Nutrition, Metabolism & Cardiovascular Diseases RSS feed: Current Issue. Nutrition, Metabolism & Cardiovascular Diseases is a forum designed to focus on the powerful interplay between nutritional and metabolic alterations, and cardiovascular disorders. It aims to be a highly qualified tool to help refine strategies against the nutrition-related epidemics of metabolic and cardiovascular diseases. By presenting original clinical and experimental findings, it introduces readers and authors into a rapidly developing area of clinical and preventive medicine, including also vascular biology. Of particular concern are the origins, the mechanisms and the means to prevent and control diabetes, atherosclerosis, hypertension, and other nutrition-related diseases. 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All rights reserved. healthpermissions@elsevier.comhttp://www.nmcd-journal.com/article/PIIS0939475310001432/abstract?rss=yesEditorial Board10.1016/S0939-4753(10)00143-2Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-07-01Nutrition, Metabolism & Cardiovascular Diseases2010-07-01206S0939-4753(10)X0006-0IFCIFChttp://www.nmcd-journal.com/article/PIIS0939475310000463/abstract?rss=yesThe health outlook for women throughout the world has changed dramatically over the past century. In most countries lifespan has increased and the risk of death from parturition or infections has decreased. However, accompanying these improvements, especially in westernized and developing countries, has been an increase in rates and mortality from cardiovascular disease (CVD). CVD is clearly the leading cause of morbidity and mortality for women in North America and Europe, and it is a major cause of death for women in Asia, the Middle East, and Latin America. In these regions there appear to be some ethnic differences, such as the contrast between Central and East Asia, but in most cases women with higher rates tend to be those living in urban areas. There are limited data from Africa, but it is likely that this same trend exists in many African countries.IntroductionBarbara V. Howard, Marja-Riitta Taskinen10.1016/j.numecd.2010.02.011Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-07-07Nutrition, Metabolism & Cardiovascular Diseases2010-07-07206S0939-4753(10)X0006-0377378http://www.nmcd-journal.com/article/PIIS0939475310000396/abstract?rss=yesAbstract: Cardiovascular diseases, defined as diseases of the heart and circulatory system are the main cause of mortality, morbidity and hospitalisation in women all over Europe. Evaluation of descriptive epidemiology of cardiovascular disease and its risk factors in the European women cannot ignore the extraordinary changes in the economic and political profile of the continent that occurred in the past 20 years. A keynote is requested by the knowledge that the Eastern female populations currently appear to be the less protected from cardiovascular disease (CVD; both coronary heart disease (CHD) and stroke) and its risk factors and require major efforts in public health for both primary prevention and risk factors and events treatment. Another important piece of information is that the traditional geographical differences in CHD indicating an advantage of Southern European women in comparison with other European ones is less evident than in the past, owing to the levelling off regarding the differences in risk factors associated lifestyles. The figures for prevalence of epidemic risk factors, such as smoking, physical inactivity, overweight and obesity, high blood pressure and cholesterol levels indicate an urgent need to implement public health interest as well as investments on the whole spectrum of CVD manifestations in terms of risk factors and events.Epidemiology of cardiovascular diseases in women in EuropeS. Panico, A. Mattiello10.1016/j.numecd.2010.02.004Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-05-31Nutrition, Metabolism & Cardiovascular Diseases2010-05-31206S0939-4753(10)X0006-0379385http://www.nmcd-journal.com/article/PIIS0939475310000360/abstract?rss=yesAbstract: Aims: Cardiovascular disease (CVD) is one of the major public health issues in women among diverse populations across the world. This article reports current information about the occurrence and risk factors of atherosclerotic CVD in American women.Data Synthesis: The most recent scientific publications from the American Heart Association, the Centers for Disease Control and Prevention, and the National Heart, Lung, and Blood Institute and elsewhere were reviewed with regard to CVD in the US population. We focussed on the atherosclerotic CVD in women, which includes coronary heart disease, stroke and heart failure. Prevalence, incidence and mortality of these diseases in women were described. The statistics about CVD on women were compared to men's. Special physiological changes in women and their relationships to CVD were discussed. The major modifiable risk factors were discussed.Conclusion: About 35% women in the United States have some form of CVD and for men, this number is 37.6%. The CVD incidence for women was close to that of men 10 years younger. The gap narrows with advancing age. Since 1984, the number of CVD deaths for women has exceeded those for men. Women represent 52.6% of CVD deaths, and CVD is the leading cause of death in US women. In both men and women risk factors such as hypertension, high blood cholesterol level, smoking, lack of physical activity and obesity increase the probability of developing CVD. Menopause, oral contraceptive use and bilateral oophorectomy in premenopausal women also affect the risk of CVD in women.Cardiovascular diseases in American womenY. Zhang10.1016/j.numecd.2010.02.001Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-05-31Nutrition, Metabolism & Cardiovascular Diseases2010-05-31206S0939-4753(10)X0006-0386393http://www.nmcd-journal.com/article/PIIS0939475310000657/abstract?rss=yesAbstract: This article presents data on CVD and risk factors in Asian women. Data were obtained from available cohort studies and statistics for mortality from the World Health Organization. CVD is becoming an important public health problem among Asian women. There are high rates of CHD mortality in Indian and Central Asian women; rates are low in southeast and east Asia. Chinese and Indian women have very high rates and mortality from stroke; stroke is also high in central Asian and Japanese women. Hypertension and type 2 DM are as prevalent as in western women, but rates of obesity and smoking are less common. Lifestyle interventions aimed at prevention are needed in all areas.Epidemiology of cardiovascular disease in Asian womenD. Hu, D. Yu10.1016/j.numecd.2010.02.016Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-06-30Nutrition, Metabolism & Cardiovascular Diseases2010-06-30206S0939-4753(10)X0006-0394404http://www.nmcd-journal.com/article/PIIS0939475310000402/abstract?rss=yesAbstract: Cardiovascular disease is a leading cause of death and disability in adults in Latin America. Women are more affected by these diseases than by all forms of cancer. Latin American countries have experienced rapid and uneven socioeconomic changes with a significant effect on lifestyle, demographic and health-related indicators. Differences in methodological approaches make it difficult to compare studies and health statistics across countries in the region. According to available statistics, female population in Latin American countries have lower mortality rate from coronary heart disease and higher mortality rate from cerebrovascular disease than North America. Current rates of obesity and type 2 diabetes are alarming in female in some countries. The high prevalence of risk factors forecasts an increase in cardiovascular disease for the coming decades in this region of the world. More systematic and sustained efforts for research, education, surveillance, prevention, early detection and affordable treatment are required across all Latin American countries to improve health conditions for adult population and particularly for women, who are more affected by obesity and diabetes. This article reviews the available information on cardiovascular disease and related risk factors in Latin American countries with a focus on female and to provide a brief description of selected multinational and national efforts to study and prevent this threat.Cardiovascular disease in Latin American womenM.E. Tejero10.1016/j.numecd.2010.02.005Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-05-31Nutrition, Metabolism & Cardiovascular Diseases2010-05-31206S0939-4753(10)X0006-0405411http://www.nmcd-journal.com/article/PIIS0939475310000335/abstract?rss=yesAbstract: Morbidity and mortality from cardiovascular disease (CVD) are rising among Middle Eastern women. Despite this threat, awareness and understanding of CVD are low and surveillance data are nonexistent for many populations in this region. In this review, the data available on CVD in Middle Eastern women will be generalized. Population-based studies in the Middle East have been sporadic and most have been cross-sectional with small samples. Many Middle Eastern countries lack reliable surveillance data regarding the prevalence and incidence of CVD and its risk factors in women. This information is crucial for monitoring the scope of the problem and for guiding intervention strategies. Because of the ethnic heterogeneity of this region and the rapidly changing lifestyles, well-designed, longitudinal, large-scale population-based studies that focus on CVD and its risk factors are needed in multiple areas of the Middle East.Cardiovascular disease in Middle Eastern womenN.M. Shara10.1016/j.numecd.2010.01.013Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-05-31Nutrition, Metabolism & Cardiovascular Diseases2010-05-31206S0939-4753(10)X0006-0412418http://www.nmcd-journal.com/article/PIIS0939475310000669/abstract?rss=yesAbstract: Aims: The aim of this article is to provide an overview of stroke in women and describe modifiable and non-modifiable risk factors for stroke.Data synthesis: Data supporting this article come from the National Center for Health Statistics, from American Heart Association publications, and from some of the large, multicenter trials and observational studies that inform guidelines for prevention of stroke. These data indicate that stroke is the third leading cause of death in women, that risk for stroke rises rapidly with age, and that the strongest risk factors for stroke are high blood pressure and atrial fibrillation, as well as diabetes and smoking. Risk rises rapidly when two or more risk factors are present. Hormone therapy in postmenopausal women increases risk of ischemic, but not hemorrhagic stroke, by 40–50%. Biomarkers of inflammation are associated with stroke risk. Other risk factors include certain lipids, physical inactivity, and low potassium diets. Although there has been improvement in the past decade, control of hypertension is inadequate in older women and many strokes could be prevented by better treatment of hypertension.Conclusion: Death and disability from stroke can be reduced with modification, treatment, and better control of risk factors like hypertension, diabetes and atrial fibrillation.Stroke in womenSylvia Wassertheil-Smoller10.1016/j.numecd.2010.02.017Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-07-05Nutrition, Metabolism & Cardiovascular Diseases2010-07-05206S0939-4753(10)X0006-0419425http://www.nmcd-journal.com/article/PIIS0939475310000621/abstract?rss=yesAbstract: Recent advances in the field of cardiovascular medicine have not led to significant declines in case-fatality rates for women as in men. There are gender-specific differences in symptoms profile, diagnosis and treatment of coronary disease in women. For women presenting for coronary heart disease (CHD) evaluation, traditional disease management approaches that focus on detection of a ‘critical stenosis’ often fail to identify those women critically at-risk. Symptoms do not help physicians in differential diagnosis of chest pain in women; indeed the most common presentation of obstructive CHD in women is atypical symptoms. In 50% of the cases, non-obstructive CHD at coronary angiography, due to ‘noncardiac chest pain’ or coronary microvascular dysfunction is frequently reported. For these reasons, the evidence reviewed suggests that prognostic risk assessment may work relatively better than diagnostic obstructive coronary disease assessment for women.Coronary artery disease: Clinical presentation, diagnosis and prognosis in womenC. Leuzzi, M.G. Modena10.1016/j.numecd.2010.02.013Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-07-01Nutrition, Metabolism & Cardiovascular Diseases2010-07-01206S0939-4753(10)X0006-0426435http://www.nmcd-journal.com/article/PIIS0939475310000633/abstract?rss=yesAbstract: Coronary artery disease (CAD) has traditionally been thought of as a disease that predominantly affects men. Women, however, are more likely than men to die from a myocardial infarction (MI). In this article, the data on access to cardiovascular care, treatment of stable and unstable coronary disease, and outcomes in women undergoing percutaneous coronary intervention (PCI) will be reviewed. Despite increased awareness of heart disease in women, and improved outcomes after PCI, women with MI have more mortality and delays to treatment than men. Women with CAD have symptoms that differ from men with CAD. Improved understanding of the symptoms of CAD in women by patients and health care providers may improve treatment and outcomes in women with CAD.Percutaneous revascularization in women with coronary artery disease: We've come so far, yet have so far to goS.D. Collins, S. Ahmad, R. Waksman10.1016/j.numecd.2010.02.014Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-07-01Nutrition, Metabolism & Cardiovascular Diseases2010-07-01206S0939-4753(10)X0006-0436444http://www.nmcd-journal.com/article/PIIS0939475310000190/abstract?rss=yesAbstract: Cardiovascular disease remains by far the leading cause of death for women worldwide. Despite a large body of research identifying effective interventions to reduce cardiovascular risk, translation into practice has been slow. This review pinpoints areas in particular need of improvement and summarizes gender-specific analyses in recent randomized trials assessing the impact of risk factor modulation on cardiovascular events.Managing cardiovascular risk factors: Trial evidence in womenJ. Hsia10.1016/j.numecd.2010.01.010Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-04-14Nutrition, Metabolism & Cardiovascular Diseases2010-04-14206S0939-4753(10)X0006-0445450http://www.nmcd-journal.com/article/PIIS0939475310000645/abstract?rss=yesAbstract: Aim: The belief in the hypothesis of cardiovascular benefit of hormone therapy (HT) in postmenopausal women was widespread; however, the Women's Health Initiative (WHI) hormone trials found no evidence of coronary heart disease (CHD) benefit among women aged 50–79 with no prior CHD diagnosis and HT increased risk of stroke. This article reviews the literature regarding HT and CHD, with emphasis on the findings from the WHI trials.Data synthesis: Findings from observational studies and animal studies addressing biological plausibility that had been interpreted as evidence to support the use of HT were reviewed and findings from the trials of women with cardiovascular disease and the WHI hormone trials are summarized, with specific commentary on the issue of differential effects of HT in younger versus older women.Conclusions: HT should not be prescribed for the purpose of preventing cardiovascular disease. The WHI offered support for the current U.S. Food and Drug Administration recommendation to limit HT to short-term use. There is a clear need for a greater understanding of the effects of both endogenous and exogenous estrogens in relationship to the aging cardiovascular system.Postmenopausal hormone therapy and cardiovascular disease in womenM.L. Stefanick10.1016/j.numecd.2010.02.015Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-05-31Nutrition, Metabolism & Cardiovascular Diseases2010-05-31206S0939-4753(10)X0006-0451458http://www.nmcd-journal.com/article/PIIS0939475310000207/abstract?rss=yesAbstract: Aims: Some food groups and supplements have been recommended for preventing coronary heart disease (CHD) in women. In this article, evidence on recommendations for some of these food groups (whole grains, fruits, vegetables, fish, nuts, and soy) and supplements (phytosterols, antioxidants, folic acid, and B-complex vitamins) is reviewed. Additionally, gender differences in nutritional requirements and recommendations are described.Data Synthesis: Studies of nutrition in women and those emphasizing gender differences in nutritional requirements were selected for this review.Conclusion: Observational data support the benefit of vegetables, fruits, and whole grains in CHD prevention. Trial data provide support for consuming fish at least twice a week, although women of childbearing age should limit their intake of fish that may contain high levels of mercury. Nuts are nutritious snacks but their caloric impact must be considered. Soy products do not affect low-density lipoprotein cholesterol (LDL-C) or CHD but may be beneficial in replacing high-fat meat. Foods supplemented with plant stanol/sterol-esters are recommended for reducing LDL-C. Antioxidant supplementation is not recommended for prevention of heart disease. A direct causal relationship between vitamin D deficiency and CHD has not been established. Homocysteine lowering through folic acid and B-complex vitamin supplementation has not been proven to improve CHD risk. More gender-specific analyses are needed to determine whether nutritional requirements differ between men and women.Nutritional recommendations for preventing coronary heart disease in women: Evidence concerning whole foods and supplementsS. Eilat-Adar, U. Goldbourt10.1016/j.numecd.2010.01.011Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-05-31Nutrition, Metabolism & Cardiovascular Diseases2010-05-31206S0939-4753(10)X0006-0459466http://www.nmcd-journal.com/article/PIIS0939475310000086/abstract?rss=yesAbstract: Epidemiologic studies suggest that as little as 30minutes of moderate-intensity physical activity per day can lower the risk of developing cardiovascular disease in women. Sedentary individuals who become physically active even at older ages derive cardiovascular benefits. Physical activity appears to slow the initiation and progression of CVD through salutary effects not only on adiposity but also on insulin sensitivity, glycemic control, incident type 2 diabetes, blood pressure, lipids, endothelial function, hemostasis, and inflammatory defense systems. Public health initiatives that promote moderate increases in physical activity may offer the best balance between efficacy and feasibility to improve cardiovascular health in sedentary populations.Physical activity and cardiovascular disease prevention in women: A review of the epidemiologic evidenceS.S. Bassuk, J.E. Manson10.1016/j.numecd.2009.12.015Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-04-16Nutrition, Metabolism & Cardiovascular Diseases2010-04-16206S0939-4753(10)X0006-0467473http://www.nmcd-journal.com/article/PIIS0939475310000177/abstract?rss=yesAbstract: Women with diabetes have a high risk of cardiovascular disease that, almost completely eliminates the gender difference in cardiovascular morbidity and mortality between non-diabetic men and women. In this chapter we have reviewed data showing that cardiovascular risk factors are more common, more likely to cluster, or more severe in diabetic women than men; this may be due to biological or behavioural factors. Disparities in accessibility, quality and, possibly, effectiveness of care further disadvantage diabetic women. Based on available data it can be concluded that a large number of CVD deaths are preventable in diabetic women; therefore special attention should be paid to risk factors detection and correction, as well as timely CHD diagnosis and treatment in diabetic women. To meet these needs gender specific guidelines and implementation measures may be in order.Cardiovascular risk in women with diabetesA.A. Rivellese, G. Riccardi, O. Vaccaro10.1016/j.numecd.2010.01.008Nutrition, Metabolism & Cardiovascular Diseases 20, 6 (2010)2010-07-12Nutrition, Metabolism & Cardiovascular Diseases2010-07-12206S0939-4753(10)X0006-0474480