简介：Chronicheartfailureisincreasinglyprevalentworldwideandisassociatedwithsignificantmorbidityandmortality.TheCochranereviewdemonstratedthatcardiacrehabilitation(CR)resultedinimprovementsinQOLandareductioninlong-termmortality.Chronickidneydisease(CKD)isanotherworldwidepublichealthproblem.ThisreviewfocusesontheimportanceandefficacyofrehabilitationforCKDpatientsasanewtargetofCR.PatientswithCKDonhemodialysis(HD)haveahighmortalityrate,withcardiovasculardiseases,suchaschronicheartfailure.Anewsystematicreviewandmeta-analysisofrandomizedcontrolledtrialsreportedthatexercise-basedrenalrehabilitationimprovedaerobiccapacity,muscularfunctioning,cardiovascularfunction,walkingcapacity,andQOLinCKDpatientswithHD.Moreover,exercisetrainingmayhaverenalprotectiveeffects,notonlyinsomeanimalmodelsofpre-HDCKD,butalsoinpre-HDCKDpatients.Exercisetherapycouldbeaneffectiveclinicalstrategyinimprovingrenalfunction,loweringtheneedforrenalreplacementtherapy,suchasHD,andreducingrenaltransplantriskinpre-HDCKDpatients.ThisledtheMinistryofHealth,LaborandWelfareofJapantoextendrenalrehabilitationpartialcoveragetostage4pre-HDCKDpatientsforthefirsttimeintheworldin2016.

简介：Inspiteofrecentadvancesintreatmentandcontrol,theprevalenceofCVDandpulmonaryhypertension(PH)aroundtheworldhasincreasedsignificantly.Webelievethataconceptualbreakthroughisneededandnoveldrugtargetsmustbediscoveredinanattempttocontrolandtreatthem.ACE2,thenewestmemberoftherenin-angiotensinsystem(RAS),appearstoholdthispotential.Ourstudieshaveestablishedanovelconcept:abalancebetweenthevasodeleteriousaxis(ACE/AngⅡ/ATlR)andthevasoprotectiveaxis(ACE2/Ang-1-7/Mas)oftheRASiscriticalinmaintainingnormalCVfunctionsandanyimbalanceinitiatesvasculardysfunctionsleadingtocardiopulmonarydiseases.ThuswehypothesizethatACE2,whichisakeyenzymeindecreasingAngⅡandincreasingAng-1-7,wouldbeanidealforconsiderationasatherapeutictarget.Theobjectiveofmypresentationwillbetopresentevidenceinsupportofthisconcept.ThedatapresentedwilldemonstratethatoverexpressionofACE2bygeneticmeansoritsactivationbenovelACE2activatorsproteststheheartfromhypertension-andMi-inducedcardiacdamage.Also,thisstrategyisextremelyeffectiveinpreventionandreversalofPHandpulmonaryfibrosis.Astructure-baseddrugdiscoveryapproachwillbepresentedtoidentifysmallmoleculeACE2acti-vatorsandtheirpotentialinproducingbeneficialoutcomesonCVDandpulmonaryhypertensionwillbediscussed.

简介：Take-homeMessages.TherecentlypublishedACC/AHAcholesterolguidelinesrecommendfixed-dosestatintherapyforthoseatrisk,andalthoughnotrecommendedasfirstlinetherapy,nonstatintherapiesarerecommendedwhenlessthananticipatedtherapeuticresponsetostatintherapyoccursorwhenpatientsarenotabletotoleratestatintherapy.Nonstatincholesterol-loweringdrugsshowntoreduceatheroscleroticcardiovasculardisease(ASCVD)eventsinrandomizedcontrolledtrials(RCTs)arepreferred.Noevidencewasfoundtosupporttheuseofspecificlow-densitylipoprotein(LDL)-cholesteroltargetlevels.