Early Vascular Aging (EVA): New Directions in Cardiovascular Protection, Second Edition continues to be the most comprehensive and authoritative resource on premature alterations in artery structure and function. The book presents a novel approach to the problem of cardiovascular disease, showing it in relation to great vessels disease and revealing a comprehensive approach to the problem of increased rigidity of the great vessels, its causes, and further consequences. This second edition contains completely updated content with expanded coverage of basic and translational research, systematic reviews of the most prominent literature, discussion of applicability of new evidence and more. Written by an international team of clinicians and researchers, this is a valuable resource to basic and translational scientists, clinical researchers and clinicians in the cardiovascular field interested in prevention, diagnosis and treatment of EVA. - Contains all the relevant information available on the main paradigm shifts in vascular aging research, from different fields of knowledge (from basic biology to epidemiology) - Reviews the most prominent evidence produced on early vascular aging (EVA), highlighting recent research advances, clinical applications, and research opportunities - Formulates, in each chapter, a set of research questions that need to be addressed, challenging the vast research community to take on new directions and collaborations

BACKGROUND AND AIM Atherosclerosis is the most common cause of cardiovascular disease (CVD) and has its origin early in life. The prevalence of classic CVD risk factors like smoking, overweight, hypertension and unfavorable blood lipids in childhood and adolescence is associated with an increased risk for CVD in adulthood. Therefore this study aims to assess vascular changes and predictors for early vascular ageing (EVA) in a large cohort of healthy Tyrolean adolescents.METHODS Volunteering Tyrolean schools and companies were invited to take part in this regional cohort study. Common risk factors for CVD like smoking, activity, and diet were assessed as well as anthropometric data (BMI, blood pressure) and blood lipids. Vascular changes were evaluated by measuring intima-media-thickness of the common carotid artery (cIMT) by high resolution ultrasound as a marker for subclinical atherosclerosis.RESULTS 1573 (691 male, 882 female) adolescents with a mean age of 16 years were included in this analysis. 1556 participants had ultrasound measurement of cIMT. In a multivariable linear regression analysis male sex, BMI, daily physical activity and systolic blood pressure showed a positive relation to mean cIMT. Maximum cIMT was predicted by sex, BMI and systolic blood pressure. CONCLUSION Risk factors for atherosclerosis are present in Tyrolean adolescents and are associated with early vascular aging. The positive association between physical activity and mean cIMT may be explained by a non-atherosclerotic adaptation process. Maximum cIMT as a marker for first atherosclerotic lesions is not affected by physical activity.

This textbook focuses on the vascular biology and physiology that underlie vascular disorders in clinical medicine. Vascular biomedicine is a rapidly growing field as new molecular mechanisms of vascular health and disease are unraveled. Many of the major cardiovascular diseases including coronary artery disease, heart failure, stroke and vascular dementia are diseases of the vasculature. In addition vascular injury underpins conditions like kidney failure and cardiovascular complications of diabetes. This field is truly multidisciplinary involving scientists in many domains such as molecular and vascular biology, cardiovascular physiology and pharmacology and immunology and inflammation. Clinically, specialists across multiple disciplines are involved in the management of patients with vascular disorders, including cardiologists, nephrologists, endocrinologists, neurologists and vascular surgeons. This book covers a wide range of topics and provides an overview of the discipline of vascular biomedicine without aiming at in-depth reviews, but rather offering up-to-date knowledge organized in concise and structured chapters, with key points and pertinent references. The structure of the content provides an integrative and translational approach from basic science (e.g. stem cells) to clinical medicine (e.g. cardiovascular disease). The content of this book is targeted to those who are new in the field of vascular biology and vascular medicine and is ideal for medical students, graduate and postgraduate students, clinical fellows and academic clinicians with an interest in the vascular biology and physiology of cardiovascular disease and related pathologies.

The increasing mean age of the population in developed countries has turned out to be an economic and social problem. Cardiovascular disease has long been considered to be age related in terms of their onset and progression. As such, we can say that the increase in life expectancy goes in parallel with increased incidence of cardiovascular disease. With age, a number of changes occur in the vasculature altering the homeostasis of the irrigated organs promoting target organ damage. While different adaptive mechanisms to protect vessels against mild stress have been described, the aging process induces a progressive failure of protective mechanisms, leading to vascular changes and higher susceptibility to cardiovascular diseases. Indeed, vascular aging is exacerbated by coexisting cardiovascular risk factors, such as hypertension, metabolic syndrome and diabetes. Compelling evidence indicates that diminished endothelial relaxation and increase, decrease, or no change in contractile responses to several agonists is associated with aging. There is an increase of vasoconstrictor factors expression and a decrease of vasodilators. Morphologic changes include lumen diameter enlargement, wall thickening and alterations of matrix substances as increased collagen or decreased elastin deposition, ultimately leading to greater arterial stiffening (reduced compliance). Importantly, arterial stiffness is an independent predictor of cardiovascular morbidity and mortality. Cellular and molecular mechanisms have also been documented. Senescence at the cellular level involves alterations in Ca2+ signaling and down regulation of anti-aging proteins. Both endothelial and smooth muscle cells change their number, morphology, function and their regenerative ability. Aging is also associated with a gradual loss of antioxidant defense mechanisms, a proinflammatory shift in the cytokine expression profile and a production of reactive oxygen species such as superoxide (O2-) that promotes the breakdown of nitric oxide. Nitric oxide and O2- interact to form peroxynitrite known to nitrosylate proteins affecting their physiological function. However, vascular wall proteins may also suffer from other potentially deleterious modifications as glycation (Maillard reaction) and glyco-oxidative reactions with increasing age, which could be linked to the age-associated changes in vascular function. Various strategies have shown benefit in preventing, delaying or attenuating vascular aging. For instance, a healthy lifestyle including low fat diet and/or exercise have a favorable effect. Nevertheless, it yet remains to be fully demonstrated whether vascular aging can be pharmacologically prevented. This Research Topic is intended to bring together research efforts to understand the causes and consequences of vascular aging and propose new therapeutic strategies for the management of vascular senescence.

Photoplethysmography: Technology, Signal Analysis, and Applications is the first comprehensive volume on the theory, principles, and technology (sensors and electronics) of photoplethysmography (PPG). It provides a detailed description of the current state-of-the-art technologies/optical components enabling the extreme miniaturization of such sensors, as well as comprehensive coverage of PPG signal analysis techniques including machine learning and artificial intelligence. The book also outlines the huge range of PPG applications in healthcare, with a strong focus on the contribution of PPG in wearable sensors and PPG for cardiovascular assessment. - Presents the underlying principles and technology surrounding PPG - Includes applications for healthcare and wellbeing - Focuses on PPG in wearable sensors and devices - Presents advanced signal analysis techniques - Includes cutting-edge research, applications and future directions

This is the sixth edition of a popular textbook on multivariate analysis. Well-regarded for its practical and accessible approach, with excellent examples and good guidance on computing, the book is particularly popular for teaching outside statistics, i.e. in epidemiology, social science, business, etc. The sixth edition has been updated with a new chapter on data visualization, a distinction made between exploratory and confirmatory analyses and a new section on generalized estimating equations and many new updates throughout. This new edition will enable the book to continue as one of the leading textbooks in the area, particularly for non-statisticians. Key Features: Provides a comprehensive, practical and accessible introduction to multivariate analysis. Keeps mathematical details to a minimum, so particularly geared toward a non-statistical audience. Includes lots of detailed worked examples, guidance on computing, and exercises. Updated with a new chapter on data visualization.