Summary

Hypertension is a major public health concern worldwide because of its rising prevalence and concomitant risks of cardiovascular diseases. Coping strategies may encompass a full spectrum of clinical, epidemiological, experimental, and technological factors to inspire front-line practices and shape critical thinking. This entry collection aims to assemble entries of wealthy topics related to clinical, therapeutic, and population sciences of hypertension and cardiovascular diseases that could inform research scientists and healthcare professionals.

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Topic Review
Structural Components of the Neurovascular Unit
Formulated as a group effort of the stroke community, the transforming concept of the neurovascular unit (NVU) depicts the structural and functional relationship between brain cells and the vascular structure. Composed of both neural and vascular elements, the NVU forms the blood–brain barrier that regulates cerebral blood flow to meet the oxygen demand of the brain in normal physiology and maintain brain homeostasis. Conversely, the dysregulation and dysfunction of the NVU is an essential pathological feature that underlies neurological disorders spanning from chronic neurodegeneration to acute cerebrovascular events such as ischemic stroke and cerebral hemorrhage.
  • 1.4K
  • 29 Sep 2022
Topic Review
Polyphenols from Red and White Grape Pomace
Grape pomace (GP) represents a very reliable source of polyphenols because it could be found globally as a remnant of the wine industry. During the winemaking process, two types of GP are generated: red GP and white GP, according to the produced wine, red or white. Grape pomace represents a viable source of polyphenols, mainly flavanols, procyanidins anthocyanins, and resveratrol which possess antioxidant and anti-inflammatory activities. Multiple differences were observed between red and white GP in terms of their antioxidant and anti-inflammatory activity in both in vitro and in vivo studies. Although most studies are focused on the antioxidant and anti-inflammatory effect of red grape pomace, there are still many variables that need to be taken into consideration, as well as extensive study of the white GP. It was observed that in both in vitro and in vivo studies, the GP polyphenols have a direct antioxidant activity by acting as a free radical scavenger or donating a hydrogen atom. It also possesses an indirect antioxidant and anti-inflammatory activity by reducing mitochondrial reactive oxygen species (ROS) generation, malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α), interleukin-1-beta (IL-1β), interleukin-6 (IL-6), nuclear factor kappa-light-chain-enhancer of activated B cells (NF- κβ), and inhibitor of nuclear factor kappa-B kinase subunit beta (Iκκβ) levels or nitrate oxide-4 (NOX4) expression and by increasing the levels of antioxidants enzymes like superoxide dismutase (SOD), catalase (CAT) glutathione reductase (GRx) and glutathione peroxidase(GPx). Besides these activities, many beneficial effects in ischemic heart diseases were also observed, such as the maintenance of the ventricular function as close as possible to normal, and the prevention of infarcted area extension.
  • 688
  • 29 Sep 2022
Topic Review
Biofunctionalization of the Tissue Engineered Heart Valves
Valve replacement is the mainstay of treatment for end-stage valvular heart disease, but varying degrees of defects exist in clinically applied valve implants. A mechanical heart valve requires long-term anti-coagulation, but the formation of blood clots is still inevitable. A biological heart valve eventually decays following calcification due to glutaraldehyde cross-linking toxicity and a lack of regenerative capacity. The goal of tissue-engineered heart valves is to replace normal heart valves and overcome the shortcomings of heart valve replacement commonly used in clinical practice. Surface biofunctionalization has been widely used in various fields of research to achieve functionalization and optimize mechanical properties.
  • 470
  • 28 Sep 2022
Topic Review
Pulmonary Artery Banding for Dilated Cardiomyopathy in Children
Current treatment paradigms for end-stage dilated cardiomyopathy (DCM) in children include heart transplantation and mechanical support devices. However, waitlist mortality, shortage of smaller donors, time-limited durability of grafts, and thrombo-hemorrhagic events affect long-term outcomes. Moreover, both these options are noncurative and cannot preserve the native heart function. Pulmonary artery banding (PAB) has been reinvented as a possible “regenerative surgery” to retrain the decompensated left ventricle in children with DCM. The rationale is to promote positive ventricular–ventricular interactions that result in recovery of left ventricular function in one out of two children, allowing transplantation delisting.
  • 518
  • 27 Sep 2022
Topic Review
Cardiogenic Shock Complicating Acute Myocardial Infarction
Cardiogenic shock complicating acute myocardial infarction is a complex clinical condition associated with dismal prognosis. Routine early target vessel revascularization remains the most effective treatment to substantially improve outcomes, but mortality remains high. Temporary circulatory support devices have emerged with the aim to enhance cardiac unloading and improve end-organ perfusion.
  • 597
  • 21 Sep 2022
Topic Review
Hypoxia-Inducible Factor in the Development of Pulmonary Hypertension
Pulmonary hypertension (PH) is a severe progressive lung disorder characterized by pulmonary vasoconstriction and vascular remodeling, culminating in right-sided heart failure and increased mortality.
  • 660
  • 19 Sep 2022
Topic Review
Synergistic Hypolipidemic Effects and Mechanisms of Phytochemicals
Hyperlipidemia, a chronic disorder of abnormal lipid metabolism, can induce obesity, diabetes, and cardiovascular and cerebrovascular diseases such as coronary heart disease, atherosclerosis, and hypertension. Increasing evidence indicates that phytochemicals may serve as a promising strategy for the prevention and management of hyperlipidemia and its complications. At the same time, the concept of synergistic hypolipidemic and its application in the food industry is rapidly increasing as a practical approach to preserve and improve the health-promoting effects of functional ingredients. Due to the complexity of the lipid metabolism regulatory network, the synergistic regulation of different metabolic pathways or targets may be more effective than single pathways or targets in the treatment of hyperlipidemia.
  • 566
  • 23 Sep 2022
Topic Review
Sphingosine-1-Phosphate and Platelets in Diseases
Sphingosine-1-phosphate (S1P) is a versatile signaling lipid involved in the regulation of numerous cellular processes. S1P regulates cellular proliferation, migration, and apoptosis as well as the function of immune cells. S1P is generated from sphingosine (Sph), which derives from the ceramide metabolism. In particular, high concentrations of S1P are present in the blood. This originates mainly from erythrocytes, endothelial cells (ECs), and platelets. While erythrocytes function as a storage pool for circulating S1P, platelets can rapidly generate S1P de novo, store it in large quantities, and release it when the platelet is activated. Platelets can thus provide S1P in a short time when needed or in the case of an injury with subsequent platelet activation and thereby regulate local cellular responses. In addition, platelet-dependently generated and released S1P may also influence long-term immune cell functions in various disease processes, such as inflammation-driven vascular diseases. New pharmacological approaches that target the auto- or paracrine effects of S1P may be therapeutically helpful in the future for pathological processes involving S1P.
  • 420
  • 15 Sep 2022
Topic Review
Pathophysiology of Septic Cardiomyopathy
Septic cardiomyopathy may be broadly defined as an acute cardiac dysfunction unrelated to ischemia that manifests in different ways: arrhythmias, left and/or right ventricular impairment during systole or diastole, with or without reduction in cardiac output. Endothelial, metabolic, and immune response abnormalities are generally involved in the pathogenesis of ventricular dysfunction and arrhythmias during sepsis, whereas the potential role of myocardial ischemia seems limited. Impaired blood flow autoregulation in coronary microcirculation and altered metabolism of lactate, free fatty acid, and glucose likely play a leading role. 
  • 473
  • 14 Sep 2022
Topic Review
Gut Microbiota Modulation in Cardiometabolic Diseases Treatment
The diverse relationship between cardiometabolic diseases (CMD) vulnerability and changes in gut microbiota make-up and metabolites has emphasized that gut microbiota is an unfamiliar modulator of CMD. These connections are possible targets for new CMD therapy. The host–microbiota interaction is made up of various levels at which potential therapeutic interventions can be instituted. These levels include dietary substrates, microbial ecology, and microbiota–host pathways that liberate metabolites that modulate host processes. Agents that inhibit recognized gut microbial enzymes can also be produced. The interesting part of this is that interventions directed at gut microbiota and/or their metabolism in lieu of the host may not necessarily be taken up into the host circulation, hence minimizing the likely adverse effects in comparison to those directed at host metabolism. Among the challenges of therapeutically targeting the gut microbiota are the individual variations, in addition to differences, in gut microbiota make-up, which can affect the action of the medication. This may call for individualized treatment. The gut-microbiota-directed therapeutic concept is based on targeting microbiota compositions, metabolic pathways, and mucosal barrier protection.
  • 492
  • 09 Sep 2022
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