While the adverse health risks associated with smoking have been well-documented, few studies have examined the cardiovascular outcomes associated with secondhand smoking. The purpose of the study was to assess the distributions and association of cardiovascular diseases (CVDs) in nonsmokers exposed to secondhand smoke (SHS). Data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 cycle. Self-reported smoking status and cotinine levels were used to identify exposure groups (smokers, nonsmokers, and secondhand smokers), and medical history of several cardiovascular diseases such as coronary heart diseases and stroke were also collected via self-report survey. The association between exposure to SHS and seven cardiovascular outcomes were analyzed using chi-square analysis and odd ratios (OR) with 95% confidence intervals (CIs) were calculated using two logistic regression models. The data included 5,709 subjects including 18.5% smokers, 23.6% secondhand smokers, and 57.9% nonsmokers. There was statistically significant association between exposure to SHS and only two out of seven cardiovascular outcomes, hypertension (OR 1.554, 95% CI [1.066, 2.265]) and cholesterol levels (OR 1.213, 95% CI [1.017, 1.446]). This study is one of the first to determine an association between SHS and seven cardiovascular outcomes, thus highlighting the importance of reducing SHS exposure and can be used for further research on SHS and cardiovascular health.

No description available.

La adolescencia es una etapa clave para la promoción de estilos de vida saludables, tales como el incremento de la actividad física y la mejora de la condición física. El objetivo de este estudio ha sido conocer el nivel de práctica de actividad física habitual en adolescentes y analizar su influencia en la salud, especialmente cardiovascular. Así como, diseñar y llevar a cabo un programa de intervención de mejora de la condición física y el estilo de vida en esta misma población. Se evaluó, pre-intervención, nivel de práctica de actividad física y tiempo dedicado a actividades sedentarias; y pre- y postintervención, presión arterial, frecuencia cardiaca en reposo, composición corporal, y condición física orientada a la salud. Concluimos que el nivel de práctica de actividad física de los adolescentes es bajo, asociándose los chicos a un nivel de práctica muy superior al de las chicas. El sexo tiene una alta influencia en los hábitos de práctica de actividad física, por lo que se debería tener muy en cuenta a la hora de llevar a cabo programas de intervención. Los adolescentes que practican más actividad física tienen mayor probabilidad de presentar mejor salud cardiovascular y la prevalencia de adolescentes que posee una capacidad aeróbica indicativa de riesgo cardiovascular futuro es alta, por lo que sería aconsejable realizar programas de intervención para aumentar el nivel de práctica de actividad física y de condición física de los adolescentes, especialmente en las chicas. El programa de intervención aplicado ha tenido un efecto positivo en la circunferencia de la cintura, índice cintura/cadera y porcentaje de grasa corporal; y en la forma física, en resistencia aeróbica, fuerza-resistencia y fuerza muscular, siendo estas las cualidades físicas que más nos interesaba mejorar desde el punto de vista de la salud cardiovascular. / Adolescence is a key stage to promote healthy lifestyles like increased physical activity and improved physical condition. This study aims to know the usual level of practicing physical activity among adolescents and to analyse its influence on health, particularly cardiovascular health. The other aim is to design and carry out an intervention programme to improve this population’s physical condition and lifestyle. A pre-intervention assessment was done of level of practicing physical activity and time spent on sedentary activities, and a pre- and post-intervention assessment was done of blood pressure, cardiac frequency at rest, build and physical condition in health terms. We conclude that the level of practicing physical activity is low, and males are associated with a much higher level of practice than females. Gender has a high influence on practicing physical activity habits, and should be taken into account when carrying out intervention programmes. There is a greater likelihood of presenting better cardiovascular health among adolescents who practice more physical activities. The prevalence of those adolescents with aerobic capacity indicative of future cardiovascular risk is high. Therefore, intervention programmes would be advisable to increase the level of practicing physical activity and the physical condition of adolescents, especially females. The applied intervention programme has had a positive effect on waist circumference, waist:hip ratio and percentage of body fat, and on physical fitness, aerobic resistance, force resistance and muscle strength, these being physical qualities which need improving the most from the cardiovascular health viewpoint.

The aim of this dissertation was to address several gaps in the existing literature focused on the association between levels and variability in blood pressure (BP) and cognitive functioning. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Chapter 1 synthesizes and critically analyzes the outcomes of research reporting the association between BP variability (BPV) and cognition. Fifty-five studies met eligibility criteria, including reports measuring short-term, mid-term, and long-term BPV. Despite substantial between-study heterogeneity in study characteristics, the majority of studies reported that higher systolic BPV is associated with adverse cognitive outcomes. Further, Chapter 1 identified several gaps in the existing literature. For instance, no research has investigated the association between BPV and short-term fluctuations in cognitive functioning, or the association between mid-term BPV and concurrent cognitive functioning. Building on Chapter 1, Chapter 2 used an intensive measurement design to investigate the extent to which mid-term variability in BP, recorded using home-based BP monitoring, is associated with levels and variability in cognitive functioning in a sample of community-living older adults (N=64; Mage=70.58, SD=3.5; 77% female) assessed twice daily over a two-week period. Partial correlation coefficients estimated the association between BPV and variability in several ambulatory cognitive assessments, accounting for the learning effect during the study protocol, while multi-level models (MLMs) estimated the association between BPV and concurrent cognitive functioning. In addition, MLMs examined the extent to which BP and cognitive functioning fluctuate within and between days at the intraindividual and interindividual levels. Findings suggest that more BPV may be associated with slower or more variable reaction time, while higher BP may be associated with worse performance on accuracy tasks. / Graduate / 2022-08-30

No description available.

No description available.

Pulse wave velocity (PWV) and augmentation index (AI) are independent predictors of cardiovascular health. However, the comparability of multiple oscillometric modalities currently available for their assessment was not studied in detail. In the present study, we aimed to evaluate the relationship between indices of arterial stiffness assessed by diastolic and suprasystolic oscillometry. In total, 56 volunteers from the general population (23 males; median age 70 years [interquartile range: 65–72 years]) were recruited into observational feasibility study to evaluate the carotid-femoral/aortic PWV (cf/aoPWV), brachial-ankle PWV (baPWV), and AI assessed by 2 devices: Vicorder (VI) applying diastolic, right-sided oscillometry for the determination of all 3 indices, and Vascular explorer (VE) implementing single-point, suprasystolic brachial oscillometry (SSBO) pulse wave analysis for the assessment of cfPWV and AI. Within- and between-device correlations of measured parameters were analyzed. Furthermore, agreement of repeated measurements, intra- and inter-observer concordances were determined and compared for both devices. In VI, both baPWVand cfPWVinter-correlatedwell and showed good level of agreement with bilateral baPWVmeasured byVE (baPWV[VI]– baPWV[VE]R: overall concordance correlation coefficient [OCCC]¼0.484, mean difference¼1.94 m/s; cfPWV[VI]–baPWV[- VE]R: OCCC¼0.493, mean difference¼1.0m/s). In contrast, SSBO derived aortic PWA (cf/aoPWA[VE]) displayed only weak correlation with cfPWV(VI) (r¼0.196; P¼0.04) and ipsilateral baPWV (cf/ aoPWV[VE]R–baPWV[VE]R: r¼0.166; P¼0.08). cf/aoPWA(VE) correlated strongly with AI(VE) (right-sided: r¼0.725, P<0.001). AI exhibited marginal between-device agreement (right-sided: OCCC¼ 0.298, mean difference: 6.12%). All considered parameters showed good-to-excellent repeatability giving OCCC > 0.9 for 2-point-PWV modes and right-sided AI(VE). Intra- and inter-observer concordances were similarly high except for AI yielding a trend toward better reproducibility in VE (interobserver–OCCC[VI] vs [VE]¼0.774 vs 0.844; intraobserver OCCC[VI] vs [VE]¼0.613 vs 0.769). Both diastolic oscillometry-derived PWV modes, and AI measured either with VI or VE, are comparable and reliable alternatives for the assessment of arterial stiffness. Aortic PWV assessed by SSBO in VE is not related to the corresponding indices determined by traditional diastolic oscillometry.

Determinants of circulatory system diseases among the Czech population Abstract The determinants of circulatory system diseases are very well known, modifiable risk factors and factors widely spread among populations are in focus for the public health research. The aim of this thesis is a quantification of main cardiovascular risk factors in the Czech population using the survival analysis and HAPIEE cohort data. The epidemiologic situation, trends in the Czech population health including "the cardiovascular revolution" is discussed in the first part of the thesis. Among the Czech population high prevalence of many risk factors were found. The education had the strongest impact on cardiovascular health from sociodemographic characteristics. The negative effect of smoking, prevalence of high blood pressure, prevalence of diabetes and physical inactivity was confirmed. On the other hand the impact of obesity, binge drinking and high blood cholesterol level was not significant among the Czech population. The population approach in cardiovascular epidemiology and cardiovascular health promotion as well are discussed in the last chapter. Keywords: diseases of the circulatory system, mortality, health transition, cardiovascular health, risk factors, survival analysis, health promotion

A complex trait is a trait or disease that is controlled by both genetic and environmental factors, along with their interactions. Trait architecture encompasses the genetic variants and environmental causes of variation in the trait or disease, their effects on the trait or disease and the mechanism by which these factors interact at molecular and organism levels. It is important to understand trait architecture both from a biological viewpoint and a health perspective. In this thesis, I laid emphasis on exploring the influence of familial environmental factors on complex trait architecture alongside the genetic components. I performed a variety of studies to explore the architecture of anthropometric and cardio-metabolic traits, such as height, body mass index, high density lipoprotein content of blood and blood pressure, using a cohort of 20,000 individuals of recent Scottish descent and their phenotype measurements, Single Nucleotide Polymorphism (SNP) data and genealogical information. I extended a method of variance component analysis that could simultaneously estimate SNP-associated heritability and total heritability whilst considering familial environmental effects shared among siblings, couples and nuclear family members. I found that most missing heritability could be explained by including closely related individuals in the analysis and accounting for these close relationships; and that, on top of genetics, couple and sibling environmental effects are additional significant contributors to the complex trait variation investigated. Subsequently, I accounted for couple and sibling environmental effects in Genome- Wide Association Study (GWAS) and prediction models. Results demonstrated that by adding additional couple and sibling information, both GWAS performance and prediction accuracy were boosted for most traits investigated, especially for traits related to obesity. Since couple environmental effects as modelled in my study might, in fact, reflect the combined effect of assortative mating and shared couple environment, I explored further the dissection of couple effects according to their origin. I extended assortative mating theory by deriving the expected resemblance between an individual and in-laws of his first-degree relatives. Using the expected resemblance derived, I developed a novel pedigree study which could jointly estimate the heritability and the degree of assortative mating. I have shown in this thesis that, for anthropometric and cardio-metabolic traits, environmental factors shared by siblings and couples seem to have important effects on trait variation and that appropriate modelling of such effects may improve the outcome of genetic analyses and our understanding of the causes of trait variation. My thesis also points out that future studies on exploring trait architecture should not be limited to genetics because environment, as well as mate choice, might be a major contributor to trait variation, although trait architecture varies from trait to trait.

L’objectif de ce travail a été de tester l’hypothèse selon laquelle l’effet bénéfique de l’administration de la forme recombinante de l’activateur tissulaire du plasminogène (rt-PA) chez le patient victime d’un accident vasculaire cérébral (AVC) ischémique ne résulte pas uniquement de son action fibrinolytique mais aussi de sa capacité à augmenter le brain-derived neurotrophic factor (BDNF) dans le cerveau. Dans ce but, nous avons conduit une première étude visant à évaluer chez l’animal sain, l’effet du rt-PA sur les taux cérébraux de BDNF. Dans une seconde approche, nous avons étudié l’effet du rt-PA sur les taux sériques de BDNF chez le patient victime d’un AVC ischémique et chez l’animal soumis à une ischémie cérébrale focale. Le sang a été prélevé chez l’Homme à l’admission (J0), J1, J7 et J90 après l’AVC, et chez le Rat avant et après (1h, 4h et 24h) l’ischémie. Le BDNF a été mesuré dans le cerveau par technique de Western blot et dans le sang par technique ELISA. Dans les deux études le rt-PA (Actilyse®) a été administré sous forme d’un bolus suivi d’une perfusion d’une heure. La première étude montre que 1) le rt-PA augmente les taux de BDNF dans l’hippocampe, 2) le traitement par MK801 (un antagoniste des récepteurs NMDA) mais pas par l’acide tranexamique (un inhibiteur de la plasmine) annule l’effet du rt-PA sur les taux de BDNF. La deuxième étude met en évidence que 1) la récupération neurologique est meilleure chez les patients recevant le rt-PA, 2) le traitement par rt-PA augmente les taux sériques de BDNF à J1 et J7 chez l’Homme, mais ne modifie pas les taux sanguins de BDNF chez l’animal, 3) les taux de BDNF ne sont pas corrélés à la récupération neurologique mais sont inversement corrélés au score cardiovasculaire du patient. En conclusion, nos résultats suggèrent que le rt-PA peut exercer un effet protecteur extra-fibrinolytique en augmentant les taux de BDNFm par une potentialisation de l’activité glutamatergique. Même si le rt-PA induit une meilleure récupération neurologique et augmente les taux circulants de BDNF chez les patients victimes d’un AVC, l’absence de corrélation entre ces deux paramètres n’est pas en faveur de l’utilisation du BDNF circulant comme un marqueur prédictif de récupération neurologique, mais pourrait être un reflet de la capacité de l’endothélium à sécréter le BDNF. / Our objective was to test the hypothesis that the beneficial effect of the administration of the recombinant form of tissue plasminogen activator (rt-PA) in ischemic stroke patient not only results from its fibrinolytic activity but also from its ability to increase brain-derived neurotrophic factor (BDNF) in the brain. To this end, we conducted an initial study to evaluate the effect of rt-PA on brain BDNF levels in healthy animals. In a second study, we investigated the effect of rt-PA on serum BDNF levels in ischemic stroke patients and in animals subjected to permanent focal cerebral ischemia. Blood samples were obtained from patient on admission (D0), D1, D7 and D90 after stroke and in rats before and after (1h, 4h and 24h) ischemia. BDNF was measured in the brain by Western blot and in the blood by ELISA. In both studies, the rt-PA (Actilyse®) was administered as a bolus followed by an infusion of one hour. The first study evidences that 1) rt-PA increases the BDNF levels in the hippocampus, 2) treatment with MK801 (a NMDA receptor antagonist) but not with tranexamic acid (a plasmin inhibitor) canceled the effect of rt-PA on BDNF levels. The second study exhibits that 1) neurological recovery was higher in the patients receiving rt-PA, 2) treatment with rt-PA increases serum BDNF at D1 and D7 in patients, but does not change the blood BDNF levels in animals, 3) BDNF levels are not correlated with neurological recovery but are inversely correlated to the patient cardiovascular score. In conclusion, our results suggest that rt-PA may have a protective extra-fibrinolytic effect by increasing in BDNF levels through a potentiation of glutamatergic pathway. Although rt-PA induces a better neurological recovery and increases circulating BDNF levels in stroke patients, the lack of correlation between these two parameters is not in favor of using circulating BDNF as a predictive marker of neurological recovery, but could be a reflect of the endothelium ability to synthesize BDNF.