Atherosclerosis ; blood ; prevention & control ; Cardiovascular Diseases ; blood ; drug therapy ; prevention & control ; Cholesterol ; blood ; Humans ; Hypercholesterolemia ; drug therapy ; Practice Guidelines as Topic

B-type natriuretic peptide (BNP) is a plasma marker of left ventricular dysfunction and cardiac volume overload. Currently it is mainly used in the cardiovascular field. BNP is an intrinsic regulator of the embryonic stem cell proliferation, and the reduction in BNP can increase the apoptosis rate. The epitope of N terminal pro-brain natriuretic peptide-BNP is most stable. BNP1-32 has the strongest biological activity but with lower plasma level in heart failure patients. The plasma BNP level plays an important role in the diagnosis, prognosis, hospital admission and mortality of heart failure, and can be used as a monitoring indicator in the treatment of heart failure. The deficiency of corin enzyme in patients with heart failure can cause the increase of cracking pro-BNP. BNP can also provide diagnostic and prognostic information for other populations and diseases. Genetic studies on BNP and its receptors also provide important information. Nesiritide, neutral endopeptidase inhibitors, and vasopeptidase inhibitors of the natriuretic peptide synthesis have been used for the treatment of cardiovascular disorders. However, more reliable and accurate approaches for detecting BNP and N terminal pro-brain natriuretic peptide-BNP require further investigations.
Cardiovascular Diseases ; blood ; diagnosis ; drug therapy ; Humans ; Natriuretic Peptide, Brain ; blood ; physiology ; therapeutic use

Cardiovascular Diseases ; blood ; drug therapy ; Cholesterol ; blood ; Humans ; Practice Guidelines as Topic ; Risk Factors

Diabetes mellitus is a major chronic disease worldwide, and its prevalence is expected to increase in the near future. Because cardiovascular disease continues to be the leading cause of morbidity and mortality in diabetic patients, it is important to detect and address other risk factors of cardiovascular disease such as hypertension and dyslipidemia. Moreover, presence of diabetes increases the risk of developing hypertension. Despite significant advances in the understanding of the pathophysiology and treatment of hypertension, there are still many debates regarding the management of hypertension, especially in patients with diabetes. The most important unresolved questions are at what blood pressure to initiate drug therapy and the target blood pressure. Recently, the Korean Diabetes Association published "Treatment Guideline for Diabetes 2015." This review will compare major guidelines from other countries and discuss how to determine the target goal for blood pressure control in Korean diabetic patients.
Blood Pressure ; Cardiovascular Diseases ; Chronic Disease ; Diabetes Mellitus ; Drug Therapy ; Dyslipidemias ; Humans ; Hypertension* ; Mortality ; Prevalence ; Risk Factors

OBJECTIVETo investigate the effect of oral sodium selenite and vitamin E on thyroid hormones in patients with cardiovascular disease at altitude.

METHODSNinety patients with cardiovascular disease were divided into A group (n = 42, sodium selenite + VE), B group (n = 28, sodium selenite only) and control group (n = 20). Serum selenium (Se), plasma glutathione peroxidase (GSH-Px), plasma malondialdehyde (MDA) and serum T(3) and T(4) were determined before and after 6 month treatment.

RESULTSSerum Se in A and B group after 6 month treatment were higher than before [(0.71 +/- 0.22) micromol/L vs (0.31 +/- 0.17) micromol/L, (0.68 +/- 0.18) micromol/L vs (0.33 +/- 0.14) micromol/L respectively, P < 0.01], and so were plasma GSH-Px levels [(87.12 +/- 13.61) U/L vs (58.43 +/- 18.93) U/L, (84.79 +/- 12.13) U/L vs (57.12 +/- 17.36) U/L respectively] while plasma MDA were lower than before [(4.86 +/- 1.18) nmol/ml vs (8.66 +/- 0.96) nmol/ml, (4.18 +/- 1.23) nmol/ml vs (8.71 +/- 0.87) nmol/ml respectively, P < 0.01]. Serum T(3) and T(4) levels in A and B group were also obviously decreased (P < 0.01). The levels of plasma GSH-Px were positively correlated with those of serum Se (r = 0.781, P < 0.01). The levels of plasma MDA and serum T(3) and T(4) were negatively correlated with those of serum Se (r = -0.385, -0.687, -0.412 respectively, P < 0.05). 31 cases (73.81%) in A group and 20 cases (71.42%) in B group completely recovered to normal; 4 cases (9.52%) in A group and 2 cases (7.43%) in B group partly recovered. The recovered rates were significantly different from that of control (P < 0.05).

CONCLUSIONSupplementation of adequate selenium may correct the abnormal function of secretion in thyroid hormones of patients because of lack of selenium at altitude areas.

Adult ; Altitude ; Cardiovascular Diseases ; blood ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Sodium Selenite ; administration & dosage ; therapeutic use ; Thyroid Hormones ; blood ; Vitamin E ; administration & dosage ; therapeutic use

Hyperglycemia significantly increases the risk of cardiovascular disease (CVD) in diabetics. However, it has been shown by a series of large scale international studies that intensive lowering of blood glucose levels not only has very limited benefits against cardiovascular problems in patients, but may even be harmful to patients at a high risk for CVD and/or poor long-term control of blood glucose levels. Therefore, Western medicine is faced with a paradox. One way to solve this may be administration of Chinese herbal medicines that not only regulate blood glucose, blood fat levels and blood pressure, but also act on multiple targets. These medicines can eliminate cytotoxicity of high glucose through anti-inflammatory and anti-oxidant methods, regulation of cytokines and multiple signaling molecules, and maintenance of cell vitality and the cell cycle, etc. This allows hyperglycemic conditions to exist in a healthy manner, which is called "harmless hyperglycemia" Furthermore, these cardiovascular benefits go beyond lowering blood glucose levels. The mechanisms of action not only avoid cardiovascular injury caused by intensive lowering of blood glucose levels, but also decrease the cardiovascular dangers posed by hyperglycemia.
Blood Glucose ; analysis ; Cardiovascular Diseases ; prevention & control ; Diabetes Mellitus ; blood ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hyperglycemia ; complications ; etiology

OBJECTIVETo evaluate the efficacy and safety of Tongxinluo Capsule (, TXL) for patients with cardiac syndrome X (CSX).

METHODSRandomized controlled trials (RCTs) regarding TXL in the treatment of CSX were searched in Chinese Biomedicine Literature Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, PubMed, EMBASE, Cochrane Central Register of Controlled Trial, websites of the Chinese and International Clinical Trial Registry platform up to June 30, 2015. The intervention was either TXL alone or TXL combined with conventional treatment, while the control intervention was conventional treatment with or without placebo. Data extraction, methodological quality assessment and data analyses were performed according to the Cochrane criteria. The primary outcome was a composite event of death, acute myocardial infarction (AMI), angina requiring hospitalization, revascularization, and heart failure. The secondary outcome measures were angina symptom improvement, electrocardiograph (ECG) improvement, and serum endothelin-1 (ET-1) level. The adverse events were also recorded. RevMan 5.3 software was applied for data analyses.

RESULTSTwelve RCTs (696 patients) were included. Compared with conventional treatment, the addition of TXL to conventional treatment showed some benefits on relieving angina symptoms [risk ratio (RR): 1.46, 95% confidence interval (CI) (1.25, 1.71), P<0.01], and improving ECG [RR: 1.45, 95% CI (1.21, 1.74), P<0.01]. The pooled result did not support a benefit of TXL on reducing the incidence of primary outcome [RR: 0.20, 95% CI (0.02, 1.61), P=0.13]. In addition, TXL decreased serum ET-1 concentration of CSX patients [standardized mean number:-1.63, 95% CI (-2.29,-0.96), P<0.01]. No serious adverse events were reported.

CONCLUSIONSTXL documents potential benefits on attenuating angina symptoms, improving ECG and decreasing serum ET-1 level for CSX patients. However, more rigorous RCTs with high quality are needed to confirm its efficacy and safety.

Capsules ; Cardiovascular Diseases ; diagnostic imaging ; drug therapy ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Electrocardiography ; Endothelin-1 ; blood ; Humans ; Middle Aged ; Outcome Assessment (Health Care) ; Publication Bias ; Syndrome

BACKGROUND: Childhood cancer survivors have been reported to have an increased risk of prevalence of metabolic syndrome compared to the normal population. The purpose of this study was to investigate the prevalence of the components of metabolic syndrome in childhood cancer survivors in a single institute.METHODS: The study included survivors who had survived for at least 5 years after off chemotherapy without evidence of recurrence. We measured body mass index (BMI), triglycerides (TG), high-density lipoprotein (HDL)-cholesterol, systolic and diastolic blood pressure, and fasting glucose.RESULTS: We investigated 58 childhood cancer survivors, median age 5.4 years (range, 0.1-17.2 years) at diagnosis and median follow-up time elapsed after off chemotherapy 7.4 years (range, 4.7-18.6 years). The frequency of metabolic syndrome was 3.4%. The prevalence of each component was: obesity, 17.2%; elevated TG level, 46.6%; low HDL cholesterol, 34.5%; elevated blood pressure, 1.7%; and elevated fasting glucose, 9.3%, respectively. Sixty nine percentage of survivors had at least 1 abnormal component of metabolic syndrome. The increased TG level was found more frequently in obese subjects than normal weight subjects.CONCLUSION: We observed the high incidence of increased TG level in childhood cancer survivors. It is necessary to be closely monitored the components of metabolic syndrome in childhood cancer survivors, in order to prevent them from cardiovascular diseases and improve their health outcomes.
Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol, HDL ; Diagnosis ; Drug Therapy ; Fasting ; Follow-Up Studies ; Glucose ; Humans ; Incidence ; Lipoproteins ; Obesity ; Prevalence ; Recurrence ; Survivors ; Triglycerides

The aim was to verify the effectiveness of slide platelet aggregation test (SPAT) to monitor the inhibition effect of anti-platelet drugs. A group of eight healthy volunteers was examined for SPAT value and T(50) (time necessary for reaching 50% of total aggregation) induced by ADP, arachidonic acid (AA) and cationic propyl gallate (c-PG) respectively before and after administration of ASA in dose of 100 mg/day for 3 days. The group of 41 inpatients at the Department of Cardiovascular Disease treated with anti-platelet drugs and the group of 327 healthy blood donors were also examined for SPAT. The SPAT value of healthy volunteer samples stored at room temperature were measured hourly for four hours. The results showed that: (1) no significant difference was detected between the T(50) before and after ASA administration in health volunteer group when ADP was used as inducer, but a significant difference was detected in this group when AA or c-PG was used as inducer. There was significant linear correlation between SPAT value and T(50) induced by c-PG in health volunteer group before and after administration of ASA (r = 0.998, P = 0.000); (2) there was no significant difference between the SPAT value of health volunteer group before administration of ASA and the SPAT value of health blood donors group (P = 0.853), but there was a significant difference between the SPAT values before and after administration of ASA in health volunteer group (P = 0.000). There was significant difference when the SPAT value of the inpatients treated with anti-platelet drugs was compared with that of healthy blood donor group and with that of health volunteer group before and after administration of ASA (P = 0.000). The cut-off value of SPAT in health blood donor group was 44.6 +/- 11.7 seconds, reference value was from 21.1 seconds to 68.0 seconds; (3) there was no significant difference between SPAT values when platelets samples stored at room temperature for 1, 2, 3, 4 hours (P = 0.815). In conclusion, SPAT can rapidly monitor the inhibition effect of anti-platelet drugs and SPAT may have the similar clinic value with T(50) induced by c-PG.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aspirin ; therapeutic use ; Cardiovascular Diseases ; blood ; drug therapy ; Drug Monitoring ; methods ; Female ; Humans ; Male ; Middle Aged ; Platelet Activation ; drug effects ; Platelet Aggregation ; drug effects ; Platelet Aggregation Inhibitors ; therapeutic use ; Reproducibility of Results

The link between cholesterol levels and atherosclerotic cardiovascular disease (ASCVD) is well-established. In Singapore, there is an increasing prevalence of risk factors for ASCVD. Like many Asian countries, Singapore's population is rapidly ageing and increasingly sedentary, which predisposes individuals to chronic health problems. Current international and local guidelines recommend statin therapy for the primary and secondary prevention of ASCVD. However, despite the effectiveness of statin therapy, some studies have highlighted that Asian patients with cardiovascular disease are not achieving target lipid goals. Furthermore, it is widely believed that the responses of Asians (both patients and physicians) to statin therapy are different from those of their Western counterparts. Experts convened in 2014 to determine the impact of current guidelines on clinical practice in Singapore. This review summarises the key findings and recommendations of these guidelines, and presents key principles to aid clinicians to manage the cardiovascular risk of their patients more effectively.
Aging ; Atherosclerosis ; drug therapy ; Cardiology ; standards ; Cardiovascular Diseases ; drug therapy ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Life Style ; Lipoproteins, LDL ; blood ; Practice Guidelines as Topic ; Risk Assessment ; Risk Factors ; Singapore