bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of air pollution on mortality due to cerebrovascular diseases
Authors: Kuzma L , Dabrowski EJ , Kurasz A , Swieczkowski M , Bachorzewska-Gajewska H , Dobrzycki S 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The short-term effect of air pollution on cardiovascular mortality is well-documented but a scarce number of studies focus on cause-specific mortality in low-polluted areas.

Purpose
We decided to distinguish deaths due to cerebrovascular disease (CbVD) from a region widely known as the Green Lungs of Poland to assess the short-term effect of air pollution on CbVD mortality.

Methods
The analysis with almost 4,500,000 person-years of follow-up with a time-stratified case-crossover design was performed. Results are reported as odds ratio (OR) associated with an increase in interquartile range (IQR) of air pollution.

Results
In the overall analysis of the studied region PM2.5 had an impact on increased CbVD mortality at LAG 0 (OR 1.046, 95% CI 1.013 – 1.080, P = 0.006), LAG 0-1 (1.048, 1.002-1.082, P = 0.040), and LAG 0-3 (1.052, 1.015-1.090, P = 0.006). The influence of PM10 was noted at LAG 0 (1.041, 1.002-1.082, P = 0.040). CbVD mortality in Bialystok was increased by exposure to PM10 at LAG 0 (1.05, 1.00-1.09, P = 0.048) and CO at LAG 1 (1.07, 1.00-1.14, P = 0.04). Additionally, an effect of CO was observed in cold season at LAG 1 (1.09, 1.02-1.17, P = 0.02), LAG 0-1 (1.08, 1.00-1.016, P = 0.04), and LAG 0-3 (1.09, 1.01-1.18, P = 0.04). In Suwalki, an impact of PM2.5 was also observed.

Conclusions
A short-term increase in air pollutants concentrations, especially in PM2.5 and CO, had an influence on CbVD mortality. Mortality rates were significantly increased in cold season. We also found heterogeneity in the influence of major contributors on mortality between analyzed cities.
Body composition, lipid profile and mediterranean diet adherence in cardiovascular disease patients attending a long-term exercise-based cardiac rehabilitation program during COVID-19 pandemic
Authors: Linan Pinto M , Pinto R , Charneca S , Vasques J , Lemos Pires M , Borges M , Rodrigues C , Alves Da Silva P , Ricardo I , Santa-Clara H , Abreu A , Pinto FJ , Sousa Guerreiro C 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiovascular disease (CVD) is recognized as a major public health issue and remains the leading cause of mortality worldwide. There is a clear association between adiposity, blood lipid profile, and adherence to the Mediterranean diet (MD) with the risk of CVD. However, the assessment of body composition parameters, dietary patterns and nutritional intervention in CVD patients undergoing a cardiovascular rehabilitation (CR) program remains insufficient.

Purpose
to characterize body composition, lipid profile and MD adherence in patients with CVD who were attending an exercise-based CR program during COVID-19 era.

Methods
The study was developed between October 2020 and January 2021 in a phase III centre-based CR program. Body composition was assessed by dual energy x-ray absorptiometry Hologic Explorer-W. Adherence to the MD was assessed by the 14-item MD questionnaire. Fasting blood sample was taken for measurement of lipid profile.

Results
A sample of 41 patients (mean age 64.4 ± 7.9 years, 87.8% male) was evaluated. The most prevalent CVD were coronary artery disease (89.5%) and heart failure (21.1%). The main CVD risk factors at admission in the CR program were dyslipidaemia (71.1%), hypertension (68.4%), physical inactivity (26.3%) and diabetes mellitus (21.0%). In our sample the mean body mass index was 28 ± 3.8 kg/m2, being most patients overweight (75.6%), and having a substantially increased risk of metabolic complications (85.3%) accordingly to waist-hip ratio. Body composition assessment showed that 14.6% of the patients had a body fat mass index above 90th percentile. Although only 9.8% of the patients had reduced fat free mass, 17.1% showed appendicular lean mass below the reference value. In addition, less than one third of the patients (31.7%) revealed a high adherence to the MD pattern. A sub-analysis on blood lipids (n = 26) showed that most patients had levels of LDL cholesterol (76.9%) and non-HDL cholesterol (65.4%) above the therapeutic target and 15.4% had triglycerides higher than 150 mg/dl.

Conclusion
Body composition, lipid profile and dietary patterns, play a major role in CVD secondary prevention. Our findings showed that a substantial number of CVD patients, in COVID-19 era, did not have optimal body composition, were above lipid profile targets, and had a low/medium adherence to the MD. Thus, this study highlights the relevance of nutrition on cardiometabolic status and demonstrates the crucial role of nutritional intervention as an integrated part of a long-term phase III CR program. Moreover, further research about nutritional intervention in patients undergoing CR is warranted.
High-intensity interval vs moderate-intensity continuous exercise in heated water-based on acute hemodynamic, vascular, and cardiac autonomic responses in older individuals with hypertension
Authors: Roque Marcal I , Amaral VT , Fernandes B , Abreu RM , Guimaraes GV , Ciolac EG 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP #2017/25648-4 #2018/09695-5) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES – Finance Code 001).

OnBehalf
Exercise and Chronic Disease Research Laboratory (ECDR)

Introduction
Post-exercise hypotension is an important tool in the treatment and control of hypertension. In recent years, high-intensity interval exercise (HIIE) has gained significant popularity in exercise-based prevention and rehabilitation of clinical populations. However, to date, it is not clarifying the acute responses of exercise performed in heated water-based in older individuals with hypertension.

Purpose
To assess hemodynamic, vascular, and cardiac autonomic responses to heated water-based HIIE versus moderate-intensity continuous exercise (MICE) in older individuals with hypertension.

Methods
Twenty older individuals (67 ± 7 y) under treatment for hypertension were randomly assigned to perform HIIE (25 min), MICE (30 min) and control (CON; 30 min) sessions in a heated swimming pool (30-32ºC). Blood pressure (BP), arterial stiffness, endothelial reactivity, and heart rate variability (HRV) were measured before (PRE), immediately after (POST), and after 45 min (REC). 24-h ambulatory BP monitoring and ambulatory HRV were also performed after each intervention. HRV were analyzed in ms² (ms²) or normalized units (nu) and then converted into natural logarithms (ln). Time domain markers as mean of intervals R-R (µi-RR), and frequency domain such as high frequency band (HF) and low frequency band (LF).

Results
Systolic BP increased at POST (p &lt; 0.05) in all interventions, with higher increases in CON (29 ± 3 mmHg) and MICE (19 ± 3 mmHg) than HIIE (9 ± 4 mmHg). Although systolic BP reduced at REC in all interventions, it returned to levels similar to PRE in HIIE, and continue at higher levels than PRE in MICE and CON. HIIE promoted a higher response on markers of parasympathetic modulation at REC compared to MICE (HFln,nu 0.14 ± 0.06, p = 0.02) and CON (µi-RR: 0.02 ± 0.01, p = 0.05). By contrast, during night-time, HIIE demonstrated a lower parasympathetic modulation than CON (HFln,nu: -0.06 ± 0.03, p = 0.05). In addition, CON showed a higher HRV during 24-h compared to HIIE and MICE.

Conclusion
Despite differences between interventions in BP and cardiac autonomic responses, heated water-based HIIE or MICE were not effective to improve hemodynamic and vascular responses. These results may have important implications in the management of older individuals with hypertension in heated water-based.
Arterial stiffness and age moderate the association between physical activity and global cognition in the older adults
Authors: Noriega De La Colina A , Badji A , Lamarre-Cliche M , Bherer L , Girouard H , Kaushal N 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Merck Sharp & Dohme Corp Program of the Faculty of Medicine of the Université de Montréal The Canadian Institutes of Health Research (CIHR)

Background
The growing concern on the impact of higher arterial stiffness on cognitive decline in older adults, leads to the question of whether non-pharmacological interventions like physical activity should be introduced to correct or diminish the progression of arterial stiffness.

Purpose
The goal of this study is to elaborate a model for arterial stiffness as a moderator for the physical activity and global cognition relationship in function of age.

Methods
One hundred ten healthy older adults aged 60 to 75 years old (46 men and 64 women) were examined for arterial stiffness (carotid-femoral Pulse Wave Velocity (cf-PWV)), global cognition (Montreal Cognitive Assessment and Mini Mental State Examination) and self-reported physical activity (PACED diary). The double moderation analysis used PROCESS macro for SPSS, where physical activity was included as the independent variable (X), global cognition as the dependent variable (Y), arterial stiffness as moderator 1 (W), and age moderator 2 (Z). This study used a cf-PWV cutoff of 8.5 m/s to identify micro-structural damage in the brain related to arterial stiffness.

Results
Results found that the arterial stiffness x age interaction moderated the effect of physical activity on global cognition (β = -.89, SE = .42, p = .037) (Model: R2 = .15, p = .018). Physical activity had a positive effect on cognition in younger-older adults (aged 60 to 68.5 years) with high arterial stiffness i.e. cf-PWV &gt; 8.5 m/s (β = .57, SE = .222, p = .011, 95% CI .133 to 1.014), and in older-older adults (aged 68.6 to 75 years) with low arterial stiffness i.e. cf-PWV &lt; 8.5 m/s (β = .49, SE = .190, p = .010, 95% CI = .116 to .869).

Conclusions
These results support targeted physical activity interventions based on age and degree of arterial stiffness, furthering the notion that even daily life physical activity could play an important role in older adults’ cognitive performances.
Physical activity on global cognition Conditional effects of physical activity on global cognition Moderators cf-PWV Age Effect SE p CI &lt; 8.5 m/s &lt; 68.5 years .171 .245 .487 -.315 to .657 &lt; 8.5 m/s &gt; = 68.5 years .574 .222 .011* .133 to 1.014 &gt; = 8.5 m/s &lt; 68.5 years .492 .190 .010* .116 to .868 &gt; = 8.5 m/s &gt; = 68.5 years .002 .180 .990 -.355 to .359 Physical activity conditional effects on global cognition at determined values of arterial stiffness and age. SE: Standard Error, CI: Confidence Interval, cf-PWV: carotid-femoral Pulse Wave Velocity, *p-value&lt;.05.
Assessment of the quality of life in the treatment approaches of patients with the comorbid course of arterial hypertension and metabolic disorders aimed at reducing cardiovascular risk
Authors: Zlatkina V , Shkapo V , Nesen A , Starchenko T 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction. Cardiovascular diseases (CVD) remain the leading cause of premature death worldwide. According to epidemiological studies CVD prevention is highly effective. A 50% reduction in mortality from coronary artery disease (CAD) is associated with exposure to risk factors and only 40% with improved treatment.
Purpose. To assess the quality of life (QOL) in patients with arterial hypertension (AH) and metabolic disorders, to establish its impact on therapy effectiveness. We examined 280 patients with AH and comorbidity - 171 women and 109 men aged 45-75 years. Along with AH, all patients had comorbidities: 72.6 % suffered from coronary artery disease (CAD), 10.5% after myocardial infarction (MI), 35 % had clinical signs of heart failure (HF), 22, 1% - type 2 diabetes mellitus (t2DM), 27.4% - chronic kidney disease (CKD).
Methods. Anthropometry, blood pressure (BP) measurement, immunoassay (C-reactive protein), biochemical blood analysis (lipid, carbohydrate metabolism parameters, QOL determination (questionnaire Sf-36).
Results. In patients with comorbidity of pathologies (presence of AH, t2DM, CKD, CAD, obesity), there was a decrease in assessments in almost all indicators of QOL, and especially significant limitations in the performance of daily activities due to both physical and mental state.
Conclusion. The degree of AH in patients with t2DM decreased QOL of physical activity, role-physical functioning, pain and general health, reflecting physical health, as well as mental health, including vitality, social activity, role emotional functioning. T2DM in patients with AH significantly worsens QOL of this category of patients as in physical component summary and mental component summary. The indicators of QOL are significantly affected by the duration of t2DM, as well as the degree of compensation. Achievement of the target BP levels in patients with AH with t2DM shows an improvement in a number of QOL parameters and makes it possible to recommend the Sf-36 questionnaire as a criterion for the effectiveness of the therapy.
Hypertensive response in exercise - a tool to predict stroke risk?
Authors: Graca Rodrigues TE , Cunha N , Silverio-Antonio P , Couto Pereira P , Valente Silva B , Alves Da Silva P , Brito J , David C , Pinto FJ , Almeida AG 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
There is some evidence suggesting that exaggerated hypertensive response to exercise (HRE) may be associated with higher risk of future cardiovascular events, however the relationship between systolic blood pressure (SPB) during exercise test and stroke is not fully understood.

Purpose
To evaluate the ability to predict the risk of stroke in patients with HRE in exercise test.

Methods
Single-center retrospective study of consecutive patients submitted to exercise test from 2012 to 2015 with HRE to stress test. HRE was defined as a peak systolic blood pressure (PSBP) &gt; 210 mmHg in men and &gt; 190 mmHg in women, or a rise of the SBP of 60 mmHg in men or 50 mmHg in women or as a diastolic blood pressure &gt; 90 mmHg or a rise of 10 mmHg. Patient’s demographics, baseline clinical characteristics, vital signs during the stress test and the occurrence of stroke during follow-up were analysed

Results
We included 458 patients with HRE (76% men, 57.5 ± 10.83 years). The most frequent comorbidities were hypertension (83%), dyslipidaemia (61%), previously known coronary disease (32%), diabetes (28%) and smoking (38%). Atrial fibrillation was present in 5.9% of patients.
During a mean follow-up of 60 ± 2 months, the incidence of stroke was 2.1% (n = 8), all with ischemic origin. Considering the parameters analysed on exercise test, only PSBP demonstrated to be an independent predictor of stroke (HR 1.042, CI95% 1.002-1.084, p = 0.039,) with moderate ability to predict stroke (AUC 0.735, p = 0.0016) with a most discriminatory value of 203 mmHg (sensibility 56%, specify 67%). Regarding baseline characteristics, after age, sex and comorbidities adjustment, previously controlled hypertension was found to be an independent protective factor of stroke (OR 4.247, CI 95% 0.05-0.9, p = 0.036) and atrial fibrillation was an independent predictor of stroke occurrence (HR 8.1, CI95% 1.4-46.9, p = 0.018). Atrial fibrillation was also associated with hospitalization of cardiovascular cause and major cardiovascular events occurrence (mortality, coronary syndrome and stroke). Baseline SBP was associated with atrial fibrillation development (p = 0.008).

Conclusion
According to our results, PSBP during exercise test is an independent predictor of stroke occurrence and should be considered as a potencial additional tool to predict stroke occurrence, particularly in high risk patients. The identification of diagnosed hypertension as a protective factor of stroke may be explained by the cardioprotective effect of antihypertensive drugs.
Improvement of cardiovascular risk prediction by longitudinal risk factor and competing risk data
Authors: Roman Degano I , Marrugat J , Elosua R , Subirana I 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Spanish Society of Cardiology

OnBehalf
REGICOR Study

Background
Cardiovascular risk assessment is the cornerstone of cardiovascular primary prevention. However, most of the recommended or regionally validated risk assessment tools are not updated.

Purpose
To analyze the effect of including longitudinal information of risk factors as well as competing risks for cardiovascular risk prediction.

Methods
Data from 10,152 general population individuals from North-Eastern Spain was included. Individuals were recruited in 1995-2000-2005 in three different cohorts of the REGICOR Study. Risk factor data was obtained at baseline and in 2 follow-up visits. Risk factor data included age, sex, education, lipid profile, blood pressure, glucose, smoking, body mass index, and treatment for hypercholesterolemia, hypertension and diabetes. Event data was obtained by cross linkage with healthcare and mortality databases. Cardiovascular events included myocardial infarction, angina and stroke. Cancer mortality and other mortality were included as competing risks. Four cox proportional hazards models developed to model time to coronary/cerebrovascular events with longitudinal or competing risk data. Interactions between age and risk factors were included. Discrimination was assessed with the area under the ROC curve (AUC) and Sommer’s D statistic, and compared with discrimination of Framingham-REGICOR function.

Results
The variable with the largest effect on coronary/cerebrovascular event incidence was diabetes treatment in the longitudinal models [Hazard ratio -HR- (95% confidence interval -CI-): 3.02 (2.00, 4.58)/2.58 (1.33, 5.00)] as well as in the competing risk models [HR (95% CI): 3.08 (2.09, 4.55)/2.77 (1.48, 5.18)]. In addition to currently used variables, medication for hypertension and diabetes, and interaction between age and diabetes medication were included in all models. Compared to the Framingham-REGICOR function, discrimination improved with the inclusion of longitudinal or competing risk data as shown in the Table.

Conclusion
Including longitudinal information of cardiovascular risk factors or competing risks improved discrimination of a regionally validated cardiovascular risk function. The availability of these data in healthcare databases would allow its use in primary care cardiovascular risk assessment.
Discrimination analysis Models AUC (95% CI) developed models AUC (95% CI) Framingham-REGICORfunction p-value Competing risks - coronary events 0.80 (0.77-0.82) 0.74 (0.71-0.77) &lt; 0.001 Competing risks - cerebrovascular events 0.78 (0.74-0.82) 0.68 (0.63-0.72) &lt; 0.001 Longitudinal data - coronary events 0.79 (0.78-0.81) 0.76 (0.74-0.78) &lt; 0.001 Longitudinal data - cerebrovascular events 0.80 (0.78-0.83) 0.71 (0.69-0.74) &lt; 0.001
Untargeted metabolites and vascular health in cardiovascular risk patients
Authors: Streese L , Springer AM , Deiseroth A , Carrard J , Infanger D , Schmaderer C , Schmidt-Trucksaess A , Madl T , Hanssen H 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swiss National Science Foundation

Background
The mechanistic pathways how classical cardiovascular (CV) risk factors affect macro- and microvascular health are not fully understood. The metabolome reflects a chemical fingerprint of the upstream epigenetic processes and seems to have the potential to provide insights into multiple molecular mechanisms underlying vascular health or vascular abnormalities that contribute to the pathogenesis of CV disease.

Purpose
We aimed to investigate the associations of CV risk factors with the metabolic fingerprint and macro- as well as microvascular health in an untargeted metabolic approach in predefined CV risk groups of aged individuals.

Methods
This cross-sectional study investigated the metabolic fingerprint, as well as the macro- and microvascular health from a well-characterized aged (50-80 years) cohort, based on the EXAMIN AGE study. One hundred and fifty-five participants with no to ≥three previously defined CV risk factors were analysed. Nuclear magnetic resonance spectroscopy was used to analyse the metabolic fingerprint. Carotid-femoral pulse wave velocity as well as retinal vessel diameters were analysed to quantify macro- and microvascular health.

Results
The metabolic fingerprint gradually changed with increasing number of risk factors. Whereas the metabolic profile of individuals with a small number of risk factors were more homogenous, the profile became more heterogeneous with increasing numbers of risk factors. There was strong evidence for a negative association of glutamine [estimate (95% CI): -14.54 (-17.81 to -11.27), p &lt; 0.001], glycine [-5.84 (-7.88 to -3.79), p &lt; 0.001], histidine [-0.73 (-0.96 to -0.50), p &lt; 0.001], and acetate [-1.68 (-2.91 to -0.46), p = 0.007] with a higher CV risk profile. Tryptophan was positively associated with higher CV risk [0.31 (0.06 to 0.56), p = 0.015]. The combination of a priori defined CV risk factors explained up to 45.4% of the metabolic variation. The metabolic fingerprint explained 20% of macro- and 23% of microvascular variation.

Conclusion
Metabolic profiling has the potential to improve and individualise CV risk stratification. It may help better understand some of the underlying metabolic mechanisms of atherosclerotic disease development. Our findings support future preventive strategies to target specific metabolites and thereby reduce CV risk and associated vascular disease. Metabolic profiling may have added value to predict CV disease development and potentially guide future treatment strategies.
Changes in physical activity behavior and development of cardiovascular risk in children
Authors: Lona G , Hauser C , Koechli S , Infanger D , Endes K , Faude O , Hanssen H 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Swiss National Foundation

Background
Prevention of cardiovascular (CV) disease should start early in life. The study aimed to investigate the association of changes in physical activity, sedentary behavior and cardiorespiratory fitness (CRF) with development of body mass index (BMI), blood pressure (BP) and retinal microvascular health in children over four years.

Methods
In 2014, 391 children aged 6-8 years were screened, and thereof 262 children were reexamined after four years following standardized protocols. Retinal arteriolar (CRAE) and venular diameters were measured by a retinal vessel analyzer. CRF was objectively assessed by a 20m shuttle run, physical activity and sedentary behavior by use of a questionnaire.

Results
Children who achieved higher CRF levels reduced their BMI (β [95% CI] -0.35 [-0.46 to -0.25] kg/m2 per stage, P ≤ 0.001) and thereby developed wider CRAE (β [95% CI] 0.25 [0.24 to 0.48] µm per stage, P = 0.03) at follow-up. Moreover, children with elevated or high systolic BP at baseline, but lower levels of sedentary behavior during the observation period, had wider CRAE at follow-up (β [95% CI] -0.37 [-0.66 to -0.08] µm per 10 min/d, P = 0.013).

Conclusion
An increase of CRF over four years was associated with a reduced BMI and consequently wider retinal arterioles at follow-up. In children with elevated or high systolic BP, a reduction of sedentary behavior by merely 10 min per day significantly improved retinal microvascular health as a primary prevention strategy to promote childhood health and combat development of manifest CV disease later in life.