Cardiovascular disease, with coronary artery disease (CAD) as its main culprit, remains a leading cause of death worldwide. Traditional diagnostic methods that focus on the degree of arterial narrowing (percent diameter stenosis, or
Digital devices play an increasingly important role in the detection and screening of cardiac arrhythmias. Atrial fibrillation (AF), the most common arrhythmia, is associated with an increased risk of stroke, heart failure, and mortality. This review summarises the current evidence on wearable devices for screening and diagnosing atrial fibrillation. Numerous studies have demonstrated the value of wearables for AF detection and diagnosis. In addition, artificial intelligence enhances automated rhythm analysis and signal processing, supporting the increasing clinical implementation of digital technologies in outpatient care. Single-lead ECG devices provide the strongest evidence for AF detection, with smartwatches representing one of the most extensively investigated wearable technology. Limitations include motion artefacts and predominantly semi-continuous monitoring. Future research should focus on integrating artificial intelligence to improve signal analysis and artefact reduction, and on evaluating the impact of wearable-based strategies on clinically relevant outcomes, including stroke and heart failure.
Hypertension remains the leading modifiable risk factor for cardiovascular morbidity and mortality worldwide, yet blood pressure control rates remain suboptimal despite the widespread availability of effective antihypertensive therapies. Poor long-term adherence, therapeutic inertia, and the need for lifelong daily treatment continue to limit the effectiveness of current pharmacological strategies. This review examines the biological rationale, available clinical evidence, and potential role of long-acting RNA-based therapies targeting hepatic angiotensinogen synthesis in hypertension. Small interfering RNAs (siRNAs) and antisense oligonucleotides (ASOs) targeting angiotensinogen represent a novel therapeutic approach that suppresses production of the unique precursor of the renin–angiotensin system. Zilebesiran has demonstrated sustained reductions in circulating angiotensinogen and ambulatory blood pressure following infrequent subcutaneous administration in phase 1 and phase 2 clinical trials. Antisense strategies have provided additional clinical validation of sustained angiotensinogen inhibition, although their antihypertensive efficacy has been less consistent. Ongoing clinical development is addressing long-term cardiovascular outcomes, safety, and optimal patient selection. RNA-based antihypertensive therapies may represent an important evolution in hypertension management by combining upstream renin–angiotensin system inhibition with prolonged pharmacological activity and reduced dependence on daily medication adherence. However, their future clinical role will depend on evidence regarding long-term safety, cardiovascular outcomes, reversibility, cost-effectiveness, patient selection, and integration with conventional antihypertensive therapy.
To provide an overview of the dual role of psychological factors: as determinants of cardiac rehabilitation (CR) engagement and long-term behavior change, and as consequences and treatment targets. CR is central to cardiovascular care but remains underused. Beyond systemic and logistical barriers, psychological factors influence whether patients participate in and complete CR and maintain a healthy lifestyle post-CR. Psychological distress is common in patients eligible for CR and negatively affects quality of life and prognosis. Without addressing these factors, CR jeopardizes remaining an effective but underused intervention which full potential is not realized. Psychological factors should be understood both as barriers to CR participation, completion, and long-term benefit, and as actionable targets to improve these outcomes. They should therefore not be limited to intake risk screening but assessed and acted upon across the CR pathway to support engagement and enhance sustained behavior change and patient-centered recovery.
Chest radiotherapy has improved cancer survival in various thoracic malignancies, including breast cancer, Hodgkin lymphoma, and lung cancer. However, inadvertent radiation exposure to the heart is associated with a broad spectrum of cardiovascular toxicities, collectively termed radiation-induced heart disease (RIHD). We aim to review the pathophysiology of RIHD and the current evidence for their incidence, risk factors, clinical management, and prevention strategies. RIHD is mediated by oxidative stress, DNA damage, endothelial dysfunction, inflammation, and progressive fibrosis, leading to accelerated atherosclerosis, myocardial stiffening, valvular degeneration, pericardial disease, and arrhythmias. The risk, timing, and severity of cardiovascular complications are influenced by radiation dose and distribution, age at exposure, baseline cardiovascular risk, and concomitant cardiotoxic therapies. While younger patients may experience prolonged latency before clinical disease onset, older individuals and those with pre-existing cardiovascular disease often develop complications earlier, reflecting radiation-mediated acceleration of underlying pathology. This review summarizes the epidemiology, latency, clinical presentation, surveillance strategies, and management of the different forms of RIHD. It also discusses contemporary approaches to risk mitigation, including advances in radiation delivery techniques, aggressive cardiovascular risk factor modification, lifestyle interventions, and emerging pharmacologic strategies.
