Comment in 2020

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  • Extreme heat events are now more frequent in many parts of the world as a result of climate change. The combined effects of heat, air pollution, individual age, and socioeconomic and health status are responsible for avoidable acute events of cardiovascular disease and need to be considered in order to prevent and treat cardiovascular diseases effectively.

    • Annette Peters
    • Alexandra Schneider
    Comment
  • In this Comment, Nikki Gillum Posnack discusses how the increasing use of plastics in everyday life has potentially harmful effects on cardiovascular health.

    • Nikki Gillum Posnack
    Comment
  • The disparities amplified by the COVID-19 pandemic present disturbing evidence that we are far from cardiovascular health-care equity. Individuals, leaders and institutions must prioritize research, policies and structures to advance diversity, equity, inclusion and belonging — Diversity 4.0, a justice imperative, essential to advancing workforce excellence and cardiovascular health.

    • Renate B. Schnabel
    • Emelia J. Benjamin
    Comment
  • The COVID-19 pandemic has provided the vital stepping stones to improve how clinical trials are conducted. We provide an overview of the major changes to the clinical trial process instigated by the pandemic and suggest ways to make these changes sustainable.

    • Prakriti Gaba
    • Deepak L. Bhatt
    Comment
  • Social determinants of health in the African diaspora drive the lack of disease testing, increased prevalence of comorbid disease and reduced access to drugs, resulting in disproportionately higher COVID-19-related mortality among Black individuals than the rest of the population. We urge decisive attention to and action against ethnicity-based inequities that undermine cardiovascular health.

    • Peter Chin-Hong
    • Kevin M. Alexander
    • Michelle A. Albert
    Comment
  • Yoga has been associated with improvements in numerous cardiovascular risk factors and has the potential to address the unmet needs of current cardiovascular prevention strategies. Large and well-designed clinical trials are needed to assess the benefits of yoga across the spectrum of cardiovascular diseases and to provide the evidence required for its widespread implementation.

    • Dorairaj Prabhakaran
    • Ambalam M. Chandrasekaran
    Comment
  • The notion that atherosclerosis can be prevented or mitigated by vaccination is now moving towards clinical trials. This strategy is based on the existence of autoimmunity to LDL, the cholesterol-carrying particles that accumulate in arteries. In this Comment, we discuss the underlying concepts, research basis and challenges for the development of a vaccine against atherosclerosis.

    • Göran K. Hansson
    • Jan Nilsson
    Comment
  • Cybersecurity vulnerabilities of cardiac implantable electronic devices have been an area of increasing concern in the past 4 years. Physicians should be informed of these issues as they evolve so they can counsel their patients with the most accurate and up-to-date information.

    • Bryce Alexander
    • Adrian Baranchuk
    Comment
  • The available literature suggests that electronic cigarettes (e-cigarettes), although not without risk, might decrease cardiovascular risk in chronic smokers of tobacco cigarettes who switch to e-cigarettes. However, to safeguard our youth, e-cigarettes must be required to meet product standards, all flavourings must be banned and laws regulating e-cigarette sales must be strictly enforced.

    • Holly R. Middlekauff
    Comment
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells through ACE2 receptors, leading to coronavirus disease (COVID-19)-related pneumonia, while also causing acute myocardial injury and chronic damage to the cardiovascular system. Therefore, particular attention should be given to cardiovascular protection during treatment for COVID-19.

    • Ying-Ying Zheng
    • Yi-Tong Ma
    • Xiang Xie
    Comment
  • Awareness of the effect of the neighbourhood built environment on cardiovascular diseases is growing. In this Comment, we identify major conceptual, methodological and policy-relevant issues in research related to the built environment and describe potential future directions to improve the scientific rigour of research in this field.

    • Mohammad Javad Koohsari
    • Gavin R. McCormack
    • Koichiro Oka
    Comment
  • Our understanding of the causes and consequences of pulmonary hypertension is limited. Consequently, its most distinctive forms with the worst prognosis have been the focus for diagnosis and treatment. We highlight the emerging challenge of reframing the prevalence and prognostic implications of pulmonary hypertension, focusing on the optimal therapeutic window to address the high mortality linked to this condition.

    • Simon Stewart
    • Geoffrey A. Strange
    • David Playford
    Comment