和营养状况的变化。为了评估与美国人群相比,南亚人群中心血管疾病患病率的增加,对可访问数据进行叙述性审查。支持本文件的数据来自疾病预防和控制中心,2023年心脏病和中风统计数据,关于2017年心脏病发病率和全球负担的趋势分析,都可以追溯到过去二十年。PubMed和GoogleScholar的相关文章也被收录,在适当的情况下,并在必要时提供其参考。使用MicrosoftExcel制作疾病发病率地理变化的图表(Microsoft®Corp.,雷德蒙德,西澳)。审查表明,与南亚人病例数的稳定增长相比,美国公民的心血管疾病患病率显着下降,这归因于南亚人的独特遗传倾向更容易患CVD。与美国人相比,不断变化的饮食习惯在南亚人HDL水平下降中也起着重要作用。这是由遗传差异驱动的,包括APOA1和APOA2基因,和营养差异,包括饮食消费质量和数量的差异。为了应对南亚人心血管疾病的不断升级,需要进行更多的研究,以加强积极的预防措施,并实施专门针对人群中普遍存在的风险因素的筛查计划。
    Cardiovascular disease (CVD) continues to pose a global health challenge, demonstrating significant disparities in occurrence among various populations. A wide number of research studies have indicated a higher prevalence of cardiovascular disease in South Asian immigrants compared to the local American population. The demand to improve the cardiovascular benefits of immigrants is increasing, which calls for further research with larger and more diverse population samples. This study will investigate the major causes of this variation, which include genetically diverse characteristics and changes in nutritional status among the study population groups. To assess the increase in the prevalence of cardiovascular disease among South Asian populations compared to the US population, a narrative review of accessible data is carried out. The data in support of the present document are from the Centre for Disease Prevention and Control, Statistics for Heart Diseases and Stroke 2023, a trend analysis about incidences of cardiac diseases and global burden in 2017, all dating back to the last two decades. Relevant articles from PubMed and Google Scholar have also been included, as appropriate, and their references are provided wherever necessary. Graphs for the geographical variations in disease incidence are produced using Microsoft Excel (Microsoft® Corp., Redmond, WA). The review shows that there is a significant decline in the prevalence of CVD among American citizens when compared to the steady increase in the number of cases among South Asians, which is attributed to the unique genetic predisposition of South Asians to be more prone to CVDs. The changing dietary habits also play an important role in the fall in HDL levels in South Asians when compared to Americans. This is driven by genetic disparities, including the APOA1 and APOA2 genes, and nutritional disparities, including variance in quality and quantity of dietary consumption. Addressing the escalating cases of CVD among South Asians necessitates additional research to enhance proactive preventive measures and implement screening programs specifically tailored to address prevalent risk factors within the population.
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  • 文章类型: Meta-Analysis
    目的:许多研究调查了性早熟对心血管疾病(CVD)结局的影响以及血脂水平与性早熟之间的关系。然而,结果不一致。这项荟萃分析的目的是评估甘油三酯(TG)总胆固醇(TC),与健康对照组相比,性早熟女孩的高密度脂蛋白(HDL)和低密度脂蛋白(LDL)水平发生改变.
    方法:2022年6月之前在EMBASE中发布的参考资料,科克伦图书馆,搜索PubMed和WebofScience数据库以确定合格的研究。使用DerSimonian-Laird随机效应模型来评估性早熟和健康对照之间的总体标准平均差(SMD)。进行了亚组分析和敏感性分析,并评估发表偏倚.
    结果:共选择了14项研究,其中1023名性早熟女孩和806名健康女孩进行分析。Meta分析显示TG(SMD:0.28;95%CI:0.01~0.55;P=0.04),TC(SMD:0.30;95%CI:0.01至0.59;P=0.04),早熟女孩的LDL(SMD:0.45;95%CI:0.07至0.84;P=0.02)水平显着升高。HDL水平没有显着变化(SMD:-0.06;95%CI:-0.12至0.61;P=0.62)。亚组分析显示,在这项荟萃分析中,血脂谱与性早熟之间的关系的异质性可能来自疾病类型,区域,样本量,实际年龄,体重指数差异和药物使用。
    结论:与健康对照相比,性早熟女孩的血脂水平发生了改变。为了最大限度地降低CVD发病率和死亡率的风险,需要早期干预来预防儿童和青少年的肥胖,尤其是那些性早熟的人.
    OBJECTIVE: Many studies have investigated the impact of precocious puberty on cardiovascular disease (CVD) outcomes and the association between lipid profile levels and precocious puberty. However, the results have been inconsistent. The aim of this meta-analysis was to evaluate whether triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL)and low density lipoprotein (LDL) levels were altered in girls with precocious puberty compared with healthy controls.
    METHODS: References published before June 2022 in the EMBASE, Cochrane Library, PubMed and Web of Science databases were searched to identify eligible studies. A DerSimonian-Laird random-effects model was used to evaluate the overall standard mean difference (SMD) between precocious puberty and healthy controls. Subgroup analyses and sensitivity analyses were preformed, and publication bias was assessed.
    RESULTS: A total of 14 studies featuring 1023 girls with precocious puberty and 806 healthy girls were selected for analysis. The meta-analysis showed that TG (SMD: 0.28; 95% CI: 0.01 to 0.55; P = 0.04), TC (SMD: 0.30; 95% CI: 0.01 to 0.59; P = 0.04), LDL (SMD: 0.45; 95% CI: 0.07 to 0.84; P = 0.02)levels were significantly elevated in girls with precocious puberty. HDL levels did not change significantly (SMD: -0.06; 95% CI: -0.12 to 0.61; P = 0.62). Subgroup analyses revealed that the heterogeneity in the association between lipid profile and precocious puberty in this meta-analysis may arise from disease type, region, sample size, chronological age, body mass index difference and drug usage.
    CONCLUSIONS: Lipid profile levels altered in girls with precocious puberty compared with healthy controls. In order to minimize the risk of CVD morbidity and mortality, early interventions were needed to prevent obesity in children and adolescents, especially those with precocious puberty.
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  • 文章类型: Journal Article
    撒哈拉以南非洲(SSA)面临着高血压和人类免疫缺陷病毒(HIV)的双重负担。在这篇综述中,我们试图确定患病率,意识,和控制艾滋病毒感染者(PLHIV)中的高血压,以及SSA艾滋病毒护理点高血压服务的可用性。我们搜查了PubMed,Embase,Scopus,科克伦图书馆,全球指数Medicus,非洲杂志在线,和世卫组织信息共享机构存储库(IRIS)用于高血压流行病学研究,和SSA中PLHIV的高血压服务。确定了26篇文章供审查,150,886名参与者;加权平均年龄为37.5岁,女性比例为62.6%。合并患病率为19.6%(95%置信区间[CI],16.6%,22.5%);高血压知晓率为28.4%(95%CI,15.5%,41.3%),高血压控制率为13.4%(95%CI,4.7%,22.1%)。与HIV相关的因素,如CD4计数,病毒血症,抗逆转录病毒治疗方案与高血压的发生率并不一致.然而,高体重指数(BMI)超过25kg/m2[比值比:1.64,95%CI(1.26,2.02)]和年龄超过45岁[比值比:1.44,95%CI(1.08,1.79)]与高血压患病率相关.即使ART上的PLHIV更有可能进行高血压筛查和监测,大多数HIV诊所很少筛查和治疗高血压.大多数研究建议整合艾滋病毒和高血压服务。我们报告了在相对年轻的PLHIV人群中高血压的高患病率,筛查不理想。治疗,控制高血压.我们建议整合艾滋病毒和高血压服务的策略。
    Sub-Saharan Africa (SSA) is faced with a dual burden of hypertension and human immunodeficiency virus (HIV). In this review we sought to determine the prevalence, awareness, and control of hypertension among persons living with HIV (PLHIV), and the availability of hypertension services at the HIV care points in SSA. We searched the PubMed, Embase, Scopus, Cochrane library, Global index Medicus, African Journal online, and WHO Institutional Repository for Information Sharing (IRIS) for studies on the epidemiology of hypertension, and hypertension services for PLHIV in SSA. Twenty-six articles were identified for the review, with 150,886 participants; weighted mean of age 37.5 years and female proportion of 62.6%. The pooled prevalence was 19.6% (95% confidence interval [CI], 16.6%, 22.5%); hypertension awareness was 28.4% (95% CI, 15.5%, 41.3%), and hypertension control was 13.4% (95% CI, 4.7%, 22.1%). HIV-related factors like CD4 count, viremia, and antiretroviral therapy regimen were not consistently associated with prevalent hypertension. However, high body mass index (BMI) above 25 kg/m2 [odds ratio: 1.64, 95% CI (1.26, 2.02)] and age above 45 years [odds ratio: 1.44, 95% CI (1.08, 1.79)] were associated with prevalent hypertension. Even when PLHIV on ART were more likely to be screened for hypertension and monitored, there was infrequent screening and treatment of hypertension in most HIV clinics. Most studies recommended integrating of HIV and hypertension services. We report a high prevalence of hypertension in a relatively young population of PLHIV with suboptimal screening, treatment, and control of hypertension. We recommend strategies to integrate HIV and hypertension services.
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  • 文章类型: Journal Article
    新型严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)病毒是本世纪迄今为止最严重的大流行的原因:2019年冠状病毒病(COVID-19)。它导致了前所未有的死亡率和发病率,在全世界造成毁灭性后果。COVID-19的急性表现,包括呼吸系统和多系统受累,已引起医生的极大关注。然而,冠状病毒的长期影响使许多患者与慢性症状作斗争,从极度疲劳到心肌病。在这篇文章中,我们回顾了COVID-19的慢性表现,重点是心血管表现.我们讨论病理生理学,急性后遗症后,临床表现,长COVID心血管表现的实验室诊断方法,和提出的多学科治疗方法。我们还探讨了疫苗接种与长COVID综合征之间的关系。
    The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has been the cause of the century\'s worst pandemic so far: coronavirus disease 2019 (COVID-19). It has led to unprecedented mortality and morbidity, resulting in devastating consequences worldwide. The acute manifestations of COVID-19 including respiratory as well as multisystem involvement have been causes of great concern among physicians. However, the long-term effects of the coronavirus have left many patients battling with chronic symptoms, ranging from extreme fatigue to cardiomyopathy. In this article, we review the chronic manifestations of COVID-19 with a focus on cardiovascular manifestations. We discuss the pathophysiology, post-acute sequelae, clinical manifestations, approach to the laboratory diagnosis of cardiovascular manifestations of long COVID, and a proposed multidisciplinary treatment method. We also explore the relationship between vaccination and the long COVID syndrome.
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  • 文章类型: Journal Article
    随着最近几个国家娱乐性大麻合法化,关于它是“安全”的有争议的信念正在蔓延。在这次系统审查中,我们决定调查这一信念,并提出大麻和吸烟对心血管系统的不利影响。我们对包括PubMed在内的数据库进行了电子搜索,PubMedCentral,Medline医学主题词(MeSH)术语和不同关键词用于数据收集。我们纳入了过去10年发表的英文研究。接受所有类型的研究对象。灰色文学,书籍,病例报告和病例系列,重叠和重复的研究,超过10岁的研究被排除.在这次审查中,我们纳入了18项研究,然后,我们将其分为“烟草和心血管疾病”臂和“大麻素和心血管疾病”臂。我们对每个手臂进行了11和7项研究,分别。本综述中包含的文章类型是传统和系统综述以及荟萃分析。在查看了本文中包含的所有数据之后,我们发现,与烟草相比,大麻素消费对心血管系统的破坏性影响更大。令人震惊的事实是,在几个案例中,患者在食用后几小时内甚至在首次使用大麻素期间观察到致命的不良反应。
    With the recent legalization of marijuana in several countries for recreational use, a controversial belief is spreading about it being \"safe\". In this systematic review, we decided to investigate this belief and present the adverse effects of marijuana and tobacco smoking on the cardiovascular system. We carried out an electronic search on databases including PubMed, PubMed Central, and Medline. Medical Subject Headings (MeSH) terms and different keywords were used for data collection. We included studies published in the last 10 years that were in English. All types of study subjects were accepted. Grey literature, books, case reports and case series, overlapping and duplicate studies, and studies older than 10 years were excluded. In this review, we included 18 studies, which we then separated into the \"tobacco and cardiovascular disease\" arm and the \"cannabinoids and cardiovascular disease\" arm. We had 11 and seven studies for each of the arms, respectively. The types of articles included in this review were traditional and systematic reviews and meta-analyses. After reviewing all the data included in this article, we found out that cannabinoid consumption has a more devastating effect on the cardiovascular system when compared to tobacco. The shocking fact was that in several cases, deadly adverse effects were observed in patients within a few hours after consumption or even during their first time using cannabinoids.
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  • 文章类型: Journal Article
    炎症性肠病(IBD),包括溃疡性结肠炎(UC)和克罗恩病(CrD),是肠道外受累的慢性复发性炎症。在过去十年中发表的许多研究强调了IBD的危险心血管疾病(CVD)结果,比如缺血性心脏病,心力衰竭,和中风,以及需要更好的治疗和预后策略。本文阐明了将IBD与CVD联系起来的病理机制网络,比如免疫失调,内皮功能障碍,动脉僵硬度,和生态失调,全面回顾了在儿科和成人人群中支持和反对这一概念的临床研究。当前的治疗和预防旨在缓解疾病和饮食策略,以降低CVD风险。探索其他补充预防和治疗方法,尤其是在疾病的活动性耀斑期间,降低动脉血栓栓塞性疾病(ATED)的风险是必要的。
    Inflammatory bowel disease (IBD), comprising of ulcerative colitis (UC) and Crohn\'s disease (CrD), is a chronic relapsing-remitting inflammation of the bowel with extraintestinal involvement. Numerous studies published in the last decade have underlined the dangerous cardiovascular disease (CVD) outcomes of IBD, such as ischemic heart disease, heart failure, and stroke, and the need for better therapeutic and prognostic strategies. This article elucidated the pathological web of mechanisms that link IBD with CVD, such as immune dysregulation, endothelial dysfunction, arterial stiffness, and dysbiosis, with a comprehensive review of clinical studies standing for and against the notion in pediatric and adult populations. The current treatment and prevention aim at disease remission and dietary strategies shown to reduce the CVD risk. Exploration of other supplemental preventive and treatment methods, especially during active flares of disease, to reduce the risk of arterial thromboembolic disease (ATED) is the need of the hour.
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  • 文章类型: Journal Article
    牛皮癣是一种持久的,皮肤和关节的非传染性慢性炎性疾病。以前的流行病学研究表明,银屑病患者的预期寿命较短,主要是由于心血管(CV)事件,心血管危险因素如血脂异常的患病率较高,糖尿病,胰岛素抵抗,肥胖,和高血压。除了这些危险因素,银屑病可能在增加CV事件中起独立作用,可能是由于慢性炎症状态。本文综述了动脉粥样硬化的形成机制,CV危险因素,诊断亚临床动脉粥样硬化的工具,以及各种疗法对银屑病患者预防银屑病心血管相关死亡的影响。这篇评论是通过在PubMed和GoogleScholar数据库中搜索相关文章来进行的,不包括任何排除标准和时间限制。我们的综述表明,由于慢性炎症和相关的CV危险因素,银屑病患者发生CV事件的风险增加。此外,抗炎治疗可以预防早期亚临床动脉粥样硬化血管改变,从而减少心血管事件.然而,现有的研究缺乏建立心血管危险因素的确切目标,评估银屑病患者亚临床血管变化筛查的临床重要性以及抗炎治疗对CV风险状况的影响.ThishighedawarenessabouttheCVinvolvementincrisershouldencourageconductionlarger,精心计划的全面研究,以解决这些问题,可以降低心血管发病率和死亡率。
    Psoriasis is a long-lasting, noncontagious chronic inflammatory disease of skin and joints. Previous epidemiological studies have demonstrated that psoriatic patients have a shorter life expectancy, mainly due to cardiovascular (CV) events with a higher prevalence of cardiovascular risk factors like dyslipidemia, diabetes mellitus, insulin resistance, obesity, and hypertension. Besides these risk factors, psoriasis likely plays an independent role in increasing CV events probably due to the chronic inflammatory state. This literature review aims to summarize the mechanism of atherosclerosis formation, CV risk factors, tools to diagnose subclinical atherosclerosis, and the effects of various therapies in psoriatic patients to prevent cardiovascular-related deaths in psoriasis. This review was performed by searching the relevant articles in PubMed and Google Scholar databases without including any exclusion criteria and time limitations. Our review documented that psoriatic patients are at increased risk of CV events due to chronic inflammatory profile and the associated CV risk factors. Also, anti-inflammatory therapies may prevent early subclinical atherosclerotic vascular changes reducing cardiovascular events. However, the available studies lack to establish the exact targets for CV risk factors, to assess the clinical importance of screening for subclinical vascular changes and the impact of anti-inflammatory therapies on CV risk profile in psoriatic patients. This heightened awareness about the CV involvement in psoriasis should encourage conducting large, well planned comprehensive studies to address these issues that can reduce cardiovascular morbidity and mortality.
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