Modern environmental and lifestyle risk factors, oxidative stress, perturbed epigenetic processes, and increasing incidence of neurodevelopmental, neurodegenerative and neurological disorders

Our goal is not to describe a single harmful environmental or lifestyle risk factor in great detail, as most scientific articles do. In contrast, we aim to point out that human beings are continuously and simultaneously exposed to countless kinds of harmful environmental and lifestyle risk factors. First, we briefly review and evaluate several environmental, technological, and lifestyle risk factors. We point out that each of these can be associated with perturbed oxidative and epigenetic processes, and the onset of various diseases, including neurodevelopmental, neurodegenerative, and neurological disorders, with a worldwide increasing prevalence. In addition, disturbed epigenetic changes by modern technological innovations and lifestyle risk factors can be inheritable to offspring and subsequent generations. Furthermore, disturbed epigenetic changes may also accumulate in the genome. Finally, diverse environmental and lifestyle risk factors may enhance vulnerability and decrease the resilience of modern humans. Keywords: Modern environmental and lifestyle risk factors, oxidative stress, perturbed epigenetic processes, neurodevelopmental, neurodegenerative and neurological disorders.

ASPIRE-3-PREVENT: a cross-sectional survey of preventive care after a coronary event across the UK

ObjectiveTo quantify the implementation of the third Joint British Societies’ Consensus Recommendations for the Prevention of Cardiovascular Disease (JBS3) after coronary event.MethodsUsing a cross-sectional survey design, patients were consecutively identified in 36 specialist and district general hospitals between 6 months and 2 years, after acute coronary syndrome or revascularisation procedure and invited to a research interview. Outcomes included JBS3 lifestyle, risk factor and therapeutic management goals. Data were collected using standardised methods and instruments by trained study nurses. Blood was analysed in a central laboratory and a glucose tolerance test was performed.Results3926 eligible patients were invited to participate and 1177 (23.3% women) were interviewed (30% response). 12.5% were from black and minority ethnic groups. 45% were persistent smokers, 36% obese, 52.9% centrally obese, 52% inactive; 30% had a blood pressure >140/90 mm Hg, 54% non-high-density lipoprotein ≥2.5 mmol/L and 44.3% had new dysglycaemia. Prescribing was highest for antiplatelets (94%) and statins (85%). 81% were advised to attend cardiac rehabilitation (86% <60 years vs 79% ≥60 years; 82% men vs 77% women; 93% coronary artery bypass grafting vs 59% unstable angina), 85% attended if advised; 69% attended overall. Attenders were significantly younger (p=0.03) and women were less likely to attend (p=0.03).ConclusionsPatients with coronary heart disease (CHD) are not being adequately managed after event with preventive measures. They require a structured preventive cardiology programme addressing lifestyle, risk factor management and adherence to cardioprotective medications to achieve the standards set by the British Association for Cardiovascular Prevention and Rehabilitation and JBS3 guidelines.