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
Perivascular Adipose Tissue
Perivascular adipose tissue (PVAT) is the connective tissue surrounding most of the systemic blood vessels. PVAT is now recognized as an important endocrine tissue that maintains vascular homeostasis. Healthy PVAT has anticontractile, anti-inflammatory, and antioxidative roles. Vascular oxidative stress is an important pathophysiological event in cardiometabolic complications of obesity, type 2 diabetes, and hypertension. Accumulating data from both humans and experimental animal models suggests that PVAT dysfunction is potentially linked to cardiovascular diseases, and associated with augmented vascular inflammation, oxidative stress, and arterial remodeling. Reactive oxygen species produced from PVAT can be originated from mitochondria, nicotinamide adenine dinucleotide phosphate (NADPH) oxidases, and uncoupled endothelial nitric oxide synthase. PVAT can also sense vascular paracrine signals and response by secreting vasoactive adipokines. Therefore, PVAT may constitute a novel therapeutic target for the prevention and treatment of cardiovascular diseases.
  • 1.3K
  • 17 Jun 2021
Topic Review
Single Ventricle
In this paper, the author enumerates cardiac defects with a functionally single ventricle, summarizes single ventricle physiology, presents a summary of management strategies to address the single ventricle defects, goes over the steps of staged total cavo-pulmonary connection, cites the prevalence of inter-stage mortality, names the causes of inter-stage mortality, discusses strategies to address the inter-stage mortality, reviews post-Fontan issues, and introduces alternative approaches to Fontan circulation. 
  • 2.1K
  • 10 Jun 2021
Topic Review
Antihypertensives’ around the Clock
Although homeostasis is a commonly accepted concept, there is incontrovertible evidence that biological processes and functions are variable, and that variability occurs in cycles. So allostatic model has emerged as the first challenge to homeostasis. Circadian variation is the predominant variation in the body. As there is strong scientific and clinical evidence that blood pressure fluctuations undergo circadian rhythm, there is equally strong evidence that targeted time therapy for hypertension provides a better outcome of the disease. The research has gone even further by ensuring better patients' adherence throughout the development and approval process for the use of pulsatile drug release systems which can be considered as an option for an even more convenient dosage regimen of the medicines needed.
  • 1.9K
  • 20 May 2021
Topic Review
Saliva biomarkers for Heart Failure
Heart Failure (HF) is a clinical syndrome characterized by symptoms such as dyspnoea or fatigue on exertion or at rest, and clinical signs (i.e. lower extremity oedema, elevated jugular venous pressure, pulmonary crackles, etc.) caused by a structural and/or functional cardiac abnormality, ultimately leading to reduced cardiac output. Despite advances in the knowledge on HF, decisions on diagnosis and treatment of HF remain challenging. In everyday clinical practice, biomarkers such as plasma natriuretic peptides such as brain natriuretic peptide (BNP) and N-terminal fragment BNP (NT-proBNP), play an important role in HF diagnosis, therapy monitoring and risk stratification, while many other serum biomarkers have also been studied without definite evidence on how to use them in clinical practice. Biomarkers that could be measured in other biological fluids other than blood, easily and non-invasively, and outside the hospital setting, have attracted research interest. During the last years, saliva has emerged as a body fluid for this purpose.  This review assessed the potential role of salivary biomarkers in diagnosis and progression monitoring of patients with HF. 18 salivary biomarkers were analyzed and the levels of all biomarkers studied were found to be higher in HF patients compared to controls, except for amylase, sodium, and chloride that had smaller saliva concentrations in HF patients. Natriuretic peptides are the most commonly used plasma biomarkers in the management of HF. Their saliva levels show promising results, although the correlation of saliva to plasma values is weakened in higher plasma values. In most of the publications, differences in biomarker levels between HF patients and controls were found to be statistically significant. Due to small number of patients included, larger studies need to be conducted in order to facilitate the use of saliva biomarkers in clinical practice.
  • 1.4K
  • 19 May 2021
Topic Review
Toll-Like Receptors in Essential Hypertension
Essential hypertension (EH) is a highly heterogenous disease with a complex etiology. Toll-like receptors (TLRs) have been implied as novel effectors in this inflammatory environment since they can significantly stimulate the production of pro-inflammatory cytokines, the migration and proliferation of smooth muscle cells and the generation of reactive oxygen species (ROS), facilitating a low-intensity inflammatory background that is evident from the very early stages of hypertension. Furthermore, the net result of their activation is oxidative stress, endothelial dysfunction, vascular remodeling, and finally, vascular target organ damage, which forms the pathogenetic basis of EH. Importantly, evidence of augmented TLR expression and activation in hypertension has been documented not only in immune but also in several non-immune cells located in the central nervous system, the kidneys, and the vasculature which form the pathogenetic core systems operating in hypertensive disease.
  • 948
  • 18 May 2021
Topic Review
Familial Hypercholesterolaemia
Familial hypercholesterolaemia (FH) is a common inherited cause of premature cardiovascular disease, but the majority of patients remain undiagnosed. 
  • 985
  • 15 May 2021
Topic Review
COVID-19 and Chagas Disease Patients
Chagas disease is considered a neglected tropical disease. The acute phase of Chagas disease is characterized by several symptoms: fever, fatigue, body aches, headache and cardiopathy’s. Chronic phase could be asymptomatic or symptomatic with cardiac compromise. Since the emergence of the pandemic caused by the SARS-CoV-2 virus, the cardiovascular involvement has been identified as a complication commonly reported in coronavirus disease 2019 (COVID-19). Due to the lack of knowledge of the cardiac affectations that this virus could cause in patients with Chagas disease.
  • 1.1K
  • 11 May 2021
Topic Review
Stereotactic Arrhythmia Radioablation
Ventricular tachycardia is a type of arrhythmia (heart rhythm disorder) characterized by fast heart rate (exceeding 100 beats per minute), originating from abnormal electrical impulse localized in heart ventricles. The electrophysiology-guided noninvasive cardiac radioablation, also known as STAR (stereotactic arrhythmia radioablation), is an emerging treatment method of non-invasive treatment for ventricular tachycardia persistent after conventional methods of ablation.
  • 1.2K
  • 10 May 2021
Topic Review
Heart Disease and Metabolic Steatosis
The liver-heart axis is a growing field of interest owing to rising evidence of complex bidirectional interplay between the two organs. Recent data suggest non-alcoholic fatty liver disease (NAFLD) has a significant, independent association with a wide spectrum of structural and functional cardiac diseases, and seems to worsen cardiovascular disease (CVD) prognosis.
  • 1.0K
  • 28 Apr 2021
Topic Review
Artificial Intelligence (AI)-Empowered Echocardiography Interpretation
Echocardiography (Echo), a widely available, noninvasive, and portable bedside imaging tool, is the most frequently used imaging modality in assessing cardiac anatomy and function in clinical practice. Artificial-intelligence-empowered echo (AI-Echo) can potentially reduce inter-interpreter variability and indeterminate assessment and improve the detection of unique conditions as well as the management of various cardiac disorders.
  • 1.2K
  • 28 Apr 2021
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