بیماری های قلبی عروقی

Cardiovascular diseases (CVD) are considered the leading cause of mortality worldwide. According to World Health Organization statistics in 2022, these diseases resulted in the deaths of nearly 19.8 million people globally. The early diagnosis and timely treatment are among the main challenges in managing these diseases. Generally, since some of the currently used biomarkers lack specificity; therefore, a stronger need for more specific markers in this area is felt. Exosomes, as one of the extracellular vesicles, are produced in almost all eukaryotic cells. These microvesicles are covered with a bilayer phospholipid membrane and carry proteins, nucleic acids, lipids, etc.

The current narrative review research included studies available in the international databases of PubMed, Scopus, and Web of Science.

Various factors, including stress, cellular damage, medications, and toxins can influence the production and secretion of exosomes. Exosomes play a crucial role in intercellular communications and can serve as biological markers for diagnostic and prognostic strategies. Additionally, exosomes have therapeutic potential and act as biological carriers for targeted drug delivery to the heart.

Based on the findings obtained, the use of the exosomes in the diagnosis and treatment of cardiovascular diseases could aid in the better management of these conditions; however, its application may be clinically challenging. Moreover, the present study explores the potential of using exosomes as a novel tool in the medical field.

Cardiovascular diseases are responsible for about one-third of deaths worldwide. Consequently, innovative strategies for the development and treatment of cardiovascular diseases are of great interest. Vitamin E is known for its unique and remarkable anti-oxidant and anti-inflammatory properties. The advantages of vitamin E in cardiovascular diseases have been investigated and the relationship between lower vitamin E levels and increased cardiovascular events supports this view. However, clinical trials reveal inconsistent and disappointing results in reducing cardiovascular events with vitamin E supplementation. The analysis of studies shows that in addition to the amount, duration of consumption, the type of vitamin E isoform, and its natural or synthetic source, factors such as genetic polymorphisms and the clinical status of users also affect the impact of vitamin E supplementation on cardiovascular events.

Patients with cardiovascular diseases, as well as those receiving preventive care for cardiovascular events or at risk of bleeding, should take Vitamin E only under medical supervision.  Considering that low concentrations of antioxidants such as alpha-tocopherol can lead to greater susceptibility to diseases related to oxidative stress and inflammation in the population, reviewing or reinterpreting the mechanisms of vitamin E effects in the cardiovascular process is essential for a better understanding of the relationship between Vitamin E and cardiovascular diseases. It is equally important to establish public health initiatives and strategies to encourage the intake of natural vitamin E sources and healthy fats.

Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality. Various studies have focused on the association between copper intake and CVD in epidemiological studies; however, the effects of dietary copper in CVD remains controversial. Some animal model studies have observed a strong association between copper intake and atherogenesis based on molecular pathways, while other studies were unable to confirm this correlation. Clinical trials have not demonstrated a clear link between copper intake and CVD, and the optimal copper intake to reduce the risk of developing CVDs remain unclear. Magnesium is another crucial element that plays essential roles in various biological processes. Several randomized controlled trials (RCTs) and meta-analyses have reported that individuals with high magnesium intake have a lower risk of developing CVD. It has been observed that increased magnesium intake reduces the risk of CVD risk factors and CVD. The study also indicated that individuals with high magnesium intake have a lower risk of developing hypertension and diabetes. The purpose of this review is to summarize recent findings on the link between copper and magnesium intake and CVD. Furthermore, more thorough RCTs are required to fully understand the underlying mechanisms involved in the effect of magnesium on cardiovascular health.

The high prevalence of cardiovascular diseases among dental clients requires sufficient knowledge in this regard. For this purpose, we aimed to develop a valid and reliable questionnaire to assess the awareness of cardiovascular diseases among final year dental students.

After designing 38 questions, four areas were identified and to determine the validity, 7 specialists from the departments of Community Oral Health (2 people), Oral and Maxillofacial Diseases (2 people), Oral and Maxillofacial Surgery (2 people) and Cardiologist (n=1) evaluated the validity indicators and then to measure the reliability. The final form was distributed among 24 senior year dental students two weeks apart using the test-retest method and kappa statistics were calculated.

To determine the total validity of the instrument, the S-CVI value of the general agreement approach was 94.73% and in the mean approach was 87.84%. Also, the I-CVI values ​​of each question were above 0.70. Finally, out of the first 38 questions, 4 questions were removed due to lack of simplicity and the kappa coefficient of the remaining 34 questions, except for three questions, was obtained above 0.61, the middle of the total kappa coefficient was equal to 0.77.

With regard to desirable validity and reliability indices, it seems that this questionnaire is a useful tool to assess the awareness of dental students about cardiovascular diseases.

Cardiovascular diseases are recognized as the leading cause of death globally, accounting for a substantial proportion of mortality and disabilities worldwide.
Given that exposure to secondhand smoke is one of the risk factors for cardiovascular diseases, this policy brief presents strategies for reducing exposure to secondhand smoke in the healthy population and cardiovascular patients.
Reducing the burden of cardiovascular diseases caused or aggravated by secondhand smoke exposure and improving health levels requires a multifaceted approach.

This article is an update on our previous review of clinical studies on the role of polypills in the secondary prevention of cardiovascular diseases (CVD). We also present the preliminary results of the Persian Polypill study.

Persian Polypill is a randomized clinical trial with two parallel arms on hospitalized patients due to acute myocardial infarction (AMI). It is planned that 1100 patients will be randomly assigned to one of the two arms of Polypill or usual care and will be followed up for 34 months. The primary outcome will be a composite clinical outcome of major adverse cardiovascular events (MACE), and the secondary outcome will be the cost-effectiveness of polypill treatment.

We identified ten completed studies and two ongoing trials in which at least 10% of participants had CVD. The evaluation of these studies showed the lack of research in low- and middle-income countries about the role of polypill in secondary prevention of CVD and limited information about cost-effectiveness resulting from clinical trials. In Persian Polypill, so far, 624 patients admitted to three hospitals due to AMI have been included in the study. The average age of patients is 60.9 ± 8.7 and 506 are male (81.1%). Overall, 94.4% of the patients underwent percutaneous coronary intervention in the hospital, and 26.3% had hospital complications.

The final results of this study can compensate for the gap in the past studies. They may confirm the role of polypill in the initial management of AMI and long-term secondary prevention in these patients.

In recent years, the field of biology has witnessed the discovery of new molecules with remarkable functions. One of these molecules is circular RNAs (CircRNAs), which are part of the large family of noncoding RNAs. These RNAs are abundantly present in body tissues and are located either in the cytoplasm or stored in exosomes, where they are not affected by cellular RNA exonucleases. Unlike other linear RNAs, circular RNAs lack free ends and therefore possess a more stable structure compared to linear transcripts. These unique characteristics make them ideal candidates for use as biomarkers. It is well established that these special RNAs play an important role in regulating gene expression. Furthermore, studies have demonstrated that circular RNAs play a crucial role in a wide range of biological processes, including cell proliferation, apoptosis, and aging. Importantly, circular RNAs are described as microRNA sponges. This mechanism, which has been extensively studied in cancers, holds promise as a biomarker in other diseases, particularly cardiovascular diseases. This study aims to evaluate the role of circular RNAs as biomarkers in the prognosis of cardiovascular diseases.

Hyperlipidemia, a chronic metabolic disorder marked by elevated blood lipid levels, significantly increases the risk of cardiovascular disease in individuals with diabetes, hypertension, and obesity. While pharmacological interventions exist, factors such as medication side effects, cost considerations, and a growing interest in complementary and alternative medicine have stimulated research into the therapeutic potential of medicinal plants in managing hyperlipidemia. This study aims to assess the efficacy and safety of these botanical agents in reducing blood lipid levels.

A comprehensive literature search was conducted across reputable databases, including PubMed, ScienceDirect, Google Scholar, and other relevant online platforms. Keywords such as "hyperlipidemia," "herbal medicine," "traditional medicine," "herbal extract," and "herbal therapy" were employed to identify studies published up to 2024. Inclusion criteria were established to select studies that reported the impact of medicinal plants on lipid profile modifications.

Based on the results, the study revealed that various medicinal plants, including Thymus vulgaris, Apium graveolens, Cichorium intybus, Fumaria officinalis, Heracleum rawianum, Anthemis altissima, Gundelia tourneforttii, Cynodon dactylon, Anthriscus sylvestrianum, Solanum nigrum, Arum elongatum, Glycyrrhiza glabra, Berberis vulgaris, Rheum ribes, and Mentha spicata, are commonly used in traditional medicine to address hyperlipidemia.

The use of indigenous Iranian medicinal plants for managing hyperlipidemia is deeply rooted in the country’s ancient history and has been increasingly validated by contemporary scientific research. These natural compounds can help lower blood lipid levels by inhibiting fat absorption and boosting lipid metabolism. The growing interest in traditional medicine and medicinal plants can be attributed to their inherent advantages, such as a lower incidence of side effects compared to synthetic drugs. Ongoing scientific research in this field offers promising avenues for developing innovative and effective herbal-based therapies

 To overcome the limitations of the definition of metabolic syndrome (MetS) in clinical use, a health index named quantitative Metabolic Syndrome Severity Score (cMetS-S), has been recently introduced and validated in the Tehran Lipid and Glucose Study. This study investigated the association between the severity of MetS based on age and gender (cMetS- score), and cardiovascular diseases (CVD) beyond the components of MetS.

 At the beginning of the study, participants aged 20-60 years were enrolled. Those with cardiovascular disease, cancer, use of corticosteroid, estimated glomerular filtration rate <30 ml/min/1.73m², or pregnancy were excluded. The association between cMetS-S and cardiovascular diseases was evaluated continuously for 18 years follow-up among 8,500 participants using Cox proportional hazards regression models and its performance in predicting cardiovascular disease events was compared with the MetS criteria.

 Participants with higher cMetS-S showed a significant increase in the risk of cardiovascular disease (CVD), coronary heart disease (CHD), and non-coronary heart disease (non-CHD). Independent of the confounding factors of metabolic syndrome components, each 1-SD unit increase in cMetS-S was associated with risk ratios of 1.67, 1.60 and 1.88 for cardiovascular diseases, coronary and non-coronary cardiac events, respectively. Model fit analysis showed better CVD prediction value for cMetS-S independent of (MetS) components, compared with metabolic syndrome (p<0.0001).

 The cMetS-S predicts cardiovascular diseases more accurately than the MetS and its components. The standardized cMetS-S, which considers the weighted contribution of MetS components and their variations by age and gender, may serve as a health metric for determining the severity of metabolic syndrome.

The association between the consumption of dairy products and the risk of cardiovascular disease (CVD) is not well-known yet. Here, we aimed to determine the potential effects of total intake and subtypes of dairy products on the development of CVD in an Iranian adult population.

Among adult participants of the third phase of the Tehran Lipid and Glucose Study (TLGS), after excluding those with incomplete dietary, biochemical and anthropometric data, and those who had CVD events at baseline, 2635 adults were selected and followed up till the sixth phase of the TLGS. Baseline dietary intakes were evaluated using a validated food frequency questionnaire with 168 items. There was no significant difference between the baseline characteristics of participants who did not complete the FFQ and those of the total population in the third phase of the TLGS. Finally, the risk of CVD events after adjusting for potential confounding variables was evaluated across the tertile categories of dairy products using the Cox proportional hazard regression models.

During a 10.6-year follow-up, the incidence rate of CVD was 6.5%. After adjusting for confounding factors, there was no significant association between CVD risk and total dairy, low-fat and high-fat dairy, fermented and non-fermented dairy products, high- and low-fat milk, high- and low-fat yogurt, cheese, and cream cheese, as well as ice cream.

According to numerous evidence in previous studies that revealed there is no association between the consumption of dairy products, and CVD risk, independent of high-fat or low-fat dairy products. Hence, it is vital to reconsider dietary recommendations on lowering the intake of high-fat dairy products for the prevention of CVD.

An unhealthy diet is of significant risk factor leading to the incidence of CVDs. Regarding the effect of carbohydrates in the development of such diseases, this study aimed to evaluate the risk of a high carbohydrate diet in the development of CVDs in the habitat of Guilan province.

This research was a cross-sectional study within the framework of the Guilan Cohort Study. Demographic and food intake information of 10276 individuals including 4787 men and 5489 women was collected. To estimate the effect of carbohydrate intake on the development of CVDs in the habitat, the population-attributable risk was assessed.

Among the macronutrients, the most intake was related to carbohydrates which was %66.38 and %66.50 of calories in women and men, respectively. Intake of dietary fibers in men was higher than in women. Consumption of dietary fibers in both groups was lower than the recommendation. of 10276 individuals, 6147 persons consumed the carbohydrate more than %65 of calories. The risk assessment study revealed that more than %30 of CVDs are attributed to high carbohydrate intake.

Considering the high risk of CVDs in the habitat of Guilan, their diet should be modified towards higher consumption of plant fat protein, and dietary fibers. Therefore, the use of health education and promotion models is recommended.

COVID-19 infection primarily leads to respiratory failure in severe cases, though; cardiovascular complications also account for a high percentage of mortality. The present study reviews the sex and gender differences in COVID-19 cardiovascular complications.       

In this narrative study, the English and Persian papers from PubMed, Scopus, and Google Scholar from 2019 to 2023 were reviewed. The used keywords were COVID-19, coronavirus, sex differences, gender, and cardiovascular disorders. 180 papers were found in total and 62 papers were selected finally.         

COVID-19 infection leads to many cardiovascular complications such as acute myocardial injuries, myocarditis, stress cardiomyopathy, etc… It seems that differences in cardiovascular status in health and disease between two sexes are among the most important factors involved in different severity and mortality of covid-19. Different sociocultural situations of men and women as well as distinctive factors such as pregnancy, parturition, and lactation could also be effective in the susceptibility of women.            

A comprehensive understanding of different cardiovascular outcomes and pathologic responses between males and females could have a fundamental role in promoting and designing customized strategies in clinical evaluation, prevention, and treatment for each sex.

 Cardiovascular disease (CVD) is the most common cause of death and disability in both developed and developing countries. The role of nutrition in preventing and reducing these diseases is undeniable.

This study examines the relationship between the Healthy Eating Index, 2010 and cardiovascular diseases in patients referred to army hospitals in 1401.
 

 This study is a case-control study conducted on 119 patients with cardiovascular disease (case group) and 239 patients without cardiovascular disease (control group) referred to one of the hospitals in Isfahan. Personal information including demographic information, lifestyle and anthropometric characteristics of the participants was collected. Nutritional status was assessed using a semi-quantitative food frequency questionnaire (FFQ) (including 178 food items) completed by face-to-face interview and food intake and Healthy Eating Index, 2010 (HEI, 2010) were calculated.
 

The results showed that the case group (with cardiovascular disease) had significantly higher body mass index, fewer hours of sleep, higher fasting blood sugar, higher fat intake, soluble and insoluble fiber intake, and lower Healthy Eating Index score. Individuals in higher HEI quintiles were less likely to have cardiovascular disease (e.g., OR = 0.01 for the first quintile (Q1), OR = 0.3 for Q3, and OR = 1 for Q5, and p < 0.001).

 This study showed that higher HEI, 2010 score is associated with lower risk of cardiovascular disease.

Knowledge, positive attitude, and proper practice are the most important factors in controlling cardiovascular complications in chronic diseases such as diabetes. So, this study investigated the knowledge, attitude, and practice of cardiovascular disease prevention in patients with type 2 diabetes.

In this descriptive-cross-sectional study, 385 patients with type 2 diabetes who visited the Diabetes Clinic of Ganjavian Dezful Hospital from January 2023 to April 2024 were selected by convenience sampling method. To collect data, the demographic information questionnaire and the questionnaire by Koohi et al. (2021) related to the knowledge, attitude and practice of prevention of cardiovascular diseases were used. The Cronbach's alpha of the questionnaire was >0/6 for all dimensions of the questionnaire, and its CVR and CVI in this study were 0/90 and 0/85. Data were analyzed using SPSS version 16 software and p-value of less than 0.05. Descriptive statistics including frequency, mean, and standard deviation as well as inferential statistics such as Pearson correlation, independent t test, and ANOVA were used to analyze the data.

This study showed that 57.1 percent of the participants were in the age range of 40 to 60 67/5 percent of whom were women. Patients had a high level of knowledge and attitude toward preventing cardiovascular disease (20/06 ± 5/42) and (46/80 ± 4/99), respectively); however, their performance level was not high (8.65 ± 5.03). A significant positive relationship was also observed between knowledge and attitude (r = 0/6, P= 0/001).

Despite patients’ high level knowledge and attitude toward the prevention of cardiovascular diseases, their performance in this field is not appropriate, and this issue requires planning by hospital managers

Occupational stress is related to coronary heart disease, high blood pressure, musculoskeletal disorders, cancer and psychosomatic symptoms. One of the most stressful environments, is the work environments related to legal matters, including notary offices. This study was conducted with the aim of determining the relationship between job stress and some risk factors of cardiovascular diseases in notary administrators and office assistants in Qom province in 2023.

This cross-sectional and descriptive-analytical study was conducted in 2023 on 147 notary administrators and office assistants in Qom province in the form of a census. In addition to demographic information, participants' height, weight, waist circumference and blood pressure were also measured and recorded and their blood samples were taken. Job stress data was collected using Osipow job stress questionnaire and chi-square and U Mann-Whitney tests were used to analyze the results.

The average total job stress score was 176.88 out of 300 with a standard deviation of 25.83. In terms of biochemical factors, 28.6% had high blood pressure. 21.1% had blood sugar above 126 mg/dL. 65.3% had blood cholesterol above 200 mg/dL. Also, 48.9% had triglycerides above 150 mg/dL. A significant relationship was observed between gender, and marital status, with occupational stress. The Mann-Whitney U test did not show a significant diference between the low-stress and high-stress groups in terms of cardiovascular disease risk factors.

The majority of notary administrators and office assistants suffer from a high level of job stress. Despite the high level of occupational stress, the results of this study showed that there is no significant relationship between occupational stress and cardiovascular disease risk factors. In terms of demographic factors, gender and marital status, were related to occupational stress.

Cardiovascular diseases are among the most lethal physical diseases of the 21st century, posing a greater threat to human life than any other disease and problem. This research compared the effectiveness of mindfulness-based stress reduction and emotion-focused therapy on the cognitive flexibility of cardiovascular patients in Isfahan City. The research was conducted using a quasi-experimental design with a pre-test-post-test and a three-month follow-up with a control group. The statistical population included 380 male cardiovascular patients admitted to Shahid Chamran Cardiovascular Hospital in Isfahan in the winter of 2023. Forty-five patients were selected by purposive sampling and randomly assigned to two experimental groups and one control group. Patients in the first experimental group received eight 90-minute sessions of mindfulness-based stress reduction, while those in the second experimental group received eight 90-minute sessions of emotion-focused therapy. The measurement tools were the Cognitive Flexibility Questionnaire (Dennis & Vanderwaal, 2010) and a short clinical interview. Research data were analyzed through mixed variance analysis using SPSS version 24 software. The results showed that both intervention methods increased the average cognitive flexibility and its components, including alternatives, control, and alternatives for human behaviors of patients (P≥0.01). No significant difference was observed between the effectiveness of the two methods (P≤0.01). According to the research results, it is possible to use the intervention method of mindfulness-based stress reduction program and emotion-focused therapy to improve the cognitive flexibility of cardiovascular patients.

Today, cardiovascular diseases are one of the main causes of death. This study was conducted to compare the effect of resistance and endurance training on predictors of cardiovascular diseases and arteriosclerosis in aged male rats.

The present study is an experimental and fundamental research with a control group conducted in 2021 in the basic science laboratory of Shahrekord University in Iran. Fifty elderly male Wistar rats with an average weight of 432.7±4.4 grams and an age of 23±2 months were randomly divided into five groups. The control group was divided into two resistance training groups (climbing a special ladder) and two continuous training groups (running on a treadmill), and they did the training protocols for eight weeks and five sessions every week. Data analysis was performed using a one-way analysis of variance and Bonferroni post hoc test with SPSS 22 software at p≤0.05 level.

The results of the present study showed that the level of HDL increased significantly in all four training groups compared to the control group (p≤0.05). LDL level and LDL/HDL ratio decreased significantly in all four training groups compared to the control group (p≤0.05). The level of TC decreased significantly only in the high-intensity resistance training group (p≤0.05). Even though both training methods led to changes in the levels of TG, VLDL, ApoA1, ApoB, and ApoB/ ApoA1 ratio, these changes were not statistically significant (p>0.05). The difference between the two training methods was insignificant (p>0.05).

Both training methods caused positive changes in HDL, LDL factors, and LDL/ HDL ratio. Performing both training methods is recommended for older adults and people at risk, especially the military, although endurance training has more effect and fewer risks.

Food insecurity and poor quality of diet are among risk factors of cardiovascular diseases (CVD). The main objective of this study was to assess the association of food insecurity with atherogenic glucose and lipid profile in women.

In this cross-sectional study, 630 women between 18 and 50 years of age were selected by cluster sampling and interviewed face-to-face. To assess the household’s food security status, we used a household food insecurity access scale (HFIAS) questionnaire, which its validity and reliability had been determined in the Iranian population. The serum levels of glucose (FBS), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were measured and LDL/HDL, TC/HDL, and TG/HDL ratios were calculated.

The mean serum concentrations of TG and TG/HDL ratio were significantly higher in the women suffering from moderate and severe food insecurity compared to those in the food-secure women (p=0.002). Compared with the food secure group, women with moderate and severe food security were more likely to develop hypertriglyceridemia (adjusted OR, 1.63; p=0.018) and a high TG/HDL ratio (adjusted OR, 1.52; p=0.030). However, food security status showed no significant associations with the probability of having the impaired fasting glucose, hypercholesterolemia, high LDL, low HDL, and abnormal ratios of LDL/HDL and TC/HDL.

Food insecurity may be associated with increased risk of hypertriglyceridemia and high TG/HDL in women.