The triglyceride–glucose index and its obesity-related derivatives as predictors of all-cause and cardiovascular mortality in hypertensive patients: insights from NHANES data with machine learning analysis

Cardiovascular Diabetology, Journal Year: 2025, Volume and Issue: 24(1)

Published: Jan. 29, 2025

Language: Английский

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Systemic aging fuels heart failure: Molecular mechanisms and therapeutic avenues

ESC Heart Failure, Journal Year: 2024, Volume and Issue: unknown

Published: July 22, 2024

Abstract Systemic aging influences various physiological processes and contributes to structural functional decline in cardiac tissue. These alterations include an increased incidence of left ventricular hypertrophy, a diastolic function, atrial dilation, fibrillation, myocardial fibrosis amyloidosis, elevating susceptibility chronic heart failure (HF) the elderly. Age‐related dysfunction stems from prolonged exposure genomic, epigenetic, oxidative, autophagic, inflammatory regenerative stresses, along with accumulation senescent cells. Concurrently, age‐related changes vascular system, attributed endothelial dysfunction, arterial stiffness, impaired angiogenesis, oxidative stress inflammation, impose additional strain on heart. Dysregulated mechanosignalling nitric oxide signalling play critical roles associated HF. Metabolic drives intricate shifts glucose lipid metabolism, leading insulin resistance, mitochondrial within cardiomyocytes. contribute contractility, ultimately propelling low‐grade conjunction senescence‐associated secretory phenotype, aggravates age by promoting immune cell infiltration into myocardium, fostering This is further exacerbated comorbidities like coronary artery disease (CAD), atherosclerosis, hypertension, obesity, diabetes kidney (CKD). CAD atherosclerosis induce ischaemia adverse remodelling, while hypertension hypertrophy fibrosis. Obesity‐associated inflammation dyslipidaemia create profibrotic environment, whereas diabetes‐related metabolic disturbances impair function. CKD‐related fluid overload, electrolyte imbalances uraemic toxins exacerbate HF through systemic neurohormonal renin‐angiotensin‐aldosterone system (RAAS) activation. Recognizing as modifiable process has opened avenues target both lifestyle interventions therapeutics. Exercise, known for its antioxidant effects, can partly reverse pathological remodelling elderly countering linked HF, such senescence declining cardiomyocyte regeneration. Dietary plant‐based ketogenic diets, caloric restriction macronutrient supplementation are instrumental maintaining energy balance, reducing adiposity addressing micronutrient Therapeutic advancements targeting underway. Key approaches senomorphics senolytics limit senescence, antioxidants stress, anti‐inflammatory drugs interleukin (IL)‐1β inhibitors, rejuvenators nicotinamide riboside, resveratrol sirtuin (SIRT) activators autophagy enhancers metformin sodium‐glucose cotransporter 2 (SGLT2) all which offer potential preserving function alleviating burden.

Language: Английский

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Sacubitril/Valsartan Alleviates Cardiac Remodeling and Dysfunction in L-NAME-Induced Hypertension and Hypertensive Heart Disease

Biomedicines, Journal Year: 2024, Volume and Issue: 12(4), P. 733 - 733

Published: March 25, 2024

There is ample evidence on the benefit of angiotensin receptor-neprilysin inhibitors (ARNIs) in heart failure, yet data regarding potential protective action ARNIs hypertensive disease are sparse. The aim this study was to show whether an ARNI exerts a effect model Nω-nitro-L-arginine methyl ester (L-NAME)-induced hypertension with and compare angiotensin-converting enzyme inhibitor, captopril. Five groups adult male Wistar rats were studied (14 per group) for four weeks: untreated controls; (68 mg/kg/day); L-NAME (40 treated ARNI; captopril (100 mg/kg/day). administration induced hypertension, accompanied by increased left ventricular (LV) weight fibrotic rebuilding LV terms concentration content hydroxyproline insoluble collagen total histological finding fibrosis. These alterations associated compromised systolic diastolic function. Treatment either or reduced blood pressure (SBP), alleviated hypertrophy fibrosis, prevented development both dysfunction. Moreover, serum levels prolactin receptor significantly slightly In conclusion, L-NAME-induced dual inhibition neprilysin AT1 receptors SBP hypertrophy, suggest that could provide protection against structural remodeling functional disorders disease.

Language: Английский

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Hypertension and Heart Failure: From Pathophysiology to Treatment

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(12), P. 6661 - 6661

Published: June 17, 2024

Hypertension represents one of the primary and most common risk factors leading to development heart failure (HF) across entire spectrum left ventricular ejection fraction. A large body evidence has demonstrated that adequate blood pressure (BP) control can reduce cardiovascular events, including HF. Although pathophysiological epidemiological role hypertension in HF is well largely known, some critical issues still deserve be clarified, BP targets, particularly patients. Indeed, management relies on extrapolation findings from high-risk hypertensive patients general population not specifically designed studies populations. In with reduced fraction (HFrEF), it recommended combine drugs documented outcome benefits BP-lowering effects. preserved EF (HFpEF), a therapeutic strategy all major antihypertensive drug classes recommended. Besides commonly used drugs, different suggests other for beneficial effect outcomes exert advantageous pressure-lowering actions. this regard, type 2 sodium glucose transporter inhibitors (SGLT2i) have been shown induce actions favorably affect cardiac afterload, arterial coupling, efficiency, reverse remodeling. More recently, finerenone, non-steroidal mineralocorticoid receptor antagonist, reduces new-onset improves chronic kidney disease diabetes, irrespective history Other proposed agents, such as endothelin antagonists, provided contrasting results novel, promising could represented by small interfering RNA, whose are under investigation ongoing clinical trials.

Language: Английский

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Soy protein β-conglycinin ameliorates pressure overload-induced heart failure by increasing short-chain fatty acid (SCFA)-producing gut microbiota and intestinal SCFAs

Clinical Nutrition, Journal Year: 2024, Volume and Issue: 43(12), P. 124 - 137

Published: Oct. 1, 2024

Language: Английский

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The role of diagnostic modalities in differentiating hypertensive heart disease and hypertrophic cardiomyopathy: strategies in adults for potential application in paediatrics

Cardiology in the Young, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 15

Published: Jan. 24, 2025

Abstract Hypertensive heart disease and hypertrophic cardiomyopathy both lead to left ventricular hypertrophy despite differing in aetiology. Elucidating the correct aetiology of presenting can be a challenge for clinicians, especially patients with overlapping risk factors. Furthermore, drugs typically used combat hypertensive may contraindicated treatment cardiomyopathy, making diagnosis imperative. In this review, we discuss characteristics that enable clinicians discriminate two as causes hypertrophy. We summarise current literature, which is primarily focused on adult populations, containing discriminative techniques available via diagnostic modalities such electrocardiography, echocardiography, cardiac MRI, noting strategies yet applied paediatric populations. Finally, review pharmacotherapy each regard pathophysiology.

Language: Английский

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Diagnosis and Management of Hypertensive Heart Disease: Incorporating 2023 European Society of Hypertension and 2024 European Society of Cardiology Guideline Updates

Journal of Cardiovascular Development and Disease, Journal Year: 2025, Volume and Issue: 12(2), P. 46 - 46

Published: Jan. 26, 2025

Hypertensive heart disease (HHD) continues to be a leading cause of cardiovascular morbidity and mortality worldwide, necessitating the evolution evidence-based management strategies. This literature review examines most recent updates from 2023 2024 hypertension guidelines issued by European Society Hypertension (ESH) Cardiology (ESC). These are compared with previous key recommendations, such as 2017 American College Cardiology/American Heart Association 2018 ESC/ESH guidelines. The updated recommendations reflect paradigm shift in approach diagnosis management, including stricter systolic blood pressure (BP) target 120–129 mmHg, which underscores importance early precise BP control. difference between classification “elevated BP” ESC versus ESH guidelines, particularly, regarding their implications for detection prevention HHD, critically examined, highlighting areas clinical academic debate. introduction new category (120–139/70–89 mmHg) highlights proactive strategy aimed at identifying at-risk individuals earlier course prevent progression HHD. Additionally, divergent roles hypertension-mediated organ damage (HMOD), risk stratification recommended discussed, emphasising significance tailoring approaches. For patients resistant hypertension, also endorse innovative therapies, renal denervation, an interventional procedure that has demonstrated significant promise managing treatment-resistant cases. synthesises these updates, focusing on practice diagnosing By aggressive intervention integration novel treatment modalities, aims bridge existing gaps approaches management. critical evaluation guideline discrepancies evolving evidence seeks provide clinicians nuanced understanding optimise outcomes particularly considering emerging therapeutic possibilities more stringent control targets.

Language: Английский

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Exploring the impact of angiotensin-converting enzyme (ACE) gene polymorphism on early diastolic function in hypertension using four-dimensional echocardiography

BMC Cardiovascular Disorders, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 12, 2025

This study explores the relationship between angiotensin-converting enzyme (ACE) gene polymorphisms and early diastolic dysfunction in patients with hypertension utilizing four-dimensional echocardiography assesses prognosis. consecutively selected 470 who visited Fourth Affiliated Hospital of Soochow University September 2021 August 2022, 274 meeting inclusion criteria. Hypertension testing was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) techniques, Hardy–Weinberg equilibrium test used to confirm genetic equilibrium. Patients were categorized into D allele group (n = 163) non-D 111). Diastolic function assessed echocardiography, which included averaging E/e' ratio over three cardiac cycles, measuring left atrial (LA) maximum volume index (LA volume), tricuspid regurgitation velocity (TR velocity), LA strain, ventricular isovolumic relaxation time (IVRT). subsequently classified 133) normal 141). Chi-square tests analyze differences indicators groups, Logistic regression applied control for potential confounding factors, receiver operating characteristic (ROC) curves plotted assess predictive value different ACE alleles hypertension. The genotype distribution both consistent (P > 0.05). Compared group, echocardiographic showed a decline function: average cycles (14.67 [13.82, 15.80] vs. 9.30 [8.12, 12.00]), (32.76 [29.34, 34.61] 25.61 [22.63, 29.64] ml/m2), TR (2.90 [2.40, 2.90] 1.40 [1.10, 2.40] cm/s), strain (18.00 [14.00, 25.00] 37.00 [24.00, 40.00] %), IVRT (104.25 [95.87, 106.25] 88.09 [80.99, 96.56] ms). Differences each statistically significant (all P < number higher 102; 62.6%) compared 31; 27.9%). In logistic model, associated an increased risk (OR 4.32, 95% CI 2.56–7.27, 0.01). adjusted remained elevated 3.83, 2.24–6.54, ROC curve analysis indicated that has (area under [AUC], 0.667; confidence interval [CI], 0.608–0.723; sensitivity, 76.7%; specificity, 56.7%; ACE-D is can enhance

Language: Английский

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Characterization of two novel angiotensin converting enzyme-inhibitory peptides from yellow tuna peptides: Inhibitory mechanism, transport route and network pharmacology analysis

Food Research International, Journal Year: 2025, Volume and Issue: unknown, P. 116232 - 116232

Published: March 1, 2025

Language: Английский

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Prolonged Hospital Stay in Hypertensive Patients: Retrospective Analysis of Risk Factors and Interactions

Nursing Reports, Journal Year: 2025, Volume and Issue: 15(3), P. 110 - 110

Published: March 19, 2025

Background/Objectives: Arterial hypertension (HT) is a leading modifiable risk factor for cardiovascular diseases, often contributing to prolonged lengths of hospital stay (LOHS), which place significant strain on healthcare systems. This study aimed analyze the factors associated with in patients HT, focusing key biochemical and clinical predictors. Methods: retrospective included 356 adult hospitalized Cardiology Department University Hospital Wroclaw, Poland, between January 2017 June 2021. Data collected demographic characteristics, body mass index (BMI), comorbidities, laboratory parameters. Logistic regression models were used identify predictors LOHS, defined as four or more days, evaluate interactions variables. Results: Lower levels low-density lipoprotein cholesterol (LDL-c) elevated concentrations high-sensitivity C-reactive protein (hsCRP) identified each 1 mg/dL decrease LDL-c increasing odds LOHS by 1.21% (p < 0.001) mg/L increase hsCRP raising 3.80% = 0.004). An interaction sex heart failure (HF) was also observed. Female HF had 3.995-fold higher compared females without 0.001), while no difference found among male 0.890). Conclusions: The HT include lower LDL-c, hsCRP, (HF). Specifically, female demonstrated significantly HF, this relationship not observed patients.

Language: Английский

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