1.Frontiers in subclinical atherosclerosis and the latest in early life preventive cardiology.
Mayank DALAKOTI ; Ching Kit CHEN ; Ching-Hui SIA ; Kian-Keong POH
Singapore medical journal 2025;66(3):141-146
Subclinical atherosclerosis underlies most cardiovascular diseases, manifesting before clinical symptoms and representing a key focus for early prevention strategies. Recent advancements highlight the importance of early detection and management of subclinical atherosclerosis. This review underscores that traditional risk factor levels considered safe, such as low-density lipoprotein cholesterol (LDL-C) and glycated haemoglobin (HbA1c), may still permit the development of atherosclerosis, suggesting a need for stricter thresholds. Early-life interventions are crucial, leveraging the brain's neuroplasticity to establish lifelong healthy habits. Preventive strategies should include more aggressive management of LDL-C and HbA1c from youth and persist into old age, supported by public health policies that promote healthy environments. Emphasising early education on cardiovascular health can fundamentally shift the trajectory of cardiovascular disease prevention and optimise long-term health outcomes.
Humans
;
Atherosclerosis/diagnosis*
;
Risk Factors
;
Cardiovascular Diseases/prevention & control*
;
Cholesterol, LDL/blood*
;
Glycated Hemoglobin
;
Cardiology/trends*
;
Heart Disease Risk Factors
2.Expert consensus on fundus photograph-based cardiovascular risk assessment using artificial intelligence technology.
Chinese Journal of Internal Medicine 2024;63(1):28-34
Cardiovascular risk assessment is a basic tenet of the prevention of cardiovascular disease. Conventional risk assessment models require measurements of blood pressure, blood lipids, and other health-related information prior to assessment of risk via regression models. Compared with traditional approaches, fundus photograph-based cardiovascular risk assessment using artificial intelligence (AI) technology is novel, and has the advantages of immediacy, non-invasiveness, easy performance, and low cost. The Health Risk Assessment and Control Committee of the Chinese Preventive Medicine Association, in collaboration with the Chinese Society of Cardiology and the Society of Health Examination, invited multi-disciplinary experts to form a panel to develop the present consensus, which includes relevant theories, progress in research, and requirements for AI model development, as well as applicable scenarios, applicable subjects, assessment processes, and other issues associated with applying AI technology to assess cardiovascular risk based on fundus photographs. A consensus was reached after multiple careful discussions on the relevant research, and the needs of the health management industry in China and abroad, in order to guide the development and promotion of this new technology.
Humans
;
Cardiovascular Diseases/prevention & control*
;
Artificial Intelligence
;
Consensus
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Risk Factors
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Heart Disease Risk Factors
4.Lipid lowering effects and safety of evolocumab in Chinese patients at very high cardiovascular risk: a single-center study.
Meng CHAI ; Haitao ZHANG ; Lixia YANG ; Jing LIANG ; Hongya HAN ; Xiaoli LIU ; Xiaoteng MA ; Yan LIU ; Dongmei SHI ; Yingxin ZHAO ; Yuyang LIU ; Yujie ZHOU
Chinese Medical Journal 2023;136(11):1358-1360
5.Analysis of serum CA125 and related influencing factors in silicosis patients with pulmonary heart disease.
Ye CHEN ; Lei TU ; Ling JIANG ; Hui Xia JI
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(3):209-212
Objective: To analyze the serum carbohydrate antigen 125 (CA125) level and its influencing factors in male silicosis patients with pulmonary heart disease. Methods: In October 2021, data of 38 male patients with simple silicosis (silicosis group), 28 cases of silicosis with pulmonary heart disease (pulmonary heart disease group), and 27 healthy controls (control group) in the same age group were collected in inpatient and outpatient of Nanjing Occupational Disease Prevention and Control Hospital from January 2017 to December 2020. The serum CA125 levels of the three groups were compared, and the correlation between disease-related indexes and serum CA125 in silicosis patients with pulmonary heart disease was analyzed, as well as the influencing factors of pulmonary heart disease and serum CA125 levels in silicosis patients. Results: The serum CA125 level[ (19.95±7.52) IU/ml] in pulmonary heart disease group was higher than that in silicosis group[ (12.98±6.35) IU/ml] and control group[ (9.17±5.32) IU/ml] (P<0.05). There was no significant difference in serum CA125 level between the silicosis group and the control group (P>0.05). Serum CA125 levels were positively correlated with blood uric acid and fasting blood glucose in silicosis patients with pulmonary heart disease (r=0.39, 0.46, P<0.05). Serum CA125 level was a risk factor for silicosis patients with pulmonary heart disease (OR=1.13, 95%CI: 1.02-1.24, P<0.05). Dust exposure time, lactate dehydrogenase and smoking history were positively correlated with serum CA125 level in silicosis patients (P<0.05) . Conclusion: The serum CA125 level of male silicosis patients with pulmonary heart disease is significantly increased, and the level of CA125 is correlated with the level of fasting blood glucose and blood uric acid.
Humans
;
Male
;
Pulmonary Heart Disease
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Blood Glucose
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Uric Acid
;
Silicosis/complications*
;
Risk Factors
6.Summary of the 2022 Report on Cardiovascular Health and Diseases in China.
Zengwu WANG ; Liyuan MA ; Mingbo LIU ; Jing FAN ; Shengshou HU
Chinese Medical Journal 2023;136(24):2899-2908
Recent decades have seen the remarkable development of China in medical accessibility and quality index, and the application of a number of new advanced cardiovascular technologies benefits more patients. However, according to the Annual Report on Cardiovascular Health and Diseases in China published in this article, which was organized and summarized by National Center for Cardiovascular Diseases, there is still a huge population living with risk factors of cardiovascular diseases (CVD), and the morbidity and mortality of CVD are increasing. It is estimated that there are around 330 million patients suffering from CVD currently, including 245 million of hypertension, 13 million of stroke, 45.3 million of peripheral artery disease, 11.39 million of coronary heart disease (CHD), 8.9 million of heart failure, 5 million of pulmonary heart disease, 4.87 million of atrial fibrillation, 2.5 million of rheumatic heart disease, and 2 million of congenital heart disease. Tobacco use, diet and nutrition factors, physical activity, overweight and obesity, and psychological factors are what affect cardiovascular health, while hypertension, dyslipidemia, diabetes, chronic kidney disease, metabolic syndrome, and air pollution are the risk factors for CVD. In this article, in addition to risk factors for CVD, we also report the epidemiological trends of CVD, including CHD, cerebrovascular disease, arrhythmias, valvular heart disease, congenital heart disease, cardiomyopathy, heart failure, pulmonary vascular disease and venous thromboembolism, and aortic and peripheral artery diseases, as well as the basic research and medical device development in CVD. In a word, China has entered a new stage of transforming from high-speed development focusing on scale growth to high-quality development emphasizing on strategic and key technological development to curb the trend of increasing incidence and mortality of CVD.
Humans
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Cardiovascular Diseases/etiology*
;
Hypertension/complications*
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Risk Factors
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Cardiomyopathies
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Heart Failure/complications*
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Heart Defects, Congenital/complications*
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Coronary Disease
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Atrial Fibrillation/complications*
7.Prevalence of Metabolic Syndrome and specific cardiovascular risk factors among older persons in the Philippines: Results from the 8th Philippine National Nutrition Survey
Patricia Marie M. Lusica ; Cecilia A. Jimeno
Acta Medica Philippina 2023;57(12):5-11
Background:
Cardiovascular diseases are the leading causes of deaths among adults in the Philippines, and this is true also among older persons aged 60 years and above. Identification of risk factors and diseases that lead to cardiovascular mortality among the elderly is important to have an impact on longevity.
Objective:
This study aimed to determine the prevalence of metabolic syndrome and specific cardiovascular risk factors among older persons in the Philippines.
Methods:
A cross sectional design was used, with data taken from the results of the 8th Philippine National Nutrition Survey (NNS) Clinical and Health Survey done in 2013. Although there is a more recent survey, only the 2013 data is complete and available for secondary analyses.
Results:
There were 1,835 older persons who were participants in the 8th Philippine NNS who had complete clinical data. The prevalence of Metabolic Syndrome was 52.6% in this population with the distribution of the components as follows: 33.5% have elevated waist circumference; 59.25 had elevated BP >130/85 mm Hg; 30.1% had fasting blood glucose ≥100 mg/dL (includes prediabetes and diabetes); 63% have low HDL, and 39% have elevated triglycerides ≥150 mg/dL.
The results for other cardiovascular diseases and risk factors are as follows: 44% had hypertension using the criterion of the JNC VII report (BP ≥140/90 mm Hg); 85% had LDL cholesterol ≥100 mg/dL; 31% are current alcohol drinkers; 22% are current smokers; 53.7% have low physical activity; and 82% have an unhealthy diet.
Conclusions
Fifty-two percent (52%) of older Filipinos have metabolic syndrome and have a high prevalence of cardiovascular risk factors, foremost of which are elevated LDL-cholesterol at 85%, hypertension at 44% based on JNC VII, approximately 10% with diabetes mellitus, but with a double burden of overweight/obesity and undernutrition. This data can help plan for public health approaches to improve quality of life and increase longevity of Filipinos.
Metabolic Syndrome
;
Heart Disease Risk Factors
8.Sex differences in Cardiovascular risk factors and management in a preventive Cardiology clinic at a tertiary referral center
Emily Mae L. Yap ; Lucky R. Cuenza ; Varinder K. Randhawa ; Gerald C. Vilela
Philippine Journal of Internal Medicine 2022;60(3):192-197
Background:
Cardiovascular disease is the leading cause of death in both genders worldwide. Gender differences in clinical presentation and treatment have been reported.
Objective:
This study aims to describe and compare the cardiovascular risk factors and management strategies for primary prevention among Filipinos.
Methods:
An analytical cross-sectional study was done on 2,082 patients at the Preventive Cardiology Clinic of a tertiary referral center in Quezon City, Philippines from January 1, 2002 to December 31, 2017.
Results:
Seventy-two percent of the patients were females with a higher mean age compared to males (57.67 + 10.50 vs 55.66 + 11.82, p 0.002). There were more women who were unemployed (75.2 vs 45.9, p<0.001). There was no significant difference in the prevalence of hypertension (68.6% vs 67.9%, p=0.542) and type 2 diabetes mellitus (19.8% vs 21.5%, p=0.437) in both genders. Beta blockers (24.1%), calcium channel blockers (22.9%) and angiotensin receptor blockers (22.1%) were the most commonly prescribed anti-hypertensive drugs. Biguanides were the most commonly prescribed glucose-lowering drug (11.3%). Compared to men, more women had dyslipidemia (51.8% vs 38.6%, p<0.001). Statins were more commonly prescribed in women (22.4 vs 18.1%, p=0.033).
Conclusion
There were significantly more women seen in our Preventive Cardiology clinic. Smoking and alcoholic drinking were higher in males. BMI, total cholesterol and HDL were significantly higher in females than in males.
Sex Characteristics
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Heart Disease Risk Factors
;
Primary Prevention
;
Preventive Medicine
9.Prevalence, risk factors, and survival associated with pulmonary hypertension and heart failure among patients with underlying coronary artery disease: a national prospective, multicenter registry study in China.
Li HUANG ; Lingpin PANG ; Qing GU ; Tao YANG ; Wen LI ; Ruilin QUAN ; Weiqing SU ; Weifeng WU ; Fangming TANG ; Xiulong ZHU ; Jieyan SHEN ; Jingzhi SUN ; Guangliang SHAN ; Changming XIONG ; Shian HUANG ; Jianguo HE
Chinese Medical Journal 2022;135(15):1837-1845
BACKGROUND:
Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the prevalence, risk factors, and survival in CAD-associated HF (CAD-HF) complicated with PH.
METHODS:
Symptomatic CAD-HF patients were continuously enrolled in this prospective, multicenter registry study. Echocardiography, coronary arteriography, left and right heart catheterization (RHC), and other baseline clinical data were recorded. Patients were followed up and their survival was recorded.
RESULTS:
One hundred and eighty-two CAD-HF patients were enrolled, including 142 with HF with a preserved ejection fraction (heart failure with preserved ejection fraction [HFpEF]; left ventricular ejection fraction [LVEF] ≥50%) and 40 with a reduced ejection fraction (heart failure with reduced ejection fraction [HFrEF]; LVEF < 50%). PH was diagnosed with RHC in 77.5% of patients. Patients with PH showed worse hemodynamic parameters and higher mortality. HFrEF-PH patients had worse survival than HFpEF-PH patients. CAD-HF patients with an enlarged left ventricular end-diastolic diameter and reduced hemoglobin were at higher risk of PH. Nitrate treatment reduced the risk of PH. Elevated creatinine and mean pulmonary arterial pressure (mPAP), diastolic pressure gradient (DPG) ≥7 mmHg, and previous myocardial infarction (MI) entailed a higher risk of mortality in CAD-HF patients with PH.
CONCLUSIONS:
PH is common in CAD-HF and worsens the hemodynamics and survival in these patients. Left ventricle enlargement and anemia increase the risk of PH in CAD-HF. Patients may benefit from nitrate medications. Renal impairment, elevated mPAP, DPG ≥7 mmHg, and previous MI are strong predictors of mortality in CAD-HF-PH patients.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT02164526.
Coronary Artery Disease/epidemiology*
;
Creatinine
;
Heart Failure/complications*
;
Humans
;
Hypertension, Pulmonary/complications*
;
Nitrates
;
Prevalence
;
Prognosis
;
Prospective Studies
;
Registries
;
Risk Factors
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Stroke Volume
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Ventricular Function, Left
10.Global and Regional Trends and Projections of Infective Endocarditis-Associated Disease Burden and Attributable Risk Factors from 1990 to 2030.
Li-Jin LIN ; Ye-Mao LIU ; Juan-Juan QIN ; Fang LEI ; Wen-Xin WANG ; Xue-Wei HUANG ; Wei-Fang LIU ; Xing-Yuan ZHANG ; Zhi-Gang SHE ; Peng ZHANG ; Xiao-Jing ZHANG ; Zhao-Xia JIN ; Hong-Liang LI
Chinese Medical Sciences Journal 2022;37(3):181-194
Objective To forecast the future burden and its attributable risk factors of infective endocarditis (IE). Method We analyzed the disease burden of IE and its risk factors from 1990 to 2019 using the Global Burden of Disease 2019 database and projected the disease burden from 2020 to 2030 using a Bayesian age-period-cohort model. Results By 2030, the incidence of IE will increase uncontrollably on a global scale, with developed countries having the largest number of cases and developing countries experiencing the fastest growth. The affected population will be predominantly males, but the gender gap will narrow. The elderly in high-income countries will bear the greatest burden, with a gradual shift to middle-income countries. The incidence of IE in countries with middle/high-middle social-demographic indicators (SDI) will surpass that of high SDI countries. In China, the incidence rate and the number of IE will reach 18.07 per 100,000 and 451,596 in 2030, respectively. IE-associated deaths and heart failure will continue to impose a significant burden on society, the burden on women will increase and surpass that on men, and the elderly in high-SDI countries will bear the heaviest burden. High systolic blood pressure has become the primary risk factor for IE-related death. Conclusions This study provides comprehensive analyses of the disease burden and risk factors of IE worldwide over the next decade. The IE-associated incidence will increase in the future and the death and heart failure burden will not be appropriately controlled. Gender, age, regional, and country heterogeneity should be taken seriously to facilitate in making effective strategies for lowering the IE disease burden.
Male
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Humans
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Female
;
Aged
;
Global Burden of Disease
;
Bayes Theorem
;
Global Health
;
Risk Factors
;
Cost of Illness
;
Endocarditis
;
Heart Failure


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