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Moderate coffee consumption (2–5 cups per day) has been consistently associated with a lower risk of cardiovascular disease in epidemiological studies. For most individuals, a caffeine intake of up to 400 mg per day is safe and moderate coffee consumption can be included as part of a healthy lifestyle.
In this Review, Khan and colleagues discuss the benefits and challenges of including pragmatism in the design, conduct and interpretation of randomized controlled trials (RCTs) for cardiovascular disease and highlight selected ongoing and completed cardiovascular RCTs that incorporate a pragmatic design.
The adventitia of atherosclerotic arteries is innervated by efferent and afferent neurons that form neuroimmune cardiovascular interfaces and modulate disease progression; ablating the sympathetic innervation to these regions is a potential therapeutic strategy.
Cardiovascular researchers face a range of challenges, including reduced grant funding, job insecurity and a lack of diversity in leadership roles. In this Roadmap article, Marques and colleagues propose strategies to overcome these challenges, focusing on three key areas: capacity building, research funding and fostering diversity and equity.
In this Review, Quiles and Gustafsson compare the physiological and pathophysiological roles of mitochondrial fission and discuss the therapeutic potential of preventing excessive mitochondrial fission in the heart and vasculature.
In this Review, the authors summarize the latest advances in cardioimmunology and discuss experimental tools and strategies that are currently available for the study of immune cells, guiding readers through case-based examples to provide recommendations for the use of immunological tools and strategies in the study of immune cells in cardiac disease.
Heart failure is a systemic disease in which neuroendocrine activation, inflammation and metabolic changes can impair cardiac function. In addition, variants in genes encoding sarcomeric proteins can predispose individuals to develop heart failure. The 2022 Gordon Research Conference on Cardiac Regulatory Mechanisms aims to identify novel treatment targets by applying high-resolution approaches to complex cardiac disorders.
The results of two early-phase trials of novel lipid-lowering agents targeting ANGPTL3 and lipoprotein(a) might help to combat the residual risk of cardiovascular events in patients treated with statins and/or PCSK9 inhibitors to lower LDL-cholesterol levels.
Optical coherence tomography (OCT) has been widely adopted in research on coronary atherosclerosis and adopted clinically to optimize percutaneous coronary intervention. In this Review, Jang and colleagues summarize this rapidly progressing field, with the aim of standardizing the use of OCT in coronary atherosclerosis.
In patients with atrial fibrillation, treatment with asundexian, a novel, oral, small-molecule inhibitor of coagulation factor XIa, reduces the incidence of bleeding compared with standard dosing with the factor Xa inhibitor apixaban.
A strategy of treating mild chronic hypertension in pregnant women using a blood pressure target of <140/90 mmHg reduces the risk of pre-eclampsia and does not increase the risk of poor fetal growth or fetal death.
In the PROMPT-HF trial, alerts embedded within electronic health records that contained guideline-directed recommendations for patients with heart failure improved the prescription of guideline-directed medical therapy.
Use of hormone-replacement therapy (HRT) for menopausal symptoms is associated with a modest reduction in plasma lipoprotein(a) (Lp(a)) levels but is not associated with a lower Lp(a)-associated risk of coronary heart disease compared with no HRT use, according to findings presented at ACC.22.
A model generated using proteomics and machine learning that included 27 proteins was able to predict the 4-year risk of myocardial infarction, heart failure, stroke or all-cause death better than a clinical model and was sensitive to the adverse and beneficial changes in outcome.
Paradigm-shifting studies have revealed that the heart contains heterogeneous and dynamic immune and stromal cell populations that are crucial determinants of health and disease. Advances in molecular imaging now make it possible to non-invasively visualize the cardiac cellular landscape in humans, providing a means to guide precision therapies.
In this Review, the authors explore metabolic dysregulation as an important theme in cardio-oncology. They discuss metabolic reprogramming in cardiovascular disease and cancer and the possibility that therapeutically targeting metabolic and immunometabolic changes in patients with cancer might also reduce their risk of cardiovascular disease.
The microtubule network of cardiomyocytes has unique architectural and biophysical features. In this Review, Caporizzo and Prosser discuss the contribution of microtubules to cardiac mechanics, the drivers of microtubule network remodelling in heart failure and the therapeutic potential of targeting cardiac microtubules in acquired heart diseases.
The most commonly available blood pressure (BP) monitoring devices are useful for capturing a snapshot BP value, but most have limited utility in measuring BP variability. In this Review, Schutte and colleagues outline the advantages and disadvantages of conventional and novel techniques to measure average BP levels and BP variability.
