Lifestyle, Environment, and Cardiovascular Diseases

Cardiovascular diseases (CVDs), as the leading causes of global mortality, claim the lives of around 17.9 million people each year. The most significant risk factor for CVD is an unhealthy lifestyle, which includes an unhealthy diet, physical inactivity, tobacco use, harmful use of alcohol, and inadequate sleep, etc.[1-3] These behaviors may lead to hypertension, high blood sugar levels, overweight, and obesity. In addition, individuals with unhealthy lifestyles are more likely to develop heart attack, stroke, heart failure, and other complications. Substantial evidence has proved that measures of improving lifestyle and controlling the main risk factors of CVD before its occurrence can effectively delay or avoid the occurrence of CVD events, thereby reducing the morbidity and mortality of CVD. Certainly, a great deal of evidence has demonstrated the profound effects of physical activity (PA) and cardiorespiratory fitness (CRF) against major CVD events.[4-8] In fact, substantial evidence indicates that PA and CRF are perhaps the strongest risk factors for CVD and CVD mortality.[9-11] Furthermore, there are findings indicating that environmental pollutants and noise pollution also increase the risk of CVD,[12-16] and even more supporting data for the adverse effects of poor sleep to increase CVD risk.[17-20] It is well-founded that many lifestyle factors increase CVD risk and CVD mortality, which is the reason for this issue of Heart and Mind. Ozemek C and Hardwick J provided an article entitled “The Essential Role of Physical Activity in Healthy Living and Cardiovascular Disease: A Narrative Review.” The American Heart Association identified eight essential measures (PA, diet, blood glucose, weight, lipids, blood pressure, smoking status, and sleep quality) to maintain general and cardiovascular health. Yet the central focus of this review is on PA and its role/impact on healthy living while highlighting how it can improve other behaviors and measures that are a part of Essential 8™. The authors concluded that meeting the minimum requirements of these guidelines leads to substantial health benefits. However, higher intensities and volume of aerobic and resistance PA can further increase CRF and muscular fitness and improve health span. In the article entitled “Optimizing Cardiovascular Health: A Narrative Review of Lifestyle, Psychobehavioral, and Alternative Strategies for Management and Prevention,” DiCaro MV et al. presented a review of highlighting the importance of a holistic approach to CVD management. They provided a detailed examination of the evidence supporting various nonpharmacological interventions in managing CVD, followed by a holistic and multimodal approach to integrating multiple therapies into comprehensive care plans. They suggested that future research should continue to explore and refine these interventions, ensuring that patients receive the most effective and comprehensive care possible. In “Cardiovascular Benefits of Dance as a Unique Form of Exercise: A Literature Review,” Tatavarthy M and Oktay AA examined the potential benefits of dance, as a unique form of PA/exercise, on cardiac, musculoskeletal, and psychosocial health by primarily focusing on interventional studies. Dance can further improve engagement and retention in exercise programs that are comparable to traditional aerobic exercise programs. The authors concluded that available evidence from studies evaluating the potential cardiovascular benefits of dance training has limitations, and therefore, should be considered hypothesis generating. It also remains unknown if the psychological and musculoskeletal benefits of dance training would directly translate into CVD risk reduction. Yoshihara R et al. contributed an article entitled “Mobile Health Intervention Reduces Sedentary Time and Physical Inactivity in Patients with Cardiovascular Diseases after Discharge: Systematic Review and Meta-Analysis.” The researchers conducted a systematic search in databases including PubMed, Web of Science, and CiNii and included 5 randomized controlled trials out of 502 articles. As a result of their analysis, long sedentary time and physical inactivity pose negative effects among patients with CVD. Their recommendation is to use mobile health interventions among CVD patients to reduce sedentary time as well as increase PA. Saldana G, Liu L, and German CA’s article, “Physical Activity, Steps, and Cardiovascular Disease: A Literature Review,” provides the latest data on the benefits of PA, steps, and CVD. The authors searched the MEDLINE database from inception to August 2024 and composed the article with extensive evidence. In short, they believe that improving the global PA levels is an international public health priority for its significant impact on preventing CVD. In addition, using health tracking technology to count steps can help patients monitor and take more steps daily. “Connecting the Dots: NLRP3 Inflammasome as a Key Mediator in the Intersection of Depression and Cardiovascular Disease: A Narrative Review” was contributed by Ghazaleh Jahromi GG and Rezaei N. This review gathered evidence to illustrate the link between depressive mood disorder and CVD. Among these, the authors put forward the research on nucleotide-binding oligomerization domain-, leucine-rich repeat-, and pyrin domain-containing protein 3 (NLRP3), showing that its activation causes vascular damage in the blood–brain barrier. Such damages could cause endothelial dysfunction and alter lipid metabolism, hypertension, atherosclerosis, aneurysm, and hypercoagulable states. They recommend regulating inflammasome (i.e., NLRP3) as a target for the treatment of depression and CVD. This issue aims to collect current evidence and offer evidence-based strategies for CVD prevention in terms of behavior and other CVD risk factors, hoping to benefit all humanity. I want to express my heartfelt gratitude to all authors from various countries for their remarkable contributions.