Beijing, October 20, 2016 - The Cardiovascular Innovations and Applications journal (CVIA) has just published its fourth issue, Volume 1, Issue 4, which is a Special Issue on Cardiovascular Risk Factors. Editor-in-Chief, C. Richard Conti of the University of Florida Medical School and Guest Editor, Ezra A. Amsterdam of UC Davis Health System have produced a highly informative and up-to-date critique of major clinical issues in the field of risk management.
The issue was launched to coincide with the 27th Great Wall International Congress of Cardiology (GW-ICC) which took place in Beijing on October 13-16 2016. CVIA is now the official journal of the GW-ICC.
Writing in his Introduction to the issue, Guest Editor, Ezra A Amsterdam writes:
''The collection of papers on cardiovascular risk factors in this issue of CVIA was conceived by Dr Richard Conti, editor in chief of the journal and I have been privileged to invite and work with the authors who have produced a highly informative and current critique of the major clinical issues in the field. Representing distinguished leaders in preventive cardiology in this country and Europe, their papers provide contemporary standards for the management of risk factors, illuminate controversial areas and consider future perspectives in this discipline so crucial to the reduction of cardiovascular disease burden.''
Highlighted papers for this issue are as follows:
Management of Hypertension: JNC 8 and Beyond by Ezra A. Amsterdam, Sandhya Venugopal, Jonathan Bui, Balasingam Thevakumar, Angela Thinda, Sabrina Virk, William J. Bommer, Aman Khullar, and Gagan Singh
In this paper Dr Amsterdam and co-authors consider hypertension as a leading risk factor for cardiovascular disease (CVD). Hypertension is a leading risk factor for CVD and the leading cause of death and morbidity on a global scale. Major components of CVD include stroke, coronary artery disease, heart failure, and chronic kidney disease, in all of which hypertension plays a major role. The risk of these complications increases directly and linearly with systolic blood pressure starting at 115 mmHg. Although usually asymptomatic, hypertension is readily detectable on physical examination and is amenable to both lifestyle modification and pharmacologic treatment in most patients. However, large proportions of the hypertensive population remain undetected and undertreated. Numerous guidelines have been issued during the past few decades to promote detection and optimal therapy. Despite the increase in risk with systolic blood pressure greater than 115 mmHg, the generally accepted threshold for diagnosis and treatment has been systolic blood pressure greater than 139 mmHg and diastolic blood pressure greater than 80 mmHg because until recently treatment to lower levels has been associated with an unfavorable relation between clinical benefit and harm. The long-awaited eighth report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC8) recommended patients older than 60 years be treated to a systolic blood pressure of less than 150 mmHg, which has generated considerable controversy and caution. The striking findings of the Systolic Blood Pressure Intervention Trial have received considerable attention because of the demonstration that intensive therapy to a target systolic blood pressure below 120 mmHg decreases cardiovascular mortality and morbidity more than less intensive treatment to a target systolic blood pressure below 140 mmHg. This article addresses major issues in the management of hypertension, including those in the JNC7 and JNC8 reports and subsequent studies, considering maintenance of prior standards as well as the potential application of important new findings.
In this paper, Dr La Rosa and Dr Biasucci consider the role of the human gut microbiota in cardiometabolic syndrome and atherosclerosis. Among the areas studied in this review is the role of the gut microbiota as a driver for inflammation in obesity and type 2 diabetes mellitus. The writers also consider the role of the gut microbiota and atherothrombosis, looking at the proatherogenic effects and the antiatherogenic effects. The authors conclude ''Different bacterial species play a pivotal role in this complex relationship, leading either to metabolic syndrome or a lean phenotype. Recent observational and interventional studies confirm a potent correlation among diets rich in choline and trimethylamines, altered gut microbiota composition, probiotics and anthocyanin metabolism and cardiovascular disease.''
In this paper, Dr Estel and Dr Conti explore the growth of cardiovascular disease (CVD) as the number one cause of mortality world-wide with a particular emphasis on the high medical and socio-economic burden it imposes on developing countries. The authors write '' Reasons for the increased rate of CVD in the developing world include rapid urbanization and the demographic shift known as the modern epidemiologic transition. The case for intervention is based on both major human and economic impacts of CVD. It has been estimated that cost-effective interventions in developing countries with a high burden of CVD could result in a projected 24 million lives saved. This reduction in CVD mortality could reduce economic costs by $8 billion. Approaches to intervention include: 1) cardiovascular health promotion and CVD prevention and 2) action plans advocated by the World Health Organization.''
Other papers in this issue are:
Primary Prevention of Cardiovascular Disease
Authors: Eapen, Danny J.; Schultz, William M.; Heinl, Robert E.; Ghasemzadeh, Nima; Varghese, Tina; Kurian, Diana E.; Mathai, Christina E.; Sandesara, Pratik; Kindya, Bryan R.; Allard-Ratick, Marc P.; Bhatia, Neal K.; Isiadinso, Ijeoma; Sperling, Laurence
Smoking and Passive Smoking
Author: Luepker, Russell V.
Inflammasomes and Atherosclerosis
Authors: Vallurupalli, S.; Dai, Yao; Mehta, J. L.
Outcome Trials in the Therapeutic Management of Hypertension in East Asians
Authors: Wang, Ji-Guang; Li, Yan
What Do We Mean by "Preventive Medicine"?
Author: Conti, C. Richard
About the journal: CVIA is available on the IngentaConnect platform and at http://cvia-journal.