Hypertensive disorders of pregnancy (HDP) are associated with significantly increased risk of developing future cardiovascular disease (CVD). Obstetricians play a crucial role in CVD prevention for postpartum women and birthing people with HDP because they are primarily responsible for immediate postpartum management and can assist with care transitions to other health care practitioners for long-term management of CVD risk factors. Standardized calculators can be used to evaluate long-term CVD risk, which can help guide intensity of treatment. Emerging technologies such as remote blood pressure monitoring demonstrate promise for improving outcomes among patients with HDP. After HDP, all patients should be advised of their increased CVD risk. A plan should be made to initiate lifestyle modifications and antihypertensive therapy to achieve optimal blood pressure control with a target of lower than 130/80 mm Hg, assess lipids within 2-3 years of delivery, and evaluate for development of type 2 diabetes. Other CVD risk factors such as nicotine use should similarly be identified and addressed. In this review, we summarize the essential components of managing CVD risk after a pregnancy complicated by HDP, including blood pressure monitoring, risk stratification tools, and evidence-based lifestyle recommendations.

BACKGROUND: Psychosocial stressors at work, defined by the job strain and effort-reward imbalance at work (ERI) models, were shown to increase coronary heart disease risk. No previous study has examined the adverse effect of psychosocial stressors at work from both models on atrial fibrillation (AF) incidence. The objective of this study was to examine the separate and combined effect of psychosocial stressors at work from the job strain and ERI models on AF incidence in a prospective cohort study.
RESULTS: A total of 5926 white-collar workers (3021 women and 2905 men) free of cardiovascular disease at baseline were followed for an average of 18 years. Job strain (high psychological demands combined with low decision latitude) and ERI were assessed using validated instruments. AF events were identified in medical databases with universal coverage. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression models, controlling for socioeconomic characteristics and lifestyle-related and clinical risk factors. A total of 186 AF incident events were identified over 18 years. Workers exposed to job strain (HR, 1.83 [95% CI, 1.14-2.92]) and ERI (HR, 1.44 [95% CI, 1.05-1.98]) had a higher risk of AF in fully adjusted models. Combined exposure to job strain and ERI was associated with a 2-fold AF risk increase (HR, 1.97 [95% CI, 1.26-3.07]).
CONCLUSIONS: Psychosocial stressors at work from the job strain and ERI models are associated with an increased risk of AF, separately and in combination. Workplace prevention strategies targeting these psychosocial stressors at work may be effective to reduce the burden associated with AF.

BACKGROUND: The global prevalence of metabolic syndrome (MetS) increases susceptibility to non-communicable diseases such as obesity, type 2 diabetes, and cardiovascular disease, posing significant health risks. Effective prevention and management require objective tools. The hypertriglyceridemic waist (TG+WC+) phenotype is proposed as a less expensive approach to identify individuals with metabolic syndrome and other cardiovascular risk factors.
OBJECTIVE: The current aim of this investigation is to study the epidemiological characteristics of the hypertriglyceridemic waist phenotype and their correlations with cardiovascular risk factors and MetS in the Moroccan Amazigh ethnic group from the Souss region of Morocco.
METHODS: A total of 827 Amazigh adults from the Sousse region of Morocco were divided into four distinct phenotype groups: TG-WC-, TG+WC-, TG-WC+, and TG+WC+ (normal TG- or high TG+ triglycerides/normal WC- or high WC+ waist circumference). The association of the different phenotypes with MetS and other cardiovascular risk factors was established by logistic regression analysis.
RESULTS: The prevalence of the TG+WC+ phenotype was 27.7% and varied according to age group and sex. Among subjects with the TG+WC+ phenotype, most were 41-60 years old (53.3%) and in women (74.2%). Participants with the TG+WC+ phenotype had the highest prevalence of dyslipidemia (87.3%), hypoHDLaemia (69.9%), and general obesity (37.12%). The three phenotypes TG-WC-, TG+WC- and TG-WC+ were less associated with MetS and other cardiovascular risk factors. Moreover, people with the TG+WC+ phenotype had a very high odds ratio for MetS.
CONCLUSIONS: These findings suggest that the TG+WC+ phenotype exhibits a robust correlation with MetS and additional variables connected to cardiovascular risk. The TG+WC+ phenotype serves as a valuable clinical instrument for detecting individuals vulnerable to MetS and cardiovascular diseases.

BACKGROUND: The prevalence of cardiovascular disease is burgeoning in low- and middle-income countries (LMICs). In sub-Saharan Africa, the prevalence of cardiovascular risk factors is increasing, though rates of CVD diagnosis and management remain low. Awareness of the influence of social determinants of health (SDOH) on cardiovascular outcomes is growing, however, most work focuses on high-income countries. Material needs security is a measure of SDOH that may be particularly relevant for LMICs. This study investigated the relationship between material needs security and cardiovascular risk in older adults living in South Africa.
METHODS: The analysis included 5059 respondents age ≥ 40 in the Health and Aging in Africa survey, an observational cohort study administered in 2014 in Mpumalanga Province, South Africa. Linear regression models tested the association between material needs and eight cardiovascular risk factors (waist-to-hip ratio, body mass index, blood pressure, glucose, cholesterol, LDL, and triglycerides). Adjusted linear regression models controlled for sociodemographic confounders.
RESULTS: There were significant adjusted associations found between increased material needs security and four cardiovascular risk factors, including waist-to-hip ratio (β = 0.001; 95% CI [0.00002,0.002]), BMI (β = 0.19; 95%CI=[0.14,0.24]), glucose (β = 0.46; 95%CI=[0.02,0.90]), and triglycerides (β = 0.26; 95%CI=[0.02,0.49]).
CONCLUSIONS: Increased material needs security was associated with significantly increased cardiovascular risk in older adults in rural South Africa. These findings can inform the approach to treatment and management of cardiovascular disease in South Africa and similar LMICs. Future investigations should evaluate the implementation and efficacy of interventions that recognize the role of material needs security in cardiovascular risk.

UNASSIGNED: To explore the associations between dietary zinc intake and cardiovascular diseases (CVDs), including congestive heart failure (CHF), coronary heart disease (CHD), angina, heart attack, and cerebrovascular accident (CVA), this study was performed.
UNASSIGNED: Data from the National Health and Nutrition Examination Survey (2005-2018) were used in this study. Dietary zinc intake was stratified into quartiles. Restricted cubic splines were constructed to assess nonlinear associations and identify cut-off values based on the type of nonlinearity. Binary logistic regressions were performed using the cut-offs.
UNASSIGNED: Positive associations were detected between the second, third, and fourth quantiles of dietary zinc intake and decreased risks of overall CVDs (Q2: OR = 0.83, 95 % CI = 0.72-0.96; Q3: OR = 0.83, 95 % CI = 0.71-0.96; Q4: OR = 0.79, 95 % CI = 0.67-0.93). The second, third, and fourth quantiles were significantly associated with decreased risks of various CVDs (all P < 0.05), except for CHD and angina (all P > 0.05). Restricted cubic spline regression revealed significant nonlinear trends for associations of dietary zinc intake with the risk of developing CVDs and CHF (both P for nonlinear <0.05), whereas those for heart attack and CVA were marginally significant (P for nonlinear = 0.072, and 0.075, respectively).
UNASSIGNED: This study revealed that high dietary zinc intake is associated with reduced risks of developing CVDs, CHF, heart attack, and CVA, but not CHD or angina.

Cardiovascular diseases are the leading cause of death globally. The objective of this study was to estimate the 10-year cardiovascular risk in the Portuguese population using the new Systematic Coronary Risk Evaluation 2. Data from the first National Health Examination Survey from 2015 were used. Inclusion criteria were age between 40 and 69 years, absence of pregnancy, available information on sex, age, smoking status, systolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol. Participants who had an acute myocardial infarction or a stroke, had diabetes, chronic kidney disease, or reported taking medication for these conditions were excluded from the analysis. The prevalence of high and very high cardiovascular risk was stratified by sex, age group, marital status, education level, occupational activity, degree of urbanization of the area of residence, health region, and income quintile. The sample consisted of 2817 individuals. In Portugal, in 2015, 36.7% (95% CI: 34.2 - 39.3) and 6.1% (95% CI: 4.8 - 7.4) of the individuals aged between 40 and 69 years had a high and a very high risk of having a cardiovascular disease in the following 10 years, respectively. In 2015, there was a high percentage (42.8%) of the Portuguese population aged 40 to 69 years in high or very high risk of developing cardiovascular disease (fatal and non-fatal) in the following 10 years. A possible explanation may be the high prevalence of risk factors for cardiovascular disease in Portugal.

Anderson-Fabry disease (AFD), a genetic disorder caused by mutations in the α-galactosidase-A (GLA) gene, disrupts lysosomal function, leading to vascular complications. The accumulation of globotriaosylceramide (Gb3) in arterial walls triggers upregulation of adhesion molecules, decreases endothelial nitric oxide synthesis, and induces reactive oxygen species production. This cascade results in fibrotic thickening, endothelial dysfunction, hypercontractility, vasospasm, and a pro-thrombotic phenotype. AFD patients display increased intima-media thickness (IMT) and reduced flow-mediated dilation (FMD), indicating heightened cardiovascular risk. Nailfold capillaroscopy (NFC) shows promise in diagnosing and monitoring microcirculatory disorders in AFD, though it remains underexplored. Morphological evidence of AFD as a storage disorder can be demonstrated through electron microscopy and immunodetection of Gb3. Secondary pathophysiological disturbances at cellular, tissue, and organ levels contribute to the clinical manifestations, with prominent lysosomal inclusions observed in vascular, cardiac, renal, and neuronal cells. Chronic accumulation of Gb3 represents a state of ongoing toxicity, leading to increased cell turnover, particularly in vascular endothelial cells. AFD-related vascular pathology includes increased renin-angiotensin system activation, endothelial dysfunction, and smooth muscle cell proliferation, resulting in IMT increase. Furthermore, microvascular alterations, such as atypical capillaries observed through NFC, suggest early microvascular involvement. This review aims to unravel the complex interplay between inflammation, oxidative stress, and endothelial dysfunction in AFD, highlighting the potential connections between metabolic disturbances, oxidative stress, inflammation, and fibrosis in vascular and cardiac complications. By exploring novel cardiovascular risk factors and potential diagnostic tools, we can advance our understanding of these mechanisms, which extend beyond sphingolipid accumulation to include other significant contributors to disease pathogenesis. This comprehensive approach can pave the way for innovative therapeutic strategies and improved patient outcomes.

In younger generations, excess weight has reached very alarming levels. Excess weight in adults is associated with increased mortality and morbidity from cardiovascular disease. However, it is not easy to distinguish to what extent these effects are the result of obesity itself or how much is due to the various cardiovascular risk factors that often accompany excess weight. Several risk factors, such as hypertension, dyslipidemia, hyperuricemia, glucose intolerance, and type 2 diabetes mellitus, are already present in pediatric age. Therefore, early intervention with the goal of correcting and/or eliminating them is particularly important. In the child and adolescent with obesity, the first approach to achieve weight reduction and correct the risk factors associated with severe excess weight should always be non-pharmacologic and based on changing poor eating habits and unhealthy lifestyles. The purpose of this review is to give an update on non-pharmacological interventions to be implemented for cardiovascular prevention in children and adolescents with obesity, and their effectiveness. In particular, interventions targeting each individual cardiovascular risk factor will be discussed.

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. This study focused on evaluating the impact of a Mediterranean-type diet combined with physical exercise on CVD risk factors of high-risk individuals. A randomized clinical trial (RCT) recruited individuals (≥50 years old) with no history of acute myocardial infarction, but with high CVD risk criteria according to the SCORE2/SCORE2 OP. Anthropometric and biochemical parameters were assessed at baseline and after 12 weeks of diet and exercise intervention. Participants were randomly assigned into 3 groups: no intervention group (Group 1a), physical exercise group (Group 1b), and physical exercise (±2 h/week) plus diet group (Group 2). Briefly, the dietary intervention was based on the principles of an isocaloric Mediterranean diet (MD), with seven main meals/week centered on plant-based foods (legumes and pulses). The combined effect of exercise and the diet showed significant decrease in WC (p = 0.002), BST (p < 0.001), visceral fat (p < 0.001), and TG (p = 0.029), compared with control groups. The intervention significantly increased legume intake (p < 0.001), as well as adherence to the MD, which associates with WC decrease (p = 0.024) and visceral fat (p = 0.017). A combined intervention of exercise and diet should be endorsed as an efficient modifier of cardiometabolic parameters.

OBJECTIVE: This study aims to identify the association between adherence to healthy eating, using the Lebanese Mediterranean Diet Scale (LMDS), and cardiovascular risk factors in the Lebanese population.
METHODS: A cross-sectional study using a multistage cluster sample was conducted in Lebanon. Sociodemographic characteristics were collected through structured interviews and self-administered questionnaires. The LMDS assessed dietary habits. The associations between diabetes, dyslipidemia, and cardiovascular disease were investigated using stratification analysis.
RESULTS: The study included 2048 people (mean age: 41.54 ± 17.09 years). Higher adherence to the Mediterranean diet was associated with older age (Beta = 0.175, p < 0.001), being female (Beta = 0.085, p = 0.001), being married (Beta = 0.054, p = 0.047), participating in regular physical activity (Beta = 0.142, p < 0.001), and having cardiovascular disease (Beta = 0.115, p < 0.001) and diabetes (Beta = 0.055, p = 0.043). Adherence was, however, negatively associated with being a smoker (Beta = -0.083, p = 0.002), a previous smoker (Beta = -0.059, p = 0.026), and having higher distress levels (Beta = -0.079, p = 0.002). Stratification analysis by diabetes, dyslipidemia, and cardiovascular disease (CVD) consistently demonstrated these associations.
CONCLUSIONS: These findings suggest that demographic and health factors influence the Lebanese population\'s adherence to the Mediterranean diet. Older age, female gender, married status, physical activity, CVD, and diabetes were all found to be associated with adherence to the Mediterranean diet in the Lebanese population. In contrast, smoking and distress were inversely associated with it.