This review examines strategies for the prevention and management of obesity, hypertension, type 2 diabetes mellitus and dyslipidaemia, conditions that are increasing in Singapore, as components of individualised health plans in 'Healthier SG' and beyond. We describe cardiometabolic disease prevention and management initiatives in Changi General Hospital (CGH), including collaborations with SingHealth Polyclinics, Active SG, Exercise is Medicine Singapore and community partners in the Eastern Community Health Outreach programme, and highlight advances in curable hypertension (e.g., primary hyperaldosteronism) and novel cardiovascular risk markers such as lipoprotein(a). We also outline technology-based interventions, notably the CGH Health Management Unit, which demonstrate the utility and convenience of telemedicine, and digital therapeutics in the form of apps that have been shown to improve treatment adherence and clinical outcomes. Individual empowerment, in partnership with community and healthcare providers and supported by research and innovation of care delivery, is key to building a healthier and stronger nation.
Humans ; Singapore ; Diabetes Mellitus, Type 2/therapy* ; Hypertension/therapy* ; Obesity/therapy* ; Dyslipidemias/therapy* ; Telemedicine ; Cardiovascular Diseases/prevention & control* ; Exercise ; Metabolic Diseases/prevention & control*

This article provides an overview of the current evidence on the epidemiology, overlapping risk factors, and pathophysiology of cardiovascular disease (CVD) in patients with cancer. It explores the cardiotoxic effects of anticancer therapy and their impact on prognosis. Although cancer survival rates have improved over the last two decades, the risk of CVD has risen over time in patients with cancer. CVD and cancer share similar risk factors and a common pathophysiology involving inflammation. Many chemotherapeutic agents used to treat cancer are associated with cardiovascular complications (such as heart failure, myocardial infarction, and thrombosis). Current evidence indicates a significant burden of CVD in patients with cancer, particularly in the first year following cancer diagnosis, with elevated risk persisting beyond this period. This short- and long-term risk of CVD may vary depending on the cancer type and treatment regimen. Early identification of potential cardiovascular risk in patients with cancer, can lead to more favorable clinical and survival outcomes. Given the acute and long-term consequences, patients with cancer require increased cardiovascular care and lifestyle optimization. This article offers valuable insights into the cardiovascular burden and needs of patients with cancer. It is intended for a general medical research readership interested in the intersection of cardiology and oncology.
Humans ; Neoplasms/drug therapy* ; Cardiovascular Diseases/etiology* ; Prognosis ; Risk Factors ; Antineoplastic Agents/therapeutic use*

Leonurus japonicas Houtt., has been recorded as "light body and long life" properties in the oldest classical medicinal book Shennong Bencao Jing thousands of years ago. Herba leonuri, also named Chinese Motherwort or Siberian Motherwort, has the effects of activating blood circulation, regulating menstruation, diuresis and detumescence, clearing heat and detoxifying, and is known as the "sacred medicine of gynecology." It has been well known by doctors and usually used in the treatment of common gynecological diseases in clinic. Leonurine is a very important alkaloid in Herba leonuri, which has many biological activities such as anti-oxidation, anti-inflammation, and anti-apoptosis. Diseases of the cardiovascular system and central nervous system are "major health threats" that threaten human life and health worldwide, however, many drugs have certain side effects right now. This paper reviews the potential molecular therapeutic effects of leonurine on cardiovascular system and central nervous system diseases, highlights the current findings of research progress, and focuses on the therapeutic effects of leonurine in various diseases. At present, leonurine is in the stage of clinical experiment, and we hope that our summary can provide guidance for its future molecular mechanism study and clinical application.
Humans ; Gallic Acid/therapeutic use* ; Leonurus/chemistry* ; Cardiovascular Diseases/drug therapy* ; Animals ; Central Nervous System Diseases/drug therapy*

Objective: To analyze the status of statins use and low-density lipoprotein cholesterol (LDL-C) management in patients with atrial fibrillation (AF) and very high/high risk of atherosclerotic cardiovascular disease (ASCVD) from Chinese Atrial Fibrillation Registry (CAFR). Methods: A total of 9 119 patients with AF were recruited in CAFR between January 1, 2015 to December 31, 2018, patients at very high and high risk of ASCVD were included in this study. Demographics, medical history, cardiovascular risk factors, and laboratory test results were collected. In patients with very high-risk, a threshold of 1.8 mmol/L was used as LDL-C management target and in patients with high risk, a threshold of 2.6 mmol/L was used as LDL-C management target. Statins use and LDL-C compliance rate were analyzed, multiple regression analysis was performed to explore the influencing factors of statins use. Results: 3 833 patients were selected (1 912 (21.0%) in very high risk of ASCVD group and 1 921 (21.1%) in high risk of ASCVD group). The proportion of patients with very high and high risk of ASCVD taking statins was 60.2% (1 151/1 912) and 38.6% (741/1 921), respectively. Attainment rate of LDL-C management target in patients with very high and high risk were 26.7% (511/1 912) and 36.4% (700/1 921), respectively. Conclusion: The proportion of statins use and attainment rate of LDL-C management target are low in AF patients with very high and high risk of ASCVD in this cohort. The comprehensive management in AF patients should be further strengthened, especially the primary prevention of cardiovascular disease in AF patients with very high and high risk of ASCVD.
Humans ; Atrial Fibrillation/drug therapy* ; Cardiovascular Diseases ; Cholesterol, LDL ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use* ; Atherosclerosis ; Dyslipidemias/drug therapy*

Humans ; Cardiovascular Diseases/drug therapy* ; Consensus ; Lymphoma, B-Cell ; Lymphoma, Mantle-Cell ; Tyrosine Protein Kinase Inhibitors/therapeutic use*

Humans ; Cardiovascular Diseases/therapy* ; China ; Cognitive Dysfunction/therapy* ; Consensus

Chronic kidney disease (CKD) is a global public health problem that is usually progressive. Hypertension is a risk factor for the progression of CKD, and cardiovascular disease is the most common cause of death in patients with CKD. In Chinese patients with CKD, there is a high prevalence of hypertension and a poor rate of control. Several studies have demonstrated that effective blood pressure control can delay the progression of kidney disease and reduce the risk of cardiovascular events and all-cause mortality. Based on previously published high-quality evidence, guidelines and consensus reports, the Zhongguancun Nephropathy and Blood Purification Innovation Alliance formulated a new consensus. This consensus includes blood pressure measurement; the blood pressure management of non-dialysis patients, dialysis patients and kidney transplantation patients, and the interaction between commonly used drugs and antihypertensive drugs. The consensus aims to further strengthen the standardization and safety of blood pressure management in CKD patients, delay disease progression, reduce disease burden, and comprehensively improve the quality-of-life and prognosis of patients with CKD.
Humans ; Cardiovascular Diseases ; Consensus ; East Asian People ; Hypertension/therapy* ; Renal Insufficiency, Chronic/therapy* ; Renal Dialysis

Pyroptosis is a programmed cell death initiated by the activation of caspases, which is involved in the development and progression of several cardiovascular diseases. The gasdermins, a protein family, are key executive proteins in the development of pyroptosis, which increase cell membrane permeability, mediate the release of inflammatory factors, and aggravate the inflammatory injury. Traditional Chinese medicine(TCM)has shown unique therapeutic advantages in cardiovascular diseases with multi-component and multi-target characteristics. Currently, the effective prevention and treatment of cardiovascular diseases based on the theory of pyroptosis become a new research hotspot in this field. Based on the theories of TCM and modern medicine, this study summarized the role of pyroptosis in cardiovascular diseases such as atherosclerosis, myocardial infarction, diabetic cardiomyopathy, hypertension, and myocarditis. The role of TCM, including active monomers, crude extracts, and compound preparations, in cardiovascular protection through the regulation of pyroptosis was also summarized, providing a theoretical basis for the clinical prevention and treatment of cardiovascular diseases by TCM.
Humans ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal/therapeutic use* ; Cardiovascular Diseases/prevention & control* ; Pyroptosis ; Myocardial Infarction/drug therapy*

High mortality rates from cardiovascular diseases (CVDs) persist worldwide. Older people are at a higher risk of developing these diseases. Given the current high treatment cost for CVDs, there is a need to prevent CVDs and or develop treatment alternatives. Western and Chinese medicines have been used to treat CVDs. However, several factors, such as inaccurate diagnoses, non-standard prescriptions, and poor adherence behavior, lower the benefits of the treatments by Chinese medicine (CM). Artificial intelligence (AI) is increasingly used in clinical diagnosis and treatment, especially in assessing efficacy of CM in clinical decision support systems, health management, new drug research and development, and drug efficacy evaluation. In this study, we explored the role of AI in CM in the diagnosis and treatment of CVDs, and discussed application of AI in assessing the effect of CM on CVDs.
Humans ; Aged ; Cardiovascular Diseases/drug therapy* ; Medicine, Chinese Traditional ; Artificial Intelligence ; Integrative Medicine

OBJECTIVE: The main aim of this study is to investigate whether acupuncture could be an effective complementary treatment for reducing the risk of macrovascular complications in diabetic patients currently taking antidiabetic medications using a nationwide population-based database. METHODS: We conducted a retrospective cohort study to assess the efficacy of acupuncture on cardiovascular complications in diabetic patients using data from patients between 40 and 79 years of age, newly diagnosed with diabetes between 2003 and 2006, found in the National Health Insurance Service-National Sample Cohort (NHIS-NSC) in Korea. From the data, we identified 21,232 diabetic patients who were taking antidiabetic medication between 2003 and 2006. The selected patients were divided into two groups-those who received acupuncture at least three times and those who received no acupuncture (non-acupuncture) in the year following their diagnosis of diabetes. After 1:1 propensity score matching (PSM), each group had 3350 patients, and the observation ceased at the occurrence of a major adverse cardiovascular event (MACE), which was defined as either myocardial infarction, stroke, or death due to cardiovascular cause. RESULTS: After PSM, the acupuncture group had a lower incidence of MACE (hazard ratio [HR]: 0.87; 95% confidence interval [CI]: 0.81-0.94; P = 0.0003) and all-cause mortality (HR: 0.77; 95% CI: 0.70-0.84; P < 0.0001) than the non-acupuncture group; the HRs for stroke-related mortality (HR: 0.75; 95% CI: 0.56-1.00; P = 0.0485), ischemic heart disease mortality (HR: 0.53; 95% CI: 0.34-0.84; P = 0.006) and circulatory system disease mortality (HR: 0.67; 95% CI: 0.55-0.82; P < 0.0001) were lower in the acupuncture group than in the non-acupuncture group in the secondary analysis. CONCLUSION Our results indicate that diabetic patients receiving acupuncture treatment might have a lower risk of MACE, all-cause mortality and cardiovascular mortality. This population-based retrospective study suggests beneficial effects of acupuncture in preventing macrovascular complications associated with diabetes. These findings call for further prospective cohort or experimental studies on acupuncture treatment for cardiovascular complications of diabetes. Please cite this article as: Jung H, Won T, Kim GY, Jang J, Yeo S, Lim S. Efficacy of acupuncture on cardiovascular complications in patients with diabetes mellitus in Korea: A nationwide retrospective cohort. J Integr Med. 2023; 21(2): 176-183.
Humans ; Retrospective Studies ; Cardiovascular Diseases/etiology* ; Diabetes Mellitus, Type 2/drug therapy* ; Hypoglycemic Agents/therapeutic use* ; Stroke/complications* ; Acupuncture Therapy ; Republic of Korea/epidemiology*