Progress in cardiovascular diseases
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Prog Cardiovasc Dis · May 2019
ReviewIs sauna bathing protective of sudden cardiac death? A review of the evidence.
Sudden cardiac death (SCD) is a global public health burden accounting for 15-20% of all deaths. Though established atherosclerotic risk factors explain a large proportion of the risk of SCD, these factors are often absent in a large proportion of SCD victims and the pathogenesis of SCD is still not fully established. It therefore appears that additional factors may be involved. ⋯ Sauna bathing is generally safe for most healthy people and even among patients with stable CVD, if used sensibly and with caution. Plausible pathways underlying the protective effect of sauna bathing on SCD may be linked to the impact on CV function via reduced arterial stiffness, decreases in inflammation and oxidative stress, stabilization of the autonomic nervous system, beneficial changes in circulating lipid profiles and other CVD risk markers, and lowering of systemic blood pressure. Sauna is a potential novel tool to promote SCD prevention in addition to other known means, being an enjoyable way to take care of general health and well-being.
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Prog Cardiovasc Dis · Jul 2018
ReviewMetabolic and Bariatric Surgery: An Effective Treatment Option for Obesity and Cardiovascular Disease.
Obesity is a chronic and debilitating disease that has become a global epidemic. Especially severe in the Unites States, obesity currently affects almost 40% of the population. Obesity has a strong causal relationship with numerous serious comorbidities that impair quality of life, shorten life expectancy, and carry a major economic burden. ⋯ Multiple treatment options are available, but metabolic and bariatric surgery offers the most effective and durable treatment for obesity. Moreover, metabolic and bariatric operations alleviate and often completely eliminate numerous comorbidities, particularly type 2 diabetes and other cardiovascular risk factors, such as hypertension and dyslipidemia. With their low risk of complications and morbidity, metabolic and bariatric operations significantly improve quality of life and overall survival, particularly reducing death due to cardiovascular disease.
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Recent advances in medical technology and health care have greatly improved the management for chronic diseases and prolonged human lifespan. Unfortunately, increased lifespan and the aging population impose a major challenge on the ever-rising prevalence of chronic diseases, in particular cardiometabolic stress associated with the pandemic obesity in our modern society. Although overweight and obesity are associated with incident cardiovascular diseases (CVD), including heart failure (HF), it paradoxically leads to a more favorable prognosis in patients with chronic HF, a phenomenon commonly defined as "obesity paradox". ⋯ These findings suggested that a complex relationship among aging, metabolism, and HF severity/chronicity, which may explain the shift in obesity paradox in the elderly. Aging negatively affects body metabolism and cardiac function although its precise impact on obesity paradox remains elusive. To develop new strategies for cardiovascular health in the elderly, it is imperative to understand the precise role for aging on obesity-related CVD.
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Obesity continues to be a public health problem in the general population, and also significantly increases the risk for the development of new-onset heart failure (HF). However, in patients with already-established, chronic HF, overweight and mild to moderate obesity is associated with substantially improved survival compared to normal weight patients; this has been termed the "obesity paradox". ⋯ Other areas of investigation such as the relationship of the obesity paradox to cardiorespiratory fitness, gender, and race are also discussed. Finally, this review explores various explanations for the obesity paradox, and summarizes the current evidence for intentional weight loss treatments for HF in context.
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Prog Cardiovasc Dis · May 2018
Review Meta AnalysisPortfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials.
The evidence for the Portfolio dietary pattern, a plant-based dietary pattern that combines recognized cholesterol-lowering foods (nuts, plant protein, viscous fibre, plant sterols), has not been summarized. ⋯ Current evidence demonstrates that the Portfolio dietary pattern leads to clinically meaningful improvements in LDL-C as well as other established cardiometabolic risk factors and estimated 10-year CHD risk.