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CPP : Cardiovascular Prevention and Pharmacotherapy

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Most-read articles are from the articles published in 2021 during the last three month.

Special Article
Inflammation in Metabolic Diseases and Insulin Resistance
Won-Young Lee
Cardiovasc Prev Pharmacother. 2021;3(2):31-37.   Published online April 30, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e5
  • 14,274 View
  • 13 Download
Abstract PDF
Increased inflammation and insulin resistance are commonly observed in obesity and diabetes. Inflammatory mediators secreted by the adipose tissue contribute to the pathogenesis of diabetes and cardiovascular diseases. Free fatty acids and pro-inflammatory cytokines from adipose tissue inhibit the intracellular insulin signaling pathway, further contributing to the progression of diabetes. Meta-analysis studies show that high sensitivity C-reactive protein can be used as a predictor of future all-cause mortality, including cardiovascular and cancer mortality. In addition to the discovery of novel therapeutic methods targeting inflammatory mediators, basic lifestyle interventions, such as regular exercise, healthy eating, and proper weight control, are absolutely crucial for reducing inflammation and preventing mortality.
Review Article
Adverse effects of statin therapy and their treatment
Dae Young Cheon, Sang-Ho Jo
Cardiovasc Prev Pharmacother. 2022;4(1):1-6.   Published online January 20, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e4
  • 3,925 View
  • 196 Download
Abstract PDF
Statins are one of the most widely used drugs worldwide as first-line drugs for the treatment of hyperlipidemia and the prevention and treatment of cardiovascular diseases. Most of the side effects of statins are known to be mild, and mainly hepatotoxicity and various muscle symptoms are known. Recently, there have been studies on concerns about an increase in the incidence of diabetes after using statins, but it was found that the benefits sufficiently outweigh the risk of side effects. Therefore, the use of statins in the appropriate group should be actively performed, and it seems that the side effects can be prevented through close physical observation and appropriate examination.
Original Article
Development of a predictive model for the side effects of liraglutide
Jiyoung Min, Jiwon Shinn, Hun-Sung Kim
Cardiovasc Prev Pharmacother. 2022;4(2):87-93.   Published online April 27, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e12
  • 1,514 View
  • 26 Download
  • 1 Citations
Abstract PDFSupplementary Material
Background
Liraglutide, a drug used for the management of obesity, has many known side effects. In this study, we developed a predictive model for the occurrence of liraglutide-related side effects using data from electronic medical records (EMRs).
Methods
This study included 237 patients from Seoul St. Mary's Hospital and Eunpyeong St. Mary's Hospital who were prescribed liraglutide. An endocrinologist obtained medical data through an EMR chart review. Model performance was evaluated using the mean of the area under the receiver operating characteristic curve (AUROC) with a 95% confidence interval (CI).
Results
A predictive model was developed for patients who were prescribed liraglutide. However, 37.1% to 75.5% of many variables were missing, and the AUROC of the developed predictive model was 0.630 (95% CI, 0.551–0.708). Patients who had previously taken antiobesity medication had significantly fewer side effects than those without previous antiobesity medication use (20.7% vs. 41.4%, P<0.003). The risk of side effect occurrence was significantly higher in patients with diabetes than in patients without diabetes by 2.389 times (odds ratio, 2.389; 95% CI, 1.115–5.174).
Conclusions
This study did not successfully develop a predictive model for liraglutide-related side effects, primarily due to issues related to missing data. When prescribing antiobesity drugs, detailed records and basic blood tests are expected to be essential. Further large-scale studies on liraglutide-related side effects are needed after obtaining high-quality data.

Citations

Citations to this article as recorded by  
  • The effects and side effects of liraglutide as a treatment for obesity
    Jeonghoon Ha, Jin Yu, Joonyub Lee, Hun-Sung Kim
    Cardiovascular Prevention and Pharmacotherapy.2022; 4(4): 142.     CrossRef
Special Articles
Geriatric Considerations in the Management of Elderly Patients with Cardiovascular Diseases
Doo Soo Jeon
Cardiovasc Prev Pharmacother. 2021;3(2):38-46.   Published online April 30, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e6
  • 2,160 View
  • 36 Download
  • 1 Citations
Abstract PDF
Cardiovascular disease (CVD) is the most frequently diagnosed disease as well as the leading cause of death in the elderly. It usually results from long-term effects of cardiovascular risk factors as well as the aging process itself. Elderly people commonly have geriatric syndrome, which is an age-specific problem that is complicated by the presence of cardiovascular, cognitive, and physical dysfunction and is accompanied by many other chronic diseases. While caring for the elderly, in addition to CVD, various inherent problems must be considered. The patient-centered approach, instead of evidence-based guidelines that are designed for young adult patients, is the most important concept when it comes to elderly patients with CVD and multiple comorbidities. This approach should be used to maintain the functionality, independence, quality of life, and dignity of these patients.

Citations

Citations to this article as recorded by  
  • Assessment of Quality of Life in Patients With Cardiovascular Disease Using the SF-36, MacNew, and EQ-5D-5L Questionnaires
    Aikaterini Chatzinikolaou, Stergios Tzikas, Maria Lavdaniti
    Cureus.2021;[Epub]     CrossRef
Tafamidis for Cardiac Transthyretin Amyloidosis
Darae Kim, Jin-Oh Choi, Eun-Seok Jeon
Cardiovasc Prev Pharmacother. 2021;3(1):1-9.   Published online January 31, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e1
  • 1,873 View
  • 31 Download
  • 1 Citations
Abstract PDF
Transthyretin amyloid (ATTR) cardiomyopathy is a progressive disease caused by the infiltration of ATTR fibrils in the myocardium. Although it is a rare disease, ATTR cardiomyopathy is an important cause of heart failure with preserved ejection fraction, and its incidence is increasing due to improved diagnostic imaging tools. There has been a breakthrough in the field of transthyretin amyloidosis, which opens a new therapeutic door for the patients. In this review, an overview of tafamidis therapy in ATTR cardiomyopathy with recent results from clinical trials will be discussed.

Citations

Citations to this article as recorded by  
  • Multimodal Imaging and Biomarkers in Cardiac Amyloidosis
    Mi-Hyang Jung, Suyon Chang, Eun Ji Han, Jong-Chan Youn
    Diagnostics.2022; 12(3): 627.     CrossRef
Review Articles
Antiplatelet Therapy for Secondary Stroke Prevention in Patients with Ischemic Stroke or Transient Ischemic Attack
Kyung-Yul Lee
Cardiovasc Prev Pharmacother. 2021;3(4):86-94.   Published online October 31, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e10
  • 2,047 View
  • 54 Download
Abstract PDF
The risk of stroke recurrence is highest in the acute phase after transient ischemic attack (TIA) or ischemic stroke. Therefore, patients with TIA or ischemic stroke should be treated with antiplatelet medication for stroke prevention. The short-term use of dual antiplatelet therapy between 21 and 90 days may be considered in those with acute minor stroke or TIA and highrisk of recurrence. However, the long-term use of dual antiplatelet therapy is not recommended due to the risk of bleeding. The current stroke guideline does not specify the administration of an antiplatelet for the secondary prevention of ischemic stroke. However, as clinical studies progress, antiplatelet therapy may become a personalized treatment in the future.
Blood pressure control in hypertensive disorders of pregnancy
Helsi Rismiati, Hae-Young Lee
Cardiovasc Prev Pharmacother. 2022;4(3):99-105.   Published online July 29, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e16
  • 1,078 View
  • 48 Download
  • 1 Citations
Abstract PDF
Hypertension is a major cause of maternal morbidity and occurs as a complication in up to one in ten pregnancies. Hypertensive disorders of pregnancy encompass gestational hypertension, preeclampsia, chronic hypertension, and chronic hypertension with superimposed preeclampsia. However, the management of hypertensive disorders of pregnancy remains a matter of debate, particularly the blood pressure thresholds and targets for managing hypertension in pregnancy. Previously, there was no clear evidence of the effectiveness of aggressive blood pressure control in pregnancy due to the risk of fetal growth restriction. Recent clinical trials have shown that aggressive control of blood pressure in pregnant women is safe for both the mother and fetus. The purpose of this paper is to present a clinically oriented guide to the drugs of choice in patients with hypertension during pregnancy, present contrasts among different guidelines and recent clinical trials, and discuss the blood pressure thresholds and targets for hypertension during pregnancy based on recent studies.

Citations

Citations to this article as recorded by  
  • Combined Effects of Methyldopa and Baicalein or Scutellaria baicalensis Roots Extract on Blood Pressure, Heart Rate, and Expression of Inflammatory and Vascular Disease-Related Factors in Spontaneously Hypertensive Pregnant Rats
    Michał Szulc, Radosław Kujawski, Przemysław Ł. Mikołajczak, Anna Bogacz, Marlena Wolek, Aleksandra Górska, Kamila Czora-Poczwardowska, Marcin Ożarowski, Agnieszka Gryszczyńska, Justyna Baraniak, Małgorzata Kania-Dobrowolska, Artur Adamczak, Ewa Iwańczyk-S
    Pharmaceuticals.2022; 15(11): 1342.     CrossRef
Perioperative Management of Hypertensive Patients
Helsi Rismiati, Hae-Young Lee
Cardiovasc Prev Pharmacother. 2021;3(3):54-63.   Published online July 31, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e7
  • 1,539 View
  • 123 Download
Abstract PDF
Due to the high prevalence of hypertension, hypertensive patients undergo perioperative evaluation and management. Severe hypertension may increase the operative risk. However, hypertension with a diastolic blood pressure of less than 110 mmHg usually does not appear to increase the risk. In general, it is recommended that oral antihypertensive drugs be continued before and after surgery. In particular, sympathetic blockers, such as beta-blockers, should be maintained. It is generally recommended to continue intake of calcium channel blockers, especially for surgeries with a low bleeding risk. However, in the case of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, it is recommended that they be stopped 24 hours before surgery because they can inhibit excessive compensatory renin-angiotensin activation during surgery. Statin and aspirin medications are often prescribed for patients with hypertension. It is recommended to continue intake of statins in the perioperative period. Aspirins are recommended for low-risk patients undergoing noncardiac surgery.
Severe hypoglycemia as a risk factor for cardiovascular outcomes in patients with type 2 diabetes: is it preventable?
Seung-Hyun Ko
Cardiovasc Prev Pharmacother. 2022;4(3):106-113.   Published online July 29, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e13
  • 1,143 View
  • 10 Download
Abstract PDF
Hypoglycemia in people with type 2 diabetes mellitus (T2DM) is troublesome and an important barrier to diabetes management. Although more intensive glycemic control is emphasized to prevent diabetes-related long-term complications, it raises the risk of hypoglycemia in people with T2DM. Severe hypoglycemia (SH), defined as critical events characterized by altered mental and/or physical status requiring assistance for recovery, is considered an advanced and life-threatening form of hypoglycemia. The detection of SH is an important issue because it is associated with further adverse clinical outcomes such as cardiovascular events, mortality, cognitive impairment, and decreased quality of life. By identifying the potential risk factors for SH and introducing measures to minimize SH, SH itself and subsequent harmful clinical outcomes could be prevented in people with T2DM. The traditional risk factors for SH in T2DM, such as older age, long-standing diabetes with decreased insulin secretion, advanced vascular complications, serious comorbidities, and insulin use, are usually unmodifiable. However, unhealthy lifestyle factors, defined as current smoking, heavy alcohol consumption, and lack of regular exercise, can be improved through active patient education. In recent research, greater adherence to healthy lifestyle factors and any improvement in unhealthy lifestyle habits were found to be associated with a substantially lower risk of SH in individuals with T2DM. As well as being an essential component of diabetes self-care and optimal glycemic control, lifestyle modification probably contributes to the prevention of SH in individuals with T2DM.
Original Article
Public awareness of cardiovascular disease prevention in Korea
Eunji Kim, Chan-Hee Jung, Eun-Jung Rhee, Junghyun Noh, Jae Hyuk Lee, Hun-Jun Park, Sungha Park, Sang-Hyun Ihm, Won-Young Lee, Hyeon Chang Kim
Cardiovasc Prev Pharmacother. 2022;4(4):149-157.   Published online October 26, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e20
  • 570 View
  • 7 Download
Abstract PDFSupplementary Material
Background
The burden of cardiovascular disease (CVD) is significant in Korea. Ultimately, public knowledge and awareness of CVD risk factors and prevention are essential to reduce its burden. Hence, this study aimed to examine the level of public awareness of CVD risk factors and prevention in Korea in 2022.
Methods
We used data from the Cardiovascular Disease Prevention Awareness Survey conducted by the Korean Society of Cardiovascular Disease Prevention in June 2022. Using a structured web-based questionnaire, 2,000 individuals aged 20 years or more were surveyed on computers or mobile devices. Information on sociodemographic characteristics, the presence of cardiometabolic disease, CVD concerns and self-assessed likelihood, and awareness of CVD prevention were analyzed.
Results
Cancer (44.3%) was the most feared disease, followed by CVD (19.5%). Nevertheless, most respondents stated that they were likely to develop CVD in their lifetime (67.4%). Only 9.2% of respondents were aware of the details of recommendations to prevent CVD, and this level of knowledge was also low among respondents with cardiometabolic diseases (10.7%). Not smoking, being physically active, eating a healthy diet, and reducing alcohol consumption were deemed easy to implement. On the contrary, reducing stress, being physically active, and eating a healthy diet were considered the most difficult recommendations to practice.
Conclusions
Public awareness of CVD risk factors and prevention appeared to be insufficient in Korea. Our research suggests that simple but practical recommendations should be conveyed and promoted to raise public awareness, which is currently inadequate.
Review Articles
Metabolically healthy obesity: it is time to consider its dynamic changes
Yun Kyung Cho, Chang Hee Jung
Cardiovasc Prev Pharmacother. 2022;4(4):123-131.   Published online October 24, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e19
  • 557 View
  • 8 Download
Abstract PDF
Obesity reduces life expectancy, lowers quality of life, and causes numerous cardiometabolic diseases and some cancers. However, the individual risk of developing obesity-associated comorbidities is highly variable and cannot be explained only by body mass index. Observations that some obese people have a low risk for cardiometabolic disorders gave rise to the notion of metabolically healthy obesity (MHO). Despite the lack of a precise definition, MHO is typically identified by normal glucose and lipid metabolism indices, as well as the absence of hypertension. In individuals with MHO, the absence of metabolic abnormalities may minimize the risk of mortality, cardiovascular diseases, chronic kidney disease, dementia, and cancer, compared to metabolically unhealthy individuals with obesity. However, MHO appears to be a temporary phenotype that may not confer permanent benefits to individuals with obesity, further justifying therapeutic efforts to maintain metabolic fitness. In this review, we describe the traits of the MHO phenotype, its changeable nature, and the factors associated with phenotype change. In addition, we discuss the clinical outcomes of the MHO phenotype, particularly focusing on the transition of metabolic health over time and its effect on cardiometabolic disorders. Finally, the clinical importance of maintaining metabolic health is emphasized.
The crosstalk between insulin resistance and nonalcoholic fatty liver disease/metabolic dysfunction-associated fatty liver disease: a culprit or a consequence?
Dae-Jeong Koo, Won-Young Lee
Cardiovasc Prev Pharmacother. 2022;4(4):132-141.   Published online October 20, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e17
  • 573 View
  • 14 Download
Abstract PDF
Nonalcoholic fatty liver disease (NAFLD), which has recently undergone a change in its definition and acronym to “metabolic dysfunction associated fatty liver disease (MAFLD),” is clinically significant as an increasingly prevalent independent risk factor for cardiovascular diseases. Insulin resistance is considered to be a key mechanism in the development and progression of NAFLD/MAFLD, and fatty liver disease itself may exacerbate insulin resistance. In this review, we describe the mechanisms underlying the interaction between insulin resistance and fatty liver, and we summarize the therapeutic attempts based on those mechanisms.
Original Article
Effects of exercise on reducing diabetes risk in Korean women according to menopausal status
Jung-Hwan Cho, Hye-Mi Kwon, Se-Eun Park, Ju-Hwan Yoo, Kyung-Do Han, Eun-Jung Rhee, Won-Young Lee
Cardiovasc Prev Pharmacother. 2022;4(2):75-86.   Published online April 21, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e8
  • 1,175 View
  • 18 Download
Abstract PDF
Background
Exercise and estrogen play key roles in preventing diabetes and obesity. Women’s risk of diabetes could increase due to the loss of the protective effect of estrogen after menopause. Therefore, we investigated the relationship of the intensity and frequency of exercise with diabetes risk in Korean women.
Methods
Hazard ratios (HRs) for the development of diabetes were analyzed in 926,807 premenopausal and 1,188,346 postmenopausal women without diabetes over the age of 40 who underwent the Korean National Health Examination in 2009 and were followed up until 2018. The number of days of physical activity according to exercise intensity and metabolic equivalent of task-minutes per week (MET-min/wk) were calculated.
Results
In total, 38,096 premenopausal (4.1%) and 120,605 postmenopausal (10.2%) women were newly diagnosed with diabetes. Regardless of menopausal history, the risk of diabetes was significantly lower in groups with higher MET-min/wk than in sedentary participants (0 MET-min/wk, reference), although this effect disappeared in postmenopausal women with the highest level of MET-min/wk (MET-min/wk ≥1,500) after adjusting for all variables (HR, 1.0; 95% confidence interval, 0.97–1.02). Participants who exercised for more than 1 day per week had a significantly lower risk of diabetes, regardless of the intensity. However, this benefit was lost in women with near-daily exercise (≥6 days/wk).
Conclusions
Exercise was effective in preventing diabetes in both premenopausal and postmenopausal women. A moderate amount of exercise should be actively encouraged to lower the risk of diabetes in women, especially after menopause, while simultaneously considering the insignificant benefits of excessive exercise.
Review Articles
Polygenic risk score: a useful clinical instrument for disease prediction and risk categorization
Jae-Seung Yun
Cardiovasc Prev Pharmacother. 2022;4(1):13-17.   Published online January 21, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e7
  • 1,817 View
  • 83 Download
Abstract PDF
Genetic information is one of the essential components of precision medicine. Over the past decade, substantial progress has been made, such as low-cost, high-throughput genotyping arrays, advances in statistical techniques, and progressively larger discovery datasets, enabling the discovery of alleles contributing to common diseases, such as coronary artery disease and type 2 diabetes. The polygenic risk score (PRS) represents the aggregate contribution of numerous common genetic variants, individually conferring small to moderate effects, and can be used as a marker of genetic risk for major chronic diseases. PRSs can be obtained from early childhood, and only one measurement is needed to determine the score. PRSs can potentially be used for triage of further investigations to confirm disease susceptibility and to optimize individualized preventive strategies for high-risk disease groups. We provide an overview and commentary on important advances in deriving and validating PRSs, as well as the implementation of PRSs for clinically useful purposes.
The effects and side effects of liraglutide as a treatment for obesity
Jeonghoon Ha, Jin Yu, Joonyub Lee, Hun-Sung Kim
Cardiovasc Prev Pharmacother. 2022;4(4):142-148.   Published online October 20, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e18
  • 480 View
  • 11 Download
Abstract PDF
The incidence of obesity is increasing throughout the world, including Korea. Liraglutide, the main purpose of which is glucose control, has recently gained significant attention due to its additional effect on weight loss. Liraglutide injections have been widely used as an important treatment for obese patients in Korea. In addition to weight loss, liraglutide has various other effects, such as prevention of cardiovascular disease. Despite its excellent effect on weight loss, notable side effects, such as nausea and vomiting, have also been associated with liraglutide. Despite these side effects, liraglutide has not been discontinued due to its beneficial effects on weight loss. Nonetheless, there are reports wherein patients did not experience weight loss upon taking the drug. As such, there is a possibility of liraglutide misuse and abuse. Therefore, physicians need to have a broad understanding of liraglutide and understand the advantages and disadvantages of liraglutide prescription.

CPP : Cardiovascular Prevention and Pharmacotherapy