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
Gap Junctions in Atrial Fibrillation
Atrial fibrillation (AF) represents the most common type of clinical cardiac arrhythmia worldwide and contributes to substantial morbidity, mortality and socioeconomic burden. Aggregating evidence highlights the strong genetic basis of AF. In addition to chromosomal abnormalities, pathogenic mutations in over 50 genes have been causally linked to AF, of which the majority encode ion channels, cardiac structural proteins, transcription factors and gap junction channels. In the heart, gap junctions comprised of connexins (Cxs) form intercellular pathways responsible for electrical coupling and rapid coordinated action potential propagation between adjacent cardiomyocytes. Among the 21 isoforms of connexins already identified in the mammal genomes, 5 isoforms (Cx37, Cx40, Cx43, Cx45 and Cx46) are expressed in human heart. Abnormal electrical coupling between cardiomyocytes caused by structural remodeling of gap junction channels (alterations in connexin distribution and protein levels) has been associated with enhanced susceptibility to AF and recent studies have revealed multiple causative mutations or polymorphisms in 4 isoforms of connexins predisposing to AF.
  • 1.3K
  • 11 Apr 2022
Topic Review
Mitral Paravalvular Leak
Paravalvular leak incidence after mitral surgical replacement ranges from 7% to 17%. Between 1% and 5% of these are clinically significant. Large PVLs can cause important clinical manifestations such as heart failure or haemolysis. Current guidelines consider that surgical reparation is the gold-standard therapy in symptomatic patients with paravalvular leak. However, these recommendations are based in non-randomized observational registries. On the other hand, transcatheter paravalvular leak closure has shown excellent results with a low rate of complications, and nowadays it is considered the first option in selected patients in some experienced centres.
  • 1.4K
  • 11 Apr 2022
Topic Review
Endothelial Ion Channel Therapy-Targets for Pulmonary Arterial Hypertension
Endothelial cells (ECs) form a multifunctional signal-transducing surface that performs diverse tasks depending on its localization in the vessel tree. A diverse variety of ion channels is expressed in the plasma and organelle membranes that control the function of these cells. Pulmonary arterial hypertension (PAH) is a severe disease characterized by vascular remodeling in pulmonary arteries attributable to persistent vasoconstriction, proliferation, inflammation, and in situ thrombosis.  Ion channels play a crucial role in the pathophysiology of the disease and can be carefully considered as new therapeutic targets relevant for PAH.
  • 919
  • 08 Apr 2022
Topic Review
Cross-Sectional Imaging in Pediatric Interventional Cardiac Catheterization
Computed tomography (CT)  and Cardiac magnetic resonance (CMR) continue to advance the field of congenital cardiology by allowing for new and unique procedures not previously imagined. Enabling the interventionalist to enter the catheterization lab with a plan of attack expedites the procedure and has been shown to reduce procedural times and improve outcomes. Substantial advances in cross-sectional image resolution with a significant decrease in radiation exposure for cardiac CTs have led to more mainstream utilization. CMR has a unique ability to deliver real-time functional imaging in several views without exposing the patient to the detrimental effects of ionizing radiation. This can reduce procedural times in the interventional fluoroscopic suite to allow for more directed procedures.
  • 1.1K
  • 08 Apr 2022
Topic Review
Statin Residual Cardiovascular Disease Risk
Several randomized, double blind, placebo-controlled trials (RCTs) have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering by using statins, including high-doses of strong statins, reduced the development of cardiovascular disease (CVD). However, among the eight RCTs which investigated the effect of statins vs. placebos on the development of CVD, 56–79% of patients had the residual CVD risk after the trials. In three RCTs which investigated the effect of a high dose vs. a usual dose of statins on the development of CVD, 78–87% of patients in the high-dose statin arms still had the CVD residual risk after the trials. An analysis of the characteristics of patients in the RCTs suggests that elevated triglyceride (TG) and reduced high-density lipoprotein cholesterol (HDL-C), the existence of obesity/insulin resistance, and diabetes may be important metabolic factors which determine the statin residual CVD risk. 
  • 1.2K
  • 06 Apr 2022
Topic Review
Proprotein Convertase Subtilisin/Kexin Type 9 and Atherosclerosis
Proprotein convertase subtilisin/kexin type 9 (PCSK9) is the last discovered member of the family of proprotein convertases (PCs), mainly synthetized in hepatic cells. This serine protease plays a pivotal role in the reduction of the number of low-density lipoprotein receptors (LDLRs) on the surface of hepatocytes, which leads to an increase in the level of cholesterol in the blood. The main anti-atherosclerotic effect of PCSK9 inhibitors results from their lipid-lowering efficiency.
  • 865
  • 01 Apr 2022
Topic Review
Sphingolipid Catabolism
In the plasma membrane and other cellular compartments (endosome/lysosome), sphingomyelin can be hydrolyzed to ceramide by sphingomyelinases.  Ceramide generated by this pathway is further degraded into sphingosine by ceramidases. Shingosine can also be phosphorylated by sphingosine kinases to sphingosine-1-phosphate. Changes in the profiles of sphingomyelin and its metabolites ceramide, sphingosine, and sphingosine-1-phosphate (S1P) can result in a pathological condition triggered by accumulation or by altering cell signaling.
  • 3.8K
  • 16 May 2022
Topic Review
Consumption of Dairy Foods and Cardiovascular Disease
A high intake of saturated fatty acids (SFAs) has been linked to an enhanced risk of cardiovascular diseases (CVD), and this effect is thought to be largely mediated by increased plasma LDL-cholesterol level and its proatherogenic effect. Within this context, dairy foods deserve consideration since they are largely consumed and contribute a relevant proportion to the global SFAs intake. A substantial reduction in the intake of dairy products and a preferential consumption of low-fat dairy products have been advocated as a strategy for CVD prevention, but evidence in this regard is scant and inconsistent. By reviewing the literature on the relationship of different dairy products (low/full-fat dairy, milk, cheese, yogurt) with CV events and major CV risk factors, this work provides consistent evidence that a moderate consumption of dairy foods is not associated with increased CV risk, independent of whether full-fat or low-fat products are considered. As for specific foods, fermented products and products added with probiotics are associated with a lower risk of CV events. Therefore, these results highlight the wide heterogeneity existing among dairy foods with regard to their association with CVD and expand current knowledge on the relevance of food choices with regard to cardiovascular health.
  • 1.1K
  • 22 Mar 2022
Topic Review
Nrf2 to Maintain Redox Homeostasis in Cardiometabolic Diseases
The transcription factor Nrf2 is a master regulator of multiple cytoprotective genes that maintain redox homeostasis and exert anti-inflammatory functions. The Nrf2-Keap1 signaling pathway is a paramount target of many cardioprotective strategies, because redox homeostasis is essential in cardiovascular health. Nrf2 gene variations, including single nucleotide polymorphisms (SNPs), are correlated with cardiometabolic diseases and drug responses. SNPs of Nrf2, KEAP1, and other related genes can impair the transcriptional activation or the activity of the resulting protein, exerting differential susceptibility to cardiometabolic disease progression and prevalence.
  • 1.6K
  • 21 Mar 2022
Topic Review
Definition of Hypertension and Establishment of Treatment Targets
Hypertension is the most frequent chronic and non-communicable disease all over the world, with about 1.5 billion affected individuals worldwide. Its impact is currently growing, particularly in low-income countries. Even in high-income countries, hypertension remains largely underdiagnosed and undertreated, with consequent low rates of blood pressure (BP) control.
  • 1.3K
  • 21 Mar 2022
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