Exponering för långvarig stress kan bidra till utveckling av hjärt-kärlsjukdom hos individer som också har andra riskfaktorer. Långvarig stress kan tänkas inverka på hjärt-kärlhälsa på flera olika sätt, exempelvis skulle stress kunna samvariera med beteendemässiga och biomedicinska riskfaktorer. I denna studie undersöktes samband mellan utmattningssymtom och riskfaktorer för hjärt-kärlsjukdom med fysisk aktivitet och kön som moderatorer. Beteendemässiga och biomedicinska riskfaktorer var rökning, alkoholkonsumtion, kosthållning, glukosvärde, midjemått, systoliskt blodtryck och intimamedia tjocklek (IMT). Deltagare var 880 personer 43, 53 eller 63 år bosatta i Västerbotten. Data erhölls från studien Visualization of asymptomatic Atherosclerotic disease for optimum cardiovascular prevention. Totalt gjordes sju linjära regressioner. För rökning, kosthållning, glukosvärde, midjemått och IMT hittades inga interaktionseffekter och inte heller en huvudeffekt av utmattningssymtom. För alkoholkonsumtion fanns en interaktion mellan utmattningssymtom och kön, män med mer symtom på utmattning hade också ett mer riskfyllt drickande. En huvudeffekt av utmattningssymtom för systoliskt blodtryck fanns. De med mer utmattningssymtom hade lägre blodtryck. En möjlig förklaring till att samband mellan utmattningssymtom och riskfaktorer för hjärt-kärlsjukdom inte var tydliga kan vara brist på spridning i stickprovet. Stickprovet bestod av äldre vuxna, en åldersgrupp som på populationsnivå rapporterar låg stressnivå jämfört med yngre åldersgrupper. Det är också möjligt att sambanden mellan utmattningssymtom och riskfaktorer för hjärt-kärlsjukdom inte är linjära. / Exposure to chronic stress is likely to be a contributing factor in the development of cardiovascular disease among individuals who have other risk factors. A possible link between chronic stress and cardiovascular disease is through other risk factors for cardiovascular disease, meaning that chronic stress may co-vary with both behavioral and biomedical risk factors for cardiovascular disease. The current study investigated associations between symptoms of burnout and behavioral- and biomedical risk factors for cardiovascular disease, with physical activity and sex as moderators. The behavioral- and biomedical risk factors were smoking, alcohol consumption, diet, glucose level, waist circumference, systolic blood pressure, and carotid intima-media thickness (IMT). Participants were 880 individuals in the age of 43, 53 or 63 years, living in Västerbotten, Sweden. Data were obtained from the study Visualization of asymptomatic Atherosclerotic disease for optimum cardiovascular prevention. Seven linear regression analyses were carried out. No interactions or main effects of symptoms of burnout on smoking, diet, glucose levels, waist circumference or IMT were found. Sex moderated the association between symptoms of burnout and alcohol consumption; men who reported more symptoms of burnout scored higher on the measure of alcohol consumption.Symptoms of burnout were negatively associated with systolic blood pressure. A possible explanation for the weak associations is lack of variation in symptom level of burnout in the sample. The sample consisted of older adults, who on a population basis report low level of stress compared to youngeradults. There is also the possibility that potential associations between symptoms of burnout and the risk factors for cardiovascular disease are nonlinear.

The heterodimeric ATP-binding cassette (ABC) transporter, ABCG5/G8, is responsible for direct secretion of cholesterol and dietary sterols into the gut lumen and the bile. Inactivating mutations of ABCG5/G8 cause sitosterolemia, a rare autosomal recessive disease characterized by the accumulation of plant sterols in plasma, hypercholesterolemia and development of premature coronary heart disease. Functional and structural characterization of ABCG5/G8 is necessary to understand its mechanism and how the genetic defects impact its function. In this thesis, I expressed seventeen constructs of various disease-causing or catalytically deficient missense mutations in Pichia pastoris yeast. This establishes reagents for in vitro functional and structural studies. Secondly, I focused on two disease mutants (ABCG5-E146Q and ABCG8-R543S) and a sterol binding mutation (ABCG5-A540F) and established large-scale purification of these mutants. Using a cholesterol hemisuccinate (CHS)-dependent ATPase assay, I determined ATP hydrolysis by these three mutants and analyze their kinetic parameters. All missense mutants showed a significantly impaired ATPase activity, but the ability of ATP binding appeared unchanged between the WT and the mutants. This work demonstrates an intimate structure-function relationship in ABCG5/G8 and sheds some light on the mechanistic details of this important cholesterol-regulating ABC transporter.

Cardiometabolic conditions, including hypertension, diabetes, and obesity are associated with adverse health outcomes, including increased rates of hospitalization and deaths in patients who are diagnosed with COVID-19. However, little to no evidence is known currently on the cardiometabolic conditions before and during the COVID-19 pandemic. This study utilizes a nationally representative sample of adults in the United States (U.S.) to estimate the prevalence of cardiometabolic conditions, focusing on diabetes, hypertension, and obesity, and determine their prevalence and absolute and relative rates before and during COVID-19 pandemic declaration. Furthermore, the study aims to determine the association between these cardiometabolic conditions and physical activity, tobacco use, anxiety/depression, and sociodemographic characteristics among U.S. adults during the COVID-19 pandemic. Data from the 2019 (N = 5359) and 2020 (N = 3830) Health Information National Trends Surveys (HINTS) on adults were utilized. Dependent variable was cardiometabolic conditions and the main explanatory variable was response before and during the COVID-19 pandemic. We conducted weighted descriptive and multivariable logistic regression controlling for confounders such as age, sex, and intensity of physical activity. While there was a slight increase in the prevalence of cardiometabolic conditions during the pandemic (56.09%) compared to before (54.96%), there was only a slight increase in the prevalence of diabetes (18.10% vs 17.28%) and obesity (34.68% vs 34.18%) and a slight decrease in the prevalence of hypertension (36.38% vs 36.36%). Results showed an increase in the prevalence of cardiometabolic conditions among former smokers (67.91% vs 63.86%), and current cigarette smokers (59.39% vs 55.43%), current e-cigarette users (37.24% vs 28.66%), individuals with mild (59.62% vs 55.43%), or moderate (61.98% vs 57.83%) anxiety/depression, sexual minority (53.50% vs 51.12%) and heterosexual (56.45% vs 54.96%) individuals during the pandemic, compared to before the pandemic. Additionally, people with mild anxiety/depression had higher odds of cardiometabolic conditions during the pandemic (AOR = 1.55, 95% CI = 1.01, 2.38), compared to before (AOR = 1.52, 95% CI =1.06, 2.19), relative to those without anxiety/depression. Similarly, former smokers had higher odds of cardiometabolic outcomes before and during the pandemic (AOR = 1.38, 95% CI = 1.01, 1.87 vs AOR = 1.57, 95% CI = 1.10, 2.25), when compared to never smokers. Odds were lower for current e-cigarette users (AOR = 0.44, 95% CI = 0.23, 0.85) compared to never e-cigarette users before the pandemic. There were no significant differences in odds of cardiometabolic conditions between sexual minorities and heterosexual individuals before and during the pandemic. In conclusion, increased risk for adverse cardiometabolic conditions was higher for individuals with cigarette use and mental health diagnoses during the COVID-19 pandemic, suggesting the critical need for smoking cessation and programs to support behavioral health.

Serum C-reactive protein (CRP) is used as a marker of inflammation in several diseases including autoimmune disease and cardiovascular disease. CRP, a member of the pentraxin family, is comprised of five identical subunits. CRP has diverse ligand-binding properties which depend upon different structural states of CRP. However, little is known about the molecular dynamics and interaction properties of CRP. In this study, we used SAPS, SCRATCH protein predictor, PDBsum, ConSurf, ProtScale, Drawhca, ASAView, SCide and SRide server and performed comprehensive analyses of molecular dynamics, protein-protein and residue-residue interactions of CRP. We used 1GNH.pdb file for the crystal structure of human CRP which generated two pentamers (ABCDE and FGHIJ). The number of residues involved in residue-residue interactions between A-B, B-C, C-D, D-E, F-G, G-H, H-I, I-J, A-E and F-J subunits were 12, 11, 10, 11, 12, 11, 10, 11, 10 and 10, respectively. Fifteen antiparallel β sheets were involved in β-sheet topology, and five β hairpins were involved in forming the secondary structure. Analysis of hydrophobic segment distribution revealed deviations in surface hydrophobicity at different cavities present in CRP. Approximately 33 % of all residues were involved in the stabilization centers. We show that the bioinformatics tools can provide a rapid method to predict molecular dynamics and interaction properties of CRP. Our prediction of molecular dynamics and interaction properties of CRP combined with the modeling data based on the known 3D structure of CRP is helpful in designing stable forms of CRP mutants for structure-function studies of CRP and may facilitate in silico drug design for therapeutic targeting of CRP.

Serum C-reactive protein (CRP) is used as a marker of inflammation in several diseases including autoimmune disease and cardiovascular disease. CRP, a member of the pentraxin family, is comprised of five identical subunits. CRP has diverse ligand-binding properties which depend upon different structural states of CRP. However, little is known about the molecular dynamics and interaction properties of CRP. In this study, we used SAPS, SCRATCH protein predictor, PDBsum, ConSurf, ProtScale, Drawhca, ASAView, SCide and SRide server and performed comprehensive analyses of molecular dynamics, protein-protein and residue-residue interactions of CRP. We used 1GNH.pdb file for the crystal structure of human CRP which generated two pentamers (ABCDE and FGHIJ). The number of residues involved in residue-residue interactions between A-B, B-C, C-D, D-E, F-G, G-H, H-I, I-J, A-E and F-J subunits were 12, 11, 10, 11, 12, 11, 10, 11, 10 and 10, respectively. Fifteen antiparallel β sheets were involved in β-sheet topology, and five β hairpins were involved in forming the secondary structure. Analysis of hydrophobic segment distribution revealed deviations in surface hydrophobicity at different cavities present in CRP. Approximately 33 % of all residues were involved in the stabilization centers. We show that the bioinformatics tools can provide a rapid method to predict molecular dynamics and interaction properties of CRP. Our prediction of molecular dynamics and interaction properties of CRP combined with the modeling data based on the known 3D structure of CRP is helpful in designing stable forms of CRP mutants for structure-function studies of CRP and may facilitate in silico drug design for therapeutic targeting of CRP.

Elevation in serum parathyroid hormone (PTH) often accompanies vitamin D deficiency and renal impairment. PTH elevation in renal failure is viewed as an unfavorable development. Evidence is increasing that PTH elevation may be associated with increased morbidity and mortality. In many instances these PTH effects appear to be independent of vitamin D status. PTH mediates its effects through the ubiquitous type 1 PTH/PTH-related peptide receptor, which is notably present in the cardiovascular system. Increased PTH may promote cardiovascular disease through diminished cardiac contractility, enhanced coronary risk, and cardiac valvular and vascular calcification. High PTH levels appear to be linked to the metabolic syndrome and are aligned with hyperlipidemia, decreased insulin sensitivity, and, perhaps, decreased insulin secretion. Increased PTH also is associated with neuroendocrine activation, increased sympathetic activity, and endothelial stress. The relation between PTH and vitamin D is complex and may show significant threshold variations, especially when calcium intake, age, and race are considered. Moreover, evidence is increasing that fragments of PTH may not only be hormonally active but also may have opposing effects to PTH. Despite these caveats, PTH values provide useful clinical diagnostic and prognostic information in monitoring many chronic ailments such as heart and renal failure and multiple sclerosis.

Racial disparities in cardiovascular disease (CVD) have become a matter of national concern. We investigated racial disparities and trends in glycosylated hemoglobin, high-density lipoprotein (HDL), C-reactive protein, plasma homocysteine, albuminuria, and other risk factors among 4758 diagnosed hypertensive subjects age 18 years or older from the National Health and Nutrition Examination Survey, 1999-2006. Compared with non-Hispanic whites, Hispanics, and non-Hispanic blacks were more likely to have uncontrolled blood pressure (BP) (Hispanics odds ratio [OR]: 1.58, 95% confidence interval [CI]: 1.21-2.07; blacks OR: 1.42, 95% CI: 0.21-1.67), elevated glycosylated hemoglobin (Hispanics OR: 2.70, 95% CI: 1.89-3.87; blacks OR: 2.17, 95% CI: 1.70-2.77), albuminuria (Hispanics OR: 2.36, 95% CI: 1.71-3.27; blacks OR: 1.80, 95% CI: 1.47-2.20), and less likely to have central obesity (Hispanics OR: 0.68, 95% CI: 0.51-0.91; blacks OR: 0.70, 95% CI: 0.58-0.84). Blacks had lower risks of elevated serum cholesterol (OR: 0.81, 95% CI: 0.67-0.98) and low HDL (OR: 0.76, 95% CI: 0.61-0.94) than whites. The risk of high serum homocysteine was lower in Hispanics and higher in blacks compared with whites (Hispanics OR: 0.64, 95% CI: 0.46-0.90; blacks OR: 1.36, 95% CI: 1.14-1.63). These results highlight the need for targeted interventions to aggressively treat uncontrolled BP, elevated glycosylated hemoglobin in Hispanic and black hypertensive subjects, and high serum homocysteine in blacks, to reduce disparities in CVD risk factors and CVD-associated morbidity and mortality.

Purpose of Review: Electronic cigarettes (e-cigarettes) are gaining rapid popularity among all age groups, especially among youth. They have evolved into technologically advanced devices capable of delivering nicotine concentration and other substances. In addition to nicotine, e-cigarettes’ constituents possess variety of toxic chemicals that have adverse effects on human body. Recent Findings: In recent years, steady downward trend in tobacco usage has been observed; however, e-cigarette use is on upward trend. E-cigarettes are advertised as “safer” alternatives to conventional smoking and as an aid to smoking cessation. Emerging studies have, however, shown that e-cigarettes have harmful effects on the cardiovascular system and that most of the e-cigarette users are dual users, concurrently using e-cigarettes and smoking conventional cigarettes. Summary: Despite a gap in clinical studies and randomized trials analyzing adverse cardiovascular effects of e-cigarette use, the existing literature supports that different constituents of e-cigarettes such as nicotine, carbonyls, and particulate matters carry potential risk for cardiovascular diseases (CVD) on its users.

No description available.

Bakgrund: Hjärt- och kärlsjukdomar står för en tredjedel av alla dödsfall. Sömn är ett av de mest basala behoven en människa har. Det bekräftas att patienter med hjärt- och kärlsjukdomar som lider av ortopné eller bröstsmärtor tenderar att drabbas av sömnsvårigheter. Syfte: Syftet med litteraturöversikten var att belysa sömnsvårigheter hos patienter med hjärt- och kärlsjukdomar. Metod: Genom en induktiv ansats har litteraturöversikten skapats. Sökningar i tre databaser har resulterat i åtta artiklar som skapar en innehållsanalys. Koder skapades och utformade ett resultat som svarar på valt syfte. Resultat: Utifrån artiklarna framkom tre huvudkategorier: Sömnfaktorer hos patienter med hjärt- och kärlsjukdom, Konsekvenser av sömnproblematik och Patienters strategier vid utebliven sömn. Konklusion: De vanligaste sömnstörningsfaktorerna för patientgruppen är att vakna för att gå på toaletten, ha svårigheter att somna och uppvaknanden mitt i natten. Depressiva symtom är associerade med sömnsvårigheter och hjärt- och kärlpatienter. Oro och ångest för hjärt- och kärlsjukdomens tillstånd kunde leda till sömnproblematik. Symtom som smärta och andningsproblem kunde också vara en orsak till sömnsvårigheter. / Background: Cardiovascular disease account for a third of all deaths. Sleep is one of the most basic human needs. It is confirmed that patients with cardiovascular disease, who suffer from orthopnea or chest pain, tend to have difficulty sleeping. Aim: The aim of the study was to shed light on sleep difficulties in patients with cardiovascular disease. Method: Through an inductive approach, this literature review has been created. Searches through three databases were performed, which resulted in eight articles that created the content analysis. Codes were established and whose results correspond to the purpose. Results: Based on the articles, three main categories emerged: Sleep factors in patients with cardiovascular disease, Consequences of sleep problems and Patients' strategies in the event of no sleep. Conclusion: The most common sleep disturbance factors are waking up in the middle of the night to go to the toilet, having difficulty falling asleep or just waking up in the middle of the night without a reason. Depressive symptoms are associated with difficulty sleeping in cardiovascular patients. Worry and anxiety about the condition of cardiovascular disease could lead to sleep problems. Symptoms such as pain and breathing problems could also cause difficulty sleeping.