The mind and the heart are inextricably linked. Depression, worry, loneliness, anger, and chronic stress are all negative mental states that can increase the risk of heart disease or worsen existing cardiac problems. Cardiomyopathy develops in response to suddenly hearing stressful news, such as a loved one diagnosed with cancer. Thus, intense emotions, such as anger, can also lead to abnormal heart rhythms. When you are stressed, your blood pressure and heart rate both rise. Chronic stress causes your body to produce harmful quantities of stress hormones such as cortisol, which can alter blood clots. All of these factors can lead to a heart attack or a stroke. Negative thoughts, feelings, or emotions may influence lifestyle patterns, increasing the risk of heart disease. People who are chronically stressed, nervous, sad, or angry are more likely to consume excessive amounts of alcohol, smoke, overeat, and exercise insufficiently– all harmful habits that are detrimental to their heart health.

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This review focuses on the role of dietary potassium and sodium in hypertension and cardiovascular (CV) damage and protection. It briefly describes the burden of global hypertension and CV diseases; discusses some of the ways that sodium and potassium imbalance induce hypertension; provides some experimental evidence explaining how high-sodium and low-potassium diet induces target organ (kidney and heart, etc.) damage independent of blood pressure, and addresses the role that a low-sodium and high-potassium diet may play to reduce the incidence of hypertension, CV events, and death.

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Many cardiovascular diseases (CVD) are caused by the interplay of lifestyle and genetic factors. Studies have suggested an association between red meat consumption and increased CVD risk. There is evidence indicating that trimethylamine N-oxide (TMAO), a metabolite of red meat and other animal-derived foodstuffs, promotes CVD. Here, we undertake an overview of some of the reported investigations of the relationship between TMAO and CVD and briefly discuss possible underlying mechanisms.

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Background and Aim: The association of atrial fibrillation (AF) with the ischemic stroke has emerged as an area of clinical research. The purpose of the present study is to investigate possible correlations between the severity, progress, and outcome of ischemic stroke and the presence of AF. Materials and Methods and Results: The clinical assessment of patients was based on the neurological status at the time of diagnosis utilizing the National Institutes of Health Stroke Scale (NIHSS), the neurological semiology during hospitalization (improvement, deterioration, and without differentiation), and the final outcome at the end of the treatment optimizing the modified Rankin scale (mRS). A total of 344 patients diagnosed with an ischemic stroke were enrolled in the study. The presence of AF was found to be associated with higher severity, poorer progress, and more adverse clinical outcomes of the ischemic stroke. Furthermore, a lower frequency of transient ischemic attacks was observed in patients with AF. Finally, patients with AF presented higher incidence of middle cerebral artery occlusion and were more frequently found with a lesion on the left brain hemisphere. Conclusion: AF was found to be highly associated with higher severity and poorer prognosis of ischemic strokes, independently from the presence of other cardiovascular risk factors.

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Prenatal depression and preeclampsia (PE) are well-known risk factors of maternal and fetal mortality and morbidity. In recent years, there are emerging evidence suggesting that prenatal depression and PE could be environmental risk factors for several neurodevelopment disorders of offspring. Prenatal depression and PE were also found to be risk factors of each other. At present, the mechanism (s) of how prenatal depression and PE affect one another and their roles in the development of maternal and fetal adverse outcomes are uncertain. In this review, we outline the most recent clinical studies on the effects of prenatal depression and PE on the neurodevelopmental outcomes of offspring, as well as the plausible mechanism(s) of how these two maternal conditions affect each other and their roles in the neurodevelopment of offspring, including inflammation, oxidative stress, and maternal immune activation. We postulate that the overproduction of pro-inflammatory cytokines and increased cortisol levels in maternal depression can alter fetal neurodevelopment, and the autonomic nervous system dysfunction caused by maternal depression may accelerate heart rate and elevate blood pressure in mothers. Similarly, in PE, the elevated inflammation and exaggerated oxidative stress in the mothers, placenta, and fetus could negatively affect maternal depression on and impair the neurodevelopment of offspring. Further studies are needed to examine the combined effects of prenatal depression and PE on the health outcomes of mothers and offspring, to explore the mechanism of maternal depression in the development of PE and to investigate their roles in the neurodevelopment of offspring.

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Background: Patient education before the placement of an implantable cardioverter-defibrillator (ICD) is strongly recommended to prevent or mitigate feelings of regret and frustration in ICD recipients. Medicare guidelines for ICDs require a shared decision-making approach that focuses on patients' health goals, values, and preferences before implantation. However, many patients are not fully informed of what to expect when recovering from ICD placement or living with an ICD long-term. Objectives: Our objective is to understand decision-making processes and decisional regret in patients requiring ICDs using in-depth interviews. Methods: Nineteen patients at Stanford University Medical Center were recruited to participate in individual interviews using closed-ended and open-ended questions to engage dialogue. Notes taken during interviews were assessed and used to identify major themes. Results: Participants described a lack of adequate education about ICD postoperative recovery and long-term, postimplantation considerations such as avoiding electromagnetic fields, false-positive ICD shocks, and the esthetic effect of ICD implantation. In addition, feelings of fear and anxiety were prevalent in participants' recollections of accepting an ICD. Conclusion: Further improvement in patient education before ICD placement is needed. The decision-making process can be simplified and patient regret and frustration minimized by providing reliable information that is accessible and interactive.

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Objective: The objective of this study was to identify socioeconomic and clinical factors associated with disease-related knowledge of cardiac rehabilitation (CR) patients. Methods: Adults with coronary artery disease (CAD) were recruited during CR Phase 1 and completed questionnaires on the 1^st day of Phase 2. Disease-related knowledge was assessed by the short version of the CAD Education Questionnaire. Socioeconomic status was defined by educational level, family income, and employment status. MannWhitney U and Spearman correlation were calculated to determine the association of knowledge with socioeconomic factors, number of risk factors, and wait time between hospital discharge and start of outpatient CR. Results: A convenience sample of 39 patients were recruited. Overall, the mean knowledge was 12.00 ± 3.3, which corresponds to 60% of possible scores. Monthly family income and number of risk factors influenced medical condition knowledge (P < 0.05), and employment status influenced total knowledge (P = 0.005) and risk factor knowledge (P = 0.002). Participants with three or more risk factors presented significantly higher knowledge (P = 0.02). Those that waited more than 17 weeks to start the CR presented significantly lower knowledge (P = 0.04). Conclusion: Participants with low income and unemployed were more likely to have inadequate disease-related knowledge; however, the entire sample presented low understanding of their condition. Public health strategies and educational interventions must continue to focus on these vulnerable groups.

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