The American journal of the medical sciences
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Systemic lupus erythematosus (SLE) is an autoimmune disease that is characterized by the production of autoantibodies against nuclear antigens such as double-stranded DNA. Lupus predominantly affects women (ratio, 9:1). Moreover, premenopausal women with SLE are 50 times more likely to have a myocardial infarction. ⋯ Although many factors promote the development of vascular endothelial dysfunction, all pathways converge on the diminished activity of endothelial nitric oxide synthase (eNOS) and loss of nitric oxide (NO) bioavailability. Studies examining the effects of type I interferons on eNOS and NO in SLE are missing. This literature review examines the current literature regarding the role of type I interferons in cardiovascular disease and its known effects on regulators of eNOS and NO bioavailability that are important for proper endothelial cell function.
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Given the established relation between testosterone and aging in older adults, we tested whether buccal telomere length (TL), an established cellular biomarker of aging, was associated with testosterone levels in youth. ⋯ The association between testosterone and buccal TL supports gonadal maturation as a developmentally sensitive biomarker of aging within youth. As stress levels of testosterone were significantly associated with buccal TL, these findings are consistent with the growing literature linking stress exposure and accelerated maturation. The lack of association of diurnal testosterone or morning basal levels with buccal TL bolsters the notion of a shared stress-related maturational mechanism between cellular stress and the hypothalamic pituitary gonadal axis. These data provide novel evidence supporting the interaction of aging, physiologic stress and cellular processes as an underlying mechanism linking negative health outcomes and early life stress.
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Although the efficacy and effectiveness of lifestyle modifications and antihypertensive pharmaceutical treatment for the prevention and control of hypertension and concomitant cardiovascular disease have been demonstrated in randomized controlled trials, this scientific knowledge has not been fully applied in the general population, especially in low-income communities. This article summarizes interventions to improve hypertension management and describes the rationale and study design for a cluster randomized trial testing whether a comprehensive intervention program within a national public primary care system will improve hypertension control among uninsured hypertensive men and women and their families. We will recruit 1,890 adults from 18 clinics within a public primary care network in Argentina. ⋯ The primary outcome is net change in systolic BP from baseline to month 18 between intervention and control groups among hypertensive study participants. The secondary outcomes are net change in diastolic BP, BP control and cost-effectiveness of the intervention. This study will generate urgently needed data on effective, practical and sustainable intervention programs aimed at controlling hypertension and concomitant cardiovascular disease in underserved populations in low- and middle-income countries.
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This commentary provides a brief overview of theory and research that supports the idea that sexism may be related to the disproportionate negative cardiovascular health outcomes in women. It describes sexism as a stressor and outlines its association with a variety of health outcomes as evidence for why sex disparities should be examined within the context of pervasive inequities. To date, population-based studies have not explicitly examined the relationship between sexism and cardiovascular disease, but smaller studies have yielded fairly consistent results. It is suggested that future research should aim to examine the influence of 2 types of sexism (ie, hostile and benevolent) and that daily or within-day designs be used to assess cognitive, behavioral and physiological responses to everyday sexist experiences.
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The prevalence of reduced estimated glomerular filtration rate (eGFR) among U.S. adults aged 80 years and older increased between 1988 to 1994 and 2005 to 2010. Trends in the prevalence of albuminuria over this time period have not been reported in this population. ⋯ The proportion of U.S. adults aged 80 years and older with an elevated ACR remained relatively stable between 1988 to 1994 and 2005 to 2010. However, due to the growth of the oldest-old, the absolute number with albuminuria increased substantially over the past 2 decades.