In the past 2 decades, a high prevalence of risk factors for cardiovascular disease, such as obesity, physical inactivity, and poor diet, has been observed among young individuals living in developed ...countries. The rate of substance abuse (opioids, cocaine, electronic cigarettes, and anabolic steroids) is also increasing among young adults, whereas cigarette smoking might be declining. Among younger individuals (aged 18-50 years), the incidence of cardiovascular diseases over the same time period has either been steady or has increased, in contrast to the trend towards a lower incidence of cardiovascular disease in adults aged >50 years. Current observations might, therefore, be used to forecast a potential epidemic of cardiovascular disease in the near future as the younger segment of the population ages. In this Review, we discuss the burden of risk factors for ischaemic heart disease, heart failure, atrial fibrillation, and sudden cardiac death among young adults aged 18-45 years. Furthermore, we discuss the prevalence, incidence, and temporal trends of various cardiovascular diseases among this young segment of the population.
Summary On Sept 29, 2013, the Framingham Heart Study will celebrate 65 years since the examination of the first volunteer in 1948. During this period, the study has provided substantial insight into ...the epidemiology and risk factors of cardiovascular disease. The origins of the study are closely linked to the cardiovascular health of President Franklin D Roosevelt and his premature death from hypertensive heart disease and stroke in 1945. In this Review we describe the events leading to the foundation of the Framingham Heart Study, and provide a brief historical overview of selected contributions from the study.
The Framingham Heart Study (FHS) has conducted seminal research defining cardiovascular disease (CVD) risk factors and fundamentally shaping public health guidelines for CVD prevention over the past ...five decades. The success of the Original Cohort, initiated in 1948, paved the way for further epidemiological research in preventive cardiology. Due to the keen observations suggesting the role of shared familial factors in the development of CVD, in 1971 the FHS began enroling the second generation cohort, comprising the children of the Original Cohort and the spouses of the children. In 2002, the third generation cohort, comprising the grandchildren of the Original Cohort, was initiated to additionally explore genetic contributions to CVD in greater depth. Additionally, because of the predominance of White individuals of European descent in the three generations of FHS participants noted above, the Heart Study enrolled the OMNI1 and OMNI2 cohorts in 1994 and 2003, respectively, aimed to reflect the current greater racial and ethnic diversity of the town of Framingham. All FHS cohorts have been examined approximately every 2-4 years since the initiation of the study. At these periodic Heart Study examinations, we obtain a medical history and perform a cardiovascular-focused physical examination, 12-lead electrocardiography, blood and urine samples testing and other cardiovascular imaging studies reflecting subclinical disease burden.The FHS has continually evolved along the cutting edge of cardiovascular science and epidemiological research since its inception. Participant studies now additionally include study of cardiovascular imaging, serum and urine biomarkers, genetics/genomics, proteomics, metabolomics and social networks. Numerous ancillary studies have been established, expanding the phenotypes to encompass multiple organ systems including the lungs, brain, bone and fat depots, among others. Whereas the FHS was originally conceived and designed to study the epidemiology of cardiovascular disease, it has evolved over the years with staggering expanded breadth and depth that have far greater implications in the study of the epidemiology of a wide spectrum of human diseases. The FHS welcomes research collaborations using existing or new collection of data. Detailed information regarding the procedures for research application submission and review are available at http://www.framinghamheartstudy.org/researchers/index.php.
A comprehensive study on classifying the aerosol types and absorbing aerosol types, and quantifying the effect of absorbing aerosols on aerosol optical and radiative properties using four years ...(2015–2016, 2018–2019) of high-quality Aerosol Robotic Network (AERONET) datasets over Kanpur (urban) and Gandhi College (rural) in the Indo-Gangetic Plain (IGP) region is conducted on a seasonal scale, for the first time. Biomass burning (BB), urban-industrial, and mixed aerosol types are always present, whereas dust aerosol and mostly dust absorbing aerosol types are only present in pre-monsoon and monsoon seasons. During winter and post-monsoon seasons, BB aerosols and mostly black carbon (MBC) absorbing aerosols dominate, and the contribution of aerosol optical depth (AOD) and single scattering albedo (SSA) corresponding to MBC to total AOD and SSA are higher. SSA for MBC varies over a broader range due to mixing of BC with water-soluble aerosols. During pre-monsoon and monsoon seasons, mixing of dust with anthropogenic aerosols increases the amount of mixed aerosol type. Surface cooling and atmospheric heating efficiency for mixed aerosols are higher than MBC and dust aerosols due to enhancement in aerosol absorption over both locations. Seasonal analysis of aerosol radiative properties showed that during winter and post-monsoon, MBC absorbing aerosols are the major contributor in controlling/influencing the total aerosol radiative forcing (ARF) and heating rate (HR). During the other seasons, each absorbing aerosol type significantly influences ARF depending on their AOD and SSA values. In addition to Kanpur and Gandhi College, data from seven other AERONET sites located at Karachi, Lahore, Jaipur, Lumbini, Pokhara, Bhola, and Dhaka in South Asia are analysed to conduct a regional-scale examination of aerosol optical parameters and radiative effects due to different absorbing aerosol types. As the aerosol characteristics and trends are similar over these sites, the findings from such a regional-scale analysis can be an appropriate representative for the South Asian region. The regional analysis revealed that the annual mean atmospheric ARF (ARFATM) and ARF efficiency (ARFEATM), and HR are higher for MBC, followed by mixed and MD aerosols over South Asia due to higher AOD, and higher absorbing efficiency of MBC aerosols. In comparison, mixed aerosols exhibit higher ARFATM over East Asia. This quantification of absorbing aerosol types over a global aerosol hotspot will be useful for an accurate quantification of climate impacts of aerosols.
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•Impact of absorbing aerosols on radiative forcing is quantified over South Asia.•Mostly black carbon (BC) and mixed (BC + dust) absorbing aerosols are always present.•Spectral aerosol optical properties vary significantly for absorbing aerosol types.•Enhancement in the absorption of mixed aerosol type over Kanpur and Gandhi College.•Mostly BC type is major contributor to aerosol-induced heating rate over South Asia.
The sixth assessment report released by the Intergovernmental Panel on Climate Change (IPCC) in 2021 states that our inadequate understanding of magnitudes and trends of atmospheric aerosols, ...particularly over Asia, is a major source of uncertainty in climate change. In this study, the climatology and trends in different types of aerosols with focus on absorbing aerosols over Kanpur located in the Indo-Gangetic Plain (IGP) in South Asia and Beijing in the North China Plain (NCP) in East Asia are derived for the first time. We perform a first analysis of high-quality time series of columnar aerosols observations over a period of nearly two-decades, along with satellite observations to provide a broader regional perspective. The satellite retrieved aerosol Ångström exponent (AE) values have increased (10–20%) suggesting an increasing contribution of fine aerosols to aerosol optical depth (AOD) over Asia in last 2-decades. Among the three aerosol types urban-industrial (UI), biomass burning (BB), and dust (DU), only UI and BB aerosols are present over Kanpur throughout the year, while DU is present along with UI and BB aerosols only during pre-monsoon and monsoon. Overall, there is a positive trend in BB aerosols over both Kanpur and Beijing, a positive (negative) trend in UI aerosols over Kanpur (Beijing), and positive (negative) trend in dust over Beijing (Kanpur). However, only the positive trend in BB aerosol type over Kanpur is statistically significant. Further, among the three absorbing aerosol types mostly black carbon (MBC), mostly dust (MDU), and mixed (MIX) containing BC and dust, only MBC and MIX are present in post-monsoon and winter over IGP, and MDU is present along with MBC and MIX only during pre-monsoon and monsoon, which is in agreement with aerosol types found. Trends in MBC, MIX and MDU over Kanpur in IGP and in MIX over Beijing are statistically significant. These trends are attributed mainly to the changes in anthropogenic aerosol emissions, and not to natural and climatic factors as their changes are relatively small. These findings on hitherto unavailable climatology and trends in aerosols and absorbing aerosols over two global aerosol hotspots and identified contrasts will be crucial in model simulations to better decipher the aerosol-climate interactions over Asia.
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•First time, trends in aerosol types, absorbing aerosol types over Asia are analyzed.•Biomass burning aerosol type exhibits a positive trend over South and East Asia.•Urban/industrial aerosol type shows positive (negative) trend over South (East) Asia.•Absorbing aerosol types (BC, dust and mix) show statistically significant trends.•Changes in anthropogenic emissions reason for trends not natural or climatic factors.
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•Contribution of BC, BrC and dust to aerosol absorption over Himalayas quantified.•SSA over Kathmandu is the lowest of all the locations in Himalayas.•SSA decreases with increasing ...elevation in the Himalayas.•BC dominates (≥75%) the aerosol absorption over the IGP and the Himalayas.•Aerosol absorption over South Asia is very high, compared to East Asia.
This study, based on new and high quality in situ observations, quantifies for the first time, the individual contributions of light-absorbing aerosols (black carbon (BC), brown carbon (BrC) and dust) to aerosol absorption over the Indo-Gangetic Plain (IGP) and the Himalayan foothill region, a relatively poorly studied region with several sensitive ecosystems of global importance, as well as highly vulnerable populations. The annual and seasonal average single scattering albedo (SSA) over Kathmandu is the lowest of all the locations. The SSA over Kathmandu is < 0.89 during all seasons, which confirms the dominance of light-absorbing carbonaceous aerosols from local and regional sources over Kathmandu. It is observed here that the SSA decreases with increasing elevation, confirming the dominance of light absorbing carbonaceous aerosols at higher elevations. In contrast, the SSA over the IGP does not exhibit a pronounced spatial variation. BC dominates (≥75%) the aerosol absorption over the IGP and the Himalayan foothills throughout the year. Higher BC concentration at elevated locations in the Himalayas leads to lower SSA at elevated locations in the Himalayas. The contribution of dust to aerosol absorption is higher throughout the year over the IGP than over the Himalayan foothills. The aerosol absorption over South Asia is very high, exceeding available observations over East Asia, and also exceeds previous model estimates. This quantification will be valuable as observational constraints to help improve regional simulations of climate change, impacts on the glaciers and the hydrological cycle, and will help to direct the focus towards BC as the main contributor to aerosol-induced warming in the region.
Purpose of Review
Given that the life expectancy and the burden of hypertension are projected to increase over the next decade, hypertensive heart disease (HHD) may be expected to play an even more ...central role in the pathophysiology of cardiovascular disease (CVD). A broader understanding of the features and underlying mechanisms that constitute HHD therefore is of paramount importance.
Recent Findings
HHD is a condition that arises as a result of elevated blood pressure and constitutes a key underlying mechanism for cardiovascular morbidity and mortality. Historically, studies investigating HHD have primarily focused on left ventricular (LV) hypertrophy (LVH), but it is increasingly apparent that HHD encompasses a range of target-organ damage beyond LVH, including other cardiovascular structural and functional adaptations that may occur separately or concomitantly. HHD is characterized by micro- and macroscopic myocardial alterations, structural phenotypic adaptations, and functional changes that include cardiac fibrosis, and the remodeling of the atria and ventricles and the arterial system. In this review, we summarize the structural and functional alterations in the cardiac and vascular system that constitute HHD and underscore their underlying pathophysiology.
The 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guideline advocated several changes from the previous Adult Treatment Panel III guidelines. Assuming full ...implementation, the 2013 ACC/AHA guideline would identify ≈13 million Americans as newly eligible for consideration of statin therapy. Three features of the 2013 ACC/AHA guideline primarily responsible for these differences are the specific risk assessment tool endorsed, the risk threshold considered sufficient to warrant primary prevention statin therapy, and the decision not to include cholesterol treatment targets. There is no consensus among international guidelines on the optimal approach to these 3 components. The 2013 ACC/AHA guideline recommends assessing absolute risk with the Pooled Cohort equations, which were developed to improve on previous risk assessment models by including stroke as an outcome and by broadening racial and geographic diversity. Each of the leading international guidelines recommends a different equation for absolute risk assessment. The 2013 ACC/AHA guideline advises consideration of statin therapy for an estimated 10-year risk of atherosclerotic vascular disease of ≥7.5%, which is lower than the thresholds recommended by other leading international guidelines. Lastly, the 2013 ACC/AHA guideline does not endorse a treat-to-target strategy but instead specifies the appropriate intensity of statin for each risk category. This approach is shared by the National Institute for Health and Care Excellence guidelines but differs from other international guidelines. In this review, we summarize the 2013 ACC/AHA cholesterol guideline recommendations and compare them with recommendations from Adult Treatment Panel III and other leading international guidelines.
70-year legacy of the Framingham Heart Study Andersson, Charlotte; Johnson, Andrew D; Benjamin, Emelia J ...
Nature reviews cardiology,
11/2019, Letnik:
16, Številka:
11
Journal Article
Recenzirano
The Framingham Heart Study (FHS) was established in 1948 to improve understanding of the epidemiology of coronary heart disease (CHD) in the USA. In 1961, seminal work identified major risk factors ...for CHD (high blood pressure, high cholesterol levels and evidence on the electrocardiogram of left ventricular hypertrophy), which later formed the basis for multivariable 10-year and 30-year risk-prediction algorithms. The FHS cohorts now comprise three generations of participants (n ≈ 15,000) and two minority cohorts. The FHS cohorts are densely phenotyped, with recurring follow-up examinations and surveillance for cardiovascular and non-cardiovascular end points. Assessment of subclinical disease and physiological profiling of these cohorts (with the use of echocardiography, ambulatory electrocardiographic monitoring, exercise stress testing, cardiac CT, heart and brain MRI, serial vascular tonometry and accelerometry) have been performed repeatedly. Over the past decade, the FHS cohorts have undergone deep 'omics' profiling (including whole-genome sequencing, DNA methylation analysis, transcriptomics, high-throughput proteomics and metabolomics, and microbiome studies). The FHS is a rich, longitudinal, transgenerational and deeply phenotyped cohort study with a sustained focus on state-of-the-art epidemiological methods and technological advances to facilitate scientific discoveries.
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