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Cardiovascular Disease: Risk Factors and Prevention

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A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Epidemiology, Lifestyle, and Cardiovascular Health".

Deadline for manuscript submissions: 15 August 2024 | Viewed by 14925

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Prof. Dr. Roman Leischik

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Guest Editor

Department of Cardiology, Section Preventive Medicine, Health Promotion, Sports Medicine, Faculty of Health, School of Medicine, University Witten/Herdecke, 58095 Hagen, Germany
Interests: sports medicine; echocardiography; general cardiology; prevention; health promotion; cardiovascular physiology
Special Issues, Collections and Topics in MDPI journals

Dr. Markus Strauß

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Guest Editor

1. Department of Cardiology I-Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Münster, 48149 Münster, Germany
2. Department of Cardiology, Faculty of Health, School of Medicine, University Witten/Herdecke, 58095 Hagen, Germany
Interests: cardiology; cardiovascular risk factors; metabolic syndrome; cardiovascular risk at work; prevention; health promotion

Special Issue Information

Dear Colleagues,

We have all wondered why cardiovascular disease affects some people and not others.

Why does someone suffer a heart attack? Why does someone suffer a stroke?

Our patients may think that “my grandmother lived to be 90 years old and always smoked”.

They do not mention that some patients suffer an acute myocardial infarction at age 35 and die suddenly without smoking; however, they may not have known, for instance, that lipoprotein (a) was elevated in these patients. This causes plaque build-up, heart attacks, and relatively severe coronary artery disease.

There are, therefore, many unanswered questions regarding risk factors and cardiovascular diseases; however, many questions are answered relatively well and, above all, have been statistically proven. For example, we know from numerous meta-analyses that long-term high cholesterol levels can lead to severe coronary heart disease; we know that smokers are much more likely to have an acute heart attack and that 80% of acute heart attacks occur in active smokers; and we know that mental stress can certainly trigger an acute heart attack.

Physical inactivity is one of the most important risk factors for cardiovascular and metabolic disorders. Do not forget socioeconomic factors, metabolic syndrome, and mental disorders. Tell us all of your experiences and ideas for the prevention of nicotine abuse, because stopping nicotine abuse is one of the biggest challenges in a lot of countries.

How all the underlying mechanisms work in detail, however, is always an issue that needs to be discussed.

Prof. Dr. Roman Leischik
Dr. Markus Strauß
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Cardiovascular system
Cardiovascular risk
Cardiovascular risk factors
prevention
metabolic syndrome
Cardiovascular disease

Published Papers (10 papers)

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Research

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14 pages, 929 KiB

Open AccessArticle

Fasting Triglycerides in the Upper Normal Range Are Independently Associated with an Increased Risk of Diabetes Mortality in a Large Representative US Population

by Yutang Wang

J. Cardiovasc. Dev. Dis. 2024, 11(4), 128; https://doi.org/10.3390/jcdd11040128 - 21 Apr 2024

Viewed by 391

Abstract

The association between normal-range triglyceride levels and diabetes mortality remains unclear. This cohort study aimed to elucidate this relationship by examining 19,010 US adult participants with fasting serum triglycerides below 150 mg/dL. Cox proportional hazards models were employed to estimate mortality hazard ratios (HRs) and 95% confidence intervals (CIs). Participants were followed up for a mean of 15.3 years, during which 342 diabetes deaths were recorded. A 1 natural log unit increase in triglycerides was associated with a 57% higher risk of diabetes mortality (adjusted HR, 1.57; 95% CI, 1.04–2.38). Comparable results were obtained when triglycerides were analyzed in quartiles. Receiver operating characteristic curve analysis identified an optimal triglyceride cutoff of 94.5 mg/dL for diabetes mortality; individuals with triglyceride levels above this threshold faced a greater risk of diabetes mortality (adjusted HR, 1.43; 95% CI, 1.12–1.83). Further investigation revealed a positive association between normal triglyceride levels and all-cause mortality, though no association was observed between normal triglycerides and mortality from hypertension or cardiovascular disease. In conclusion, elevated triglyceride levels within the normal range were associated with an increased risk of diabetes mortality. Individuals with triglyceride levels of 95 mg/dL or higher may require vigilant monitoring for diabetes and its associated complications. Full article

(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)

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12 pages, 317 KiB

Open AccessArticle

Vascular Health of Females with History of Assisted Reproductive Technology

by Pengzhu Li, Magdalena Langer, Theresa Vilsmaier, Marie Kramer, Franziska Sciuk, Brenda Kolbinger, André Jakob, Nina Rogenhofer, Robert Dalla-Pozza, Christian Thaler, Nikolaus Alexander Haas and Felix Sebastian Oberhoffer

J. Cardiovasc. Dev. Dis. 2024, 11(2), 66; https://doi.org/10.3390/jcdd11020066 - 18 Feb 2024

Viewed by 1240

Abstract

The use of assisted reproductive technologies (ART) for the treatment of infertility is gaining popularity. Limited data on the overall vascular health of females with history of ART are available. This pilot study aimed to investigate the overall vascular health of females with history of ART compared to individuals who conceived spontaneously. The assessment of overall vascular health included the measurement of brachial blood pressure, central blood pressure, and pulse wave velocity, as well as the evaluation of the arterial stiffness and carotid intima-media thickness (cIMT) of the common carotid arteries. Conventional blood lipids including lipoprotein a (Lp(a)) were also determined. In total, 45 females with history of ART and 52 females who conceived spontaneously were included (mean age: 47.72 ± 5.96 years vs. 46.84 ± 7.43 years, p = 0.525). An initial comparison revealed a significantly higher prevalence of elevated Lp(a) in ART females (p = 0.011). However, after multiple comparison correction, the significant result disappeared (p = 0.132). Within the cohort of ART females, no significantly higher cardiovascular risk was detected regarding vascular function. The potentially higher prevalence of elevated Lp(a) in ART females must be further investigated in future studies, as it might contribute to the impaired reproductive process in this cohort. Full article

(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)

11 pages, 708 KiB

Open AccessArticle

Evaluation of Conventional Cardiovascular Risk Factors and Ordinal Coronary Artery Calcium Scoring in a Lung Cancer Screening Cohort

by Piotr Kasprzyk, Aleksandra Undrunas, Katarzyna Dziadziuszko, Robert Dziedzic, Krzysztof Kuziemski, Edyta Szurowska, Witold Rzyman and Tomasz Zdrojewski

J. Cardiovasc. Dev. Dis. 2024, 11(1), 16; https://doi.org/10.3390/jcdd11010016 - 05 Jan 2024

Viewed by 1483

Abstract

(1) Background: Lung cancer screening (LCS) consists of low-dose computed tomography (LDCT) results to reduce lung cancer-related mortality. The LCS program has a unique opportunity to impact CVD mortality by providing tools for CVD risk assessment and implementing preventative strategies. In this study, we estimated standardized CVD risk (SCORE) and assessed the prevalence of coronary artery calcium (CAC) in a Polish LCS cohort. (2) Methods: In this observational study, 494 LCS participants aged 50–79 years with a cigarette smoking history of at least 30 pack-years were included. Medical history, anthropometric measurements, blood pressure measurements, serum glucose, and cholesterol levels were assessed in one visit. CVD risk assessment using SCORE tables was performed. The results were compared to the general population (NATPOL 2011 study). On LDCT scans, CAC was classified using an Ordinal Score ranging from 0 to 12. (3) Results: The prevalence of classic cardiovascular risk factors was very high. Among study participants, 83.7% of men and 40.7% of women were classified with a very high CVD SCORE risk (>10%). CAC was reported in 190 (47%) participants. Calcification was categorized as severe (CAC ≥ 4) in 84 (21%) participants. (4) Conclusions: Due to the high cardiovascular risk, intensive preventive strategies are recommended for LCS participants. Full article

(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)

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10 pages, 585 KiB

Open AccessArticle

The Association between Birthweight and Use of Cardiovascular Medications: The Role of Health Behaviors

by Minjia Mo, Robert Thiesmeier, George Kiwango, Christian Rausch, Jette Möller and Yajun Liang

J. Cardiovasc. Dev. Dis. 2023, 10(10), 426; https://doi.org/10.3390/jcdd10100426 - 15 Oct 2023

Cited by 1 | Viewed by 1346

Abstract

Background: There is limited evidence on the effect of low birthweight on the use of cardiovascular medications and the role of health behaviors. This study aims to determine the independent effect of low birthweight and its combination with adult health behaviors on the number of dispensed cardiovascular medications. Methods: We included 15618 participants with information on birthweight and self-reported health behaviors. Dispensed cardiovascular medications were identified from the Prescribed Drug Register based on a three-digit level Anatomical Therapeutic Chemical classification code (C01 to C10 and B01) and categorized into 0, 1, and ≥2 different types of medications. We applied multinomial logistic regression models estimating odds ratios (ORs) and 95% confidence intervals (CIs). Results: Participants with low birthweight had a higher estimated OR of using ≥2 types of cardiovascular medications (OR = 1.46, 95% CI = 1.06, 2.01). Further, an increased risk for using ≥2 types of cardiovascular medications was found in participants with poor health behaviors for normal (OR = 2.17, 95% CI = 1.80, 2.62) and high (OR = 1.84, 95% CI = 1.29, 2.62) birthweight. The strongest effect on using ≥2 types of cardiovascular medications was found for low birthweight and poor health behaviors (OR = 3.14, 95% CI = 1.80, 5.50). Conclusion: This cohort study provides evidence that low birthweight increases the risk of using more types of cardiovascular medications in adulthood. This study also suggests that ideal health behaviors reduce this risk. Full article

(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)

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14 pages, 1175 KiB

Open AccessArticle

Age-Specific Cardiovascular Risk Factors for Major Adverse Cardiac Events in Patients Undergoing Myocardial Perfusion Imaging

by Rosario Megna, Mario Petretta, Carmela Nappi, Roberta Assante, Emilia Zampella, Valeria Gaudieri, Teresa Mannarino, Adriana D’Antonio, Roberta Green, Valeria Cantoni, Mariarosaria Panico, Wanda Acampa and Alberto Cuocolo

J. Cardiovasc. Dev. Dis. 2023, 10(9), 395; https://doi.org/10.3390/jcdd10090395 - 13 Sep 2023

Viewed by 1030

Abstract

Background: The prevalence of traditional cardiovascular risk factors shows different age-specific patterns. It is not known whether the prognostic impact of risk factors is similarly age-specific. We evaluated the profiles of cardiovascular risk factors and their prognostic impact on coronary artery disease (CAD) in relation to age. Methods: We included 3667 patients with suspected or known CAD undergoing stress myocardial perfusion imaging (MPI). We evaluated the risk for major adverse cardiac events (MACE) within three years from the index MPI in patients belonging to three groups according to age tertile distribution: <59, 59–68, and >68 years. Gender, body mass index, diabetes, hypertension, dyslipidemia, family history of CAD, smoking, angina, dyspnea, previous CAD, and MPI outcome were assessed as risk factors by a multivariable Cox’s regression. Results: The three-year risk of MACE increased progressively with age and was 9%, 13%, and 18% for each group, respectively (p < 0.0001). Dyspnea and abnormal MPI outcome were significant risk factors for all age groups. Diabetes and smoking were significant from the age of 59 onwards, while hypertension resulted significant for patients older than 68 years. Conclusions: The number of risk factors was significantly associated with the occurrence of MACE increase with age. It is noteworthy that a personal history of CAD was not useful for risk stratification, while MPI results were. Full article

(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)

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14 pages, 2248 KiB

Open AccessArticle

Assessment of Hypertensive Patients’ Complex Metabolic Status Using Data Mining Methods

by Beáta Kovács, Ákos Németh, Bálint Daróczy, Zsolt Karányi, László Maroda, Ágnes Diószegi, Mariann Harangi and Dénes Páll

J. Cardiovasc. Dev. Dis. 2023, 10(8), 345; https://doi.org/10.3390/jcdd10080345 - 13 Aug 2023

Viewed by 1060

Abstract

Cardiovascular diseases are among the leading causes of mortality worldwide. Hypertension is a preventable risk factor leading to major cardiovascular events. We have not found a comprehensive study investigating Central and Eastern European hypertensive patients’ complex metabolic status. Therefore, our goal was to calculate the prevalence of hypertension and associated metabolic abnormalities using data-mining methods in our region. We assessed the data of adults who visited the University of Debrecen Clinical Center’s hospital (n = 937,249). The study encompassed data from a period of 20 years (2001–2021). We detected 292,561 hypertensive patients. The calculated prevalence of hypertension was altogether 32.2%. Markedly higher body mass index values were found in hypertensive patients as compared to non-hypertensives. Significantly higher triglyceride and lower HDL-C levels were found in adults from 18 to 80 years old. Furthermore, significantly higher serum glucose and uric acid levels were measured in hypertensive subjects. Our study confirms that the calculated prevalence of hypertension is akin to international findings and highlights the extensive association of metabolic alterations. These findings emphasize the role of early recognition and immediate treatment of cardiometabolic abnormalities to improve the quality of life and life expectancy of hypertensive patients. Full article

(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)

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13 pages, 1907 KiB

Open AccessArticle

Risk Factors of Secondary Cardiovascular Events in a Multi-Ethnic Asian Population with Acute Myocardial Infarction: A Retrospective Cohort Study from Malaysia

by Sophia Rasheeqa Ismail, Mohd Shawal Faizal Mohammad, Adam S. Butterworth, Rajiv Chowdhury, John Danesh, Emanuele Di Angelantonio, Simon J. Griffin, Lisa Pennells, Angela M. Wood, Mohd Fairulnizal Md Noh and Shamsul Azhar Shah

J. Cardiovasc. Dev. Dis. 2023, 10(6), 250; https://doi.org/10.3390/jcdd10060250 - 09 Jun 2023

Cited by 1 | Viewed by 1806

Abstract

This retrospective cohort study investigated the incidence and risk factors of major adverse cardiovascular events (MACE) after 1 year of first-documented myocardial infarctions (MIs) in a multi-ethnic Asian population. Secondary MACE were observed in 231 (14.3%) individuals, including 92 (5.7%) cardiovascular-related deaths. Both histories of hypertension and diabetes were associated with secondary MACE after adjustment for age, sex, and ethnicity (HR 1.60 [95%CI 1.22–2.12] and 1.46 [95%CI 1.09–1.97], respectively). With further adjustments for traditional risk factors, individuals with conduction disturbances demonstrated higher risks of MACE: new left-bundle branch block (HR 2.86 [95%CI 1.15–6.55]), right-bundle branch block (HR 2.09 [95%CI 1.02–4.29]), and second-degree heart block (HR 2.45 [95%CI 0.59–10.16]). These associations were broadly similar across different age, sex, and ethnicity groups, although somewhat greater for history of hypertension and BMI among women versus men, for HbA1c control in individuals aged >50 years, and for LVEF ≤ 40% in those with Indian versus Chinese or Bumiputera ethnicities. Several traditional and cardiac risk factors are associated with a higher risk of secondary major adverse cardiovascular events. In addition to hypertension and diabetes, the identification of conduction disturbances in individuals with first-onset MI may be useful for the risk stratification of high-risk individuals. Full article

(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)

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Review

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33 pages, 904 KiB

Open AccessEditor’s ChoiceReview

Contaminant Metals and Cardiovascular Health

by Karl Kristian Lundin, Yusuf Kamran Qadeer, Zhen Wang, Salim Virani, Roman Leischik, Carl J. Lavie, Markus Strauss and Chayakrit Krittanawong

J. Cardiovasc. Dev. Dis. 2023, 10(11), 450; https://doi.org/10.3390/jcdd10110450 - 31 Oct 2023

Cited by 2 | Viewed by 2318

Abstract

A growing body of research has begun to link exposure to environmental contaminants, such as heavy metals, with a variety of negative health outcomes. In this paper, we sought to review the current research describing the impact of certain common contaminant metals on cardiovascular (CV) health. We reviewed ten metals: lead, barium, nickel, chromium, cadmium, arsenic, mercury, selenium, zinc, and copper. After a literature review, we briefly summarized the routes of environmental exposure, pathophysiological mechanisms, CV health impacts, and exposure prevention and/or mitigation strategies for each metal. The resulting article discloses a broad spectrum of pathological significance, from relatively benign substances with little to no described effects on CV health, such as chromium and selenium, to substances with a wide-ranging and relatively severe spectrum of CV pathologies, such as arsenic, cadmium, and lead. It is our hope that this article will provide clinicians with a practical overview of the impact of these common environmental contaminants on CV health as well as highlight areas that require further investigation to better understand how these metals impact the incidence and progression of CV diseases. Full article

(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)

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29 pages, 1899 KiB

Open AccessReview

Interventions to Address Cardiovascular Risk in Obese Patients: Many Hands Make Light Work

by Valeria Visco, Carmine Izzo, Davide Bonadies, Federica Di Feo, Giuseppe Caliendo, Francesco Loria, Costantino Mancusi, Pierpaolo Chivasso, Paola Di Pietro, Nicola Virtuoso, Albino Carrizzo, Carmine Vecchione and Michele Ciccarelli

J. Cardiovasc. Dev. Dis. 2023, 10(8), 327; https://doi.org/10.3390/jcdd10080327 - 31 Jul 2023

Cited by 1 | Viewed by 1670

Abstract

Obesity is a growing public health epidemic worldwide and is implicated in slowing improved life expectancy and increasing cardiovascular (CV) risk; indeed, several obesity-related mechanisms drive structural, functional, humoral, and hemodynamic heart alterations. On the other hand, obesity may indirectly cause CV disease, mediated through different obesity-associated comorbidities. Diet and physical activity are key points in preventing CV disease and reducing CV risk; however, these strategies alone are not always sufficient, so other approaches, such as pharmacological treatments and bariatric surgery, must support them. Moreover, these strategies are associated with improved CV risk factors and effectively reduce the incidence of death and CV events such as myocardial infarction and stroke; consequently, an individualized care plan with a multidisciplinary approach is recommended. More precisely, this review explores several interventions (diet, physical activity, pharmacological and surgical treatments) to address CV risk in obese patients and emphasizes the importance of adherence to treatments. Full article

(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)

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Other

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11 pages, 760 KiB

Open AccessSystematic Review

Evaluation of Exercise Mobile Applications for Adults with Cardiovascular Disease Risk Factors

by Shiqi Chen, Yin Wu, Erica L. Bushey and Linda S. Pescatello

J. Cardiovasc. Dev. Dis. 2023, 10(12), 477; https://doi.org/10.3390/jcdd10120477 - 28 Nov 2023

Cited by 1 | Viewed by 1454

Abstract

Objective: To conduct a systematic review to determine if there are exercise mobile applications (apps) that can produce evidence-based, individualized exercise plans. Materials and Methods: We searched the Apple Store and Google Play for exercise apps with terms related to exercise and health. Exercise apps were eligible if they: (1) had a ≥4 out of 5 overall rating with ≥1000 reviews; (2) were free to download; and (3) were not gender specific. Exercise apps were evaluated via the evidence-based exercise prescription (ExRx) standards of the American College of Sports Medicine (ACSM) and American Heart Association. For the exercise app evaluation criteria, an app was included if it (1) was evidence-based; (2) contained a preparticipation health screening protocol; (3) built a cardiovascular disease (CVD) risk factor profile; (4) prioritized one chronic disease or health condition to focus on; (5) framed the exercise plan by the frequency, intensity, time, and type principle (FITT) of ExRx; and (6) specified special considerations. Results: Of the 531 potentially qualifying apps, 219 qualified. The qualifying apps were rarely evidenced-based (0.5%) or had a preparticipation screening protocol (3.7%). Only 27.7% built CVD risk factor profiles. Most apps (64.8%) focused on body image and/or athletic performance. Only 4.3% focused on chronic diseases or health conditions, while the remainder (34.5%) did not disclose a focus. No app framed the exercise plans by the FITT of ExRx. Only 1.4% of the apps specified special considerations. Conclusion: There are no commercially available exercise apps that generate an evidence-based, individualized exercise plan for adults with CVD risk factors. Full article

(This article belongs to the Special Issue Cardiovascular Disease: Risk Factors and Prevention)

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