Currently, the global incidence of diabetes is increasing, particularly in populous developing regions. In China, over 290 million people are affected by diabetic cardio-cerebrovascular diseases. These diseases account for more than 40% of deaths and impose a significant economic burden on both society and families. Diabetes can result in vascular complications through multiple mechanisms, including cardiovascular and cerebrovascular diseases. Current management guidelines recommend conducting risk assessments before prescribing medications like antihypertensives, hypoglycemics, and lipid-lowering drugs, alongside lifestyle interventions, to help prevent cardio-cerebrovascular diseases. However, pharmacological approaches have several limitations, including adverse drug reactions and variability in patient responses. Chinese herbal medicine (CHM) exerts its therapeutic effects via bioactive metabolites that modulate multiple molecular targets, including enzymes, receptors, and transcriptional regulators, through complex interactions with cellular signaling networks. While modern pharmacological research validates its polypharmacological mechanisms, concerns persist regarding potential botanical drug interactions, toxicological profiles, and pharmacokinetic variability of certain botanicals. Only through a balanced scientific approach can CHM's unique therapeutic value be fully realized. This review evaluates the efficacy of CHM in mitigating metabolic disorders, focusing on its diverse pharmacological mechanisms, including antioxidant defenses, inflammation suppression, and programmed cell death regulation. It elucidates the role of pivotal signaling cascades, including the glucagon (GLC)/5'-adenosine monophosphate-activated protein kinase (AMPK)/nuclear transcription factor-κB (NF-κB) axis, the GLC/peroxisome proliferator-activated receptor α (PPARα)/PGC-1α pathway, as well as the PI3K/Akt and AMPK/mammalian target of rapamycin (mTOR) signaling pathway, alongside oxidative stress and inflammatory responses. However, future research should prioritize well-structured clinical trials and mechanistic studies to substantiate CHM's therapeutic potential.

Hypertension is a leading cause of cardiovascular diseases, stroke, and kidney failure worldwide. Despite being a preventable and manageable condition, hypertension often remains undiagnosed or poorly controlled, contributing to substantial health burdens. This study aims to estimate the prevalence of hypertension among adults in Saudi Arabia and identify key sociodemographic and behavioral risk factors associated with the condition.

This study utilized data from the 2019 Kingdom of Saudi Arabia World Health Survey (KSAWHS 2019), a nationally representative survey conducted by the Ministry of Health. The original sample included 8,912 individuals aged 15 years and older. After data cleaning, the analytical sample consisted of 8,618 individuals in this age group. For the present analysis, a subset of 8,266 adults aged 18 years and older with valid blood pressure measurements was used. Hypertension prevalence was estimated as both crude and age-standardized rates, with standardization based on the WHO 2000-2025 standard population. Poisson regression with robust variance was employed to assess associations between hypertension and a range of demographic, clinical, behavioral, and biochemical factors.

Among adults aged 18 years and older, the crude prevalence of hypertension was 12.69%. Hypertension prevalence increased markedly with age, reaching over 50% among adults aged 80 years and older. Males had a higher prevalence of hypertension than females (14.1% vs. 11.2%). Among adults aged 30-79 years, the crude prevalence of hypertension was 19.41%, with 47.96% of affected individuals receiving antihypertensive treatment; the corresponding age-standardized prevalence and treatment coverage were 22.26% and 43.97%, respectively. In multivariable analyses, hypertension was significantly associated with older age, kidney disease (PR = 2.05), obesity (PR = 1.72), dyslipidemia (PR = 1.57), diabetes (PR = 1.34), and ever smoking (PR = 1.19). Among adults with hypertension, only 34.8% were aware of their condition.

Hypertension remains a major public health challenge in Saudi Arabia. Additionally, hypertension awareness in Saudi Arabia is critically low, representing the most important gap in hypertension control. Key risk factors such as obesity, smoking, and diabetes significantly contribute to the burden of the disease. Strengthening routine blood pressure screening, expanding community-based detection initiatives, and integrating hypertension awareness into national programs are essential to improve early diagnosis and long-term cardiovascular outcomes.

Secondary prevention of cardiovascular disease (CVD) requires strict adherence to evidence based medication regimens to reduce recurrent events. Prescription errors or irrational drug use can compromise outcomes, highlighting the need for effective pre-prescription review strategies.

This study aimed to assess the application of pre-prescription review of suspicious data via an intelligent supervision platform based on evidence-based medicine (EBM) for secondary prevention of CVD.

One hundred and forty CVD patients requiring secondary prevention were randomized to a control group (traditional prescription review) and an observation group (EBM-based intelligent platform pre-review). We compared between-group differences in medication appropriateness, rational drug use rates, prescription modification rates, adverse cardiovascular events, and patient satisfaction before and after review.

Post-review assessments revealed significant improvements in both groups across all measured outcomes, including medication appropriateness, rational drug use rates, and patient satisfaction, alongside reductions in Medication Appropriateness Index inappropriateness rates, prescription modifications, and cardiovascular adverse events. However, the observation group demonstrated markedly superior outcomes compared to traditional review: higher medication appropriateness and rationality scores, greater adherence to rational drug use standards, and significantly lower rates of prescription modifications and adverse events. Patient satisfaction scores were also higher in the observation group, confirming the platform's clinical and operational advantages.

EBM based intelligent supervision platform pre review markedly enhances medication appropriateness and rational drug use in CVD secondary prevention, reduces prescription modifications and adverse cardiovascular events, and improves patient satisfaction, offering clear clinical and operational benefits over traditional review methods.

Obstructive sleep apnea (OSA) is one of the most common sleep disorders in the general population. It is characterized by recurrent alterations in nocturnal oxygenation, which have wide-ranging consequences on health. Beyond its well-established links to cardiovascular, neurocognitive, and metabolic diseases, recent evidence suggests a possible association between OSA and cancer, particularly lung cancer, one of the leading causes of death worldwide. The advent of immunotherapy has significantly improved outcomes for lung cancer patients in both early and advanced stages. However, immunotherapy is frequently associated with endocrine toxicities, which may overlap or interact with the metabolic alterations observed in OSA. This perspective aims to emphasize the clinical relevance of diagnosing and treating OSA in lung cancer patients undergoing immunotherapy, as proper management could help optimize both therapeutic efficacy and overall health.

Kawasaki Disease (KD), a leading cause of acquired heart disease in children, presents significant diagnostic and prognostic challenges due to its complex pathogenesis and lack of specific biomarkers, leading to potential delays in treatment and increased risk of coronary artery lesions (CALs). Sestrin2 (SESN2), a stress-inducible protein with documented cytoprotective functions and established biomarker utility in cardiovascular diseases, warrants investigation in KD.

We conducted a single-center prospective study enrolling 72 KD patients and 38 healthy controls (HCs). Serum SESN2 levels were quantified using enzyme-linked immunosorbent assay (ELISA). Participants were stratified by CAL presence and severity. We evaluated SESN2 levels in different groups, assessed its correlations with clinical parameters and inflammatory markers, and performed ROC analysis to determine its diagnostic and predictive accuracy for KD and CAL.

Serum SESN2 levels were significantly elevated in KD patients compared to HCs (P=0.001), with markedly higher levels in the KD-CAL subgroup (P=0.014), escalating stepwise with lesion severity. SESN2 positively correlated with inflammatory markers and coronary artery lesions. A substantial reduction in SESN2 was observed post-IVIG therapy (P=0.012). ROC analysis revealed SESN2 as a reliable diagnostic marker for KD (AUC=0.697) and a predictive marker for CAL (AUC=0.684).

Serum SESN2 is a valuable biomarker for KD, capable of reflecting disease activity and predicting CAL. This dual function highlights its potential to improve risk stratification and guide clinical management in affected children.

The Minnesota Electronic Health Record Consortium (MNEHRC) was established during the early days of the COVID-19 pandemic to provide data for public health surveillance from the eleven largest health care systems in Minnesota.

This is a descriptive study of the Consortium, which is a federated network that implements best practices for governance and data infrastructure to support public health surveillance and clinical research. We conducted an analysis of the Consortium members, governance structure, infrastructure, and the characteristics of the patient population.

The Consortium health systems collect information from 105 hospitals, 773 clinics, 100 emergency departments and 29 040 providers. Information about the health systems and the demographic and clinical characteristics of its 5 471 367 patients is provided, which represents more than 90% of the patients in Minnesota. This manuscript also details the MNEHRC governance structure, working groups, data use agreements and technical infrastructure. The Consortium has produced several studies with state-wide impact. One study, Health Trends Across Communities in Minnesota, is described in detail to illustrate aspects of this collaboration.

MNEHRC has been a successful collaboration and vital resource for public health surveillance in the state of Minnesota. Initially, the Consortium focused on surveillance related to COVID-19 infections and vaccinations but has recently expanded into other public health and chronic disease research.

Lifestyle behaviours are important predictors of morbidity and mortality in patients with cardiovascular disease. However, structured lifestyle monitoring is insufficiently integrated into clinical practice. This study evaluated dropout and long-term adherence to an eHealth system for self-monitoring lifestyle behaviours in patients with cardiovascular disease.

Patients undergoing a cardiac intervention used an eHealth system (web application with integrated health watch and chatbot) to monitor physical activity, nutrition, stress, and sleep for 1 year. The primary outcome was dropout, defined as system disengagement. Secondary outcomes included adherence (percentage of prescribed health watch wear time and chatbot responses) and usability. The predictive value of demographic, clinical, and psychosocial factors was examined using logistic regression models. Of 100 patients (mean age 61.6 ± 10.4 years; 88% male; 45% percutaneous coronary intervention, 55% other intervention), there were 43 dropouts; most (27; 63%) occurred in the first quarter, with participation burden being the most cited reason (51%). Health watch adherence was higher than chatbot adherence (80.7% (66.6-90.3%) vs. 60.8% (30.7-82.7%), P < 0.001). Low chatbot adherence was associated with poorer mental well-being, while lower health watch adherence was associated with higher levels of depressive symptoms. System usability was rated acceptably usable (62.2 ± 14.7).

Long-term lifestyle monitoring of multiple health-related behaviours is feasible after cardiac intervention, highlighting its potential for integration into clinical practice. Patient engagement could be enhanced by targeting subgroups at risk of low adherence, particularly in the early phase, and by reducing self-reporting burden while improving usability.

Oral squamous cell carcinoma (OSCC) is a predominant head and neck malignancy with epigenetic alterations key to its development; however, the role and mechanisms of methyltransferase 5, N6-adenosine (METTL5) in OSCC remain to be elucidated. This study aimed to investigate the functional role and underlying mechanism of METTL5 in OSCC progression. Western blotting analyzed METTL5 expression in OSCC cell lines and tissues, whilst Cell Counting Kit-8, Transwell, colony formation and wound healing assays, as well as cell cycle analysis and nude mouse xenografts were used to assess its functional effects. Moreover, ribosome nascent-chain complex-bound messenger RNA sequencing (RNC-seq) was used to assess gene translation efficiency (TE). Western blotting, Transwell and colony formation assays, and cell cycle analysis were employed for downstream studies. Bioinformatics analyses were conducted to complement mechanistic exploration. The Cancer Genome Atlas data demonstrated that higher METTL5 expression in metastatic head and neck squamous cell carcinoma tissues was significantly associated with poor prognosis. Furthermore, METTL5 knockout significantly inhibited OSCC tumorigenesis and metastasis in vitro and in vivo. Finally, RNC-seq identified 3,391 genes with reduced TE, with cyclin D3 (CCND3) shown to be a downstream target. In conclusion, METTL5 may promote OSCC progression by regulating CCND3 via N6-methyladenosine-mediated ribosomal methylation, positioning it as a potential therapeutic target in the future.

Alcohol-associated liver disease (ALD) is a leading cause of liver-related mortality and is increasingly recognized for its contribution to cardiovascular diseases. The renin-angiotensin-aldosterone system (RAAS), including angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB), has demonstrated benefits in modulating inflammatory pathways. Clinical data regarding the effects in patients with ALD remain limited.

We conducted a retrospective cohort study utilizing the TriNetX platform. Patients with ALD who were prescribed ACEI/ARB were compared with those prescribed calcium channel blockers (CCB). Propensity score matching (1:1) was applied to balance baseline characteristics. The primary outcome was all-cause mortality. Secondary outcomes included alcohol-associated hepatitis (AH), major adverse cardiovascular events (MACE), major adverse liver outcomes (MALO), and sepsis. Patients were followed for 5 years. Cox proportional hazards models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI).

After matching, 7884 patients were included (3942 per group). ACEI/ARB use was associated with a significantly lower risk of all-cause mortality (HR: 0.70, 95% CI: 0.64-0.78, p < 0.001) compared with CCB use. Furthermore, the ACEI/ARB cohort demonstrated significant risk reductions across all secondary outcomes, including MACE (HR: 0.69, 95% CI: 0.61-0.77, p < 0.001), MALO (HR: 0.81, 95% CI: 0.73-0.90, p < 0.001), AH (HR: 0.88, 95% CI: 0.80-0.97, p = 0.008), and sepsis (HR: 0.61, 95% CI: 0.53-0.70, p < 0.001).

In this large real-world cohort, ACEI/ARB use in patients with ALD was associated with reduced risks of mortality, cardiovascular events, liver events, AH, and sepsis, supporting a potential protective role of RAAS inhibition in ALD patients.

Oscillatory breathing (OB) observed during cardiopulmonary exercise testing (CPX) is a critical phenomenon, especially in patients with heart failure. Patients with cardiovascular diseases with OB usually present with cyclic changes not only in ventilation (VE) but also in oxygen uptake (VO2), carbon dioxide output (VCO2), end-tidal partial pressure of carbon dioxide (PETCO₂, reflecting dynamic changes in arterial PCO₂), and other respiratory gas variables. We aimed to evaluate whether the phase difference between the respiratory gas variables obtained from CPX is correlated with cardiopulmonary function.

From a retrospective analysis of 1,740 patients with cardiovascular diseases who underwent CPX, 42 patients (65±13 years) with clear OB were selected. Oscillatory changes were observed in VE, VO2, VCO2, PETCO2, and end-tidal oxygen tension (PETO2) in all patients. PETCO2 and PETO2 oscillated almost simultaneously, although their peak and nadir were reversed. Oscillatory changes in PETCO2 and PETO2 preceded those in the other cardiopulmonary variables. After the peak of oscillating PETCO2, the oscillations of VO2, VCO2, and VE followed this order.

The phase difference between PETCO2 and VE was significantly and positively correlated with the VE-VCO2 slope, PETCO2 at rest, and PETCO2 at peak (r=0.414, p=0.006; r=-0.453, p=0.003; and r=-0.424, p=0.005, respectively).

The phase difference between PETCO₂ and VE is associated with the severity of heart failure and suggests that oscillatory breathing may be partly related to impaired PaCO₂ regulation in patients with cardiovascular diseases.