Cardiovascular Health and Chronomics 9781629489766, 9781631170270

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CARDIOLOGY RESEARCH AND CLINICAL DEVELOPMENTS

CARDIOVASCULAR HEALTH AND CHRONOMICS

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CARDIOLOGY RESEARCH AND CLINICAL DEVELOPMENTS

CARDIOVASCULAR HEALTH AND CHRONOMICS

RAM B. SINGH EDITOR

New York

Copyright © 2014 by Nova Science Publishers, Inc.

All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher. For permission to use material from this book please contact us: Telephone 631-231-7269; Fax 631-231-8175 Web Site: http://www.novapublishers.com NOTICE TO THE READER The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers‘ use of, or reliance upon, this material. Any parts of this book based on government reports are so indicated and copyright is claimed for those parts to the extent applicable to compilations of such works. Independent verification should be sought for any data, advice or recommendations contained in this book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services. If legal or any other expert assistance is required, the services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS. Additional color graphics may be available in the e-book version of this book.

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Published by Nova Science Publishers, Inc. † New York

CONTENTS Preface Chapter 1

ix Diet and Lifestyle Guidelines and Desirable Levels of Risk Factors for Prevention of Cardiovascular Disease and Diabetes among Elderly Subjects. A Revised Scientific Statement of the International College of Cardiology and International College of Nutrition-2011 R. B. Singh, Adarsh Kumar, N. S. Neki, Daniel Pella, S. S. Rastogi, T. K. Basu, S. N. Acharya, Lekh Juneja, Toru Takahashi, K. Otsuka, Fabien De Meester, D. W. Wilson and Teodora Handjieva-Darlenska

1

Chapter 2

Space and Earth Weather Mirrored in Patterns of Suicide Incidence Germaine Cornélissen, Borislav D. Dimitrov, Franca Carandente and Franz Halberg

23

Chapter 3

Signatures of Space Weather in the Aging Human Blood Circulation? Franz Halberg, Robert B. Sothern, Yoshihiko Watanabe, Dewayne Hillman, William R. Best, Othild Schwartzkopff and Germaine Cornélissen

37

Chapter 4

Time Structures (Chronomes) of the Blood Circulation, Populations' Health, Human Affairs and Space Weather Franz Halberg, Germaine Cornélissen, Rollin McCraty, Jerzy Czaplicki and Abdullah A. Al-Abdulgader

59

Chapter 5

Cardiac Sudden Death of Athletes: ―Athlete´s Heart‖ J. Fedacko, D. Pella, R. B. Singh, B. Bohus, R. Rybar, J. Pella, P. Fedackova, K. Trejbal, T. Lopuchovsky, L. Merkovska, L. Jedlickova, M. Mraz, M. Babcak, I. Pirnikova and J. Simonova

113

Chapter 6

The Role of Immunogenicity in Cardiovascular Disease Michael Jan, Anthony T. Virtue, Meghanaben Pansuria, Jingshan Liu, Xinyu Xiong, Pu Fang, Shu Meng, Hong Wang and Xiao-Feng Yang

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Contents

Chapter 7

Evaluating the Form of Nonsinusoidal Variations George S. Katinas, Mikhail V. Dementyev, Franz Halberg, Patricia Grambsch, Anatoly V. Sorokin and Germaine Cornélissen

165

Chapter 8

The Gut, Brain, and Heart Connection R. B. Singh, Jayeeta Chaudhury,Fabien De Meester, Agnieszka Wilczynska, Douglas W. Wilson, A. P. S. Hungin, Branislav Milovanovic Toru Takahashi S. Sarrafi Zadeh and Shabnam Omidvor

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Chapter 9

Evolution: A Modified Synthesis in Relation to Inheritance of Diseases R. B. Singh, Fabien De Meester, Agnieszka Wilczynska, D. W. Wilson and A. P. S. Hungin

Chapter 10

Cusum-Assessed Personalized Hypotensive Treatment Surveillance D. W. Wilson, F. Halberg, G. Cornélissen, Y. Watanabe and A. P. S. Hungin

Chapter 11

Association of Coronary Risk Factors with Blood Glucose Levels in Type-2 Diabetes Mellitus K. S. N. Reddy, T. M. Reddy, K. K. Reddy, J. Lalu Naik, A. Papa Rao and R. B. Singh

Chapter 12

Plasma Fibrinogen Levels in Acute Myocardial Infarction Asna Urooj, K. Kusuma, P. P. Preetham, B. Mohan and P. Upadya

Chapter 13

Synergistic Antilipidemic and Antihepatotoxic Action of Gongronema latifolium and Nauclea latifolia in Streptozotocin Diabetic Rat Models P. E. Ebong, G. S. Effiong, I. J. Atangwho and E. U. Eyong

Chapter 14

Chapter 15

Chapter 16

24- Hour Chronomics of Ambulatory Blood Pressure Monitoring in Rotating Night Shift Workers and Controls Baby Anjum, Nar Singh Verma, Sandeep Tiwari, Vinod Jain, Ranjana Singh, Shipra Bhardwaj, Qulsoom Naz, Abbas A. Mahdi, Ram B. Singh and Raj K. Singh Association of Obesity and Abdominal Adiposity with Blood Pressure in Adults K. S. N. Reddy, K. K. Reddy and T. P. K. Reddy Chronobiologically Interpreted Clinical and Physiological Monitoring and Dietary Vistas in the Care of the Elderly R. B. Singh, F. De Meester, A. Wilcynszka, G. Cornélissen, D. W. Wilson, A. P. S. Hungin, R. Singh, S. Sarrafi Zadeh, Shabnam Omidvor, Toru Takahashi and F. Halberg

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249

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Contents Chapter 17

Chapter 18

Chapter 19

Index

Early Glimpses of Lunisolar and Reciprocal Biospheric Cycles with Overlapping Uncertainties Franz Halberg, Germaine Cornélissen and Othild Schwartzkopff In Memoriam, Salvador Sanchez Alfonso De La Pena, MD, PhD: A Comrade in the Chronousphere (November 14, 1948 November 2, 2011) R. B. Singh, Germaine Cornélissen, Robert B. Sothern, Jonathan Levi Rito Medina, Douglas W. Wilson, Miguel Revilla, Fabien De Meester, Sergey Chibisov, Radzhesh Agarval, Othild Schwartzkopff and Franz Halberg Bohumil Fiser (*22.10.1943-†21.03.2011): Chronobiologist, Emeritus Head of the Physiology Department at Masaryk University (Brno, Czech Republic), Czech Minister of Health, and Executive Board Member of the World Health Organization: His Legacies for Public and Personalized Health Care Franz Halberg, Germaine Cornélissen, Thomas Kenner, Jiri Dusek, Brigitte Kenner, Othild Schwartzkopff and Jarmila Siegelova

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PREFACE This book presents important research from around the world in the field of cardiovascular science. Particular emphasis is placed on chronomics, immunogenicity, diet and health, diabetes, coronary risk, and cardiovascular disease. Chapter 1 – Elderly subjects have unique nutrient needs with revised recommended dietary reference intakes based on age, sex, ethnicity and special vulnerability to compromised nutrient status. The food intake tends to decrease with advancing age due to decreased physical activity and metabolic rate. However vitamin; A,E,C, B vitamins and beta-carotine and minerals magnesium, calcium, selenium, chromium, zinc and copper as well as w-3 fatty acids needs either remain constant or increase. Omega-3 fatty acid, calcium, vitamin D and magnesium and antioxidant intakes are inversely associated with ageing and other complications like cardiovascular diseases, diabetes and dementia as well as cancers. It is pertinent to advise to eat 400g/day of fruits, vegetables and nuts and another 400g/day of whole grains in conjunction with 25-40g/day of canola oil or mustered oil, depending upon energy requirement, for prevention of cardiovascular disease and type 2 diabetes mellitus. Chapter 2 – Exploring any non-photic as well as photic components in the spectrum of the incidence pattern of suicides, the authors find gender differences in Minnesota, USA, and Australia, notably in the para-annual range of the spectrum. A trans-tridecadal BEL cycle (also more liberally referred to as para-tridecadal) with a period of about 35 years is found in data pooled from both genders and separately for both men and women in Finland (19692007). When fitted separately as a single component, the estimated period and its 95% confidence interval (CI) (in years) is 35.5 [26.7, 44.3] overall, 36.4 [25.3, 47.5] for males, and 38.9 [28.5, 49.3] for females, with respective amplitudes (N/100,000) of 170, 145, and 29. Differences between a Schwabe cycle and an about 7-year component (possibly a harmonic of the Hale cycle) characterizing suicide patterns of Finnish men and women, respectively, remain to be examined in longer series. In Bulgaria (1929-1945), a far-transyear with a period of about 1.3 years is noteworthy as is a quinmensal component with an about 5-month period. In France (1979-2008), in males and females, suicides are characterized by about 10.0-year and 10.1-year cycles, respectively. In Japan (1987-1999), an about 12.7-year component is detected, albeit with a broad uncertainty. A better understanding of the origin of these patterns, notably in terms of the relative contribution of non-photic and photic (daily and yearly) cycles, may lead to better prediction of incidence dynamics and to novel interventions for the prevention of major depression and suicide.

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Chapter 3 – The signature of an environmental decadal or longer cosmic cycle is found in each of 4 men's circulation. The assortment of pairs of environmental and physiological periods, s, can differ among some variables and even for some of the two circadian rhythm characteristics of the same variable in the circulation of the same subject. As gauged by overlapping CIs (95% confidence intervals) of the s in us and around us, the environmental pairing (e.g., of two subjects' diastolic blood pressure) can thus differ for the MESOR, M, a midline-estimating statistic of rhythm versus the circadian double amplitude, 2A, a measure of the extent of within-day change. A change in period length with the lengthening of a time series and/or advancing age is also recorded in the para-annual, para-decadal and paratridecadal range of the spectrum. To whatever extent these findings can be extended to the population at large, the imaginary baselines reported in investigations involving interventions in aging will be amenable to replacement by cycles here demonstrated longitudinally, yet to be mapped on a population basis. Chapter 4 – The authors complement an "Extended Consensus," focused on the individual's health, by documenting associations between the human heart and circulation and the environment near and far at the level of local and global populations in both space and time. Life in the atmosphere of the sun mimics its inanimate surroundings; its rhythmic components nearly match in length the cycles of the cosmos. Longitudinal records of the human blood circulation reveal heretofore unrecognized aspects of its variability. The view from a very few long and relatively dense series, covering mostly around-the-clock (up to) decades on individuals, reveals variability that cannot readily or necessarily be found in hundreds of thousands of individuals‘ around-the-clock 24-hour spotchecks and certainly not in single samples, unless the individuals‘ cycles are synchronized and assessed on a population basis. Periods, , longer than 28 hours, that is infradian variations, like the circadians (with  tentatively between 20 and 28 hours), have entered the genome and their characteristics await mapping. For those cycles that are already mapped, the authors consider further the extent to which the parameters and nonparametric endpoints of healthy infradian and circadian variability and their anomalies can become everyday measures of Sir William Osler's wear and tear, i.e., of Hans Selye's and Paul Rosch's stress and strain to the point of becoming gauges of distress (again complementing or replacing single samples or the mean values of dense sampling during single days). Criteria for recognizing and quantifying the alteration indicating when a load changes from benetensive to maletensive have yet to be identified, perhaps by monitoring blood pressure and heart rate in everyday life, replacing spotchecks in the clinic. The probable role of cosmos-induced loads in pathogenesis, assessed, among others, as an effect of a magnetic storm in laboratory animals and in humans, awaits study by using superposed epochs and a subtraction and addition approach. Chapter 5 – Over the past several years there is considerable interest among various experts and the lay public to find out the causes of sudden deaths in the trained athletes as well as in the clinical significance of cardiac symptoms as syncope and arrythmias. Catastrophic events in athletes are always unexpected, and although relatively uncommon, often achieve high visibility and convey a particularly devastating impact on the community. The most common causes of death in the young athletes are hypertrofic cardiomyopathy (need to be differentiated from ―athlete‘s heart‖), congenital coronary arteries anomalies and

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commotio cordis. Older athletes can also harbor occult cardiac disease, but the most common cause of death is atherosclerotic coronary artery disease (CAD). In view of these findings, the guidelines for prevention, managment and rehabilitation were established, because the overall athlete population is in low risk dying for sudden cardiac death, but the risk exists. Chapter 6 – Recently, many of the complexities associated with cardiovascular diseases (CVD) have been unlocked. However, despite these breakthroughs, CVD and its related complications are the leading contributors of morbidity and mortality worldwide, which indicates the shortcomings of current treatment regimens and the need for continued research. Published data within the field clearly indicates that CVD are built on inflammation and autoimmune platforms, though a strong, fundamental understanding of the mechanisms remains elusive. Areas such as the mechanisms underlying increased immunogenicity of selfproteins in the cardiovascular system, the roles of immunogenic auto-antigens in eliciting inflammatory autoimmune responses, and the immunosuppressive mechanisms involved in controlling inflammatory and autoimmune cardiovascular diseases remain to be wellunderstood. The authors will delve into these topics and the advancements made within the field in this review. Specifically, they will concentrate on the innate and adaptive immune responses mediating immunogenicity; the mechanisms of inflammation and autoimmunity in atherogenesis; the mechanisms of inflammation and autoimmunity in diabetic atherosclerosis; immunogenicity and stem cell therapy; as well as immunogenicity and immunosuppression. In depth examination and comprehension of these topics will provide insight into the recent progress of the field and bring to the forefront potentially novel therapeutic avenues. Chapter 7 – Structures in time series can be viewed as consisting of chaos, trends and cycles (chronomes). Since Fourier's time, cycles have been harmonically resolved; since Gauss‘, the fitting of sinusoids can be carried out on unequidistant data. But the resolution of dynamics must also consider methods that do not depend on sinusoids. To the extent that biological processes are dissipative, they are subject to various changing nonlinear influences; hence they are not necessarily stable. In principle the dynamics cannot always be sinusoidal, although cosine fitting is a useful approximation of the recurrent aspects of the given series. The goal of this work was to elaborate a method allowing us: (1). To reveal the hidden periodicities having any form of their waves, (2). To restore their form not considering them as a sum of trigonometric functions, and (3). To evaluate the statistical significance of the profile‘s characteristics (parameters). Chapter 8 – Background. Many experts have long accepted the brain-gut axis and its influence on obesity, insulin resistance and cardiovascular function. Methods. Internet search via Medline and Pub-Med and discussion with colleagues. Results. In experimental studies, it has been shown, how moderate intestinal inflammation affects complex behavior and how much treatment of such inflammation can influence factors from mind to matter, or brain to gut and the heart. It is likely that presence of long chain polyunsaturated fatty acids (PUFAs) in the duodenum, stimulates the release of cholecystokinin which in turn acts on cholecystokinin receptors, present on the abdominal vagus. After the food is ingested, it stimulates the secretion of incretins from the gut which increase the insulin secretion and initiate a gut-brain-liver axis in response to small amounts of triglycerides in the duodenum. Long chain PUFAs, particularly w-3 fatty acids, are cleaved from the dietary triglycerides by the gastrointestinal enzymes. Further studies indicated that a long chain fatty acid metabolite known as long chain fatty acid coenzyme A (LCFA CoA) is sensed by the gut. However,

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increased intake of trans fat, saturated fat and possibly w-6 fat and refined carbohydrates, particularly in presence of physical inactivity, may suppress gut-brain and liver axis by decreasing incretins, as well as cholecystokinin and leptin, resulting in insulin resistance and metabolic syndrome which is known to predispose cardiovascular diseases (CVDs). There is a rapid stimulation of leptin secretion from the gastric fundus on food ingestion, an effect which could be reproduced by cholecystokinin administration. Leptin gene expression and immune-reactivity have been reported in the gastric fundus. Leptin is known to enhance satiety–inducing effect of cholecystokinin indicating that cholecystokinin and leptin may function in concert with each other to induce satiety and regulate food consumption. Mediterranean diet and w-3 fatty acids have been reported to be protective against metabolic syndrome and CVDs but the exact mechanism of benefits is not known. It is possible that a part of the benefit may be due their protective effects on cell membrane phospholipids of the neuron, gut, liver and beta cells of pancreas apart from their direct effects on cardiovascular function. Chapter 9 – These authors have discussed, for the last two decades, those environmental factors in general and nutrition in particular could be important in the pathobiology of epigenetic inheritance. This knowledge was unknown to Julian Huxley who published his landmark Monograph; ‗Evolution: The Modern Synthesis in 1942.‘ This monograph brought Darwin‘s ideas into the 20th century and incorporated a knowledge of genes that was emerging in this century in the light of Gregor Mendel‘s experiments on inheritance (Monograph: Experiments with Plant Hybrids) at Hynčice (Vražné) in the now Czech Republic. In the mid-century, Barbara McClintock discovered transposable elements where parts of the genome can jump around and cause mutations or alter the gene expression, skewing Mendelian ratios and inheritance patterns. This report disrupted the predictable Mendelian system that went into building the Modern Synthesis. In The Origin of Species, Darwin wrote: ―Natural selection can act only by taking advantage of slight successive variations; it can never take a leap, but must advance by the shortest and slowest steps.‖ It is possible, he believed that organisms gradually adapt to their environments via minute physical adjustments. Biologists have since found evidence that dramatic adaptations can also occur, for instance in the form of major morphological changes. These adaptations appear to be the cause of changes in structure from apes to man and various human races. It is not clear whether such adaptations may be responsible for the development of diseases or health or for development of man to humans. The Modern Synthesis emphasizes that ―populations containing some level of genetic variations evolve via changes in gene frequency, induced mostly by natural selection and phenotypic changes are gradual with speciation and diversification into higher taxonomic levels come about over long periods of change. It seems that these ideas remained largely unchallenged for more than 50 years from now, although phenotypic changes have occurred rapidly in the last 100 years. Furthermore, evolutionary biology, biochemistry, genomics, developmental biology, systems biology and the impact of the environment on genes concerning mechanism of evolution have grown significantly beyond the Modern Synthesis. It is possible that some lineages have greater ‗evolvability‘ than others, independent of how much baseline genetic variation is present. In this connection, heritable phenotype variations may depend on the biology and biochemistry of the genes. Since some populations have more genetic variation than others and are expected to generate phenotypic variation more rapidly, the Modern Synthesis addresses ‗evolvability‘ in a population which may not be a distinct

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trait, independent of genetic variation. The Modern synthesis also does not place emphasis on the influence of photosynthesis, flight, multicellularity which stands out against a backdrop of slow and steady evolution. It is therefore important that Modern Synthesis should be modified by the experts because Life Sciences are dynamic, and which continue to change. Chapter 10 – An optimization approach for essential circadian timing of treatment of high blood pressure, diagnosed as one of the described vascular variability disorders, VVDs, is presented that specifically lowers the MESOR (M=Midline Estimating Statistic Of Rhythm) without inducing any other VVDs, such as CHAT (Circadian Hyper-Amplitude [A] Tension). This has been achieved using Cumulative sums and parameter tests applied to half-hourly automatic around-the-clock measurements for weeks at a time or longer. Hypotensive treatment (Rx) with a popular drug, at the wrong time was associated with CHAT, while the same dose when given at another time to the same patient was beneficial by lowering the M while leaving the 2A unaffected. In conclusion it is best to guard against an iatrogenic, excessive blood pressure overswing, systolic and/or diastolic, and against inducing other VVDs. "First do no harm" by not flying blind, i.e., by adequate surveillance of ambulatory blood pressure and heart rate measurements and concomitant sequential process control combined with statistical parameter testing. Chapter 11 – Background and Aim: The aim of the present study is to assess the association of coronary risk factors with glucose levels among patients with type-2 diabetes mellitus. Subjects and Methods: This study included 270 subjects with type 2 diabetes mellitus. The authors obtained primary risk factors, disease history, anthropometry, blood pressure, blood glucose and lipids by questionnaires following WHO guidelines and laboratory data by standard methods. Results: Of 270 patients with type 2 diabetes, 43 percent of males and 50 percent of females are having family history of diabetes mellitus. None of the subjects fall in malnutrition category whereas, 30 percent were normal weight, 50 percent were overweight and 18 to 30 percent were obese. The risk factor prevalence rates are: systolic hypertension; 40%, diastolic hypertension; 60%, hypertriglyceridemia; 55-60% and hypercholesterolemia; 32-37%. Both fasting blood glucose (FBS) and post prandial blood glucose (PPBS) levels increased from55 yrs age group (p1 (1.028, 95% CI: 1.006-1.050), systolic hypertension (1.023, 95% CI:1.016-1.030), diastolic hypertension (1.022, 95% CI: 1.015-1.030). Similar ODD‘s were obtained for PPBS levels also. Conclusion: In conclusion the results indicate that family history, duration of the disease and blood pressure are significant risk factors in type-2 diabetes mellitus. Hence preventive strategies warranted towards the management of hyperglycemia in type 2 diabetes to prevent vascular disease. Chapter 12 – Research evidence suggests that high plasma fibrinogen represents a major risk factor for cardiovascular diseases. The increased occurrence of CVD necessitates the

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need to analyze fibrinogen levels in ischemic heart disease (IHD) patients and study its relationship with physiological and behavioral risk factors. The present study analyses plasma fibrinogen levels in relation to known cardiac risk factors, in 72 patients (63 men and 9 women) afflicted with myocardial infarction. Parameters studied were anthropometry, plasma fibrinogen and lipid profile. Anthropometric data indicated a lower muscle mass status in majority of the subjects. Although the body mass index (BMI) was normal in majority of subjects, waist-to-hip ratio (WHR) was higher than normal range. Clinical data revealed atherogenic lipid profile in 58% of the subjects. Mean plasma fibrinogen values were 3.8g/L, high normal (>3.0g/L) in 28% and above normal (>4.0g/L) in 30% of the patients. Fibrinogen levels were higher (p