OX-HDL: A Starring Role in Cardiorenal Syndrome and the Effects of Heme Oxygenase-1 Intervention.

In this review, we will evaluate how high-density lipoprotein (HDL) and the reverse cholesterol transport (RCT) pathway are critical for proper cardiovascular-renal physiology. We will begin by reviewing the basic concepts of HDL cholesterol synthesis and pathway regulation, followed by cardiorenal syndrome (CRS) pathophysiology. After explaining how the HDL and RCT pathways become dysfunctional through oxidative processes, we will elaborate on the potential role of HDL dysfunction in CRS. We will then present findings on how HDL function and the inducible antioxidant gene heme oxygenase-1 (HO-1) are interconnected and how induction of HO-1 is protective against HDL dysfunction and important for the proper functioning of the cardiovascular-renal system. This will substantiate the proposal of HO-1 as a novel therapeutic target to prevent HDL dysfunction and, consequently, cardiovascular disease, renal dysfunction, and the onset of CRS.

Hispanic Ethnicity and the Risk of Cardiovascular Disease in the United States: The Behavioral Risk Factor Surveillance System 2013 / Riesgo cardiovascular entre Hispano-Americanos residiendo en los Estados Unidos: El sistema conductual de vigilancia de factores de riesgo 2013

ABSTRACT Background: Although the leading cause of death among Hispanics living in the United States (US) is cardiovascular disease (CVD), the association between Hispanic ethnicity and CVD has been scarcely explored. Objective: To examine whether being Hispanic is associated with an increased risk of CVD compared with the non-Hispanic US adult population in 2013. Methods: Secondary data analysis of a cross-sectional 2013 Behavioral Risk Factor Surveillance System survey in 2013 (n=486,905). The main exposure variable was Hispanic ethnicity (Mexican, Puerto Rican, Cuban or Spanish origin) and the main outcome variable was self-reported CVD (myocardial infarction/coronary artery disease/angina). The main covariates were sex, age, education, income, healthcare access, exercise, body mass index, current smoking, heavy drinking, diabetes, hypertension and hyperlipidemia. Unadjusted and adjusted logistic regressions were used to assess the effect between ethnicity and self-reported CVD. Odds ratios (OR) and 99% confidence intervals (CI) were calculated. Results: In total, 12% of the study participants were Hispanic (n=57,257). Approximately 24% of Hispanics were 25-34 y/o while (21%) of non-Hispanic were >65 y/o. After adjustment, Hispanics were 30% less likely to report CVD compared with non-Hispanics (OR=0.7; 99%; CI=0.6-0.8). Compared with men, women had a 40% decreased risk of having CVD (OR=0.60; 99% CI=0.5-0.6). Advanced age, lower educational attainment, income <$15,000/year, lack of exercise, smoking, non-heavy drinking, diabetes, hypertension and hyperlipidemia increased statistically significantly the likelihood of reporting CVD. Conclusion: The findings suggest that, in general, Hispanics residing in the US are significantly less likely to self-declare if they had a CVD compared with non-Hispanic Americans. These data suggest that although Hispanics are generally poorer and have less access to education and health services, their self-perceived health is better than in non-Hispanic residents of the US.

Resumen Introducción: Aunque la enfermedad cardiovascular (ECV) es una de las mayores causas de defunción entre los hispanos que viven en los EE. UU, la asociación entre la etnia hispana y la ECV apenas se ha explorado. Objetivo: Examinar si ser hispano se asocia con un mayor riesgo de padecer ECV en comparación con la población adulta no Hispana de los EE. UU, basados en los datos de la encuesta nacional sobre factores de riesgo conductuales del 2013. Métodos: Se realizó un análisis de datos secundario de la información obtenida del Sistema de Vigilancia del Factor de Riesgo Conductual (BRFSS) para estudiar la asociación entre origen étnico (hispanos: mexicano, puertorriqueño, cubano o de origen español vs. no hispanos) y la ECV en los encuestados a través del sistema BRFSS. Utilizamos una regresión logística para obtener modelos ajustados y no ajustados para evaluar el efecto de las características de la población seleccionada en participantes que informaron tener o no ECV. Resultados: En este estudio se incluyeron 486905 adultos, (48% hombres) y 57257 (11,8%) que se autodefinieron como hispanos. Aproximadamente el 24% de los hispanos tenían entre 25 y 34 años, mientras que un 21% de los no hispanos tenían más de 65 años. Después del ajuste de variables, los hispanos tenían un 30% menos de probabilidades de reportar una ECV en comparación con los no hispanos (OR = 0.7, 99% CI = 0.6-0.8); las mujeres mostraron un 40% menos de probabilidades de presentar una ECV (OR = 0,60; IC del 99% = 0,5-0,6). Tener más edad, menos nivel de educación formal, ganar menos de <$ 15000 / año, el sedentarismo, el tabaquismo, el consumo excesivo de alcohol, la diabetes, la hipertensión y la hiperlipidemia aumentaron significativamente la probabilidad de presentar una ECV. Conclusiones: Los hallazgos sugieren que en general, los hispanos que residen en los EE. UU, especialmente mujeres, tuvieron una probabilidad significativamente menor de autoreportar que tuvieron una ECV en comparación con los norteamericanos no hispanos.