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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Entries
Topic Review
Vascular Aging
Vascular aging, i.e., the deterioration of the structure and function of the arteries over the life course, predicts cardiovascular events and mortality. Vascular degeneration can be recognized before becoming clinically symptomatic; therefore, its assessment allows the early identification of individuals at risk. This opens the possibility of minimizing disease progression. Vascular remodeling with advancing age is characterized by arterial stiffening and calcification. Arterial stiffening affects the macro- and micro-vasculature in unique ways. The main function of large arteries is to dampen the pulsatility of cardiac contraction by elastic recoiling after systolic expansion, so that constant, rather than pulsatile, blood flow is propelled to organs and tissues, including the coronary arteries.
  • 444
  • 06 Sep 2023
Topic Review
Pathophysiology of Inflammation in Peripheral Artery Disease
Inflammation has a critical role in the development and progression of atherosclerosis. On the molecular level, inflammatory pathways negatively impact endothelial barrier properties and thus, tissue homeostasis. Conformational changes and destruction of the glycocalyx further promote pro-inflammatory pathways also contributing to pro-coagulability and a prothrombotic state. In addition, changes in the extracellular matrix composition lead to (peri-)vascular remodelling and alterations of the vessel wall, e.g., aneurysm formation. Moreover, progressive fibrosis leads to reduced tissue perfusion due to loss of functional capillaries.
  • 186
  • 07 Sep 2023
Topic Review
Triple Overlap Syndrome (OSAHS-COPD-CHF)
Obstructive sleep apnea-hypopnea syndrome (OSAHS) and chronic obstructive pulmonary disease (COPD) are independently linked to an increase in cardiovascular disease (CVD). Only a few studies have been published linking the association between overlap syndrome and congestive heart failure (CHF). It is becoming increasingly clear through research that there is a strong connection between OSA, COPD, and CHF. 
  • 892
  • 06 Sep 2023
Topic Review
The Ketogenic Diet and Cardiovascular Diseases
The ketogenic diet has been shown to have a multifaceted effect on the prevention and treatment of cardiovascular diseases (CVD). Among other aspects, it has a beneficial effect on the blood lipid profile, even compared to other diets. It shows strong anti-inflammatory and cardioprotective potential, which is due, among other factors, to the anti-inflammatory properties of the state of ketosis, the elimination of simple sugars, the restriction of total carbohydrates and the supply of omega-3 fatty acids. In addition, ketone bodies provide “rescue fuel” for the diseased heart by affecting its metabolism. They also have a beneficial effect on the function of the vascular endothelium, including improving its function and inhibiting premature ageing. The ketogenic diet has a beneficial effect on blood pressure and other CVD risk factors through, among other aspects, weight loss. The evidence cited is often superior to that for standard diets, making it likely that the ketogenic diet shows advantages over other dietary models in the prevention and treatment of cardiovascular diseases.
  • 242
  • 07 Sep 2023
Topic Review
Coronary No-Reflow after Primary Percutaneous Coronary Intervention
Coronary no-reflow (CNR) is a frequent phenomenon that develops in patients with ST-segment elevation myocardial infarction (STEMI) following reperfusion therapy. CNR is highly dynamic, develops gradually (over hours) and persists for days to weeks after reperfusion. Microvascular obstruction (MVO) developing as a consequence of myocardial ischemia, distal embolization and reperfusion-related injury is the main pathophysiological mechanism of CNR. The frequency of CNR or MVO after primary PCI differs widely depending on the sensitivity of the tools used for diagnosis and timing of examination. Coronary angiography is readily available and most convenient to diagnose CNR but it is highly conservative and underestimates the true frequency of CNR. Cardiac magnetic resonance (CMR) imaging is the most sensitive method to diagnose MVO and CNR that provides information on the presence, localization and extent of MVO. CMR imaging detects intramyocardial hemorrhage and accurately estimates the infarct size. MVO and CNR markedly negate the benefits of reperfusion therapy and contribute to poor clinical outcomes including adverse remodeling of left ventricle, worsening or new congestive heart failure and reduced survival.
  • 512
  • 01 Sep 2023
Topic Review
Roles of Adrenoceptors in Atherosclerosis
Atherosclerosis is an arterial disease that is characterized by the narrowing of the arterial lumen due to the subendothelial accumulation of lipids. Atherosclerosis is the key underlying mechanism for ischemic heart disease and stroke. Despite the availability of a wide array of effective lipid-lowering medications such as statins, ezetimibe, and PCSK9 (proprotein convertase subtilisin-like kexin type 9) inhibitors, ischemic heart disease and stroke remain the leading two causes of mortality globally, highlighting the need to identify new therapeutic strategies for atherosclerosis.
  • 281
  • 29 Aug 2023
Topic Review
Cardioprotective Effects of Metformin on Myocardial Ischemia/Reperfusion
The most common is coronary artery disease, which causes the death of cardiomyocytes, the cells responsible for cardiac contractility, through ischemia and subsequent reperfusion, which leads to heart failure in the medium and short term. Metformin is one of the most-used drugs for the control of diabetes, which has shown effects beyond the control of hyperglycemia. Some of these effects are mediated by the regulation of cellular energy metabolism, inhibiting apoptosis, reduction of cell death through regulation of autophagy and reduction of mitochondrial dysfunction with further reduction of oxidative stress. This suggests that metformin may attenuate left ventricular dysfunction induced by myocardial ischemia; preclinical and clinical trials have shown promising results, particularly in the setting of acute myocardial infarction. 
  • 563
  • 18 Aug 2023
Topic Review
Perivascular Adipose Tissue Oxidative Stress in Obesity
Perivascular adipose tissue (PVAT) adheres to most systemic blood vessels in the body. Healthy PVAT exerts anticontractile effects on blood vessels and further protects against cardiovascular and metabolic diseases. Healthy PVAT regulates vascular homeostasis via secreting an array of adipokine, hormones, and growth factors. Normally, homeostatic reactive oxygen species (ROS) in PVAT act as secondary messengers in various signalling pathways and contribute to vascular tone regulation.
  • 372
  • 17 Aug 2023
Topic Review
Management of Coronary Artery Disease in Older Adults
Coronary artery disease (CAD) is highly prevalent in older adults, yet its management remains challenging. Treatment choices are made complex by the frailty burden of older patients, a high prevalence of comorbidities and body composition abnormalities (e.g., sarcopenia), the complexity of coronary anatomy, and the frequent presence of multivessel disease, as well as the coexistence of major ischemic and bleeding risk factors.
  • 618
  • 16 Aug 2023
Topic Review
Subcutaneous Implantable Cardioverter Defibrillator
Subcutaneous implantable cardioverter defibrillators (S-ICDs) are structurally similar to TV-ICDs, being made of a pulse generator and a defibrillator coil. The advantage of S-ICDs concerns the components, which are completely outside of the chest.
  • 350
  • 08 Aug 2023
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