Atrial fibrillation (AF) correlates with an increased risk of all-cause mortality or stroke, mainly due to undiagnosed patients and undertreatment. Its screening is thus a key challenge, for which machine learning methods hold the promise of cheaper and faster campaigns. The robustness of such methods to varying artifacts, noise, and conditions is then crucial. We introduce the first distributional support vector machine (SVM) for robust detection of AF from short, noisy electrocardiograms. It achieves state-of-the-art performance and unprecedented robustness on the screening problem while only leveraging one interpretable feature and little training data. We illustrate these advantages by evaluating on other data sources (cross-data-set) and through sensitivity studies. These strengths result from two main components: (i) preliminary peak detection enabling robust computation of medically relevant features; and (ii) a mathematically principled way of aggregating those features to compare their full distributions. This establishes our algorithm as a relevant candidate for screening campaigns.

The effects of visceral fat on osteoporosis have attracted considerable attention. The Chinese visceral adiposity index (CVAI) has been demonstrated to respond more effectively than conventional measures in reflecting visceral fat characteristics in the Chinese population. This study aimed to explore the relationship between CVAI and bone mineral density (BMD), FRAX scores, and osteoporosis in Chinese elderly individuals with hypertension. The datasets from the People's Hospital of Xinjiang Uygur Autonomous Region from January 2021 to December 2023 were utilized in a cross-sectional investigation. The Chinese version of FRAX scores was employed to assess the probability of a major osteoporotic fracture (MOF) or hip fracture (HF) over a 10-year period in participants. Furthermore, linear and logistic regression models were employed to investigate the relationship between CVAI and BMD, FRAX scores, and osteoporosis, while adjusting for potential confounding variables. The final analysis encompassed 850 elderly hypertensive participants, with a mean age of 67.21 years. Our multivariate linear regression models revealed a robust positive correlation between the CVAI and BMD, signifying that higher CVAI values were significantly associated with greater BMD. Conversely, these models also demonstrated an inverse relationship between CVAI and FRAX scores, suggesting that an elevated CVAI is linked to a reduced 10-year risk of MOF and HF. Furthermore, logistic regression analysis confirmed an inverse correlation between CVAI and the prevalence of osteoporosis, indicating that participants with higher CVAI had a lower likelihood of osteoporosis. Our findings indicate that an elevated CVAI is significantly associated with higher BMD, lower FRAX scores, and a reduced risk of osteoporosis among the elderly hypertensive population. These results warrant further investigation to elucidate the underlying causal mechanisms linking CVAI, BMD, and osteoporotic fracture risk.

To investigate the association between serum inflammatory biomarkers and hypertension prevalence in Chinese adults.

Based on the 2018 China Health and Nutrition Survey(CHNS), we conducted a cross-sectional analysis of 1960 adults from six provinces selected through stratified random sampling by age and sex. Participants with complete dietary, biochemical, and anthropometric data were included. Blood pressure was measured three times using a mercury sphygmomanometer. Fasting venous blood samples were collected to quantify nine inflammatory biomarkers: hypersensitive C-reactive protein(hs-CRP, immunoturbidimetric assay), interleukin-1beta(IL-1beta), IL-2, IL-4, IL-6, IL-8, IL-10, IL-18, and tumor necrosis factor-α(TNF-α, ELISA). Multivariable logistic regression models adjusted for age, sex, income, residence, education, dietary approaches to stop hypertension(DASH) score, physical activity, body mass index, smoking, alcohol use, and diabetes status were used to evaluate associations. Restricted cubic spline curves explored dose-response relationships.

Among 1960 participants, 806(41.1%) had hypertension. After full adjustment, log-transformed inflammatory biomarkers showed significant positive associations with hypertension prevalence: hs-CRP(OR=1.50, 95% CI 1.22-1.86), IL-18(OR=1.98, 95%CI 1.48-2.65), TNF-α(OR=1.84, 95% CI 1.21-2.81), and IL-8(OR=1.23, 95%CI 1.02-1.49). Restricted cubic spline analysis revealed a nonlinear relationship for hs-CRP(P for nonlinear=0.007): hypertension possibility increased rapidly when ln(hs-CRP+1)<0.56, plateaued at 0.56-1.302, and rose again above 1.302. Linear trends were observed for lnIL-18, lnIL-8, and lnTNF-α.

Elevated serum hs-CRP, IL-18, IL-8, and TNF-α levels are independently associated with hypertension prevalence in Chinese adults, with a nonlinear dose-response pattern for hs-CRP. Targeting chronic low-grade inflammation may provide novel strategies for hypertension prevention.

To explore the relationship between the triglyceride-glucose(TyG) index and the risk of new onset hypertension in Chinese adults aged 18 and above.

Data was extracted from follow-up study for Nutrition and Health of Chinese Residents(2021), which was conducted from May 2021 to December 2022. Stratified systematic sampling method was used to select 10 survey sites from 150 surveillance sites based on the Chinese Nutrition and Health Surveillance 2010-2012. demographic information, physical status, lifestyle were collected through questionnaire, physical measurements and laboratory tests. The TyG index was calculated using baseline fasting serum triglyceride and blood glucose, and was divided into quartiles(Q1-Q4). Multiple-adjusted logistic regression was used to test the association between the TyG index and the risk of hypertension, after adjusting for basic demographic information, physical characteristics, lifestyle behaviors, and intake of oil and salt. The restricted cubic spline model was applied to analyze the dose-response relationship between the TyG index and hypertension. Stratified analysis and interaction tests were conducted to evaluate the interaction in different subgroups.

A total of 2516 subjects with normal blood pressure at baseline was included, with mean TyG of 8.53±0.67 on baseline. And the rate of new onset hypertension was 57.95%. Significantly positive correlation trend was observed between the TyG index and hypertension(β=1.51, P<0.05). Consistently, high levels of TyG index were significantly associated with increased risk of new-onset hypertension when TyG index was grouped into quartiles. Compared with Q1, the risks were 1.28 times(95%CI 1.01-1.62, P<0.04), 1.39 times(95%CI 1.09-1.76, P=0.01), and 2.11 times(95%CI 1.64-2.71, P<0.01)in Q2-Q4, respectively. Restricted cubic spline analysis suggested a positive linear relationship between the TyG index and the incidence of hypertension(P_(overall)<0.01, P_(nonlinear) = 0.54). The associations were consistent in various subgroups(P<0.05) such as age, gender, living area, education, household income, second-hand smoking, physical activity, family history of hypertension, cooking salt and oil intake, overweight and obesity, and central obesity.

High TyG index was significantly associated with an increased risk of hypertension among Chinese adults.

Systemic right ventricle (sRV) patients are at an increased risk of developing heart failure. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) could be a valuable treatment option. This study investigated the changes in ventricular function in sRV failure patients in the first year after starting SGLT2i.

Adult sRV patients from the international, real-world ACHIEVE-SGLT2i registry were included if they had a clinical diagnosis of sRV failure, a transthoracic echocardiogram before starting SGLT2i, and at least one in the first year after starting available for analysis. The primary outcomes were changes in sRV global longitudinal strain (GLS) and fractional area change (FAC). Longitudinal changes were evaluated using linear mixed models.

Thirty-nine sRV failure patients (46±9.3 years old, 41% female) were included. Twenty-five (64%) had transposition of the great arteries after an atrial switch procedure and 14 (36%) had congenitally corrected transposition. sRV GLS improved significantly in the first 50 days (-1.4%-point per month, p<0.001) and stabilised afterwards (<0.1%-point per month, p=0.520). Though age had a significant overall negative effect on sRV GLS (0.1%-point per year of age, p=0.049), it did not influence the longitudinal changes after starting SGLT2i. sRV FAC also improved in the first 50 days (3.2%-point per month, p=0.002), after which sRV FAC deteriorated in patients with subpulmonary left ventricular pacing (-0.9%-point per month, p=0.012) while it stabilised in patients without pacing (0.1%-point per month, p=0.573). In the first 50 days, tricuspid annular plane systolic excursion also improved significantly in all patients (1.2 mm per month, p=0.006), and stabilised afterwards (p=0.721).

SGLT2i therapy is associated with improvements in systolic ventricular function in sRV failure patients. Despite early improvement in sRV FAC, there was a negative longer term correlation with subpulmonary left ventricular pacing, potentially reflecting adverse effects of subpulmonary ventricular pacing on sRV function.

Cardiovascular morbidity is a leading cause of complaints in the older population.

The goal of this study is to present the results of a basic assessment of present cardiovascular diseases (CVD) in older people in the region of Burgas in Bulgaria.

A six-month cross-sectional study was conducted in the municipality of Burgas. People aged 65 and older were interviewed at pensioners' clubs by a team of 4 physicians including cardiologists, and a pulmonologist. Clinical parameters were also measured.

A total 647 people participated in the study with a prevalent female cohort (84%). The average age was approximately 73 years. 426 (66%) of the people reported diagnosed diseases from 1 to 5 (1.7 on average per person). Blood pressure was elevated than the normal values of 140/90 mmHg with higher levels observed in the male group. All participants had glucose levels higher than the physiological norm of 5.6mmol/l. Total cholesterol in the male cohort was below the recommended values of 5.2mmol/l, while in the female cohort levels were higher (5.59mmol/l). HDL and LDL were found to be close to the values recommended for people without CVDs, and 85% reported hypertension.

Hypertension is the most prevalent cardiovascular condition among the older population in Burgas. Almost all older individuals have comorbidities.

Research in hypertension management highlights a significant gap in the effectiveness, accessibility, and patient-centricity of existing approaches. This study aims to examine the effectiveness of digital health, telemedicine, wearable devices, and hybrid approaches in hypertension management, addressing short-term and long-term outcomes and identifying implementation challenges.

This study retrieved data from studies indexed in the Scopus, WoS, PubMed, and IEEE Xplore databases, "published between 2020 and 2025." The search keywords included "hypertension diagnosis," "therapy technologies," namely "artificial intelligence" (AI), "telemedicine," and "wearables." Bias assessments followed the Cochrane Collaboration, STROBE, and NOS with high inter-observer reliability.

This study included studies spanning multiple countries and revealed that digital health interventions, such as remote monitoring of blood pressure and artificial intelligence-supported apps, show significant short-term blood pressure reductions and improved patient adherence. Telemedicine and wearable technologies demonstrated positive outcomes in blood pressure control and patient engagement. Hybrid approaches, including artificial intelligence-driven decision support, exhibited promising potential but had limited impact on visit attendance. Long-term effects were mixed, with digital health solutions like the iHEC-APP showing early signs of sustained blood pressure improvements but requiring further evaluation.

Hypertension interventions show promise, but long-term efficacy, scalability, gender-sensitive approaches, and patient engagement remain key challenges, necessitating further research and development.

The pathophysiology of heart failure after myocardial infarction involves, as arterial hypertension, hyperactivity of the brain renin-angiotensin system and sympathetic overactivation. Among the main effector peptides of the brain renin-angiotensin system, angiotensin II (AngII) and angiotensin III (AngIII) similarly activate type 1 angiotensin receptors, thereby increasing blood pressure and inducing cardiac dysfunction after myocardial infarction. Since AngII is converted in vivo into AngIII, the nature of the effector peptide remained to be clarified. We identified the enzymes involved in the metabolism of brain angiotensins and developed specific and selective inhibitors. These studies revealed the key role of brain AngIII in blood pressure regulation and cardiac function, highlighting brain aminopeptidase A, the enzyme responsible for brain AngIII formation, as a potential therapeutic target for treating arterial hypertension and myocardial infarction-induced heart failure. This led to the development of two, orally active, centrally acting, aminopeptidase A inhibitors, firibastat and QGC606, which were tested in various experimental models of arterial hypertension and heart failure, and demonstrated therapeutic potentialities up to phase 2 clinical trials in patients after myocardial infarction.

To identify potential preoperative risk factors that predispose a patient to developing a left ventricular assist device driveline infection.

The fully magnetically-levitated left ventricular assist device has proven to be a safe and effective durable option for patients with advanced heart failure. However, driveline infections are a significant adverse event that impact patient mortality, morbidity, and quality of life. Potential preoperative risk factors such as INTERMACS score, temporary cardiovascular support, body mass index, hemoglobin A1C, prealbumin, infection, and hospital length of stay do not appear to significantly predispose a patient to developing a left ventricular assist device driveline infection. There is a need for more extensive research on postoperative patient and driveline management in order to identify high risk patients and delineate best practice to decrease the risk and burden of driveline infections.

Socioeconomic status (SES) and individual behaviors (IB) has significant effect on human health. However, the connection between SES/IB and aneurysmal subarachnoid hemorrhage (aSAH) has not been thoroughly explored. Hence, we performed MR analyses to explore the causal relationship between SES/IB and aSAH at the genetic level.

We conducted a two-sample MR analysis to examine causal relationship of SES and IB (physical activity, smoking behaviors, drinking behaviors, sleeping behaviors and sedentary behaviors) on aSAH. A series of filtering steps were taken to select eligible genetic instruments robustly associated with each of factors. Inverse variance weighting (IVW) methods was used as the main method of two-stage MR analysis, and was supplemented by the weighted median method, maximum likelihood method, simple median MR method and Mendelian randomization robust adjusted profile score. Multiple sensitivity analyses were used to test the robustness of MR methods.

We found that educational attainment (OR, 0.236; 95% CI, 0.164-0.340; P = 6.808 × 10^- 15) and moderate to vigorous physical activity (OR, 0.037; 95% CI, 0.003-0.392; P = 0.006) were identified as the protective factor for aSAH, while smoking initiation (OR, 1.879; 95% CI, 1.378-2.561; P = 6.602 × 10^- 6), number of cigarettes per day (OR, 3.048; 95% CI, 1.679-5.535; P = 2.504 × 10^- 4), insomnia (OR, 1.229; 95% CI, 1.029-1.468; P = 0.023), television watching time (OR, 3.122; 95% CI, 1.768-5.513; P = 8.698 × 10^- 5) and leisure screen time (OR, 1.603; 95% CI, 1.116-2.303; P = 0.011) were associated with increased risk of aSAH. Four additional MR analysis methods yielded similar results to the IVW method. Multiple sensitivity analyses showed that the results were stable and robust.

MR study provides robust evidence that educational attainment and moderate to vigorous physical activity were the protective factor for aSAH, while smoking initiation, number of cigarettes per day, insomnia, television watching time and leisure screen time were associated with an increased risk of aSAH.