scholarly journals Cardiovascular Protective Effects of Adjunctive Alternative Medicine (Salvia miltiorrhizaandPueraria lobata) in High-Risk Hypertension

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
K. S. Woo ◽  
Thomas W. C. Yip ◽  
Ping Chook ◽  
S. K. Kwong ◽  
C. C. Szeto ◽  
...  
Keyword(s):  
High Risk ◽  
Herbal Medicines ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Placebo Treatment ◽  
Left Ventricular ◽  
Adjunctive Treatment ◽  
Protective Effects ◽  
Double Blind ◽  
Beneficial Effects

Introduction. Hypertension in association with diabetes (DM), renal impairment (RI), and left ventricular hypertrophy (LVH) increases the risk of future cardiovascular events. We hypothesize, traditional herbal medicines Danshen and Gegen (D&G) have beneficial effects on atherogenesis in these high-risk hypertensive subjects.Subjects and Methods. 90 asymptomatic hypertensive subjects associated with LVH (63.3%), DM (62.2%), or RI (30%) were randomized to receive D&G herbal capsules 1 gm/day, 2 gm/day, or identical placebo capsules in double-blind and parallel fashion for 12 months. Brachial flow-mediated dilation (endothelium-dependent dilation, FMD) and carotid intima-media thickness (IMT) were measured by ultrasound. All data were analyzed using the Statistical Package for Social Sciences in Windows 16.0.Results. Their mean age was55±8years, and 74.4% were male. After 12 months of adjunctive therapies and compared with baseline, there were no significant changes in blood pressure, heart rate, hematological, glucose, and creatinine profiles in both placebo and D&G groups. FMD improved significantly during D&G (P=0.0001) and less so after placebo treatment (P=0.001). There was a mild but significant decrease in carotid IMT after D&G (P<0.001) but no significant changes after placebo. A trend of better improvement in FMD after higher versus lower D&G dosages was seen. D&G were well tolerated, with no significant adverse events or blood biochemistry changes.Conclusion. D&G adjunctive treatment was well tolerated and significantly improved atherogenesis in high-risk hypertensive patients, with potential in primary atherosclerosis prevention.

scholarly journals Effect of atorvastatin on subclinical atherosclerosis in virally-suppressed HIV-infected patients with CMV seropositivity: a randomized double-blind placebo-controlled trial

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 151
Author(s):  
Evy Yunihastuti ◽  
Lusiani Rusdi ◽  
Muhammad Syahrir Azizi ◽  
Riwanti Estiasari ◽  
Chyntia Olivia Maurine Jasirwan ◽  
...  
Keyword(s):  
Immune Activation ◽  
Controlled Trial ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Beneficial Effects ◽  
Informed Consent Form ◽  
Periodontal Index

Background: Persistent immune activation and inflammation in HIV-infection are linked to excess cardiovascular risk and other non-communicable diseases. Periodic asymptomatic CMV-reactivity in HIV infected patients over a lifetime may contribute to non-AIDS defining morbidity. Despite undetectable levels of HIV and CMV, these patients continue to have increased levels of biomarkers and immune activations. Statin administration is thought to reduce subclinical atherosclerosis by decreasing LDL-C levels. It may also add beneficial effects against CMV infection. Methods: We are conducting a double-blind placebo-controlled trial in which patients are randomized to receive either atorvastatin or placebo with a ratio of 1:1. This trial aims to study the effect of atorvastatin in statin-naive virally-suppressed HIV-infected patients with stable ART and CMV seropositivity on carotid intima media thickness (CIMT), tool that evaluates subclinical atherosclerosis. The study recruits 80 patients at HIV integrated care unit of Cipto Mangunkusumo hospital. All eligible subjects have CIMT evaluation as primary outcome, along with flow mediated vasodilatation (FMD), liver fibrosis and steatosis evaluation, fasting lipid, neurocognitive test, community periodontal index (CPI), and residual immune activation as secondary outcomes in 48 weeks. Ethics and dissemination: This study has received an ethical approval from Health Research Ethics Commitee–Universitas Indonesia and Cipto Mangunkusumo Hospital. Before joining the study, all participants fill in an informed consent form. At the end of study analysis, the trial results will be published and disseminated in peer-reviewed journals. Discussion: The main purpose of our study is to evaluate the effect of atorvastatin administration on CIMT changes in statin naïve virally suppressed HIV-infected patients with stable ART and CMV seropositivity Registration: ClinicalTrials.gov ID NCT04101136; registered on 24 September 2019.

scholarly journals Sirtuin 1, Visfatin and IL-27 Serum Levels of Type 1 Diabetic Females in Relation to Cardiovascular Parameters and Autoimmune Thyroid Disease

Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1110
Author(s):  
Magdalena Łukawska-Tatarczuk ◽  
Edward Franek ◽  
Leszek Czupryniak ◽  
Ilona Joniec-Maciejak ◽  
Agnieszka Pawlak ◽  
...  
Keyword(s):  
Global Longitudinal Strain ◽  
Thyroid Volume ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Sirtuin 1 ◽  
Control Group ◽  
Cardiovascular Parameters ◽  
Autoimmune Thyroid

The loss of cardioprotection observed in premenopausal, diabetic women may result from the interplay between epigenetic, metabolic, and immunological factors. The aim of this study was to evaluate the concentration of sirtuin 1, visfatin, and IL-27 in relation to cardiovascular parameters and Hashimoto’s disease (HD) in young, asymptomatic women with type 1 diabetes mellitus (T1DM). Thyroid ultrasound, carotid intima-media thickness (cIMT) measurement, electrocardiography, and echocardiography were performed in 50 euthyroid females with T1DM (28 with HD and 22 without concomitant diseases) and 30 controls. The concentrations of serum sirtuin 1, visfatin and IL-27 were assessed using ELISA. The T1DM and HD group had higher cIMT (p = 0.018) and lower left ventricular global longitudinal strain (p = 0.025) compared to females with T1DM exclusively. In women with a double diagnosis, the sirtuin 1 and IL-27 concentrations were non-significantly higher than in other groups and significantly positively correlated with each other (r = 0.445, p = 0.018) and thyroid volume (r = 0.511, p = 0.005; r = 0.482, p = 0.009, respectively) and negatively correlated with relative wall thickness (r = –0.451, p = 0.016; r = –0.387, p = 0.041, respectively). These relationships were not observed in the control group nor for the visfatin concentration. These results suggest that sirtuin 1 and IL-27 contribute to the pathogenesis of early cardiac dysfunction in women with T1DM and HD.

scholarly journals Evaluation of arterial stiffness in systolic heart failure

2021 ◽  
Vol 67 (2) ◽  
pp. 86-89
Author(s):  
Lajos Fehérvári ◽  
István Adorján Szabó ◽  
Lóránd Kocsis ◽  
Attila Frigy
Keyword(s):  
Heart Failure ◽  
Arterial Stiffness ◽  
Statistical Significance ◽  
Systolic Heart Failure ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Chi Square ◽  
Ventricular Ejection Fraction

Abstract Objective: Micro- and macrovascular changes can occur in heart failure, and could influence its prognosis and management. In a prospective study, we proposed the evaluation of arterial stiffness (macrovascular function) and its correlations in patients with systolic heart failure. Methods: 40 patients (32 men, 8 women, mean age 63±2.9 years), with hemodynamically stable systolic heart failure (left ventricular ejection fraction, EF<40%) were enrolled in the study. In every patient, beyond routine explorations (ECG, cardiac and carotid ultrasound, laboratory measurements), arterial stiffness was assessed by measuring pulse wave velocity (PWV). The correlations of PWV with clinical and echo-cardiographic characteristics were studied using t-test and chi-square test (p<0.05 being considered for statistical significance). Results: The average PWV was 8.55±2.2 m/s, and 16 patients had increased PWV (>10 m/s). We found significantly higher PWV values in patients older than 65 years (p<0.001), in patients with eGFR <60 ml/min/1.73 m2 (p<0.001), hypertension (p=0.006), and increased (>1 mm) carotid intima-media thickness (p=0.016). PWV was found to be significantly lower when EF was <30% (p=0.049). Furthermore, the presence of an increased PWV was correlated significantly with age (p<0.001), and (with borderline significance) with eGFR <60 ml/min/1.73 m2 and, inversely, with EF<30%. Conclusions: Increased arterial stiffness reflected by high PWV is frequently present in patients with systolic heart failure, and is mainly correlated with general risk factors of arterial involvement. Low EF, due to low stroke volume and decreased systolic arterial wall tension can influence the values and the interpretation of PWV.

Abstract 276: Obesity Even Without Co-morbidity Harbors more Cardiovascular Structural and Functional Abnormalities than what you think! Time for Early CV Screening!

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Mahfouz El Shahawy ◽  
Miglena Entcheva
Keyword(s):  
Risk Score ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Cvd Risk ◽  
Early Evaluation ◽  
Lipid Panel ◽  
Co Morbidity ◽  
Obese Subjects ◽  
Group B

Purpose: To determine the extent of structural and functional cardiovascular (CV) abnormalities in asymptomatic obese subjects with and without untreated comorbidities. Methods: We evaluated 2174 consecutive asymptomatic subjects, age 25 to 80, who presented to our Cardiovascular Disease (CVD) Assessment Center for CVD risk evaluation, utilizing Early CVD Risk Score [ECVDRS]. ECVDRS, also known as Rasmussen Risk Score (RRS), consists of 10 non-invasive tests: large (C1) and small artery (C2) stiffness, blood pressure (BP) at rest and post mild exercise (PME), carotid intima media thickness (CIMT), abdominal aorta and left ventricular ultrasound, retinal photography, microalbuminuria, ECG, and pro-BNP. Fasting lipid panel and blood sugar were measured for each subject. Obesity was assessed using waist circumference measurement (> 35 inches for female and 40 inches for male). Co morbidities were defined as BP>140/90mmHg, LDL>130mg/dl, HDL<40 mg/dl for male and <50 mg/dl for female, TrG>150mg/dl, and FBS>100mg/dl. Results: Among the subjects screened 949(44%) met criteria for obesity, 458(48%) were not receiving any CV medications and were divided in two groups: A 100 subjects (22%) with no comorbidities (CM): 68 (68%) female and 32(32%) male; and group B - 358 subjects (78%) with CM: 199(56%) female and 159(44%) male. The presence of CVD abnormalities among the subjects in the different groups is shown in Picture 1. Conclusions: 1. Obesity is very prevalent disease in Sarasota County-close to 50% in our study. 2. Co morbidity superimposed on obesity did alter significantly the incidence of abnormal C2 and BP rise PME, while there was only slight increase in the incidence of CIMT abnormalities.3. Based on our data early evaluation for structural and functional cardiovascular abnormalities in obese subjects will help risk stratification and appropriate therapeutic intervention to delay or overt future catastrophic events

The Indispensable Value of Clinical Trials in the Modernization of Traditional Chinese Medicine: 12 Years' Experience at CUHK and Future Perspectives

2014 ◽  
Vol 42 (03) ◽  
pp. 587-604 ◽  
Author(s):  
Willmann Liang ◽  
David T. Yew ◽  
Kam Lun Hon ◽  
Chun Kwok Wong ◽  
Timothy C. Y. Kwok ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Chinese Medicine ◽  
Herbal Medicines ◽  
Chinese Herbs ◽  
Protective Effects ◽  
Beneficial Effects ◽  
Artery Disease ◽  
The Many

The last decade has seen a wealth of information reporting the beneficial effects of Chinese herbal medicines. While a lot more studies were done using in vitro and in vivo research platforms, much fewer investigations were conducted according to evidence-based requirements in clinical settings. The Institute of Chinese Medicine at the Chinese University of Hong Kong (CUHK) has had the opportunity to collaborate with clinicians over the years to initiate and conduct dozens of clinical trials investigating and verifying the therapeutic values of Chinese herbs in selected disease conditions. Of the many disorders, we chose to focus on those that are known for their difficulties achieving perfect results with conventional treatment methods. Examples include non-healing ulcers, allergic conditions, degenerative diseases and cancer. Protective effects of the herbs in such chronic diseases as coronary artery disease and osteoporosis were also part of our focus. Even in healthy individuals and those recovering from chemotherapy, Chinese herbs could help with the immune system and were studied in our clinical trials as well. This paper aims to highlight the important findings from these clinical studies while at the same time, stressing the indispensable value of clinical trials in modernizing the use of Chinese herbs in present-day medicine.

P6219Can too much exercise “burn” your endothelium?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Terentes-Printzios ◽  
C Vlachopoulos ◽  
D Kardara ◽  
A Anastasakis ◽  
G Vogiatzi ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Marathon Running ◽  
Vigorous Exercise ◽  
Marathon Runners ◽  
Beneficial Effects ◽  
Reduced Body ◽  
Flow Mediated Dilatation

Abstract Background/Introduction Regular aerobic exercise has beneficial effects on the cardiovascular system. Marathon running is an aerobic and extremely vigorous exercise. Endothelial function and carotid subclinical atherosclerosis are independent predictors of cardiovascular risk. Purpose We investigated the chronic alterations of these indices in marathon runners. Methods We studied 30 marathon runners and 20 age- and sex-matched recreationally active control subjects. Endothelial function was evaluated with flow-mediated dilatation of the brachial artery (FMD) and early atherosclerosis with carotid intima-media thickness (cIMT). All subjects completed analytical questionnaires about their medical history and training. Results Marathon runners had significantly higher systolic and pulse pressure compared to controls. They also had reduced body-mass index, waist to hip ratio and heart rate compared to controls (p<0.05, for all). Common cIMT was significantly lower in athletes than controls (0.56±0.11 vs. 0.63±0.07, p=0.029), while there was no difference in carotid bulb IMT between groups. FMD was higher in marathon runners compared to controls and nitrate-mediated dilatation (NMD) was similar in the two groups (9.0±3.7 vs. 6.4±1.7 and 12.6±5.7 vs. 12.3±3.4; p=0.002 and p=0.821, respectively). We also observed a reverse U-shaped curve between endothelial function and amount of exercise. (Figure) Effect of amount of exercise on FMD Conclusions Our study shows, that marathon runners have higher FMD compared to controls, indicating better vascular endothelial function, and also have lower cIMT compared to controls. Increased amount of exercise training seems to abolish the beneficial effect of exercise on endothelial function. These findings provide further insights in the effects of marathon running on endothelial function and carotid atherosclerosis.

Effects of magnesium supplementation on carotid intima–media thickness and metabolic profiles in diabetic haemodialysis patients: a randomised, double-blind, placebo-controlled trial

2019 ◽  
Vol 121 (7) ◽  
pp. 809-817 ◽  
Author(s):  
Hamid Reza Talari ◽  
Mehrafrouz Zakizade ◽  
Alireza Soleimani ◽  
Fereshteh Bahmani ◽  
Amir Ghaderi ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Insulin Metabolism ◽  
Double Blind Placebo ◽  
Media Thickness ◽  
Hs Crp

AbstractThis study evaluated the effects of Mg administration on carotid intima–media thickness (CIMT), glycaemic control and markers of cardio-metabolic risk in diabetic haemodialysis (HD) patients. This randomised, double-blind, placebo-controlled clinical trial was conducted in fifty-four diabetic HD patients. Participants were randomly divided into two groups to take either 250 mg/d Mg as magnesium oxide (n27) or placebo (n27) for 24 weeks. Mg supplementation resulted in a significant reduction in mean (P<0·001) and maximum levels of left CIMT (P=0·02) and mean levels of right CIMT (P=0·004) compared with the placebo. In addition, taking Mg supplements significantly reduced serum insulin levels (β=–9·42 pmol/l; 95% CI –14·94, –3·90;P=0·001), homoeostasis model of assessment-insulin resistance (β=–0·56; 95 % CI –0·89, –0·24;P=0·001) and HbA1c (β=–0·74 %; 95 % CI –1·10, –0·39;P<0·001) and significantly increased the quantitative insulin sensitivity check index (β=0·008; 95 % CI 0·002, 0·01;P=0·002) compared with the placebo. In addition, Mg administration led to a significant reduction in serum total cholesterol (β=–0·30 mmol/l; 95% CI –0·56, –0·04;P=0·02), LDL-cholesterol (β=–0·29 mmol/l; 95% CI –0·52, –0·05;P=0·01), high-sensitivity C-reactive protein (hs-CRP) (P<0·001) and plasma malondialdehyde (MDA) (P=0·04) and a significant rise in plasma total antioxidant capacity (TAC) levels (P<0·001) compared with the placebo. Overall, we found that taking Mg for 24 weeks by diabetic HD patients significantly improved mean and maximum levels of left and mean levels of right CIMT, insulin metabolism, HbA1c, total cholesterol and LDL-cholesterol, hs-CRP, TAC and MDA levels.

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