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Sample records for adult cardiovascular medicine

  1. Nanotechnology in cardiovascular medicine.

    PubMed

    Patel, Devang N; Bailey, Steven R

    2007-04-01

    Nanotechnology is a new field of science and technology that has already had significant impact in the development of novel products in industry. In medicine, application of nanotechnology has the potential to develop new imaging agents, pharmaceutical drugs and medical devices with unique physical and chemical properties. This article reviews the potential for various nanoparticles in cardiovascular imaging and therapeutics, nanoporous structures for sensing and implant based drug delivery, and self-assembled monolayers for surface modification and implant based drug delivery.

  2. A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus

    PubMed Central

    Al Hamid, A; Ghaleb, M; Aljadhey, H; Aslanpour, Z

    2014-01-01

    Objectives To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives. Design A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies. Data sources We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature). Review methods Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies. Results The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control). Conclusions MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients’ perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients. PMID:25239295

  3. Hospitalisation Resulting from Medicine-Related Problems in Adult Patients with Cardiovascular Diseases and Diabetes in the United Kingdom and Saudi Arabia

    PubMed Central

    Al Hamid, Abdullah; Aslanpour, Zoe; Aljadhey, Hisham; Ghaleb, Maisoon

    2016-01-01

    Cardiovascular diseases (CVDs) and diabetes (DM) are two interrelated conditions that have a heavy morbidity and mortality burden worldwide. Patients with the two conditions usually take multiple medicines and thus are more susceptible to medicine-related problems (MRPs). MRPs can occur at any stage of the treatment process and in many cases can lead to unplanned hospitalisations. The aim of the study was to determine the prevalence of hospitalisation resulting from MRPs in adult patients with CVDs and/or DM and to identify the main causes, risk factors, and medicine classes involved. A retrospective study included 300 adult patients from two hospitals, one in the United Kingdom and one in Saudi Arabia. To identify MRPs, medical records were reviewed for demographic data, clinical data, laboratory assay, and prescription records. A total of 197 (65.7%) patients had MRPs, of which less than 10% were severe. The main problems were lack of treatment effectiveness and adverse drug reactions. Moreover, polypharmacy and patient non-adherence were the main risk factors contributing to MRPs. The main medicine classes associated with MRPs were insulin and antihypertensive medicines. Further research should address the pharmaceutical care processes employed in treating CVDs and DM, and to empower patients/healthcare providers in tackling MRPs. PMID:27171100

  4. Laughter is the Best Medicine? A Cross-Sectional Study of Cardiovascular Disease Among Older Japanese Adults

    PubMed Central

    Hayashi, Kei; Kawachi, Ichiro; Ohira, Tetsuya; Kondo, Katsunori; Shirai, Kokoro; Kondo, Naoki

    2016-01-01

    Background We sought to evaluate the associations between frequency of daily laughter with heart disease and stroke among community-dwelling older Japanese women and men. Methods We analyzed cross-sectional data in 20 934 individuals (10 206 men and 10 728 women) aged 65 years or older, who participated in the Japan Gerontological Evaluation Study in 2013. In the mail-in survey, participants provided information on daily frequency of laughter, as well as body mass index, demographic and lifestyle factors, and diagnoses of cardiovascular disease, hyperlipidemia, hypertension, and depression. Results Even after adjustment for hyperlipidemia, hypertension, depression, body mass index, and other risk factors, the prevalence of heart diseases among those who never or almost never laughed was 1.21 (95% CI, −1.03–1.41) times higher than those who reported laughing every day. The adjusted prevalence ratio for stroke was 1.60 (95% CI, 1.24–2.06). Conclusions Daily frequency of laughter is associated with lower prevalence of cardiovascular diseases. The association could not be explained by confounding factors, such as depressive symptoms. PMID:26972732

  5. Lymphatic System in Cardiovascular Medicine.

    PubMed

    Aspelund, Aleksanteri; Robciuc, Marius R; Karaman, Sinem; Makinen, Taija; Alitalo, Kari

    2016-02-01

    The mammalian circulatory system comprises both the cardiovascular system and the lymphatic system. In contrast to the blood vascular circulation, the lymphatic system forms a unidirectional transit pathway from the extracellular space to the venous system. It actively regulates tissue fluid homeostasis, absorption of gastrointestinal lipids, and trafficking of antigen-presenting cells and lymphocytes to lymphoid organs and on to the systemic circulation. The cardinal manifestation of lymphatic malfunction is lymphedema. Recent research has implicated the lymphatic system in the pathogenesis of cardiovascular diseases including obesity and metabolic disease, dyslipidemia, inflammation, atherosclerosis, hypertension, and myocardial infarction. Here, we review the most recent advances in the field of lymphatic vascular biology, with a focus on cardiovascular disease.

  6. Precision Medicine, Cardiovascular Disease and Hunting Elephants.

    PubMed

    Joyner, Michael J

    2016-01-01

    Precision medicine postulates improved prediction, prevention, diagnosis and treatment of disease based on patient specific factors especially DNA sequence (i.e., gene) variants. Ideas related to precision medicine stem from the much anticipated "genetic revolution in medicine" arising seamlessly from the human genome project (HGP). In this essay I deconstruct the concept of precision medicine and raise questions about the validity of the paradigm in general and its application to cardiovascular disease. Thus far precision medicine has underperformed based on the vision promulgated by enthusiasts. While niche successes for precision medicine are likely, the promises of broad based transformation should be viewed with skepticism. Open discussion and debate related to precision medicine are urgently needed to avoid misapplication of resources, hype, iatrogenic interventions, and distraction from established approaches with ongoing utility. Failure to engage in such debate will lead to negative unintended consequences from a revolution that might never come.

  7. Precision Medicine, Cardiovascular Disease and Hunting Elephants.

    PubMed

    Joyner, Michael J

    2016-01-01

    Precision medicine postulates improved prediction, prevention, diagnosis and treatment of disease based on patient specific factors especially DNA sequence (i.e., gene) variants. Ideas related to precision medicine stem from the much anticipated "genetic revolution in medicine" arising seamlessly from the human genome project (HGP). In this essay I deconstruct the concept of precision medicine and raise questions about the validity of the paradigm in general and its application to cardiovascular disease. Thus far precision medicine has underperformed based on the vision promulgated by enthusiasts. While niche successes for precision medicine are likely, the promises of broad based transformation should be viewed with skepticism. Open discussion and debate related to precision medicine are urgently needed to avoid misapplication of resources, hype, iatrogenic interventions, and distraction from established approaches with ongoing utility. Failure to engage in such debate will lead to negative unintended consequences from a revolution that might never come. PMID:26902518

  8. Redox biomarkers in cardiovascular medicine.

    PubMed

    Karimi Galougahi, Keyvan; Antoniades, Charalambos; Nicholls, Stephen J; Channon, Keith M; Figtree, Gemma A

    2015-07-01

    The central role of oxidative signalling in cardiovascular pathophysiology positions biometric measures of redox state as excellent markers for research and clinical application. However, despite this tantalizing biological plausibility, no redox biomarker is currently in widespread clinical use. Major recent insights into the mechanistic complexities of redox signalling may yet provide the opportunity to identify markers that most closely reflect the underlying pathobiology. Such redox biomarkers may, in principle, quantify the integrated effects of various known and unknown pathophysiological drivers of cardiovascular disease processes. Recent advances with the greatest potential include assays measuring post-translational oxidative modifications that have significant cellular effects. However, analytical issues, including the relative instability of redox-modified products, remain a major technical obstacle. Appreciation of these challenges may facilitate future development of user-friendly markers with prognostic value in addition to traditional risk factors, and which could be used to guide personalized cardiovascular therapies. We review both established and recently identified biomarkers of redox signalling, and provide a realistic discussion of the many challenges that remain if they are to be incorporated into clinical practice. Despite the current lack of redox biomarkers in clinical application, the integral role of reactive oxygen species in pathogenesis of cardiovascular disease provides a strong incentive for continued efforts.

  9. Native American medicine and cardiovascular disease.

    PubMed

    Nauman, Eileen

    2007-01-01

    Native American medicine provides an approach to the treatment of cardiovascular disease that is unique and that can complement modern medicine treatments. Although specific practices among the various Native American tribes (Nations) can vary, there is a strong emphasis on the power of shamanism that can be supplemented by the use of herbal remedies, sweat lodges, and special ceremonies. Most of the practices are passed down by oral tradition, and there is specific training regarding the Native American healer. Native American medicine has strong testimonial experiences to suggest benefit in cardiac patients; however, critical scientific scrutiny is necessary to confirm the validity of the benefits shown to date.

  10. Electronic health records for cardiovascular medicine.

    PubMed

    Ouhbi, Sofia; Idri, Ali; Fernández-Alemán, Jose Luis; Toval, Ambrosio; Benjelloun, Halima

    2014-01-01

    Nowadays, many cardiology health care centers and hospitals adopt new technologies to improve interaction with their patients. The Electronic Health Records (EHR) offer health care centers and institutions the possibility to improve the management of their patients' health data. Currently, many physicians are using EHRs to improve health care quality and efficiency. A large number of companies have emerged to provide hospitals with the opportunity to adopt EHRs within a health care platform proposing different functionalities and services which achieve certain certification criteria. This paper identifies the current list of certified EHRs for cardiovascular medicine and assesses the specifications of the EHRs selected. The result of this paper may assist EHR seekers for cardiovascular medicine in their tasks. PMID:25570218

  11. The Middle Ages Contributions to Cardiovascular Medicine

    PubMed Central

    Ranhel, André Silva; Mesquita, Evandro Tinoco

    2016-01-01

    The historical period called the Middle Ages, a long interval between the 5th and the 15th centuries, is still commonly known as the Dark Ages, especially in the area of health sciences. In the last decades, this "classic" view of the Middle Ages has been gradually modified with advances in historiographical studies and the history of science. During that period in Western Europe, knowledge about the human body suffered a regression in terms of anatomy and physiology, with the predominance of religious conceptions mainly about diseases and their treatments. Knowledge on the cardiovascular system and heart diseases has been classically described as a repetition of the concepts developed by Galen from the dissection of animals and his keen sense of observation. However, the Middle East, especially Persia, was the birth place of a lot of intellectuals who preserved the ancient knowledge of the Greeks while building new knowledge and practices, especially from the 8th to the 13th century. The invasion of the Arabs in North of Africa and the Iberian Peninsula and the eclosion of the Crusades resulted in a greater contact between the East and the West, which in turn brought on the arrival of the Arab medical knowledge, among others, to 12th century Europe. Such fact contributed to an extremely important change in the scientific medical knowledge in the West, leading to the incorporation of different concepts and practices in the field of cardiovascular Medicine. The new way of teaching and practicing Medicine of the great Arab doctors, together with the teaching hospitals and foundations in the Koran, transformed the Medicine practiced in Europe definitely. The objective of this paper is to describe the knowledge drawn up from the Middle Ages about the cardiovascular system, its understanding and therapeutic approach to cardiologists and cardiovascular surgeons. PMID:27556317

  12. The Middle Ages Contributions to Cardiovascular Medicine.

    PubMed

    Ranhel, André Silva; Mesquita, Evandro Tinoco

    2016-04-01

    The historical period called the Middle Ages, a long interval between the 5th and the 15th centuries, is still commonly known as the Dark Ages, especially in the area of health sciences. In the last decades, this "classic" view of the Middle Ages has been gradually modified with advances in historiographical studies and the history of science. During that period in Western Europe, knowledge about the human body suffered a regression in terms of anatomy and physiology, with the predominance of religious conceptions mainly about diseases and their treatments. Knowledge on the cardiovascular system and heart diseases has been classically described as a repetition of the concepts developed by Galen from the dissection of animals and his keen sense of observation. However, the Middle East, especially Persia, was the birth place of a lot of intellectuals who preserved the ancient knowledge of the Greeks while building new knowledge and practices, especially from the 8th to the 13th century. The invasion of the Arabs in North of Africa and the Iberian Peninsula and the eclosion of the Crusades resulted in a greater contact between the East and the West, which in turn brought on the arrival of the Arab medical knowledge, among others, to 12th century Europe. Such fact contributed to an extremely important change in the scientific medical knowledge in the West, leading to the incorporation of different concepts and practices in the field of cardiovascular Medicine. The new way of teaching and practicing Medicine of the great Arab doctors, together with the teaching hospitals and foundations in the Koran, transformed the Medicine practiced in Europe definitely. The objective of this paper is to describe the knowledge drawn up from the Middle Ages about the cardiovascular system, its understanding and therapeutic approach to cardiologists and cardiovascular surgeons. PMID:27556317

  13. Developing an action plan for patient radiation safety in adult cardiovascular medicine: proceedings from the Duke University Clinical Research Institute/American College of Cardiology Foundation/American Heart Association Think Tank held on February 28, 2011.

    PubMed

    Douglas, Pamela S; Carr, J Jeffrey; Cerqueira, Manuel D; Cummings, Jennifer E; Gerber, Thomas C; Mukherjee, Debabrata; Taylor, Allen J

    2012-05-15

    Technological advances and increased utilization of medical testing and procedures have prompted greater attention to ensuring the patient safety of radiation use in the practice of adult cardiovascular medicine. In response, representatives from cardiovascular imaging societies, private payers, government and nongovernmental agencies, industry, medical physicists, and patient representatives met to develop goals and strategies toward this end; this report provides an overview of the discussions. This expert “think tank” reached consensus on several broad directions including: the need for broad collaboration across a large number of diverse stakeholders; clarification of the relationship between medical radiation and stochastic events; required education of ordering and providing physicians, and creation of a culture of safety; development of infrastructure to support robust dose assessment and longitudinal tracking; continued close attention to patient selection by balancing the benefit of cardiovascular testing and procedures against carefully minimized radiation exposures; collation, dissemination, and implementation of best practices; and robust education, not only across the healthcare community, but also to patients, the public, and media. Finally, because patient radiation safety in cardiovascular imaging is complex, any proposed actions need to be carefully vetted (and monitored) for possible unintended consequences.

  14. Developing an action plan for patient radiation safety in adult cardiovascular medicine: proceedings from the Duke University Clinical Research Institute/American College of Cardiology Foundation/American Heart Association think tank held on February 28, 2011.

    PubMed

    Douglas, Pamela S; Carr, J Jeffery; Cerqueira, Manuel D; Cummings, Jennifer E; Gerber, Thomas C; Mukherjee, Debabrata; Taylor, Allen J

    2012-05-01

    Technological advances and increased utilization of medical testing and procedures have prompted greater attention to ensuring the patient safety of radiation use in the practice of adult cardiovascular medicine. In response, representatives from cardiovascular imaging societies, private payers, government and nongovernmental agencies, industry, medical physicists, and patient representatives met to develop goals and strategies toward this end; this report provides an overview of the discussions. This expert "think tank" reached consensus on several broad directions including: the need for broad collaboration across a large number of diverse stakeholders; clarification of the relationship between medical radiation and stochastic events; required education of ordering and providing physicians, and creation of a culture of safety; development of infrastructure to support robust dose assessment and longitudinal tracking; continued close attention to patient selection by balancing the benefit of cardiovascular testing and procedures against carefully minimized radiation exposures; collation, dissemination, and implementation of best practices; and robust education, not only across the healthcare community, but also to patients, the public, and media. Finally, because patient radiation safety in cardiovascular imaging is complex, any proposed actions need to be carefully vetted (and monitored) for possible unintended consequences.

  15. Computational fluid dynamics modelling in cardiovascular medicine.

    PubMed

    Morris, Paul D; Narracott, Andrew; von Tengg-Kobligk, Hendrik; Silva Soto, Daniel Alejandro; Hsiao, Sarah; Lungu, Angela; Evans, Paul; Bressloff, Neil W; Lawford, Patricia V; Hose, D Rodney; Gunn, Julian P

    2016-01-01

    This paper reviews the methods, benefits and challenges associated with the adoption and translation of computational fluid dynamics (CFD) modelling within cardiovascular medicine. CFD, a specialist area of mathematics and a branch of fluid mechanics, is used routinely in a diverse range of safety-critical engineering systems, which increasingly is being applied to the cardiovascular system. By facilitating rapid, economical, low-risk prototyping, CFD modelling has already revolutionised research and development of devices such as stents, valve prostheses, and ventricular assist devices. Combined with cardiovascular imaging, CFD simulation enables detailed characterisation of complex physiological pressure and flow fields and the computation of metrics which cannot be directly measured, for example, wall shear stress. CFD models are now being translated into clinical tools for physicians to use across the spectrum of coronary, valvular, congenital, myocardial and peripheral vascular diseases. CFD modelling is apposite for minimally-invasive patient assessment. Patient-specific (incorporating data unique to the individual) and multi-scale (combining models of different length- and time-scales) modelling enables individualised risk prediction and virtual treatment planning. This represents a significant departure from traditional dependence upon registry-based, population-averaged data. Model integration is progressively moving towards 'digital patient' or 'virtual physiological human' representations. When combined with population-scale numerical models, these models have the potential to reduce the cost, time and risk associated with clinical trials. The adoption of CFD modelling signals a new era in cardiovascular medicine. While potentially highly beneficial, a number of academic and commercial groups are addressing the associated methodological, regulatory, education- and service-related challenges.

  16. Computational fluid dynamics modelling in cardiovascular medicine

    PubMed Central

    Morris, Paul D; Narracott, Andrew; von Tengg-Kobligk, Hendrik; Silva Soto, Daniel Alejandro; Hsiao, Sarah; Lungu, Angela; Evans, Paul; Bressloff, Neil W; Lawford, Patricia V; Hose, D Rodney; Gunn, Julian P

    2016-01-01

    This paper reviews the methods, benefits and challenges associated with the adoption and translation of computational fluid dynamics (CFD) modelling within cardiovascular medicine. CFD, a specialist area of mathematics and a branch of fluid mechanics, is used routinely in a diverse range of safety-critical engineering systems, which increasingly is being applied to the cardiovascular system. By facilitating rapid, economical, low-risk prototyping, CFD modelling has already revolutionised research and development of devices such as stents, valve prostheses, and ventricular assist devices. Combined with cardiovascular imaging, CFD simulation enables detailed characterisation of complex physiological pressure and flow fields and the computation of metrics which cannot be directly measured, for example, wall shear stress. CFD models are now being translated into clinical tools for physicians to use across the spectrum of coronary, valvular, congenital, myocardial and peripheral vascular diseases. CFD modelling is apposite for minimally-invasive patient assessment. Patient-specific (incorporating data unique to the individual) and multi-scale (combining models of different length- and time-scales) modelling enables individualised risk prediction and virtual treatment planning. This represents a significant departure from traditional dependence upon registry-based, population-averaged data. Model integration is progressively moving towards ‘digital patient’ or ‘virtual physiological human’ representations. When combined with population-scale numerical models, these models have the potential to reduce the cost, time and risk associated with clinical trials. The adoption of CFD modelling signals a new era in cardiovascular medicine. While potentially highly beneficial, a number of academic and commercial groups are addressing the associated methodological, regulatory, education- and service-related challenges. PMID:26512019

  17. Computational fluid dynamics modelling in cardiovascular medicine.

    PubMed

    Morris, Paul D; Narracott, Andrew; von Tengg-Kobligk, Hendrik; Silva Soto, Daniel Alejandro; Hsiao, Sarah; Lungu, Angela; Evans, Paul; Bressloff, Neil W; Lawford, Patricia V; Hose, D Rodney; Gunn, Julian P

    2016-01-01

    This paper reviews the methods, benefits and challenges associated with the adoption and translation of computational fluid dynamics (CFD) modelling within cardiovascular medicine. CFD, a specialist area of mathematics and a branch of fluid mechanics, is used routinely in a diverse range of safety-critical engineering systems, which increasingly is being applied to the cardiovascular system. By facilitating rapid, economical, low-risk prototyping, CFD modelling has already revolutionised research and development of devices such as stents, valve prostheses, and ventricular assist devices. Combined with cardiovascular imaging, CFD simulation enables detailed characterisation of complex physiological pressure and flow fields and the computation of metrics which cannot be directly measured, for example, wall shear stress. CFD models are now being translated into clinical tools for physicians to use across the spectrum of coronary, valvular, congenital, myocardial and peripheral vascular diseases. CFD modelling is apposite for minimally-invasive patient assessment. Patient-specific (incorporating data unique to the individual) and multi-scale (combining models of different length- and time-scales) modelling enables individualised risk prediction and virtual treatment planning. This represents a significant departure from traditional dependence upon registry-based, population-averaged data. Model integration is progressively moving towards 'digital patient' or 'virtual physiological human' representations. When combined with population-scale numerical models, these models have the potential to reduce the cost, time and risk associated with clinical trials. The adoption of CFD modelling signals a new era in cardiovascular medicine. While potentially highly beneficial, a number of academic and commercial groups are addressing the associated methodological, regulatory, education- and service-related challenges. PMID:26512019

  18. Adult ADHD Medications and Their Cardiovascular Implications

    PubMed Central

    Lewis, O.

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobiological disorder exhibited by difficulty maintaining attention, as well as hyperactivity and impulsive behavior. Central nervous system (CNS) stimulants are the first line of treatment for ADHD. With the increase in number of adults on CNS stimulants, the question that arises is how well do we understand the long-term cardiovascular effects of these drugs. There has been increasing concern that adults with ADHD are at greater risk for developing adverse cardiovascular events such as sudden death, myocardial infarction, and stroke as compared to pediatric population. Cardiovascular response attributed to ADHD medication has mainly been observed in heart rate and blood pressure elevations, while less is known about the etiology of rare cardiovascular events like acute myocardial infarction (AMI), arrhythmia, and cardiomyopathy and its long-term sequelae. We present a unique case of AMI in an adult taking Adderall (mixed amphetamine salts) and briefly discuss the literature relevant to the cardiovascular safety of CNS stimulants for adult ADHD. PMID:27579185

  19. Adult ADHD Medications and Their Cardiovascular Implications.

    PubMed

    Sinha, A; Lewis, O; Kumar, R; Yeruva, S L H; Curry, B H

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobiological disorder exhibited by difficulty maintaining attention, as well as hyperactivity and impulsive behavior. Central nervous system (CNS) stimulants are the first line of treatment for ADHD. With the increase in number of adults on CNS stimulants, the question that arises is how well do we understand the long-term cardiovascular effects of these drugs. There has been increasing concern that adults with ADHD are at greater risk for developing adverse cardiovascular events such as sudden death, myocardial infarction, and stroke as compared to pediatric population. Cardiovascular response attributed to ADHD medication has mainly been observed in heart rate and blood pressure elevations, while less is known about the etiology of rare cardiovascular events like acute myocardial infarction (AMI), arrhythmia, and cardiomyopathy and its long-term sequelae. We present a unique case of AMI in an adult taking Adderall (mixed amphetamine salts) and briefly discuss the literature relevant to the cardiovascular safety of CNS stimulants for adult ADHD. PMID:27579185

  20. Cardiovascular genetic medicine: evolving concepts, rationale, and implementation.

    PubMed

    Hershberger, Ray E

    2008-06-01

    Cardiovascular genetic medicine is devoted to the identification and understanding of cardiac conditions resulting from genetic and genomic mechanisms and to the development and validation of diagnostic and treatment algorithms and guidelines. Cardiovascular genetic medicine clinics now provide expert cardiovascular subspecialty care, genetic counseling and clinical genetic testing, and will eventually provide disease-specific gene or genetic therapies. Currently, the most tractable diagnoses for cardiovascular genetic medicine are the single-gene disorders: the cardiomyopathies, the channelopathies, and others. The recent explosion of genetic knowledge within the single-gene disorders and consequent rapid proliferation of genetic testing enables far greater numbers of individuals to directly benefit from this progress. A compelling rationale exists for this approach: cardiovascular single-gene diseases commonly present with life-threatening events (e.g., sudden cardiac death, heart failure, stroke, etc.), but identification, evaluation, and treatment of individuals with presymptomatic genetic risk has the promise to prevent or ameliorate cardiovascular morbidity and mortality. Cardiovascular genetic medicine programs also anchor training and research, thereby enabling the next generation of academic specialists in cardiovascular genetic medicine to continue to improve cardiovascular health.

  1. [Research on Prevention and Treatment of Cardiovascular Disease by Translational Medicine Based Chinese Medicine].

    PubMed

    Lu, Shi-chao; Zhang, Jun-ping

    2015-05-01

    Translational medicine is inevitable in the development of modern medicine, and the uprising concept of translational medicine provides an opportunity for the development of Chinese medicine (CM). Their ideas are well communicated. There are two patterns of researching on CM based on translational medicine: 'literature to bench to bedside' and 'bench to bedside to bench'. CM has her advantages in preventing and treating cardiovascular disease. Effective methods for preventing and treating cardiovascular disease by CM should be further studied based on translational medicine concepts.

  2. Improved Cardiovascular Disease Outcomes in Older Adults

    PubMed Central

    Forman, Daniel E.; Alexander, Karen; Brindis, Ralph G.; Curtis, Anne B.; Maurer, Mathew; Rich, Michael W.; Sperling, Laurence; Wenger, Nanette K.

    2016-01-01

    Longevity is increasing and the population of older adults is growing. The biology of aging is conducive to cardiovascular disease (CVD), such that prevalence of coronary artery disease, heart failure, valvular heart disease, arrhythmia and other disorders are increasing as more adults survive into old age.  Furthermore, CVD in older adults is distinctive, with management issues predictably complicated by multimorbidity, polypharmacy, frailty and other complexities of care that increase management risks (e.g., bleeding, falls, and rehospitalization) and uncertainty of outcomes.  In this review, state-of-the-art advances in heart failure, acute coronary syndromes, transcatheter aortic valve replacement, atrial fibrillation, amyloidosis, and CVD prevention are discussed.  Conceptual benefits of treatments are considered in relation to the challenges and ambiguities inherent in their application to older patients. PMID:26918183

  3. Influence of forest therapy on cardiovascular relaxation in young adults.

    PubMed

    Lee, Juyoung; Tsunetsugu, Yuko; Takayama, Norimasa; Park, Bum-Jin; Li, Qing; Song, Chorong; Komatsu, Misako; Ikei, Harumi; Tyrväinen, Liisa; Kagawa, Takahide; Miyazaki, Yoshifumi

    2014-01-01

    Background. Despite increasing attention toward forest therapy as an alternative medicine, very little evidence continues to be available on its therapeutic effects. Therefore, this study was focused on elucidating the health benefits of forest walking on cardiovascular reactivity. Methods. Within-group comparisons were used to examine the cardiovascular responses to walking in forest and urban environments. Forty-eight young adult males participated in the two-day field research. Changes in heart rate variability, heart rate, and blood pressure were measured to understand cardiovascular reactivity. Four different questionnaires were used to investigate the changes in psychological states after walking activities. Results. Forest walking significantly increased the values of ln(HF) and significantly decreased the values of ln(LF/HF) compared with the urban walking. Heart rate during forest walking was significantly lower than that in the control. Questionnaire results showed that negative mood states and anxiety levels decreased significantly by forest walking compared with urban walking. Conclusion. Walking in the forest environment may promote cardiovascular relaxation by facilitating the parasympathetic nervous system and by suppressing the sympathetic nervous system. In addition, forest therapy may be effective for reducing negative psychological symptoms.

  4. [Future vascular medicine: inauguration of a cardiovascular hybrid concept].

    PubMed

    Debus, S; Larena-Avellaneda, A; Kölbel, T; Kieback, A; Atlihan, G; Diener, H

    2014-10-01

    The demographic developments will lead to an exponential increase of cardiovascular diseases. Additionally, technical developments of conservative and invasive treatment modalities will be added to distinguished, organ-orientated therapeutic concepts. This will also require a new orientation of vascular services. This concept implies that specific contents are referred to and contained in partner specialties. Since the heart and vascular system function as an anatomic and functional union, implementation of vascular medicine within cardiovascular centres represents a logical consequence.

  5. Pregenerative medicine: developmental paradigms in the biology of cardiovascular regeneration

    PubMed Central

    Yi, B. Alexander; Wernet, Oliver; Chien, Kenneth R.

    2010-01-01

    The ability to create new functional cardiomyocytes is the holy grail of cardiac regenerative medicine. From studies using model organisms, new insights into the fundamental pathways that drive heart muscle regeneration have begun to arise as well as a growing knowledge of the distinct families of multipotent cardiovascular progenitors that generate diverse lineages during heart development. In this Review, we highlight this intersection of the “pregenerative” biology of heart progenitor cells and heart regeneration and discuss the longer term challenges and opportunities in moving toward a therapeutic goal of regenerative cardiovascular medicine. PMID:20051633

  6. Heart Disease, Stroke, or Other Cardiovascular Disease and Adult Vaccination

    MedlinePlus

    ... Disease, Stroke, or Other Cardiovascular Disease and Adult Vaccination Language: English Español (Spanish) Recommend on Facebook Tweet ... more about health insurance options. Learn about adult vaccination and other health conditions Asplenia Diabetes Heart Disease, ...

  7. Herbal drugs against cardiovascular disease: traditional medicine and modern development.

    PubMed

    Li, Lingjun; Zhou, Xiuwen; Li, Na; Sun, Miao; Lv, Juanxiu; Xu, Zhice

    2015-09-01

    Herbal products have been used as conventional medicines for thousands of years, particularly in Eastern countries. Thousands of clinical and experimental investigations have focused on the effects and mechanisms-of-action of herbal medicine in the treatment of cardiovascular diseases (CVDs). Considering the history of clinical practice and the great potentials of herb medicine and/or its ingredients, a review on this topic would be helpful. This article discusses possible effects of herbal remedies in the prevention and treatment of CVDs. Crucially, we also summarize some underlying pharmacological mechanisms for herb products in cardiovascular regulations, which might provide interesting information for further understanding the effects of herbal medicines, and boost the prospect of new herbal products against CVDs.

  8. Herbal drugs against cardiovascular disease: traditional medicine and modern development.

    PubMed

    Li, Lingjun; Zhou, Xiuwen; Li, Na; Sun, Miao; Lv, Juanxiu; Xu, Zhice

    2015-09-01

    Herbal products have been used as conventional medicines for thousands of years, particularly in Eastern countries. Thousands of clinical and experimental investigations have focused on the effects and mechanisms-of-action of herbal medicine in the treatment of cardiovascular diseases (CVDs). Considering the history of clinical practice and the great potentials of herb medicine and/or its ingredients, a review on this topic would be helpful. This article discusses possible effects of herbal remedies in the prevention and treatment of CVDs. Crucially, we also summarize some underlying pharmacological mechanisms for herb products in cardiovascular regulations, which might provide interesting information for further understanding the effects of herbal medicines, and boost the prospect of new herbal products against CVDs. PMID:25956424

  9. Cardiovascular Risk Factor Levels in Adults with Mental Retardation.

    ERIC Educational Resources Information Center

    Rimmer, James H.; And Others

    1994-01-01

    Comparison of cardiovascular risk factors (blood lipids, obesity, and smoking) in 329 adults with mental retardation residing in various settings with subjects in the Framingham Offspring Study found that adults with mental retardation had cardiovascular risk profiles similar to those of individuals without mental retardation. (Author/DB)

  10. Cardiovascular and Hematological Medicine in 2013 - Advances and Insights.

    PubMed

    Mukherjee, Debabrata

    2012-12-11

    Welcome to the first issue of Cardiovascular & Hematological Agents in Medicinal Chemistry (CHAMC) for 2013. I hope everyone has had an enjoyable holiday season and I want to wish everyone a wonderful New Year. As you know, our journal (CHAMC) aims to cover the latest and outstanding developments in medicinal chemistry, rational drug design for the discovery of novel cardiovascular and hematological Agents and discusses such therapies in clinical practice. Each issue contains a series of timely in-depth reviews, original research articles and drug clinical trial studies written by leaders in the field covering a range of current topics in cardiovascular and hematological sciences. I feel that CHAMC is an essential journal for every medicinal chemist, clinician and healthcare provider who wishes to be kept informed and up-to-date with the latest and most important developments in cardiovascular and hematological drug discovery and their clinical uses. In the coming issues of the journal, we will discuss several important topics pertinent to chemists and clinicians in the cardiovascular and hematology fields such as curcumin and resveratrol as alternative medicinal agents against metabolic syndrome, interrelationship between chronic kidney disease and risk of cardiovascular diseases and effects of direct renin inhibitor, aliskiren, on arterial hypertension, chronic kidney disease and cardiovascular disease among others. The journal also delves into hot topics such as genetic testing and personalized medicine, use of literature-based discovery to identify novel therapeutic approaches, pharmacologic mechanism and clinical relevance of P2Y12 inhibitors and intracoronary injection of glycoprotein IIb/IIIa, abciximab, as adjuvant therapy in primary coronary intervention. Cardiovascular medicine and hematology are both very dynamic fields with rapid advances and we will continue to work to keep you up to date on new advances and therapies. I would also take this

  11. Systems Medicine as an Emerging Tool for Cardiovascular Genetics

    PubMed Central

    Haase, Tina; Börnigen, Daniela; Müller, Christian; Zeller, Tanja

    2016-01-01

    Cardiovascular disease (CVD) is a major contributor to morbidity and mortality worldwide. However, the pathogenesis of CVD is complex and remains elusive. Within the last years, systems medicine has emerged as a novel tool to study the complex genetic, molecular, and physiological interactions leading to diseases. In this review, we provide an overview about the current approaches for systems medicine in CVD. They include bioinformatical and experimental tools such as cell and animal models, omics technologies, network, and pathway analyses. Additionally, we discuss challenges and current literature examples where systems medicine has been successfully applied for the study of CVD. PMID:27626034

  12. Systems Medicine as an Emerging Tool for Cardiovascular Genetics

    PubMed Central

    Haase, Tina; Börnigen, Daniela; Müller, Christian; Zeller, Tanja

    2016-01-01

    Cardiovascular disease (CVD) is a major contributor to morbidity and mortality worldwide. However, the pathogenesis of CVD is complex and remains elusive. Within the last years, systems medicine has emerged as a novel tool to study the complex genetic, molecular, and physiological interactions leading to diseases. In this review, we provide an overview about the current approaches for systems medicine in CVD. They include bioinformatical and experimental tools such as cell and animal models, omics technologies, network, and pathway analyses. Additionally, we discuss challenges and current literature examples where systems medicine has been successfully applied for the study of CVD.

  13. Systems Medicine as an Emerging Tool for Cardiovascular Genetics.

    PubMed

    Haase, Tina; Börnigen, Daniela; Müller, Christian; Zeller, Tanja

    2016-01-01

    Cardiovascular disease (CVD) is a major contributor to morbidity and mortality worldwide. However, the pathogenesis of CVD is complex and remains elusive. Within the last years, systems medicine has emerged as a novel tool to study the complex genetic, molecular, and physiological interactions leading to diseases. In this review, we provide an overview about the current approaches for systems medicine in CVD. They include bioinformatical and experimental tools such as cell and animal models, omics technologies, network, and pathway analyses. Additionally, we discuss challenges and current literature examples where systems medicine has been successfully applied for the study of CVD. PMID:27626034

  14. Opportunities for the Cardiovascular Community in the Precision Medicine Initiative.

    PubMed

    Shah, Svati H; Arnett, Donna; Houser, Steven R; Ginsburg, Geoffrey S; MacRae, Calum; Mital, Seema; Loscalzo, Joseph; Hall, Jennifer L

    2016-01-12

    The Precision Medicine Initiative recently announced by President Barack Obama seeks to move the field of precision medicine more rapidly into clinical care. Precision medicine revolves around the concept of integrating individual-level data including genomics, biomarkers, lifestyle and other environmental factors, wearable device physiological data, and information from electronic health records to ultimately provide better clinical care to individual patients. The Precision Medicine Initiative as currently structured will primarily fund efforts in cancer genomics with longer-term goals of advancing precision medicine to all areas of health, and will be supported through creation of a 1 million person cohort study across the United States. This focused effort on precision medicine provides scientists, clinicians, and patients within the cardiovascular community an opportunity to work together boldly to advance clinical care; the community needs to be aware and engaged in the process as it progresses. This article provides a framework for potential involvement of the cardiovascular community in the Precision Medicine Initiative, while highlighting significant challenges for its successful implementation. PMID:27028435

  15. Opportunities for the Cardiovascular Community in the Precision Medicine Initiative.

    PubMed

    Shah, Svati H; Arnett, Donna; Houser, Steven R; Ginsburg, Geoffrey S; MacRae, Calum; Mital, Seema; Loscalzo, Joseph; Hall, Jennifer L

    2016-01-12

    The Precision Medicine Initiative recently announced by President Barack Obama seeks to move the field of precision medicine more rapidly into clinical care. Precision medicine revolves around the concept of integrating individual-level data including genomics, biomarkers, lifestyle and other environmental factors, wearable device physiological data, and information from electronic health records to ultimately provide better clinical care to individual patients. The Precision Medicine Initiative as currently structured will primarily fund efforts in cancer genomics with longer-term goals of advancing precision medicine to all areas of health, and will be supported through creation of a 1 million person cohort study across the United States. This focused effort on precision medicine provides scientists, clinicians, and patients within the cardiovascular community an opportunity to work together boldly to advance clinical care; the community needs to be aware and engaged in the process as it progresses. This article provides a framework for potential involvement of the cardiovascular community in the Precision Medicine Initiative, while highlighting significant challenges for its successful implementation.

  16. Venous disease: the missing link in cardiovascular medicine.

    PubMed

    Madyoon, Hooman; Lepor, Norman E

    2013-01-01

    Until recently, medical literature and the practice of vascular medicine focused on the cosmetic aspects of venous disease and the advanced stages of venous insufficiency such as painful varicose veins and venous ulcers. The systemic effects of venous insufficiency resulting from a reduction of venous return and increased transit time of blood from the lower extremities that can mimic heart failure are only recently being recognized. This article reviews the diagnosis and treatment options for the patients with venous insufficiency, and increases awareness about the systemic effects of venous disease and its role in the practice of cardiovascular medicine. PMID:23651983

  17. Cardiovascular Complications of Breast Cancer Therapy in Older Adults

    PubMed Central

    Klem, Igor; Crowley, Anna Lisa; Patel, Manesh R.; Winchester, Mark A.; Owusu, Cynthia; Kimmick, Gretchen G.

    2011-01-01

    Older adults frequently have pre-existing and cancer-related risk factors for cardiovascular toxicity from cancer treatment. In this review, we discuss the risk factors and strategies for prevention and management of cardiovascular complications in older women with breast cancer. PMID:21737575

  18. Cardiovascular risk factors in young adults: a literature review.

    PubMed

    Tran, Dieu-My T; Zimmerman, Lani M

    2015-01-01

    This extensive literature review focuses on cardiovascular risk factors in young adults, with an emphasis on hyperlipidemia and hypertension. Multiple studies have confirmed that hyperlipidemia and hypertension during young adulthood are associated with coronary heart disease (CHD) in later decades, and CHD is one type of cardiovascular disease. The primary risk factors identified in the literature that are predictive of CHD are age; gender; race/ethnicity; smoking status; high blood pressure; and elevated lipid levels, especially low-density lipoprotein cholesterol. The current guidelines are insufficient to address screening and treatment in young adults with cardiovascular risk factors. Future studies are warranted to confirm the extent of cardiovascular risks in young adults, which can then be targeted to this population for prevention and intervention strategies.

  19. A Multidimensional Integrative Medicine Intervention to Improve Cardiovascular Risk

    PubMed Central

    Edelman, David; Oddone, Eugene Z; Liebowitz, Richard S; Yancy, William S; Olsen, Maren K; Jeffreys, Amy S; Moon, Samuel D; Harris, Amy C; Smith, Linda L; Quillian-Wolever, Ruth E; Gaudet, Tracy W

    2006-01-01

    BACKGROUND Integrative medicine is an individualized, patient-centered approach to health, combining a whole-person model with evidence-based medicine. Interventions based in integrative medicine theory have not been tested as cardiovascular risk-reduction strategies. Our objective was to determine whether personalized health planning (PHP), an intervention based on the theories and principles underlying integrative medicine, reduces 10-year risk of coronary heart disease (CHD). METHODS We conducted a randomized, controlled trial among 154 outpatients age 45 or over, with 1 or more known cardiovascular risk factors. Subjects were enrolled from primary care practices near an academic medical center, and the intervention was delivered at a university Center for Integrative Medicine. Following a health risk assessment, each subject in the intervention arm worked with a health coach and a medical provider to construct a personalized health plan. The plan identified specific health behaviors important for each subject to modify; the choice of behaviors was driven both by cardiovascular risk reduction and the interests of each individual subject. The coach then assisted each subject in implementing her/his health plan. Techniques used in implementation included mindfulness meditation, relaxation training, stress management, motivational techniques, and health education and coaching. Subjects randomized to the comparison group received usual care (UC) without access to the intervention. Our primary outcome measure was 10-year risk of CHD, as measured by a standard Framingham risk score, and assessed at baseline, 5, and 10 months. Differences between arms were assessed by linear mixed effects modeling, with time and study arm as independent variables. RESULTS Baseline 10-year risk of CHD was 11.1% for subjects randomized to UC (n = 77), and 9.3% for subjects randomized to PHP (n = 77). Over 10 months of the intervention, CHD risk decreased to 9.8% for UC subjects and 7

  20. Direct Cardiomyocyte Reprogramming: A New Direction for Cardiovascular Regenerative Medicine

    PubMed Central

    Yi, B. Alexander; Mummery, Christine L.; Chien, Kenneth R.

    2013-01-01

    The past few years have seen unexpected new developments in direct cardiomyocyte reprogramming. Direct cardiomyocyte reprogramming potentially offers an entirely novel approach to cardiovascular regenerative medicine by converting cardiac fibroblasts into functional cardiomyocytes in situ. There is much to be learned, however, about the mechanisms of direct reprogramming in order that the process can be made more efficient. Early efforts have suggested that this new technology can be technically challenging. Moreover, new methods of inducing heart reprogramming will need to be developed before this approach can be translated to the bedside. Despite this, direct cardiomyocyte reprogramming may lead to new therapeutic options for sufferers of heart disease. PMID:24003244

  1. The Decline Effect in Cardiovascular Medicine: Is the Effect of Cardiovascular Medicine and Stent on Cardiovascular Events Decline Over the Years?

    PubMed Central

    Lee, Moo-Sik; Flammer, Andreas J.

    2013-01-01

    The term decline effect is referred to a diminution of scientifically discovered effects over time. Reasons for the decline effect are multifaceted and include publication bias, selective reporting, outcomes reporting bias, regression to the mean, scientific paradigm shift, overshadowing and habituation, among others. Such effects can be found in cardiovascular medicines through medications (e.g., aspirin, antithrombotics, proton pump inhibitor, beta-blockers, statins, estrogen/progestin, angiotensin converting enzyme inhibitor etc.), as well as with interventional devices (e.g., angioplasty, percutaneous coronary intervention, stents). The scientific community should understand the various dimensions of the decline effects, and effective steps should be undertaken to prevent or recognize such decline effects in cardiovascular medicines. PMID:23964290

  2. Cardiovascular Disease Risk Factors among Emerging Adults in College

    ERIC Educational Resources Information Center

    Abshire, Demetrius Alexander

    2014-01-01

    The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions…

  3. Mechanisms in Cardiovascular Diseases: How Useful Are Medical Textbooks, eMedicine, and YouTube?

    ERIC Educational Resources Information Center

    Azer, Samy A.

    2014-01-01

    The aim of this study was to assess the contents of medical textbooks, eMedicine (Medscape) topics, and YouTube videos on cardiovascular mechanisms. Medical textbooks, eMedicine articles, and YouTube were searched for cardiovascular mechanisms. Using appraisal forms, copies of these resources and videos were evaluated independently by three…

  4. Medicines and You: A Guide for Older Adults

    MedlinePlus

    ... Tobacco Products Drugs Home Drugs Resources for You Medicines and You: A Guide for Older Adults Share ... What You Need to Know About Your Prescription Medicines The following questions will help you get the ...

  5. Pediatric Blood Pressure and Adult Preclinical Markers of Cardiovascular Disease

    PubMed Central

    Magnussen, Costan G.; Smith, Kylie J.

    2016-01-01

    A high blood pressure level in adults is considered the single most important modifiable risk factor for global disease burden, especially those of cardiovascular (CV) origin such as stroke and ischemic heart disease. Because blood pressure levels have been shown to persist from childhood to adulthood, elevations in pediatric levels have been hypothesized to lead to increased CV burden in adulthood and, as such, might provide a window in the life course where primordial and primary prevention could be focused. In the absence of substantive data directly linking childhood blood pressure levels to overt adult CV disease, this review outlines the available literature that examines the association between pediatric blood pressure and adult preclinical markers of CV disease. PMID:27168729

  6. [Preventive medicine in adults. Fundamentals and prospects].

    PubMed

    Cavalieri, U

    1979-09-01

    The Author puts in evidence the need of a real development of the Medical Science, so to give the basis for a program of preventive medicine of the adult, that is prevention of degenerative pathology. A new way of thinking about this pathology starts from its relation with the aging process. This "interpretative way" may often be much more usefull than the mere diagnostic definition (as in the traditional medicine for the infectious disease) with its consequences of therapeutic activism and of a "by any way gained" normalization of biological parameters. Under this point of view one can look at the various aspects of the prevention. So the Author claims for a real evaluation of the risk factors and quite important, of the protective factors. These protective factors are probably of big value for preventive medical practice, as important as the health education. Actually people's health must be driven and saved much more than restored, a "Utopia" in the field of degenerative and senile pathology.

  7. [Diet as a cardiovascular risk factor in family medicine].

    PubMed

    Bergman Marković, Biserka; Katić, Milica; Vrdoljak, Davorka; Kranjcević, Ksenija; Jasna, Vucak; Ivezić Lalić, Dragica

    2010-05-01

    Although Mediterranean country by its geographic position, according to cardiovascular mortality (CVM) rate, Croatia belongs to Central-East European countries with high CV mortality. Prevention by changing nutritional habits is population (public health programmes) or individually targeted. General practitioner (GP) provides care for whole person in its environment and GP's team plays a key role in achieving lifestyle changes. GPs intervention is individually/group/family targeted by counselling or using printed leaflets (individual manner, organized programmes). Adherence to lifestyle changes is not an easy task; it is higher when recommendations are simple and part of individually tailored programme with follow- ups included. Motivation is essential, but obstacles to implementation (by patient and GPs) are also important. Nutritional intervention influences most important CV risk factors: cholesterol level, blood pressure (BP), diabetes. Restriction in total energy intake with additional nutritional interventions is recommended. Lower animal fat intake causes CVM reduction by 12%, taking additional serving of fruit/day by 7% and vegetables by 4%. Restriction of dietary salt intake (3 g/day) lowers BP by 2-8 mm Hg, CVM by 16%. Nutritional intervention gains CHD and stroke redact in healthy adults (12%, 11% respectively). Respecting individual lifestyle and nutrition, GP should suggest both home cooking and careful food declaration reading and discourage salt adding. Recommended daily salt intake is < or =6 g. In BP lowering, salt intake restriction (10-12 to 5-6 g/day) is as efficient as taking one antihypertensive drug. Lifestyle intervention targeting nutritional habits and pharmacotherapy is the most efficient combination in CV risk factors control.

  8. Allopurinol and Cardiovascular Outcomes in Adults With Hypertension.

    PubMed

    MacIsaac, Rachael L; Salatzki, Janek; Higgins, Peter; Walters, Matthew R; Padmanabhan, Sandosh; Dominiczak, Anna F; Touyz, Rhian M; Dawson, Jesse

    2016-03-01

    Allopurinol lowers blood pressure in adolescents and has other vasoprotective effects. Whether similar benefits occur in older individuals remains unclear. We hypothesized that allopurinol is associated with improved cardiovascular outcomes in older adults with hypertension. Data from the United Kingdom Clinical Research Practice Datalink were used. Multivariate Cox-proportional hazard models were applied to estimate hazard ratios for stroke and cardiac events (defined as myocardial infarction or acute coronary syndrome) associated with allopurinol use over a 10-year period in adults aged >65 years with hypertension. A propensity-matched design was used to reduce potential for confounding. Allopurinol exposure was a time-dependent variable and was defined as any exposure and then as high (≥300 mg daily) or low-dose exposure. A total of 2032 allopurinol-exposed patients and 2032 matched nonexposed patients were studied. Allopurinol use was associated with a significantly lower risk of both stroke (hazard ratio, 0.50; 95% confidence interval, 0.32-0.80) and cardiac events (hazard ratio, 0.61; 95% confidence interval, 0.43-0.87) than nonexposed control patients. In exposed patients, high-dose treatment with allopurinol (n=1052) was associated with a significantly lower risk of both stroke (hazard ratio, 0.58; 95% confidence interval, 0.36-0.94) and cardiac events (hazard ratio, 0.65; 95% confidence interval, 0.46-0.93) than low-dose treatment (n=980). Allopurinol use is associated with lower rates of stroke and cardiac events in older adults with hypertension, particularly at higher doses. Prospective clinical trials are needed to evaluate whether allopurinol improves cardiovascular outcomes in adults with hypertension.

  9. Review and Updates in Regenerative and Personalized Medicine, Preclinical Animal Models, and Clinical Care in Cardiovascular Medicine.

    PubMed

    Barbato, Emanuele; Barton, Paul J; Bartunek, Jozef; Huber, Sally; Ibanez, Borja; Judge, Daniel P; Lara-Pezzi, Enrique; Stolen, Craig M; Taylor, Angela; Hall, Jennifer L

    2015-11-01

    The goal of this paper is to provide an updated review for scientists and clinicians on the major areas in cardiovascular medicine published in the Journal. Leading topics in regenerative and personalized medicine are presented along with a critical overview of the field. New standards in large preclinical animal models of pulmonary hypertension and left bundle branch block are highlighted. Finally, clinical care in the areas of atherosclerosis, the aortic valve, platelet biology, and myocarditis is discussed as well as autonomic modulation therapies.

  10. Statin drugs: reducing cardiovascular risk in older adults.

    PubMed

    McLain, Kellie; Edlund, Barbara J

    2012-10-01

    Dyslipidemia is one of the most modifiable risk factors in preventing heart disease. Evidence demonstrates that the process of atherosclerosis, a result of dyslipidemia, begins in young adults. Initiating statin therapy has been shown to reduce the risk of cardiovascular events and mortality. Determining the right statin medication and dose for an older adult based on national guidelines can be challenging, as multiple factors must be considered in this decision. When initiating statin therapy, clinicians should determine the appropriate percentage of reduction in low-density lipoprotein cholesterol needed to achieve the target goal. Additionally, when changing from one cholesterol-lowering medication to another, knowledge of equivalent dosing is important. Generally, statin drugs are well tolerated with a good safety profile in older adults but are underused in this patient population. Issues such as existing comorbid conditions, polypharmacy with the potential for drug-drug interactions, impaired drug metabolism, and decreased functional status can contribute to adverse events and increase the frequency of myalgias and less frequently, hepatotoxicity. Clinicians prescribing statin therapy for older adults need to remain current on advances in research regarding potential interactions and contraindications within this drug class. PMID:22998096

  11. Mechanisms in cardiovascular diseases: how useful are medical textbooks, eMedicine, and YouTube?

    PubMed

    Azer, Samy A

    2014-06-01

    The aim of this study was to assess the contents of medical textbooks, eMedicine (Medscape) topics, and YouTube videos on cardiovascular mechanisms. Medical textbooks, eMedicine articles, and YouTube were searched for cardiovascular mechanisms. Using appraisal forms, copies of these resources and videos were evaluated independently by three assessors. Most textbooks were brief in explaining mechanisms. Although the overall average percentage committed to cardiovascular mechanisms in physiology textbooks (n=7) was 16.1% and pathology textbooks (n=4) was 17.5%, there was less emphasis on mechanisms in most internal medicine textbooks (n=6), with a total average of 6.9%. In addition, flow diagrams explaining mechanisms were lacking. However, eMedicine topics (n=48) discussed mechanisms adequately in 22.9% (11 of 48) topics, and the percentage of content allocated to cardiovascular mechanisms was higher (15.8%, 46.2 of 292) compared with that of any internal medicine textbooks. Only 29 YouTube videos fulfilled the inclusion criteria. Of these, 16 YouTube were educationally useful, scoring 14.1 ± 0.5 (mean ± SD). The remaining 13 videos were not educationally useful, scoring 6.1 ± 1.7. The concordance between the assessors on applying the criteria measured by κ score was in the range of 0.55–0.96. In conclusion, despite the importance of mechanisms, most textbooks and You-Tube videos were deficient in cardiovascular mechanisms. eMedicine topics discussed cardiovascular mechanisms for some diseases, but there were no flow diagrams or multimedia explaining mechanisms. These deficiencies in learning resources could add to the challenges faced by students in understanding cardiovascular mechanisms.

  12. Mechanisms in cardiovascular diseases: how useful are medical textbooks, eMedicine, and YouTube?

    PubMed Central

    2014-01-01

    The aim of this study was to assess the contents of medical textbooks, eMedicine (Medscape) topics, and YouTube videos on cardiovascular mechanisms. Medical textbooks, eMedicine articles, and YouTube were searched for cardiovascular mechanisms. Using appraisal forms, copies of these resources and videos were evaluated independently by three assessors. Most textbooks were brief in explaining mechanisms. Although the overall average percentage committed to cardiovascular mechanisms in physiology textbooks (n = 7) was 16.1% and pathology textbooks (n = 4) was 17.5%, there was less emphasis on mechanisms in most internal medicine textbooks (n = 6), with a total average of 6.9%. In addition, flow diagrams explaining mechanisms were lacking. However, eMedicine topics (n = 48) discussed mechanisms adequately in 22.9% (11 of 48) topics, and the percentage of content allocated to cardiovascular mechanisms was higher (15.8%, 46.2 of 292) compared with that of any internal medicine textbooks. Only 29 YouTube videos fulfilled the inclusion criteria. Of these, 16 YouTube were educationally useful, scoring 14.1 ± 0.5 (mean ± SD). The remaining 13 videos were not educationally useful, scoring 6.1 ± 1.7. The concordance between the assessors on applying the criteria measured by κ score was in the range of 0.55–0.96. In conclusion, despite the importance of mechanisms, most textbooks and YouTube videos were deficient in cardiovascular mechanisms. eMedicine topics discussed cardiovascular mechanisms for some diseases, but there were no flow diagrams or multimedia explaining mechanisms. These deficiencies in learning resources could add to the challenges faced by students in understanding cardiovascular mechanisms. PMID:25039083

  13. Synchronisation and coupling analysis: applied cardiovascular physics in sleep medicine.

    PubMed

    Wessel, Niels; Riedl, Maik; Kramer, Jan; Muller, Andreas; Penzel, Thomas; Kurths, Jurgen

    2013-01-01

    Sleep is a physiological process with an internal program of a number of well defined sleep stages and intermediate wakefulness periods. The sleep stages modulate the autonomous nervous system and thereby the sleep stages are accompanied by different regulation regimes for the cardiovascular and respiratory system. The differences in regulation can be distinguished by new techniques of cardiovascular physics. The number of patients suffering from sleep disorders increases unproportionally with the increase of the human population and aging, leading to very high expenses in the public health system. Therefore, the challenge of cardiovascular physics is to develop highly-sophisticated methods which are able to, on the one hand, supplement and replace expensive medical devices and, on the other hand, improve the medical diagnostics with decreasing the patient's risk. Methods of cardiovascular physics are used to analyze heart rate, blood pressure and respiration to detect changes of the autonomous nervous system in different diseases. Data driven modeling analysis, synchronization and coupling analysis and their applications to biosignals in healthy subjects and patients with different sleep disorders are presented. Newly derived methods of cardiovascular physics can help to find indicators for these health risks.

  14. Zebrafish models of cardiovascular diseases and their applications in herbal medicine research.

    PubMed

    Seto, Sai-Wang; Kiat, Hosen; Lee, Simon M Y; Bensoussan, Alan; Sun, Yu-Ting; Hoi, Maggie P M; Chang, Dennis

    2015-12-01

    The zebrafish (Danio rerio) has recently become a powerful animal model for cardiovascular research and drug discovery due to its ease of maintenance, genetic manipulability and ability for high-throughput screening. Recent advances in imaging techniques and generation of transgenic zebrafish have greatly facilitated in vivo analysis of cellular events of cardiovascular development and pathogenesis. More importantly, recent studies have demonstrated the functional similarity of drug metabolism systems between zebrafish and humans, highlighting the clinical relevance of employing zebrafish in identifying lead compounds in Chinese herbal medicine with potential beneficial cardiovascular effects. This paper seeks to summarise the scope of zebrafish models employed in cardiovascular studies and the application of these research models in Chinese herbal medicine to date.

  15. Complementary and Alternative Medicine and Cardiovascular Disease: An Evidence-Based Review

    PubMed Central

    Rabito, Matthew J.; Kaye, Alan David

    2013-01-01

    Complementary and alternative medicine (CAM) plays a significant role in many aspects of healthcare worldwide, including cardiovascular disease (CVD). This review describes some of the challenges of CAM in terms of scientific research. Biologically-based therapies, mind-body therapies, manipulative and body-based therapies, whole medical systems, and energy medicine are reviewed in detail with regard to cardiovascular risk factors and mediation or modulation of cardiovascular disease pathogenesis. CAM use among patients with CVD is prevalent and in many instances provides positive and significant effects, with biologically-based and mind-body therapies being the most commonly used treatment modalities. More rigorous research to determine the precise physiologic effects and long-term benefits on cardiovascular morbidity and mortality with CAM usage, as well as more open lines of communication between patients and physicians regarding CAM use, is essential when determining optimal treatment plans. PMID:23710229

  16. Complementary and alternative medicine and cardiovascular disease: an evidence-based review.

    PubMed

    Rabito, Matthew J; Kaye, Alan David

    2013-01-01

    Complementary and alternative medicine (CAM) plays a significant role in many aspects of healthcare worldwide, including cardiovascular disease (CVD). This review describes some of the challenges of CAM in terms of scientific research. Biologically-based therapies, mind-body therapies, manipulative and body-based therapies, whole medical systems, and energy medicine are reviewed in detail with regard to cardiovascular risk factors and mediation or modulation of cardiovascular disease pathogenesis. CAM use among patients with CVD is prevalent and in many instances provides positive and significant effects, with biologically-based and mind-body therapies being the most commonly used treatment modalities. More rigorous research to determine the precise physiologic effects and long-term benefits on cardiovascular morbidity and mortality with CAM usage, as well as more open lines of communication between patients and physicians regarding CAM use, is essential when determining optimal treatment plans. PMID:23710229

  17. HIF hydroxylase pathways in cardiovascular physiology and medicine.

    PubMed

    Bishop, Tammie; Ratcliffe, Peter J

    2015-06-19

    Hypoxia inducible factors (HIFs) are α/β heterodimeric transcription factors that direct multiple cellular and systemic responses in response to changes in oxygen availability. The oxygen sensitive signal is generated by a series of iron and 2-oxoglutarate-dependent dioxygenases that catalyze post-translational hydroxylation of specific prolyl and asparaginyl residues in HIFα subunits and thereby promote their destruction and inactivation in the presence of oxygen. In hypoxia, these processes are suppressed allowing HIF to activate a massive transcriptional cascade. Elucidation of these pathways has opened several new fields of cardiovascular research. Here, we review the role of HIF hydroxylase pathways in cardiac development and in cardiovascular control. We also consider the current status, opportunities, and challenges of therapeutic modulation of HIF hydroxylases in the therapy of cardiovascular disease.

  18. HIF hydroxylase pathways in cardiovascular physiology and medicine

    PubMed Central

    Bishop, Tammie; Ratcliffe, Peter J.

    2015-01-01

    Hypoxia inducible factors (HIFs) are alpha/beta heterodimeric transcription factors that direct multiple cellular and systemic responses in response to changes in oxygen availability. The oxygen sensitive signal is generated by a series of iron and 2-oxoglutarate dependent dioxygenases that catalyse post-translational hydroxylation of specific prolyl and asparaginyl residues in HIFalpha subunits and thereby promote their destruction and inactivation in the presence of oxygen. In hypoxia, these processes are suppressed allowing HIF to activate a massive transcriptional cascade. Elucidation of these pathways has opened several new fields of cardiovascular research. Here we review the role of HIF hydroxylase pathways in cardiac development and in cardiovascular control. We also consider the current status, opportunities and challenges of therapeutic modulation of HIF hydroxylases in the therapy of cardiovascular disease. PMID:26089364

  19. Urinary uromodulin, kidney function and cardiovascular disease in elderly adults

    PubMed Central

    Garimella, Pranav S.; Biggs, Mary L.; Katz, Ronit; Ix, Joachim H.; Bennett, Michael R.; Devarajan, Prasad; Kestenbaum, Bryan R.; Siscovick, David S.; Jensen, Majken K.; Shlipak, Michael G.; Chaves, Paulo H. M.; Sarnak, Mark J.

    2015-01-01

    Urinary uromodulin (uUMOD) is the most common secreted tubular protein in healthy adults. However, the relationship between uUMOD and clinical outcomes is still unclear. Here we measured uUMOD in 192 participants of the Cardiovascular Health Study with over a 30% decline in estimated glomerular filtration rate (eGFR) over 9 years, 54 with incident end stage renal disease (ESRD), and in a random sub-cohort of 958 participants. The association of uUMOD with eGFR decline was evaluated using logistic regression and with incident ESRD, cardiovascular disease, heart failure and mortality using Cox proportional regression. Mean age was 78 years and median uUMOD was 25.8 μg/mL. In a case-control study evaluating eGFR decline (192 cases and 231 controls), each standard deviation higher uUMOD was associated with a 23% lower odds of eGFR decline (odds ratio 0.77, (95% CI 0.62, 0.96)) and a 10% lower risk of mortality (hazard ratio 0.90, (95% CI 0.83, 0.98)) after adjusting for demographics, eGFR, albumin/creatinine ratio and other risk factors. There was no risk association of uUMOD with ESRD, cardiovascular disease or heart failure after multivariable adjustment. Thus, low uUMOD levels may identify persons at risk of progressive kidney disease and mortality above and beyond established markers of kidney disease, namely eGFR and the albumin/creatinine ratio. Future studies need to confirm these results and evaluate whether uUMOD is a marker of tubular health and/or whether it plays a causal role in preserving kidney function. PMID:26154925

  20. The continuum of personalized cardiovascular medicine: a position paper of the European Society of Cardiology.

    PubMed

    Kirchhof, Paulus; Sipido, Karin R; Cowie, Martin R; Eschenhagen, Thomas; Fox, Keith A A; Katus, Hugo; Schroeder, Stefan; Schunkert, Heribert; Priori, Silvia

    2014-12-01

    There is strong need to develop the current stratified practice of CVD management into a better personalized cardiovascular medicine, within a broad framework of global patient care. Clinical information obtained from history and physical examination, functional and imaging studies, biochemical biomarkers, genetic/epigenetic data, and pathophysiological insights into disease-driving processes need to be integrated into a new taxonomy of CVDs to allow personalized disease management. This has the potential for major health benefits for the population suffering from cardiovascular diseases.

  1. A systematic review of hospitalization resulting from medicine-related problems in adult patients

    PubMed Central

    Al Hamid, Abdullah; Ghaleb, Maisoon; Aljadhey, Hisham; Aslanpour, Zoe

    2014-01-01

    Aims Medicine-related problems (MRPs) represent a major issue leading to hospitalization, especially in adult and elderly patients. The aims of this review are to investigate the prevalence, causes and major risk factors for MRPs leading to hospitalization in adult patients and to identify the main medicine classes involved. Methods Studies were identified through electronic searches of Medline, Embase, Scopus and International Pharmaceutical Abstracts between January 2000 and May 2013. A systematic review was conducted of both retrospective and prospective studies. Studies included were those involving hospitalization resulting from MRPs in adults (≥18 years old), whereas studies excluded were those investigating drug misuse and abuse and studies investigating MRPs in hospitalized patients. Data analysis was performed using SPSS version 20. Results Forty-five studies were identified, including 21 that investigated hospitalization resulting from adverse drug reactions, six studies that investigated hospitalization due to adverse drug events and 18 studies that investigated hospitalization due to MRPs. The median prevalence rates of hospitalization resulting from adverse drug reactions, adverse drug events and MRPs were 7% (interquartile range, 2.4–14.9%), 4.6% (interquartile range, 2.85–16.6%) and 12.1% (interquartile range, 6.43–22.2%), respectively. The major causes contributing to MRPs were adverse drug reactions and noncompliance. In addition, the major risk factors associated with MRPs were old age, polypharmacy and comorbidities. Moreover, the main classes of medicines implicated were medicines used to treat cardiovascular diseases and diabetes. Conclusions Hospitalization due to MRPs had a high prevalence, in the range of 4.6–12.1%. Most MRPs encountered were prevalent among adult patients taking medicines for cardiovascular diseases and diabetes. PMID:24283967

  2. Systematic Review of Yoga Interventions to Promote Cardiovascular Health in Older Adults.

    PubMed

    Barrows, Jennifer L; Fleury, Julie

    2016-06-01

    The benefits of physical activity are well established, yet few older adults engage in adequate physical activity to optimize health. While yoga may reduce the risk of cardiovascular disease, few studies have focused on the efficacy of yoga-based physical activity to promote cardiovascular health in older adults. The objective of this review is to provide an evaluation of yoga interventions to reduce cardiovascular risk in older adults. Four databases were searched for randomized controlled trials of yoga interventions in older adults. Studies with cardiovascular outcomes were included. Literature searches identified nine articles eligible for review. Significant health benefits were reported, including favorable changes in blood pressure, body composition, glucose, and lipids. Yoga practices, participant characteristics, and outcome measures were variable. There was limited use of theory. Yoga is safe and feasible in older adults; additional research is warranted to examine the specific components of yoga interventions essential to reducing cardiovascular risk. PMID:26689218

  3. [Civilization stress, cardiovascular risk, evidence-based medicine, guidelines].

    PubMed

    Simon, Kornél

    2009-05-10

    Cardiovascular diseases have the pole-position on the list of morbidity and mortality statistics. Despite the great advances have been made in management of cardiovascular diseases, prevalence of these disorders increases worldwide, and even younger and younger ages are threatened. This phenomenon is strongly related to obesity and type 2 diabetes pandemic, which shows an unequivocal association with expansion of modernized life-style. The pathomechanism proposed to have central role is the chronic stress induced by civilized life-conduct. The authors criticizes the everyday practice suggested for management of cardiovascular diseases, focusing on normalization of cardiovascular risk factors, instead of fighting against the primary cause ie. chronic stress. There is growing evidence, that achieving the target values defined in guide-lines will not necessarily result in improvement of patient related clinical outcomes. The statistical approach generally practiced in randomized clinical trials is primarily striving for the drug-sale, instead of discovering novel pathophysiological relations. Pharmaceutical industry having decisive role in research and patient-care is mainly interested in profit-sharing, therefore patients' interest can not be optimally realized, and costs are unnecessarily augmented. Separation of patient-, and business-oriented medical care is an ethical question of fundamental importance.

  4. COCATS 4: Securing the Future of Cardiovascular Medicine.

    PubMed

    Sinha, Shashank S; Julien, Howard M; Krim, Selim R; Ijioma, Nkechinyere N; Baron, Suzanne J; Rock, Andrea J; Siehr, Stephanie L; Cullen, Michael W

    2015-05-01

    The latest iteration of the Core Cardiology Training Statement (COCATS 4) [Corrected] provides a potentially transformative advancement in cardiovascular fellowship training intended, ultimately, to improve patient care. This review addressed 3 primary themes of COCATS 4 from the perspective of fellows-in-training: 1) the evolution of training requirements culminating in a competency-based curriculum; 2) the development of novel learning paradigms; and 3) the establishment of task forces in emerging areas of multimodality imaging and critical care cardiology. This document also examined several important challenges presented by COCATS 4. The proposed changes in COCATS 4 should not only enhance the training experience but also improve trainee satisfaction. Because it embraces continual transformation of training requirements to meet evolving clinical needs and public expectations, COCATS 4 will enrich the cardiovascular fellowship training experience for patients, programs, and fellows-in-training. PMID:25945751

  5. COCATS 4: Securing the Future of Cardiovascular Medicine.

    PubMed

    Sinha, Shashank S; Julien, Howard M; Krim, Selim R; Ijioma, Nkechinyere N; Baron, Suzanne J; Rock, Andrea J; Siehr, Stephanie L; Cullen, Michael W

    2015-05-01

    The latest iteration of the Core Cardiology Training Statement (COCATS 4) [Corrected] provides a potentially transformative advancement in cardiovascular fellowship training intended, ultimately, to improve patient care. This review addressed 3 primary themes of COCATS 4 from the perspective of fellows-in-training: 1) the evolution of training requirements culminating in a competency-based curriculum; 2) the development of novel learning paradigms; and 3) the establishment of task forces in emerging areas of multimodality imaging and critical care cardiology. This document also examined several important challenges presented by COCATS 4. The proposed changes in COCATS 4 should not only enhance the training experience but also improve trainee satisfaction. Because it embraces continual transformation of training requirements to meet evolving clinical needs and public expectations, COCATS 4 will enrich the cardiovascular fellowship training experience for patients, programs, and fellows-in-training.

  6. Novel epigenetic-based therapies useful in cardiovascular medicine

    PubMed Central

    Napoli, Claudio; Grimaldi, Vincenzo; De Pascale, Maria Rosaria; Sommese, Linda; Infante, Teresa; Soricelli, Andrea

    2016-01-01

    Epigenetic modifications include DNA methylation, histone modifications, and microRNA. Gene alterations have been found to be associated with cardiovascular diseases, and epigenetic mechanisms are continuously being studied to find new useful strategies for the clinical management of afflicted patients. Numerous cardiovascular disorders are characterized by the abnormal methylation of CpG islands and so specific drugs that could inhibit DNA methyltransferase directly or by reducing its gene expression (e.g., hydralazine and procainamide) are currently under investigation. The anti-proliferative and anti-inflammatory properties of histone deacetylase inhibitors and their cardio-protective effects have been confirmed in preclinical studies. Furthermore, the regulation of the expression of microRNA targets through pharmacological tools is still under development. Indeed, large controlled trials are required to establish whether current possible candidate antisense microRNAs could offer better therapeutic benefits in clinical practice. Here, we updated therapeutic properties, side effects, and feasibility of emerging epigenetic-based strategies in cardiovascular diseases by highlighting specific problematic issues that still affect the development of large scale novel therapeutic protocols. PMID:26981216

  7. Lifestyles of older adults: can we influence cardiovascular risk in older adults?

    PubMed

    Mozaffarian, Dariush; Fried, Linda P; Burke, Gregory L; Fitzpatrick, Annette; Siscovick, David S

    2004-01-01

    Influences of lifestyle habits on cardiovascular disease risk among older adults are not well established. The authors present evidence from the Cardiovascular Health Study that dietary, physical activity, and smoking habits assessed late in life are associated with cardiovascular disease risk among adults aged 65 years or older. Persons consuming fatty fish twice per week had a 47% lower risk of coronary death compared with those who consumed fatty fish less than once per month, while cereal fiber intake (about two whole-grain bread slices per day) was associated with a 14% lower risk of myocardial infarction or stroke. Modest alcohol intake (1-6 drinks per week) predicted the fewest subclinical cerebrovascular abnormalities. Compared with little activity, moderate and high leisure-time activity predicted 28% and 44% lower mortality, respectively, while compared with nonexercisers, low, moderate, and high exercise intensity predicted 30%, 37%, and 53% more years of healthy life, respectively. Former and current smokers had 25% and 44% fewer years of healthy life than those who never smoked; lifetime smoking (pack-years) predicted higher mortality. Clinical practice and public health implications, gaps in knowledge, and future research directions are summarized.

  8. Review and Updates in Regenerative and Personalized Medicine, Preclinical Animal Models, and Clinical Care in Cardiovascular Medicine.

    PubMed

    Barbato, Emanuele; Barton, Paul J; Bartunek, Jozef; Huber, Sally; Ibanez, Borja; Judge, Daniel P; Lara-Pezzi, Enrique; Stolen, Craig M; Taylor, Angela; Hall, Jennifer L

    2015-11-01

    The goal of this paper is to provide an updated review for scientists and clinicians on the major areas in cardiovascular medicine published in the Journal. Leading topics in regenerative and personalized medicine are presented along with a critical overview of the field. New standards in large preclinical animal models of pulmonary hypertension and left bundle branch block are highlighted. Finally, clinical care in the areas of atherosclerosis, the aortic valve, platelet biology, and myocarditis is discussed as well as autonomic modulation therapies. PMID:26453460

  9. Glycemia and cardiovascular risk: challenging evidence based medicine

    PubMed Central

    Kitsios, K; Tsapas, A; Karagianni, P

    2011-01-01

    Optimal glycemic control is well known to reduce effectively the risk of micro vascular complications both in type 1 and type 2 diabetes mellitus. However the role of glycemic control in decreasing the risk of myocardial infarction and ischemic stroke, the leading causes of death in patients with diabetes, has been so far controversial. In this review, based on data recently reported from large interventional studies, we discuss the possible causal relationship between glycemia and cardiovascular outcomes in type 1 and type 2 diabetes. Strict glycemic control right from the diagnosis of the disease may be effective in reducing long term incidence of cardiovascular (CV) disease in both T1 and T2 diabetics. Nevertheless such a strategy could be potentially harmful for T2 diabetics with long duration of sub optimal glycemic control and already established CV complications. Treatment targets in these patients should be individualized taking into account other aspects of glycemic control and diabetes complications such as hypoglycemia and autonomic neuropathy. PMID:22435015

  10. Added sugar intake and cardiovascular diseases mortality among US adults.

    PubMed

    Yang, Quanhe; Zhang, Zefeng; Gregg, Edward W; Flanders, W Dana; Merritt, Robert; Hu, Frank B

    2014-04-01

    IMPORTANCE Epidemiologic studies have suggested that higher intake of added sugar is associated with cardiovascular disease (CVD) risk factors. Few prospective studies have examined the association of added sugar intake with CVD mortality. OBJECTIVE To examine time trends of added sugar consumption as percentage of daily calories in the United States and investigate the association of this consumption with CVD mortality. DESIGN, SETTING, AND PARTICIPANTS National Health and Nutrition Examination Survey (NHANES, 1988-1994 [III], 1999-2004, and 2005-2010 [n = 31,147]) for the time trend analysis and NHANES III Linked Mortality cohort (1988-2006 [n = 11 733]), a prospective cohort of a nationally representative sample of US adults for the association study. MAIN OUTCOMES AND MEASURES Cardiovascular disease mortality. RESULTS Among US adults, the adjusted mean percentage of daily calories from added sugar increased from 15.7% (95% CI, 15.0%-16.4%) in 1988-1994 to 16.8% (16.0%-17.7%; P = .02) in 1999-2004 and decreased to 14.9% (14.2%-15.5%; P < .001) in 2005-2010. Most adults consumed 10% or more of calories from added sugar (71.4%) and approximately 10% consumed 25% or more in 2005-2010. During a median follow-up period of 14.6 years, we documented 831 CVD deaths during 163,039 person-years. Age-, sex-, and race/ethnicity-adjusted hazard ratios (HRs) of CVD mortality across quintiles of the percentage of daily calories consumed from added sugar were 1.00 (reference), 1.09 (95% CI, 1.05-1.13), 1.23 (1.12-1.34), 1.49 (1.24-1.78), and 2.43 (1.63-3.62; P < .001), respectively. After additional adjustment for sociodemographic, behavioral, and clinical characteristics, HRs were 1.00 (reference), 1.07 (1.02-1.12), 1.18 (1.06-1.31), 1.38 (1.11-1.70), and 2.03 (1.26-3.27; P = .004), respectively. Adjusted HRs were 1.30 (95% CI, 1.09-1.55) and 2.75 (1.40-5.42; P = .004), respectively, comparing participants who consumed 10.0% to 24.9% or 25.0% or

  11. Induced pluripotent stem cells: at the heart of cardiovascular precision medicine.

    PubMed

    Chen, Ian Y; Matsa, Elena; Wu, Joseph C

    2016-06-01

    The advent of human induced pluripotent stem cell (hiPSC) technology has revitalized the efforts in the past decade to realize more fully the potential of human embryonic stem cells for scientific research. Adding to the possibility of generating an unlimited amount of any cell type of interest, hiPSC technology now enables the derivation of cells with patient-specific phenotypes. Given the introduction and implementation of the large-scale Precision Medicine Initiative, hiPSC technology will undoubtedly have a vital role in the advancement of cardiovascular research and medicine. In this Review, we summarize the progress that has been made in the field of hiPSC technology, with particular emphasis on cardiovascular disease modelling and drug development. The growing roles of hiPSC technology in the practice of precision medicine will also be discussed. PMID:27009425

  12. Frailty: A Vital Sign for Older Adults With Cardiovascular Disease.

    PubMed

    Forman, Daniel E; Alexander, Karen P

    2016-09-01

    Mechanisms of aging predispose to cardiovascular disease (CVD), as well as to aggregate health challenges. For older adults, CVD is likely to exist in combination with comorbid conditions, disability, polypharmacy, falling risks, and body composition changes. These other dimensions of health result in cumulative weakening with greater clinical complexity that confound basic precepts of CVD presentation, prognosis, and treatments. A convenient operational tool is needed to gauge this age-related vulnerability such that it can be integrated in the evaluation and treatment of CVD. Frailty is a concept that is neither disease- nor age-specific, but is used to characterize the reserve that a person has available to tolerate stresses associated with aging, disease, and even therapy. Frailty arises from specific biological mechanisms in association with cumulative physiological decrements, psychosocial stresses, and physical impairments. Performance-based and survey tools have been developed and tested to measure frailty. Although different frailty tools vary in practicality, measured domains, and precise applications, all are useful in identifying risks that commonly accrue with age. Although comparisons between frailty tools are ongoing and sometimes even controversial, the rationale to integrate routine use of frailty screening as part of routine care is relatively straightforward and easy to envision. Frailty assessment applied as a vital sign (for standard maintenance and evaluation of new symptoms) enhances perspectives of risk, decision-making, and opportunities for tailored CVD management. PMID:27476987

  13. Key Articles Related to Complementary and Alternative Medicine in Cardiovascular Disease

    PubMed Central

    Chow, Sheryl L.; Dorsch, Michael; Dunn, Steven; Jackevicius, Cynthia; Page, Robert Lee; Trujillo, Toby C.; Vardeny, Orly; Wiggins, Barbara S.; Bleske, Barry E.

    2014-01-01

    Complementary and alternative medicine (CAM) therapy has gained popularity in America over the past several years, reflected in the increased utilization of these agents. Given the abundance of nontraditional products available to the public, clinicians should be made aware of the existing evidence relating to CAM therapy to better provide patient care in a meaningful manner. This bibliography paper compiled key articles specific to CAM therapy and cardiovascular disease, which include primary literature, review articles, consensus statements, and abstracts of landmark studies. Based on the numerous published reports available on this topic, this bibliography, as part I of II, focuses on the efficacy of CAM therapy in cardiovascular disease. PMID:20030478

  14. Key articles related to complementary and alternative medicine in cardiovascular disease: part 1.

    PubMed

    Chow, Sheryl L; Dorsch, Michael P; Dunn, Steven P; Jackevicius, Cynthia A; Page, Robert L; Trujillo, Toby; Vardeny, Orly; Wiggins, Barbara; Bleske, Barry E

    2010-01-01

    Complementary and alternative medicine (CAM) therapy has gained popularity in America over the past several years, reflected in the increased utilization of these agents. Given the abundance of nontraditional products available to the public, clinicians should be made aware of the existing evidence relating to CAM therapy to better provide patient care in a meaningful manner. This bibliography article compiled key articles specific to CAM therapy and cardiovascular disease, which include primary literature, review articles, consensus statements, and abstracts of landmark studies. Based on the numerous published reports available on this topic, this bibliography, as part 1 of 2, focuses on the efficacy of CAM therapy in cardiovascular disease.

  15. [Genetic biomarkers and personalized medicine: application in cardiovascular pharmacology].

    PubMed

    Carrillo Norte, Juan Antonio

    2013-01-01

    Not all patients respond to drug therapy in a uniform and beneficial fashion. The goal of this article is to describe the contribution of genetic variation to drug response, with a focus on drugs used in cardiovascular therapy. The rapid development of techniques in the area of genome analysis has facilitated identification of new pharmacogenomic biomarkers that can provide predictive tools for improvement of drug response and fewer incidence of adverse drug reactions. Such biomarkers mainly originate from genes encoding drug-metabolizing enzymes, drug transporters, drug targets and human leukocyte antigens. However, despite significant progress in pharmacogenomic research, only a few drugs require a pharmacogenetic test before prescription. Among the several gaps that limit the application of pharmacogenetics, it deserves to be mentioned the complex nature of drug response, that makes difficult to disentangle the interplay between genetics and environment leading to pharmacological phenotype. We have to spare no effort in the identification of genetic biomarkers related to the pathogenesis of the diseases and therapeutic targets. It may help clinicians to individualize dosing drug regimen, maximize drug efficacy and enhance drug safety with certain drugs and populations at risk.

  16. Stem cell trials for cardiovascular medicine: ethical rationale.

    PubMed

    Niemansburg, Sophie L; Teraa, Martin; Hesam, Husna; van Delden, Johannes J M; Verhaar, Marianne C; Bredenoord, Annelien L

    2014-10-01

    Stem cell-based interventions provide new treatment prospects for many disease conditions, including cardiovascular disorders. Clinical trials are necessary to collect adequate evidence on (long-term) safety and efficacy of novel interventions such as stem cells, but the design and launch of clinical trials, from first-in-human studies to larger randomized controlled trials (RCTs), is scientifically and ethically challenging. Stem cells are different from traditional pharmaceuticals, surgical procedures, and medical devices in the following ways: the novelty and complexity of stem cells, the invasiveness of the procedures, and the novel aim of regeneration. These specifics, combined with the characteristics of the study population, will have an impact on the design and ethics of RCTs. The recently closed JUVENTAS trial will serve as an example to identify the (interwoven) scientific and ethical challenges in the design and launch of stem cell RCTs. The JUVENTAS trial has investigated the efficacy of autologous bone marrow cells in end-stage vascular patients, in a double-blind sham-controlled design. We first describe the choices, considerations, and experiences of the JUVENTAS team. Subsequently, we identify the main ethical and scientific challenges and discuss what is important to consider in the design of future stem cell RCTs: assessment of risks and benefits, the choice for outcome measures, the choice for the comparator, the appropriate selection of participants, and adequate informed consent. Additionally, the stem cell field is highly in the spotlight due to the (commercial) interests and expectations. This warrants a cautious pace of translation and scrupulous set up of clinical trials, as failures could put the field in a negative light. At the same time, knowledge from clinical trials is necessary for the field to progress. We conclude that in the scientifically and ethically challenging field of stem cell RCTs, researchers and clinicians have to

  17. How can we improve our understanding of cardiovascular safety liabilities to develop safer medicines?

    PubMed Central

    Laverty, HG; Benson, C; Cartwright, EJ; Cross, MJ; Garland, C; Hammond, T; Holloway, C; McMahon, N; Milligan, J; Park, BK; Pirmohamed, M; Pollard, C; Radford, J; Roome, N; Sager, P; Singh, S; Suter, T; Suter, W; Trafford, A; Volders, PGA; Wallis, R; Weaver, R; York, M; Valentin, JP

    2011-01-01

    Given that cardiovascular safety liabilities remain a major cause of drug attrition during preclinical and clinical development, adverse drug reactions, and post-approval withdrawal of medicines, the Medical Research Council Centre for Drug Safety Science hosted a workshop to discuss current challenges in determining, understanding and addressing ‘Cardiovascular Toxicity of Medicines’. This article summarizes the key discussions from the workshop that aimed to address three major questions: (i) what are the key cardiovascular safety liabilities in drug discovery, drug development and clinical practice? (ii) how good are preclinical and clinical strategies for detecting cardiovascular liabilities? and (iii) do we have a mechanistic understanding of these liabilities? It was concluded that in order to understand, address and ultimately reduce cardiovascular safety liabilities of new therapeutic agents there is an urgent need to: Fully characterize the incidence, prevalence and impact of drug-induced cardiovascular issues at all stages of the drug development process. Ascertain the predictive value of existing non-clinical models and assays towards the clinical outcome. Understand the mechanistic basis of cardiovascular liabilities; by addressing areas where it is currently not possible to predict clinical outcome based on preclinical safety data. Provide scientists in all disciplines with additional skills to enable them to better integrate preclinical and clinical data and to better understand the biological and clinical significance of observed changes. Develop more appropriate, highly relevant and predictive tools and assays to identify and wherever feasible to eliminate cardiovascular safety liabilities from molecules and wherever appropriate to develop clinically relevant and reliable safety biomarkers. PMID:21306581

  18. Deficient cardiovascular stress reactivity predicts poor executive functions in adults with attention-deficit/hyperactivity disorder.

    PubMed

    Hirvikoski, Tatja; Olsson, Erik M G; Nordenstrom, Anna; Lindholm, Torun; Nordstrom, Anna-Lena; Lajic, Svetlana

    2011-01-01

    Associations between cardiovascular stress markers, subjective stress reactivity, and executive functions were studied in 60 adults (30 with attention-deficit/hyperactivity disorder, ADHD, and 30 controls) using the Paced Auditory Serial Addition Test (PASAT, a test of executive functions) as a cognitive stressor. Despite higher self-perceived stress, the adults with ADHD showed lower or atypical cardiovascular stress reactivity, which was associated with poorer performance on PASAT. Using cardiovascular stress markers, subjective stress, and results on PASAT as predictors in a logistic regression, 83.3% of the ADHD group and 86.9% of the controls could be classified correctly.

  19. Physical activity is medicine for older adults

    PubMed Central

    Taylor, Denise

    2014-01-01

    There is evidence from high quality studies to strongly support the positive association between increased levels of physical activity, exercise participation and improved health in older adults. Worldwide, around 3.2 million deaths per year are being attributed to inactivity. In industrialised countries where people are living longer lives, the levels of chronic health conditions are increasing and the levels of physical activity are declining. Key factors in improving health are exercising at a moderate-to-vigorous level for at least 5 days per week and including both aerobic and strengthening exercises. Few older adults achieve the level of physical activity or exercise that accompanies health improvements. A challenge for health professionals is to increase physical activity and exercise participation in older adults. Some success in this has been reported when physicians have given specific, detailed and localised information to their patients, but more high quality research is needed to continue to address this issue of non-participation in physical activity and exercise of a high enough level to ensure health benefits. PMID:24255119

  20. Status of cardiovascular health among adults in a rural area of Northwest China

    PubMed Central

    Zhao, Yaling; Yan, Hong; Yang, Ruihai; Li, Qiang; Dang, Shaonong; Liu, Ruru; Pei, Leilei; Cao, Lei; Marshall, Roger J.; Wang, Duolao

    2016-01-01

    Abstract The aim of this study was to assess the status of cardiovascular health among a rural population in Northwest China and to determine the associated factors for cardiovascular health. A population-based cross-sectional study was conducted in the rural areas of Hanzhong in Northwest China. Interview, physical examination, and fasting blood glucose and lipid measurements were completed for 2693 adults. The construct of cardiovascular health and the definitions of cardiovascular health metrics proposed by the American Heart Association were used to assess cardiovascular health. The proportions of subjects with cardiovascular health metrics were calculated, adjusting for age and sex. The multiple logistic regression model was used to evaluate the association between ideal cardiovascular health and its associated factors. Only 0.5% (0.0% in men vs 0.9% in women, P = 0.002) of the participants had ideal cardiovascular health, whereas 33.8% (18.0% in men vs 50.0% in women, P < 0.001) and 65.7% (82.0% in men vs 49.1% in women, P < 0.001) of the participants had intermediate and poor cardiovascular health, respectively. The prevalence of poor cardiovascular health increased with increasing age (P < 0.001 for trend). Participants fulfilled, on average, 4.4 (95% confidence interval: 4.2–4.7) of the ideal cardiovascular health metrics. Also, 22.2% of the participants presented with 3 or fewer ideal metrics. Only 19.4% of the participants presented with 6 or more ideal metrics. 24.1% of the participants had all 4 ideal health factors, but only 1.1% of the participants had all 4 ideal health behaviors. Women were more likely to have ideal cardiovascular health, whereas adults aged 35 years or over and those who had a family history of hypertension were less likely to have ideal cardiovascular health. The prevalence of ideal cardiovascular health was extremely low among the rural population in Northwest China. Most adults, especially men and the elderly

  1. Normal values for cardiovascular magnetic resonance in adults and children.

    PubMed

    Kawel-Boehm, Nadine; Maceira, Alicia; Valsangiacomo-Buechel, Emanuela R; Vogel-Claussen, Jens; Turkbey, Evrim B; Williams, Rupert; Plein, Sven; Tee, Michael; Eng, John; Bluemke, David A

    2015-04-18

    Morphological and functional parameters such as chamber size and function, aortic diameters and distensibility, flow and T1 and T2* relaxation time can be assessed and quantified by cardiovascular magnetic resonance (CMR). Knowledge of normal values for quantitative CMR is crucial to interpretation of results and to distinguish normal from disease. In this review, we present normal reference values for morphological and functional CMR parameters of the cardiovascular system based on the peer-reviewed literature and current CMR techniques and sequences.

  2. Audit of Cardiovascular Disease Risk Factors among Supported Adults with Intellectual Disability Attending an Ageing Clinic

    ERIC Educational Resources Information Center

    Wallace, Robyn A.; Schluter, Philip

    2008-01-01

    Background: Little is known about the cardiovascular disease (CVD) risk factor profile for older adults with intellectual disability (ID). As many CVD risk factors are treatable by lifestyle changes, confirmation of the risk factor profile for older adults with ID could substantially impact upon preventive health practices for this group. Method:…

  3. Personalized Cardiovascular Medicine Today: A Food and Drug Administration/Center for Drug Evaluation and Research Perspective.

    PubMed

    Blaus, Alison; Madabushi, Rajanikanth; Pacanowski, Michael; Rose, Martin; Schuck, Robert N; Stockbridge, Norman; Temple, Robert; Unger, Ellis F

    2015-10-13

    Over the past decade, personalized medicine has received considerable attention from researchers, drug developers, and regulatory agencies. Personalized medicine includes identifying patients most likely to benefit and those most likely to experience adverse reactions in response to a drug, and tailoring therapy based on pharmacokinetics or pharmacodynamic response, as well. Perhaps most exciting is finding ways to identify likely responders through genetic, proteomic, or other tests, so that only likely responders will be treated. However, less precise methods such as identifying historical, demographic, or other indicators of increased or reduced responsiveness are also important aspects of personalized medicine. The cardiovascular field has not used many genetic or proteomic markers, but has regularly used prognostic variables to identify likely responders. The development of biomarker-based approaches to personalized medicine in cardiovascular disease has been challenging, in part, because most cardiovascular therapies treat acquired syndromes, such as acute coronary syndrome and heart failure, which develop over many decades and represent the end result of several pathophysiological mechanisms. More precise disease classification and greater understanding of individual variations in disease pathology could drive the development of targeted therapeutics. Success in designing clinical trials for personalized medicine will require the selection of patient populations with attributes that can be targeted or that predict outcome, and the use of appropriate enrichment strategies once such attributes are identified. Here, we describe examples of personalized medicine in cardiovascular disease, discuss its impact on clinical trial design, and provide insight into the future of personalized cardiovascular medicine from a regulatory perspective.

  4. Cardiovascular Impact of Eating Disorders in Adults: A Single Center Experience and Literature Review

    PubMed Central

    Sardar, Muhammad Rizwan; Greway, Andrea; DeAngelis, Michael; Tysko, Erin O'Malley; Lehmann, Shawn; Wohlstetter, Melinda; Patel, Riti

    2015-01-01

    Eating disorders have multiple medical sequelae, including potentially life-threatening cardiovascular complications. This article describes our cardiology practice experience of treating adults with eating disorders in the outpatient setting and documents baseline cardiac findings in this complex patient population. We describe our findings in patients across the spectrum of eating disorders; past studies have generally focused on anorexia only. This article also includes a review of the current literature on cardiovascular complications associated with disordered eating. PMID:27326349

  5. Cardiovascular Responses to Psychosocial Stress Reflect Motivation State in Adults Born at Extremely Low Birth Weight.

    PubMed

    Mathewson, Karen J; Pyhälä, Riikka; Hovi, Petteri; Räikkönen, Katri; Van Lieshout, Ryan J; Boyle, Michael H; Saigal, Saroj; Morrison, Katherine M; Kajantie, Eero; Schmidt, Louis A

    2015-01-01

    Background. Adults born extremely preterm appear to have more difficulty managing the stresses of early adulthood than their term-born peers. Objective. To examine the effects of being born at extremely low birth weight (ELBW; birth weight < 1000 g) versus at full term on cardiovascular responses to stress. Method. Cardiovascular responses were elicited during administration of a widely used laboratory stressor, the Trier Social Stress Test (TSST). Results. Term-born adults exhibited a larger decrease in total peripheral resistance and larger increase in cardiac output for TSST performance, reflecting greater resilience, than did ELBW adults. Furthermore, in ELBW participants but not controls, cardiovascular responses were correlated with anxiety, suggesting that their responses reflected feelings of stress. Conclusions. Skills-training and practice with relevant stressors may be necessary to increase the personal resources of ELBW participants for managing stress as they transition to adulthood. PMID:27335948

  6. Reprogramming and transdifferentiation for cardiovascular development and regenerative medicine: where do we stand?

    PubMed Central

    Ebert, Antje D; Diecke, Sebastian; Chen, Ian Y; Wu, Joseph C

    2015-01-01

    Heart disease remains a leading cause of mortality and a major worldwide healthcare burden. Recent advances in stem cell biology have made it feasible to derive large quantities of cardiomyocytes for disease modeling, drug development, and regenerative medicine. The discoveries of reprogramming and transdifferentiation as novel biological processes have significantly contributed to this paradigm. This review surveys the means by which reprogramming and transdifferentiation can be employed to generate induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) and induced cardiomyocytes (iCMs). The application of these patient-specific cardiomyocytes for both in vitro disease modeling and in vivo therapies for various cardiovascular diseases will also be discussed. We propose that, with additional refinement, human disease-specific cardiomyocytes will allow us to significantly advance the understanding of cardiovascular disease mechanisms and accelerate the development of novel therapeutic options. PMID:26183451

  7. Implementation strategies of Systems Medicine in clinical research and home care for cardiovascular disease patients.

    PubMed

    Montecucco, Fabrizio; Carbone, Federico; Dini, Frank Lloyd; Fiuza, Manuela; Pinto, Fausto J; Martelli, Antonietta; Palombo, Domenico; Sambuceti, Gianmario; Mach, François; De Caterina, Raffaele

    2014-11-01

    Insights from the "-omics" science have recently emphasized the need to implement an overall strategy in medical research. Here, the development of Systems Medicine has been indicated as a potential tool for clinical translation of basic research discoveries. Systems Medicine also gives the opportunity of improving different steps in medical practice, from diagnosis to healthcare management, including clinical research. The development of Systems Medicine is still hampered however by several challenges, the main one being the development of computational tools adequate to record, analyze and share a large amount of disparate data. In addition, available informatics tools appear not yet fully suitable for the challenge because they are not standardized, not universally available, or with ethical/legal concerns. Cardiovascular diseases (CVD) are a very promising area for translating Systems Medicine into clinical practice. By developing clinically applied technologies, the collection and analysis of data may improve CV risk stratification and prediction. Standardized models for data recording and analysis can also greatly broaden data exchange, thus promoting a uniform management of CVD patients also useful for clinical research. This advance however requires a great organizational effort by both physicians and health institutions, as well as the overcoming of ethical problems. This narrative review aims at providing an update on the state-of-art knowledge in the area of Systems Medicine as applied to CVD, focusing on current critical issues, providing a road map for its practical implementation.

  8. Cardiovascular

    NASA Video Gallery

    Overview of Cardiovascular research which addresses risks of space flight, including adaptive changes to the cephalad fluid shift (such as reduced circulating blood volume), potential for heart rhy...

  9. Top Three Pharmacogenomics and Personalized Medicine Applications at the Nexus of Renal Pathophysiology and Cardiovascular Medicine

    PubMed Central

    Bochud, Murielle; Burnier, Michel; Guessous, Idris

    2011-01-01

    Pharmacogenomics is a field with origins in the study of monogenic variations in drug metabolism in the 1950s. Perhaps because of these historical underpinnings, there has been an intensive investigation of 'hepatic pharmacogenes' such as CYP450s and liver drug metabolism using pharmacogenomics approaches over the past five decades. Surprisingly, kidney pathophysiology, attendant diseases and treatment outcomes have been vastly under-studied and under-theorized despite their central importance in maintenance of health, susceptibility to disease and rational personalized therapeutics. Indeed, chronic kidney disease (CKD) represents an increasing public health burden worldwide, both in developed and developing countries. Patients with CKD suffer from high cardiovascular morbidity and mortality, which is mainly attributable to cardiovascular events before reaching end-stage renal disease. In this paper, we focus our analyses on renal function before end-stage renal disease, as seen through the lens of pharmacogenomics and human genomic variation. We herein synthesize the recent evidence linking selected Very Important Pharmacogenes (VIP) to renal function, blood pressure and salt-sensitivity in humans, and ways in which these insights might inform rational personalized therapeutics. Notably, we highlight and present the rationale for three applications that we consider as important and actionable therapeutic and preventive focus areas in renal pharmacogenomics: 1) ACE inhibitors, as a confirmed application, 2) VDR agonists, as a promising application, and 3) moderate dietary salt intake, as a suggested novel application. Additionally, we emphasize the putative contributions of gene-environment interactions, discuss the implications of these findings to treat and prevent hypertension and CKD. Finally, we conclude with a strategic agenda and vision required to accelerate advances in this under-studied field of renal pharmacogenomics with vast significance for global

  10. Role of childhood food patterns on adult cardiovascular disease risk.

    PubMed

    Kaikkonen, Jari E; Mikkilä, Vera; Raitakari, Olli T

    2014-10-01

    Accumulating evidence indicates that childhood nutrition plays a role in the adulthood cardiovascular health. A lifelong tracking of dietary habits, following a long-term exposure to unhealthy dietary patterns or independent effects, is a potential effect-mediating mechanism. Dietary patterns have been studied by data-driven and hypothesis-based approaches. Typically, either data-driven healthy or prudent childhood dietary patterns have been characterized and found to be associated with lower adulthood cardiovascular disease (CVD) risk in the published cohort studies. With regard to the individual food groups or food quality indices, intakes particularly of vegetables and fruits (or fiber indicating plant food intake) and polyunsaturated fatty acids have shown protective effects. The evidence which could confirm the long-term healthiness of a hypothesis-based Mediterranean diet is limited, requiring further investigation. Overall, the recent literature strengthens the view that a healthy childhood diet is associated with lowered adulthood CVD risk.

  11. Cardiovascular Disease in Adult Survivors of Childhood Cancer

    PubMed Central

    Lipshultz, Steven E.; Franco, Vivian I.; Miller, Tracie L.; Colan, Steven D.; Sallan, Stephen E.

    2016-01-01

    Treatment advances have increased survival in children with cancer, but subclinical, progressive, irreversible, and sometimes fatal treatment-related cardiovascular effects may appear years later. Cardio-oncologists have identified promising preventive and treatment strategies. Dexrazoxane provides long-term cardioprotection from doxorubicin-associated cardiotoxicity without compromising the efficacy of anticancer treatment. Continuous infusion of doxorubicin is as effective as bolus administration in leukemia treatment, but no evidence has indicated that it provides long-term cardioprotection; continuous infusions should be eliminated from pediatric cancer treatment. Angiotensin-converting enzyme inhibitors can delay the progression of subclinical and clinical cardiotoxicity. All survivors, regardless of whether they were treated with anthracyclines or radiation, should be monitored for systemic inflammation and the risk of premature cardiovascular disease. Echocardiographic screening must be supplemented with screening for biomarkers of cardiotoxicity and perhaps by identification of genetic susceptibilities to cardiovascular diseases; optimal strategies need to be identified. The health burden related to cancer treatment will increase as this population expands and ages. PMID:25587648

  12. Translating genetic discoveries to improvements in cardiovascular care: the path to personalized medicine.

    PubMed

    Hall, Jennifer L

    2008-03-01

    Research and development has provided us with several solutions to reduce morbidity and mortality of cardiovascular disease. More solutions are anticipated in the areas of clinical medicine, personal handheld devices, and DNA technology that will continue to enhance the era of personalized medicine. Genome-wide association studies have recently identified genetic variants on chromosome 9 (interval 9p21) and chromosome 4 (4q25) that confer increased risk for myocardial infarction and atrial fibrillation, respectively. The regions on these chromosomes containing the SNPs associated with disease contain no known genes - creating a challenge for scientists. Unraveling the code on these chromosomes may reveal a deeper insight into the mechanisms underlying disease and the design of new therapeutics to prevent or slow the progression of the disease. PMID:20559956

  13. Challenges and Rewards in Medicinal Chemistry Targeting Cardiovascular and Metabolic Diseases.

    PubMed

    Neidhart, Werner; Ackermann, Jean; Amrein, Kurt; Conte, Aurelia; Hunziker, Daniel; Kuhn, Bernd; Märki, Hans Peter; Nettekoven, Matthias; Ruf, Armin; Schulz-Gasch, Tanja; Mayweg, Alexander V

    2015-01-01

    Medicinal chemistry has been transformed by major technological and conceptual innovations over the last three decades: structural biology and bioinformatics, structure and property based molecular design, the concepts of multidimensional optimization (MDO), in silico and experimental high-throughput molecular property analysis. The novel technologies advanced gradually and in synergy with biology and Roche has been at the forefront. Applications in drug discovery programs towards new medicines in cardiovascular and metabolic diseases are highlighted to show impact and advancement: the early discovery of endothelin antagonists for endothelial dysfunction (Bosentan), 11-beta hydroxysteroid dehydrogenase (11β-HSD1) inhibitors for dysregulated cellular glucocorticoid tonus (type 2 diabetes and metabolic syndrome) and non-covalent hormone sensitive lipase (HSL) inhibitors to study the scope of direct inhibition of lipolysis in the conceptual frame of lipotoxicity and type 2 diabetes. PMID:26507592

  14. Challenges and Rewards in Medicinal Chemistry Targeting Cardiovascular and Metabolic Diseases.

    PubMed

    Neidhart, Werner; Ackermann, Jean; Amrein, Kurt; Conte, Aurelia; Hunziker, Daniel; Kuhn, Bernd; Märki, Hans Peter; Nettekoven, Matthias; Ruf, Armin; Schulz-Gasch, Tanja; Mayweg, Alexander V

    2015-01-01

    Medicinal chemistry has been transformed by major technological and conceptual innovations over the last three decades: structural biology and bioinformatics, structure and property based molecular design, the concepts of multidimensional optimization (MDO), in silico and experimental high-throughput molecular property analysis. The novel technologies advanced gradually and in synergy with biology and Roche has been at the forefront. Applications in drug discovery programs towards new medicines in cardiovascular and metabolic diseases are highlighted to show impact and advancement: the early discovery of endothelin antagonists for endothelial dysfunction (Bosentan), 11-beta hydroxysteroid dehydrogenase (11β-HSD1) inhibitors for dysregulated cellular glucocorticoid tonus (type 2 diabetes and metabolic syndrome) and non-covalent hormone sensitive lipase (HSL) inhibitors to study the scope of direct inhibition of lipolysis in the conceptual frame of lipotoxicity and type 2 diabetes.

  15. Diabetes and cardiovascular disease in older adults: current status and future directions.

    PubMed

    Halter, Jeffrey B; Musi, Nicolas; McFarland Horne, Frances; Crandall, Jill P; Goldberg, Andrew; Harkless, Lawrence; Hazzard, William R; Huang, Elbert S; Kirkman, M Sue; Plutzky, Jorge; Schmader, Kenneth E; Zieman, Susan; High, Kevin P

    2014-08-01

    The prevalence of diabetes increases with age, driven in part by an absolute increase in incidence among adults aged 65 years and older. Individuals with diabetes are at higher risk for cardiovascular disease, and age strongly predicts cardiovascular complications. Inflammation and oxidative stress appear to play some role in the mechanisms underlying aging, diabetes, cardiovascular disease, and other complications of diabetes. However, the mechanisms underlying the age-associated increase in risk for diabetes and diabetes-related cardiovascular disease remain poorly understood. Moreover, because of the heterogeneity of the older population, a lack of understanding of the biology of aging, and inadequate study of the effects of treatments on traditional complications and geriatric conditions associated with diabetes, no consensus exists on the optimal interventions for older diabetic adults. The Association of Specialty Professors, along with the National Institute on Aging, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung, and Blood Institute, and the American Diabetes Association, held a workshop, summarized in this Perspective, to discuss current knowledge regarding diabetes and cardiovascular disease in older adults, identify gaps, and propose questions to guide future research.

  16. National Center for Complementary and Alternative Medicine perspectives for complementary and alternative medicine research in cardiovascular diseases.

    PubMed

    Wong, Shan S; Nahin, Richard L

    2003-01-01

    The National Center for Complementary and Alternative Medicine (NCCAM) was established in 1998 by the US Congress to conduct and support basic and applied research and research training and disseminate information with respect to identifying, investigating, and validating complementary and alternative therapies. Because of limited appropriations, NCCAM prioritizes its research programs according to the relative use of a modality, the evidence supporting its value and safety, and opportunities to advance the relevant fields of science. While NCCAM's top priority is supporting clinical trials of alternative therapeutics, increasingly it is supporting basic and preclinical research. To accomplish its mission, NCCAM encourages the research community to undertake high-quality and rigorous research in complementary and alternative medicine (CAM). In the area of cardiovascular diseases, NCCAM is supporting clinical trials, specialized centers, research training, and investigator-initiated projects. Virtually all aspects of CAM modalities are open for investigation. Current NCCAM projects are investigating Tai Chi (Taiji) exercise, hawthorn, phytoestrogens, biofeedback, Ayurvedic herbals, acupuncture, qigong, Reiki, meditation, spirituality, Ginkgo biloba, ethylenediaminetetraacetic acid chelation therapy, and special diets.

  17. Adults with genetic syndromes and cardiovascular abnormalities: Clinical history and management

    PubMed Central

    Lin, Angela E.; Basson, Craig T.; Goldmuntz, Elizabeth; Magoulas, Pilar L.; McDermott, Deborah A.; McDonald-McGinn, Donna M.; McPherson, Elspeth; Morris, Colleen A.; Noonan, Jacqueline; Nowak, Catherine; Pierpont, Mary Ella; Pyeritz, Reed E.; Rope, Alan F.; Zackai, Elaine; Pober, Barbara R.

    2009-01-01

    Cardiovascular abnormalities, especially structural congenital heart defects (CHDs), commonly occur in malformation syndromes and genetic disorders. Individuals with syndromes comprise a significant proportion of those affected with selected CHDs such as complete atrioventricular canal, interrupted arch type B, supravalvar aortic stenosis and pulmonary stenosis. As these individuals age, they contribute to the growing population of adults with special health care needs. Although most will require longterm cardiology followup, primary care providers, geneticists and other specialists should be aware of (1) the type and frequency of cardiovascular abnormalities, (2) the range of clinical outcomes, and (3) guidelines for prospective management and treatment of potential complications. This article reviews fundamental genetic, cardiac, medical and reproductive issues associated with common genetic syndromes which are frequently associated with a cardiovascular abnormality. New data are also provided about the cardiac status of adults with a 22q11.2 deletion and with Down syndrome. PMID:18580689

  18. Arterial Hypertension and other risk factors associated with cardiovascular diseases among adults1

    PubMed Central

    Radovanovic, Cremilde Aparecida Trindade; dos Santos, Lucimary Afonso; Carvalho, Maria Dalva de Barros; Marcon, Sonia Silva

    2014-01-01

    OBJECTIVE: to identify the prevalence of arterial hypertension and its association with cardiovascular risk factors among adults. METHOD: cross-sectional, population-based, descriptive study conducted with 408 adult individuals. Data were collected through a questionnaire and measurements of weight, height and waist circumference. Person's Chi-square and multiple logistic regression were used in the data analysis. RESULTS: 23.03% of the individuals reported hypertension with a higher prevalence among women. Odds Ratio indicated that smoking, body mass index, waist circumference, diabetes mellitus and dyslipidemia were positively associated with arterial hypertension. CONCLUSION: high self-reported hypertension and its association with other cardiovascular risk factors such as diabetes, obesity and dyslipidemia show the need for specific nursing interventions and the implementation of protocols focused on minimizing complications arising from hypertension, as well as to prevent the emergence of other cardiovascular diseases. PMID:25296137

  19. The Association between Cardiovascular Disease and Cochlear Function in Older Adults

    ERIC Educational Resources Information Center

    Torre, Peter, III; Cruickshanks, Karen J.; Klein, Barbara E.K.; Klein, Ronald; Nondahl, David M.

    2005-01-01

    The purpose of this research was to evaluate the relation between self-reported cardiovascular disease (CVD) and cochlear function in older adults. The Epidemiology of Hearing Loss Study (EHLS) is an ongoing population-based study of hearing loss and its risk factors in Beaver Dam, Wisconsin. As part of the EHLS questionnaire, participants were…

  20. Prevalence of cardiovascular disease risk factors among older Puerto Rican adults living in Massachusetts

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There remains limited research on cardiovascular disease (CVD) risk factors in Puerto Rican adults. We compared lifestyle and CVD risk factors in Puerto Rican men and women with normal fasting glucose (NFG), impaired fasting glucose (IFG), or type 2 diabetes (T2D), and investigated achievement of Am...

  1. Diet quality is inversely related to cardiovascular risk factors in adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The goal of the study was to determine if there was an association between diet quality and cardiovascular risk factors in adults. National Health and Nutrition Examination Survey 2001–2008 data were used to compare diet quality, as determined by using 2005 Healthy Eating Index-2005 scores, and card...

  2. Pre-Exercise Participation Cardiovascular Screening in a Heterogeneous Cohort of Adult Cancer Patients

    PubMed Central

    Kenjale, Aarti A.; Hornsby, Whitney E.; Crowgey, Theresa; Thomas, Samantha; Herndon, James E.; Khouri, Michel G.; Lane, Amy R.; Bishop, Caroline E.; Eves, Neil D.; Peppercorn, Jeffrey; Douglas, Pamela S.

    2014-01-01

    Background. The purpose of this study was to investigate the extent of pre-exercise participation (“preparticipation”) health screening in a heterogeneous cohort of adult cancer patients. Methods. Patients (n = 413) with histologically confirmed solid or hematologic malignancy were categorized into preparticipation health screening risk stratification based on American College Sports Medicine (ACSM) recommendations. Risk of an exercise-related event was evaluated during a symptom-limited cardiopulmonary exercise test (CPET) with 12-lead electrocardiography (ECG). Results. Participant risk was categorized as low risk (n = 59, 14%), moderate risk (n = 217, 53%), and high risk (n = 137, 33%). Mean peak oxygen consumption was 21.7 ± 6.7 mL/kg−1 per minute−1 or 19.5 ± 21.7% below age- and sex-predicted sedentary values. No major serious adverse events or fatal events were observed during CPET procedures. A total of 31 positive ECG tests were observed, for an event rate of 8%. ACSM risk stratification did not predict the risk of a positive test. Age, statin use, antiplatelet therapy use, cardiovascular disease, prior treatment with anthracycline or radiation therapy, and being sedentary were predictors of a positive test (all p < .10). Conclusion. The patient risk-stratification profile strongly suggests that the use of formalized preparticipation health screening is required in all oncology scenarios; however, risk of an exercise-induced event is low, suggesting that the use of exercise testing is not required for pre-exercise clearance in the majority of patients. PMID:25061091

  3. [Study on mechanism of Salvia miltiorrhiza treating cardiovascular disease through auxiliary mechanism elucidation system for Chinese medicine].

    PubMed

    He, Shuai-bing; Zhang, Bai-xia; Wang, Hui-hui; Wang, Yun; Qiao, Yan-jiang

    2015-10-01

    Salvia miltiorrhiza is a traditional Chinese medicine (TCM) and is widely used as a clinically medication for its efficiency in treating cardiovascular disease. Due to TCM is a comprehensive system, the mechanism of S. miltiorrhiza treating cardiovascular disease through integrated multiple pathways are still unclear in some aspects. With the rapid progress of bioinformatics and systems biology, network pharmacology is considered as a promising approach toward reveal the underlying complex relationship between an herb and the disease. In order to discover the mechanism of S. miltiorrhiza treating cardiovascular disease systematically, we use the auxiliary mechanism elucidation system for Chinese medicine, built up a molecule interaction network on the active component targets of S. miltiorrhiza and the therapeutic targets of cardiovascular disease to offer an opportunity for deep understanding the mechanism of S. miltiorrhiza treating cardiovascular disease from the perspective of network pharmacology. The results showed that S. miltiorrhiza treating cardiovascular disease through ten pathways as follows: improve lipid metabolism, anti-inflammation, regulate blood pressure, negatively regulates blood coagulation factor and antithrombotic, regulate cell proliferation, anti-stress injury, promoting angiogenesis, inhibited apoptosis, adjust vascular systolic and diastolic, promoting wound repair. The results of this paper provide theoretical guidance for the development of new drugs to treat cardiovascular disease and the discovery of new drugs through component compatibility.

  4. [Study on mechanism of Salvia miltiorrhiza treating cardiovascular disease through auxiliary mechanism elucidation system for Chinese medicine].

    PubMed

    He, Shuai-bing; Zhang, Bai-xia; Wang, Hui-hui; Wang, Yun; Qiao, Yan-jiang

    2015-10-01

    Salvia miltiorrhiza is a traditional Chinese medicine (TCM) and is widely used as a clinically medication for its efficiency in treating cardiovascular disease. Due to TCM is a comprehensive system, the mechanism of S. miltiorrhiza treating cardiovascular disease through integrated multiple pathways are still unclear in some aspects. With the rapid progress of bioinformatics and systems biology, network pharmacology is considered as a promising approach toward reveal the underlying complex relationship between an herb and the disease. In order to discover the mechanism of S. miltiorrhiza treating cardiovascular disease systematically, we use the auxiliary mechanism elucidation system for Chinese medicine, built up a molecule interaction network on the active component targets of S. miltiorrhiza and the therapeutic targets of cardiovascular disease to offer an opportunity for deep understanding the mechanism of S. miltiorrhiza treating cardiovascular disease from the perspective of network pharmacology. The results showed that S. miltiorrhiza treating cardiovascular disease through ten pathways as follows: improve lipid metabolism, anti-inflammation, regulate blood pressure, negatively regulates blood coagulation factor and antithrombotic, regulate cell proliferation, anti-stress injury, promoting angiogenesis, inhibited apoptosis, adjust vascular systolic and diastolic, promoting wound repair. The results of this paper provide theoretical guidance for the development of new drugs to treat cardiovascular disease and the discovery of new drugs through component compatibility. PMID:26975090

  5. ED 06-3 BLOOD PRESSURE PHENOTYPE ASSOCIATED WITH CARDIOVASCULAR RISK IN YOUNG ADULTS.

    PubMed

    Yano, Yuichiro

    2016-09-01

    Younger adults (ages ≤50 years) are increasingly prone to stroke, chronic kidney disease (CKD), and worsening cardiovascular disease (CVD) mortality in the US. An alarming increase in prevalence of high blood pressure (BP) related to the obesity epidemic appears to underlie these adverse trends. However, what specific BP characteristics measured in young adulthood optimally predict incident CVD and CKD later in life remains to be determined. Therefore, an optimization of diagnostic and therapeutic strategies in BP management for young adults is challenging but essential. In my lecture, I will fill the gap, using results from the Coronary Artery Risk Development in Young Adults (CARDIA) Study.

  6. Detection of Cardiovascular Disease Risk's Level for Adults Using Naive Bayes Classifier

    PubMed Central

    Miranda, Eka; Amelga, Alowisius Y.; Maribondang, Marco M.; Salim, Mulyadi

    2016-01-01

    Objectives The number of deaths caused by cardiovascular disease and stroke is predicted to reach 23.3 million in 2030. As a contribution to support prevention of this phenomenon, this paper proposes a mining model using a naïve Bayes classifier that could detect cardiovascular disease and identify its risk level for adults. Methods The process of designing the method began by identifying the knowledge related to the cardiovascular disease profile and the level of cardiovascular disease risk factors for adults based on the medical record, and designing a mining technique model using a naïve Bayes classifier. Evaluation of this research employed two methods: accuracy, sensitivity, and specificity calculation as well as an evaluation session with cardiologists and internists. The characteristics of cardiovascular disease are identified by its primary risk factors. Those factors are diabetes mellitus, the level of lipids in the blood, coronary artery function, and kidney function. Class labels were assigned according to the values of these factors: risk level 1, risk level 2 and risk level 3. Results The evaluation of the classifier performance (accuracy, sensitivity, and specificity) in this research showed that the proposed model predicted the class label of tuples correctly (above 80%). More than eighty percent of respondents (including cardiologists and internists) who participated in the evaluation session agree till strongly agreed that this research followed medical procedures and that the result can support medical analysis related to cardiovascular disease. Conclusions The research showed that the proposed model achieves good performance for risk level detection of cardiovascular disease. PMID:27525161

  7. Policy Implications of a Literature Review of Cardiovascular Disease in Uninsured Immigrant Older Adults.

    PubMed

    Sadarangani, Tina R

    2015-06-01

    The number of older adults emigrating to the United States is expected to quadruple by 2050. The health of immigrant older adults is complicated by the limited options for low-cost health insurance available to this population. Welfare reform has limited new immigrants' access to public assistance programs, such as Medicaid; and low-cost private insurance options rarely exist for individuals older than 65, even with the passage of the Patient Protection and Affordable Care Act (PPACA). Uninsured immigrant older adults have been found to forgo preventive care due to cost and are among the leading users of emergency departments for preventable complications of chronic disease, primarily cardiovascular disease (CVD). A review of the literature found that insurance coverage has a significant impact on CVD risk among immigrant older adults. The current article discusses the implications of welfare reform initiatives and the shortcomings of the PPACA in addressing the health care needs of immigrant older adults.

  8. Open Access Integrated Therapeutic and Diagnostic Platforms for Personalized Cardiovascular Medicine

    PubMed Central

    Gladding, Patrick A.; Cave, Andrew; Zareian, Mehran; Smith, Kevin; Hussan, Jagir; Hunter, Peter; Erogbogbo, Folarin; Aguilar, Zoraida; Martin, David S.; Chan, Eugene; Homer, Margie L.; Shevade, Abhijit V.; Kassemi, Mohammad; Thomas, James D.; Schlegel, Todd T.

    2013-01-01

    It is undeniable that the increasing costs in healthcare are a concern. Although technological advancements have been made in healthcare systems, the return on investment made by governments and payers has been poor. The current model of care is unsustainable and is due for an upgrade. In developed nations, a law of diminishing returns has been noted in population health standards, whilst in the developing world, westernized chronic illnesses, such as diabetes and cardiovascular disease have become emerging problems. The reasons for these trends are complex, multifactorial and not easily reversed. Personalized medicine has the potential to have a significant impact on these issues, but for it to be truly successful, interdisciplinary mass collaboration is required. We propose here a vision for open-access advanced analytics for personalized cardiac diagnostics using imaging, electrocardiography and genomics. PMID:25562653

  9. Appropriateness of cardiovascular care in elderly adult cancer survivors.

    PubMed

    Cheung, Winson Y; Levin, Raisa; Setoguchi, Soko

    2013-01-01

    Research suggests that the quality of non-cancer-related care among cancer survivors (CS) is suboptimal. Secondary disease prevention is an important component of survivorship care that has not been previously evaluated. Our aims were (1) to assess the utilization of and adherence to medications and treatments for the secondary prevention of myocardial infarction (MI) in CS versus non-cancer patients (NCP) and (2) to compare temporal trends in cardiovascular care between these two patient cohorts. Linking data from Medicare, pharmacy assistance programs, and cancer registries, we calculated the percentage of individuals receiving preventive medications (statins, β-blockers, angiotensin-converting enzyme inhibitors) and revascularization interventions (angioplasty, stent, bypass surgery) within 90 days after acute MI in CS and propensity score-matched NCP. We assessed trends over time and determined predictors of appropriate preventive care using modified Poisson regression. We identified 1,119 CS and 7,886 NCP. Compared to NCP, more survivors received statins (38 vs. 31 %) and β-blockers (67 vs. 59 %), but fewer underwent bypass surgery (1.5 vs. 2.8 %) after MI. From 1997 to 2004, both survivors and NCP were increasingly prescribed medications to prevent future coronary events. Over the same time period, receipt of bypass surgery was significantly lower among survivors. Co-morbidities, such as depression and lung disease, and demographic factors, such as advanced age and female, were associated with underuse of preventive care among survivors when compared to NCP. Use of preventive medications and procedures has generally improved, but uptake of bypass surgery among CS still lags behind NCP.

  10. Fetal development and risk of cardiovascular diseases and diabetes type 2 in adult life.

    PubMed

    Szostak-Węgierek, Dorota; Szamotulska, Katarzyna

    2011-01-01

    The fetal origin hypothesis of adult cardiovascular diseases, type 2 diabetes, hypertension and dyslipidemia in persons born with low birthweight, independently of their extrauterine risk factors, has been well established in the last decade of the twentieth century. However, mechanisms responsible for this relationship are still under investigation. Insulin resistance resulting from the restriction of intrauterine development of skeletal muscles and other organs is considered as the most important cause of metabolic disturbances and their cardiovascular complications in adult subjects born with intrauterine growth retardation (IUGR). Decline of insulin secretion, overactivation of the hypothalamo-pituitary-adrenal axis, reduced glucose uptake in the liver and raised lipid oxidation in the muscles may also explain this association. On the other hand, abnormal vascular development , increased activity of the sympathetic nervous system, defective endothelial function and/or impaired renal function in growth restricted newborns may contribute to hypertension in their later life. With respect to maternal conditions and life-style factors that may increase cardiovascular risk in adult offspring born with IUGR, the most consistent results concern pregnancy induced hypertension, preeclampsia, undernutrition, smoking during pregnancy, hypercholesterolemia, inflammation and/or enhanced glucocorticoid secretion. Macrosomia of the newborn, a frequent sequel to maternal diabetes and/or obesity, also increases the risk of diabetes and cardiovascular diseases in adulthood. Maternal overnutrition, and particularly high fat and sugar intake, seem to play a key role in fetal programming of cardiovascular risk in subjects born with macrosomia. Epigenetic imprinting underlies the described pathomechanisms. The presented associations are illustrated, among others, with the results of studies performed by the authors of this review.

  11. [Cardiovascular risk factors in young adults with arterial hypertension and/or diabetes mellitus].

    PubMed

    Moreira, Thereza Maria Magalhães; Gomes, Emiliana Bezerra; dos Santos, Jênifa Cavalcante

    2010-12-01

    In this study we aimed to investigate the risk factors associated with arterial hypertension and diabetes mellitus in young adults assisted in six Family Health Units (UBASF), of Fortaleza, Ceará, Brazil. This is a descriptive and documental study, based on the records of the Care Program to Arterial Hypertension and Diabetes Mellitus (HIPERDIA). The sample was composed of 60 records, including hypertensive, diabetics and patients with the two diagnoses. The results showed prevalence of young female adults (78%). Regarding the risk factors, arterial hypertension (n=45), family history (n=33), overweight (n=33) and sedentary lifestyle (n=27) stood out. Regarding the cardiovascular risk stratification, most presented Medium additional risk for cardiovascular disease. We concluded that the individualized evaluation of risk factors supports an action addressed for possible events, being necessary investments in prevention and also in training and maintenance of the HIPERDIA system.

  12. Systems Pharmacology Dissection of the Integrated Treatment for Cardiovascular and Gastrointestinal Disorders by Traditional Chinese Medicine

    PubMed Central

    Zhang, Wenjuan; Tao, Qin; Guo, Zihu; Fu, Yingxue; Chen, Xuetong; Shar, Piar Ali; Shahen, Mohamed; Zhu, Jinglin; Xue, Jun; Bai, Yaofei; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Wang, Yonghua

    2016-01-01

    Though cardiovascular diseases (CVDs) and gastrointestinal disorders (GIDs) are different diseases associated with different organs, they are highly correlated clinically. Importantly, in Traditional Chinese Medicine (TCM), similar treatment strategies have been applied in both diseases. However, the etiological mechanisms underlying them remain unclear. Here, an integrated systems pharmacology approach is presented for illustrating the molecular correlations between CVDs and GIDs. Firstly, we identified pairs of genes that are associated with CVDs and GIDs and found that these genes are functionally related. Then, the association between 115 heart meridian (HM) herbs and 163 stomach meridian (SM) herbs and their combination application in Chinese patent medicine was investigated, implying that both CVDs and GIDs can be treated by the same strategy. Exemplified by a classical formula Sanhe Decoration (SHD) treating chronic gastritis, we applied systems-based analysis to introduce a drug-target-pathway-organ network that clarifies mechanisms of different diseases being treated by the same strategy. The results indicate that SHD regulated several pathological processes involved in both CVDs and GIDs. We experimentally confirmed the predictions implied by the effect of SHD for myocardial ischemia. The systems pharmacology suggests a novel integrated strategy for rational drug development for complex associated diseases. PMID:27597117

  13. Generation and Assessment of Functional Biomaterial Scaffolds for Applications in Cardiovascular Tissue Engineering and Regenerative Medicine

    PubMed Central

    Hinderer, Svenja; Brauchle, Eva

    2015-01-01

    Current clinically applicable tissue and organ replacement therapies are limited in the field of cardiovascular regenerative medicine. The available options do not regenerate damaged tissues and organs, and, in the majority of the cases, show insufficient restoration of tissue function. To date, anticoagulant drug‐free heart valve replacements or growing valves for pediatric patients, hemocompatible and thrombus‐free vascular substitutes that are smaller than 6 mm, and stem cell‐recruiting delivery systems that induce myocardial regeneration are still only visions of researchers and medical professionals worldwide and far from being the standard of clinical treatment. The design of functional off‐the‐shelf biomaterials as well as automatable and up‐scalable biomaterial processing methods are the focus of current research endeavors and of great interest for fields of tissue engineering and regenerative medicine. Here, various approaches that aim to overcome the current limitations are reviewed, focusing on biomaterials design and generation methods for myocardium, heart valves, and blood vessels. Furthermore, novel contact‐ and marker‐free biomaterial and extracellular matrix assessment methods are highlighted. PMID:25778713

  14. Systems Pharmacology Dissection of the Integrated Treatment for Cardiovascular and Gastrointestinal Disorders by Traditional Chinese Medicine.

    PubMed

    Zhang, Wenjuan; Tao, Qin; Guo, Zihu; Fu, Yingxue; Chen, Xuetong; Shar, Piar Ali; Shahen, Mohamed; Zhu, Jinglin; Xue, Jun; Bai, Yaofei; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Wang, Yonghua

    2016-01-01

    Though cardiovascular diseases (CVDs) and gastrointestinal disorders (GIDs) are different diseases associated with different organs, they are highly correlated clinically. Importantly, in Traditional Chinese Medicine (TCM), similar treatment strategies have been applied in both diseases. However, the etiological mechanisms underlying them remain unclear. Here, an integrated systems pharmacology approach is presented for illustrating the molecular correlations between CVDs and GIDs. Firstly, we identified pairs of genes that are associated with CVDs and GIDs and found that these genes are functionally related. Then, the association between 115 heart meridian (HM) herbs and 163 stomach meridian (SM) herbs and their combination application in Chinese patent medicine was investigated, implying that both CVDs and GIDs can be treated by the same strategy. Exemplified by a classical formula Sanhe Decoration (SHD) treating chronic gastritis, we applied systems-based analysis to introduce a drug-target-pathway-organ network that clarifies mechanisms of different diseases being treated by the same strategy. The results indicate that SHD regulated several pathological processes involved in both CVDs and GIDs. We experimentally confirmed the predictions implied by the effect of SHD for myocardial ischemia. The systems pharmacology suggests a novel integrated strategy for rational drug development for complex associated diseases. PMID:27597117

  15. Generation and Assessment of Functional Biomaterial Scaffolds for Applications in Cardiovascular Tissue Engineering and Regenerative Medicine.

    PubMed

    Hinderer, Svenja; Brauchle, Eva; Schenke-Layland, Katja

    2015-11-18

    Current clinically applicable tissue and organ replacement therapies are limited in the field of cardiovascular regenerative medicine. The available options do not regenerate damaged tissues and organs, and, in the majority of the cases, show insufficient restoration of tissue function. To date, anticoagulant drug-free heart valve replacements or growing valves for pediatric patients, hemocompatible and thrombus-free vascular substitutes that are smaller than 6 mm, and stem cell-recruiting delivery systems that induce myocardial regeneration are still only visions of researchers and medical professionals worldwide and far from being the standard of clinical treatment. The design of functional off-the-shelf biomaterials as well as automatable and up-scalable biomaterial processing methods are the focus of current research endeavors and of great interest for fields of tissue engineering and regenerative medicine. Here, various approaches that aim to overcome the current limitations are reviewed, focusing on biomaterials design and generation methods for myocardium, heart valves, and blood vessels. Furthermore, novel contact- and marker-free biomaterial and extracellular matrix assessment methods are highlighted. PMID:25778713

  16. Systems Pharmacology Dissection of the Integrated Treatment for Cardiovascular and Gastrointestinal Disorders by Traditional Chinese Medicine.

    PubMed

    Zhang, Wenjuan; Tao, Qin; Guo, Zihu; Fu, Yingxue; Chen, Xuetong; Shar, Piar Ali; Shahen, Mohamed; Zhu, Jinglin; Xue, Jun; Bai, Yaofei; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Wang, Yonghua

    2016-09-06

    Though cardiovascular diseases (CVDs) and gastrointestinal disorders (GIDs) are different diseases associated with different organs, they are highly correlated clinically. Importantly, in Traditional Chinese Medicine (TCM), similar treatment strategies have been applied in both diseases. However, the etiological mechanisms underlying them remain unclear. Here, an integrated systems pharmacology approach is presented for illustrating the molecular correlations between CVDs and GIDs. Firstly, we identified pairs of genes that are associated with CVDs and GIDs and found that these genes are functionally related. Then, the association between 115 heart meridian (HM) herbs and 163 stomach meridian (SM) herbs and their combination application in Chinese patent medicine was investigated, implying that both CVDs and GIDs can be treated by the same strategy. Exemplified by a classical formula Sanhe Decoration (SHD) treating chronic gastritis, we applied systems-based analysis to introduce a drug-target-pathway-organ network that clarifies mechanisms of different diseases being treated by the same strategy. The results indicate that SHD regulated several pathological processes involved in both CVDs and GIDs. We experimentally confirmed the predictions implied by the effect of SHD for myocardial ischemia. The systems pharmacology suggests a novel integrated strategy for rational drug development for complex associated diseases.

  17. Complementary and alternative medicine for sleep disturbances in older adults.

    PubMed

    Gooneratne, Nalaka S

    2008-02-01

    Complementary and alternative medicines (CAM) are frequently used for the treatment of sleep disorders, but in many cases patients do not discuss these therapies directly with their health care provider. There is a growing body of well-designed clinical trials using CAM that have shown the following: (1) Melatonin is an effective agent for the treatment of circadian phase disorders that affect sleep; however, the role of melatonin in the treatment of primary or secondary insomnia is less well established. (2) Valerian has shown a benefit in some, but not all clinical trials. (3) Several other modalities, such as Tai Chi, acupuncture, acupressure, yoga, and meditation have improved sleep parameters in a limited number of early trials. Future work examining CAM has the potential to significantly add to our treatment options for sleep disorders in older adults.

  18. Recents patents for isolating, delivering and tracking adult stem cells in regenerative medicine.

    PubMed

    Fierabracci, Alessandra

    2010-06-01

    The field of regenerative medicine offers nowadays the potential to significantly impact a wide spectrum of healthcare issues, from insulin-dependent diabetes mellitus (Type 1 diabetes, T1D) to cardiovascular disease. In tissue engineering biomaterials, biological factors, regeneration competent cells are used in the process of creating functional tissue. Regarding the type of stem or progenitor cells which represents the best candidate for therapy, embryonic stem cells have been considered the master cells capable of differentiating into every type of cells either in vitro or in vivo, in spite of serious ethical concerns. Nevertheless experimental evidence suggests that adult stem cells and even terminally differentiated somatic cells under appropriate microenvironmental treatments can be reprogrammed and contribute to a much wider spectrum of differentiated progeny than previously anticipated. One of the main goals is to exploit novel technologies aiming to isolate, expand and enrich sources of regeneration competent cells, especially adult somatic stem cells. Researchers are also trying to develop innovative strategies for effectively delivering regenerative cell populations and to implement 'tracking' tools to verify their engraftment and destiny in vivo. Here we review recent patents on the field issued over the past five years.

  19. Triptans Use for Migraine Headache among Nonelderly Adults with Cardiovascular Risk

    PubMed Central

    2016-01-01

    Objective. To examine the association between the cardiovascular (CV) risk factors and triptans use among adults with migraine. Methods. A retrospective cross-sectional study design was used. Data were derived from 2009–2013 Medical Expenditure Panel Survey (MEPS). The study sample consisted of adults (age > 21 years) with migraine headache (N = 1,652). Multivariable logistic regression was used to examine the relationship between CV risk factors and triptans use. Results. Overall, 21% adults with migraine headache used triptans. Nearly two-thirds (61%) of adults with migraine had at least one CV risk factor. A significantly lower percentage of adults with CV risk (18.1%) used triptans compared to those without CV risk factors (25.5%). After controlling for demographic, socioeconomic status, access to care, and health status, adults with no CV risk factors were more likely to use triptans as compared to those with one CV risk factor (AOR = 1.83, 95% CI = 1.17–2.87). There were no statistically significant differences in triptans use between those with two or more CV risk factors and those with one CV risk factor. Conclusion. An overwhelming majority of adults with migraine had a contraindication to triptans based on their CV risk factors. The use of triptans among adults with migraine and multiple CV risk factors warrants further investigation.

  20. Triptans Use for Migraine Headache among Nonelderly Adults with Cardiovascular Risk

    PubMed Central

    2016-01-01

    Objective. To examine the association between the cardiovascular (CV) risk factors and triptans use among adults with migraine. Methods. A retrospective cross-sectional study design was used. Data were derived from 2009–2013 Medical Expenditure Panel Survey (MEPS). The study sample consisted of adults (age > 21 years) with migraine headache (N = 1,652). Multivariable logistic regression was used to examine the relationship between CV risk factors and triptans use. Results. Overall, 21% adults with migraine headache used triptans. Nearly two-thirds (61%) of adults with migraine had at least one CV risk factor. A significantly lower percentage of adults with CV risk (18.1%) used triptans compared to those without CV risk factors (25.5%). After controlling for demographic, socioeconomic status, access to care, and health status, adults with no CV risk factors were more likely to use triptans as compared to those with one CV risk factor (AOR = 1.83, 95% CI = 1.17–2.87). There were no statistically significant differences in triptans use between those with two or more CV risk factors and those with one CV risk factor. Conclusion. An overwhelming majority of adults with migraine had a contraindication to triptans based on their CV risk factors. The use of triptans among adults with migraine and multiple CV risk factors warrants further investigation. PMID:27630773

  1. Triptans Use for Migraine Headache among Nonelderly Adults with Cardiovascular Risk.

    PubMed

    Alwhaibi, Monira; Deb, Arijita; Sambamoorthi, Usha

    2016-01-01

    Objective. To examine the association between the cardiovascular (CV) risk factors and triptans use among adults with migraine. Methods. A retrospective cross-sectional study design was used. Data were derived from 2009-2013 Medical Expenditure Panel Survey (MEPS). The study sample consisted of adults (age > 21 years) with migraine headache (N = 1,652). Multivariable logistic regression was used to examine the relationship between CV risk factors and triptans use. Results. Overall, 21% adults with migraine headache used triptans. Nearly two-thirds (61%) of adults with migraine had at least one CV risk factor. A significantly lower percentage of adults with CV risk (18.1%) used triptans compared to those without CV risk factors (25.5%). After controlling for demographic, socioeconomic status, access to care, and health status, adults with no CV risk factors were more likely to use triptans as compared to those with one CV risk factor (AOR = 1.83, 95% CI = 1.17-2.87). There were no statistically significant differences in triptans use between those with two or more CV risk factors and those with one CV risk factor. Conclusion. An overwhelming majority of adults with migraine had a contraindication to triptans based on their CV risk factors. The use of triptans among adults with migraine and multiple CV risk factors warrants further investigation. PMID:27630773

  2. Medicines in My Home: Information for Adults on Using Over-the-Counter Medicines Safely

    MedlinePlus

    Medicines In My Home More about using medicines safely Medicines in My Home: www.fda.gov/medsinmyhome FDA Consumer Medicine Education: www.fda.gov/usemedicinesafely National Council on Patient Information and ...

  3. Distribution of Short-Term and Lifetime Predicted Risks of Cardiovascular Diseases in Peruvian Adults

    PubMed Central

    Quispe, Renato; Bazo-Alvarez, Juan Carlos; Burroughs Peña, Melissa S; Poterico, Julio A; Gilman, Robert H; Checkley, William; Bernabé-Ortiz, Antonio; Huffman, Mark D; Miranda, J Jaime

    2015-01-01

    Background Short-term risk assessment tools for prediction of cardiovascular disease events are widely recommended in clinical practice and are used largely for single time-point estimations; however, persons with low predicted short-term risk may have higher risks across longer time horizons. Methods and Results We estimated short-term and lifetime cardiovascular disease risk in a pooled population from 2 studies of Peruvian populations. Short-term risk was estimated using the atherosclerotic cardiovascular disease Pooled Cohort Risk Equations. Lifetime risk was evaluated using the algorithm derived from the Framingham Heart Study cohort. Using previously published thresholds, participants were classified into 3 categories: low short-term and low lifetime risk, low short-term and high lifetime risk, and high short-term predicted risk. We also compared the distribution of these risk profiles across educational level, wealth index, and place of residence. We included 2844 participants (50% men, mean age 55.9 years [SD 10.2 years]) in the analysis. Approximately 1 of every 3 participants (34% [95% CI 33 to 36]) had a high short-term estimated cardiovascular disease risk. Among those with a low short-term predicted risk, more than half (54% [95% CI 52 to 56]) had a high lifetime predicted risk. Short-term and lifetime predicted risks were higher for participants with lower versus higher wealth indexes and educational levels and for those living in urban versus rural areas (P<0.01). These results were consistent by sex. Conclusions These findings highlight potential shortcomings of using short-term risk tools for primary prevention strategies because a substantial proportion of Peruvian adults were classified as low short-term risk but high lifetime risk. Vulnerable adults, such as those from low socioeconomic status and those living in urban areas, may need greater attention regarding cardiovascular preventive strategies. PMID:26254303

  4. Complementary and alternative medicine use among adults in Enugu, Nigeria

    PubMed Central

    2011-01-01

    Background Attention and interest in the use of Complementary and Alternative Medicine (CAM) has been reawakened globally. Evidence from studies carried out in different parts of the world has established that CAM use is very common and varies among populations. This study investigated the use of CAM among adults in Enugu urban, irrespective of their health status. It provided information on the prevalence of CAM use, forms of CAM remedies used and reasons for utilizing them Methods The study areas were three local government areas in Enugu urban of Enugu State. Cross-sectional survey using questionnaires were administered to randomly selected households. All consenting participants were used for the study Results 732 participants (37.2% males and 62.8% females) were used for the study. Ages ranged from 18 - 65 years. 620 (84.7%) of the adult population have used CAM ranging from one single type to twenty different types while 112 (15.3%) have not used any form of CAM. The most commonly used CAM product was the biological products, followed by prayer/faith healing. Major reasons for using CAM include their natural state and also for health promotion and maintenance. Conclusion There is need for adequate policy formulation and regulation to ensure safety and efficacy of CAM products. Measures to ensure rational use of CAM should be instituted. PMID:21375759

  5. Common carotid intima-media thickness relates to cardiovascular events in adults aged <45 years.

    PubMed

    Eikendal, Anouk L M; Groenewegen, Karlijn A; Anderson, Todd J; Britton, Annie R; Engström, Gunnar; Evans, Greg W; de Graaf, Jacqueline; Grobbee, Diederick E; Hedblad, Bo; Holewijn, Suzanne; Ikeda, Ai; Kitagawa, Kazuo; Kitamura, Akihiko; Lonn, Eva M; Lorenz, Matthias W; Mathiesen, Ellisiv B; Nijpels, Giel; Dekker, Jacqueline M; Okazaki, Shuhei; O'Leary, Daniel H; Polak, Joseph F; Price, Jacqueline F; Robertson, Christine; Rembold, Christopher M; Rosvall, Maria; Rundek, Tatjana; Salonen, Jukka T; Sitzer, Matthias; Stehouwer, Coen D A; Hoefer, Imo E; Peters, Sanne A E; Bots, Michiel L; den Ruijter, Hester M

    2015-04-01

    Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavorable risk factor burden. PMID:25624341

  6. Dietary behaviors of adults born prematurely may explain future risk for cardiovascular disease.

    PubMed

    Sharafi, Mastaneh; Duffy, Valerie B; Miller, Robin J; Winchester, Suzy B; Huedo-Medina, Tania B; Sullivan, Mary C

    2016-04-01

    Being born prematurely associates with greater cardiovascular disease (CVD) risk in adulthood. Less understood are the unique and joint associations of dietary patterns and behaviors to this elevated risk among adults who are born prematurely. We aimed to model the associations between term status, dietary and lifestyle behaviors with CVD risk factors while accounting for the longitudinal effects of family protection, and medical or environmental risks. In wave-VIII of a longitudinal study, 23-year olds born prematurely (PT-adults, n = 129) and full term (FT-adults, n = 38) survey-reported liking for foods/beverages and activities, constructed into indexes of dietary quality and sensation-seeking, dietary restraint and physical activity. Measured CVD risk factors included fasting serum lipids and glucose, blood pressure and adiposity. In bivariate relationships, PT-adults reported lower dietary quality (including less affinity for protein-rich foods and higher affinity for sweets), less liking for sensation-seeking foods/activities, and less restrained eating than did FT-adults. In comparison to nationally-representative values and the FT-adults, PT-adults showed greater level of CVD risk factors for blood pressure and serum lipids. In structural equation modeling, dietary quality completely mediated the association between term status and HDL-cholesterol (higher quality, lower HDL-cholesterol) yet joined term status to explain variability in systolic blood pressure (PT-adults with lowest dietary quality had highest blood pressures). Through lower dietary quality, being born prematurely was indirectly linked to higher cholesterol/HDL, higher LDL/HDL and elevated waist/hip ratios. The relationship between dietary quality and CVD risk was strongest for PT-adults who had developed greater cumulative medical risk. Protective environments failed to attenuate relationships between dietary quality and elevated CVD risk among PT-adults. In summary, less healthy dietary

  7. Dietary behaviors of adults born prematurely may explain future risk for cardiovascular disease.

    PubMed

    Sharafi, Mastaneh; Duffy, Valerie B; Miller, Robin J; Winchester, Suzy B; Huedo-Medina, Tania B; Sullivan, Mary C

    2016-04-01

    Being born prematurely associates with greater cardiovascular disease (CVD) risk in adulthood. Less understood are the unique and joint associations of dietary patterns and behaviors to this elevated risk among adults who are born prematurely. We aimed to model the associations between term status, dietary and lifestyle behaviors with CVD risk factors while accounting for the longitudinal effects of family protection, and medical or environmental risks. In wave-VIII of a longitudinal study, 23-year olds born prematurely (PT-adults, n = 129) and full term (FT-adults, n = 38) survey-reported liking for foods/beverages and activities, constructed into indexes of dietary quality and sensation-seeking, dietary restraint and physical activity. Measured CVD risk factors included fasting serum lipids and glucose, blood pressure and adiposity. In bivariate relationships, PT-adults reported lower dietary quality (including less affinity for protein-rich foods and higher affinity for sweets), less liking for sensation-seeking foods/activities, and less restrained eating than did FT-adults. In comparison to nationally-representative values and the FT-adults, PT-adults showed greater level of CVD risk factors for blood pressure and serum lipids. In structural equation modeling, dietary quality completely mediated the association between term status and HDL-cholesterol (higher quality, lower HDL-cholesterol) yet joined term status to explain variability in systolic blood pressure (PT-adults with lowest dietary quality had highest blood pressures). Through lower dietary quality, being born prematurely was indirectly linked to higher cholesterol/HDL, higher LDL/HDL and elevated waist/hip ratios. The relationship between dietary quality and CVD risk was strongest for PT-adults who had developed greater cumulative medical risk. Protective environments failed to attenuate relationships between dietary quality and elevated CVD risk among PT-adults. In summary, less healthy dietary

  8. Dietary magnesium intake is inversely associated with mortality in adults at high cardiovascular disease risk.

    PubMed

    Guasch-Ferré, Marta; Bulló, Mònica; Estruch, Ramon; Corella, Dolores; Martínez-González, Miguel A; Ros, Emilio; Covas, Maribel; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Muñoz, Miguel Ángel; Serra-Majem, Lluís; Babio, Nancy; Pintó, Xavier; Lamuela-Raventós, Rosa M; Ruiz-Gutiérrez, Valentina; Salas-Salvadó, Jordi

    2014-01-01

    The relation between dietary magnesium intake and cardiovascular disease (CVD) or mortality was evaluated in several prospective studies, but few of them have assessed the risk of all-cause mortality, which has never been evaluated in Mediterranean adults at high cardiovascular risk. The aim of this study was to assess the association between magnesium intake and CVD and mortality risk in a Mediterranean population at high cardiovascular risk with high average magnesium intake. The present study included 7216 men and women aged 55-80 y from the PREDIMED (Prevención con Dieta Mediterránea) study, a randomized clinical trial. Participants were assigned to 1 of 2 Mediterranean diets (supplemented with nuts or olive oil) or to a control diet (advice on a low-fat diet). Mortality was ascertained by linkage to the National Death Index and medical records. We fitted multivariable-adjusted Cox regressions to assess associations between baseline energy-adjusted tertiles of magnesium intake and relative risk of CVD and mortality. Multivariable analyses with generalized estimating equation models were used to assess the associations between yearly repeated measurements of magnesium intake and mortality. After a median follow-up of 4.8 y, 323 total deaths, 81 cardiovascular deaths, 130 cancer deaths, and 277 cardiovascular events occurred. Energy-adjusted baseline magnesium intake was inversely associated with cardiovascular, cancer, and all-cause mortality. Compared with lower consumers, individuals in the highest tertile of magnesium intake had a 34% reduction in mortality risk (HR: 0.66; 95% CI: 0.45, 0.95; P < 0.01). Dietary magnesium intake was inversely associated with mortality risk in Mediterranean individuals at high risk of CVD. This trial was registered at controlled-trials.com as ISRCTN35739639. PMID:24259558

  9. Dietary magnesium intake is inversely associated with mortality in adults at high cardiovascular disease risk.

    PubMed

    Guasch-Ferré, Marta; Bulló, Mònica; Estruch, Ramon; Corella, Dolores; Martínez-González, Miguel A; Ros, Emilio; Covas, Maribel; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Muñoz, Miguel Ángel; Serra-Majem, Lluís; Babio, Nancy; Pintó, Xavier; Lamuela-Raventós, Rosa M; Ruiz-Gutiérrez, Valentina; Salas-Salvadó, Jordi

    2014-01-01

    The relation between dietary magnesium intake and cardiovascular disease (CVD) or mortality was evaluated in several prospective studies, but few of them have assessed the risk of all-cause mortality, which has never been evaluated in Mediterranean adults at high cardiovascular risk. The aim of this study was to assess the association between magnesium intake and CVD and mortality risk in a Mediterranean population at high cardiovascular risk with high average magnesium intake. The present study included 7216 men and women aged 55-80 y from the PREDIMED (Prevención con Dieta Mediterránea) study, a randomized clinical trial. Participants were assigned to 1 of 2 Mediterranean diets (supplemented with nuts or olive oil) or to a control diet (advice on a low-fat diet). Mortality was ascertained by linkage to the National Death Index and medical records. We fitted multivariable-adjusted Cox regressions to assess associations between baseline energy-adjusted tertiles of magnesium intake and relative risk of CVD and mortality. Multivariable analyses with generalized estimating equation models were used to assess the associations between yearly repeated measurements of magnesium intake and mortality. After a median follow-up of 4.8 y, 323 total deaths, 81 cardiovascular deaths, 130 cancer deaths, and 277 cardiovascular events occurred. Energy-adjusted baseline magnesium intake was inversely associated with cardiovascular, cancer, and all-cause mortality. Compared with lower consumers, individuals in the highest tertile of magnesium intake had a 34% reduction in mortality risk (HR: 0.66; 95% CI: 0.45, 0.95; P < 0.01). Dietary magnesium intake was inversely associated with mortality risk in Mediterranean individuals at high risk of CVD. This trial was registered at controlled-trials.com as ISRCTN35739639.

  10. All in the family: The link between kin network bridging and cardiovascular risk among older adults.

    PubMed

    Goldman, Alyssa W

    2016-10-01

    While considerable work has examined the association between social relationships and health, most of this research focuses on the relevance of social network composition and the quality of dyadic ties. In this study, I consider how the social network structure of ties among older adults' close family members may affect cardiovascular health in later life. Using data from 938 older adults that participated in Waves 1 and 2 of the National Social Life, Health, and Aging Project (NSHAP), I test whether older adults who occupy bridging positions among otherwise disconnected or poorly connected kin in their personal social network are more likely to present elevated levels of C-reactive protein (CRP), a biomarker for cardiovascular risk. Results indicate that occupying a bridging position among family members is significantly associated with elevated CRP. This effect is unique to bridging kin network members. These findings suggest that ties among one's closest kin may generate important resources and norms that influence older adults' health, such that bridging kin network members may compromise physical wellbeing. I discuss these results in the context of prior work on social support, family solidarity, and health in later life.

  11. Racial Differences in Ideal Cardiovascular Health Metrics Among Mississippi Adults, 2009 Mississippi Behavioral Risk Factor Surveillance System

    PubMed Central

    Gamble, Abigail; Mendy, Vincent

    2013-01-01

    Introduction Cardiovascular disease is a leading cause of death and health disparities in Mississippi. Identifying populations with poor cardiovascular health may help direct interventions toward those populations disproportionately affected, which may ultimately increase cardiovascular health and decrease prominent disparities. Our objective was to assess racial differences in the prevalence of cardiovascular health metrics among Mississippi adults. Methods We used data from the 2009 Mississippi Behavioral Risk Factor Surveillance System to determine age-standardized prevalence estimates and 95% confidence intervals of cardiovascular health metrics among 2,003 black and 5,125 white adults. Logistic regression models were used to evaluate the relationship between race and cardiovascular health metrics. The mean cardiovascular metrics score and percentage of the population with ideal and poor cardiovascular health were calculated by subgroup. Results Approximately 1.3% of blacks and 2.6% of whites exhibited ideal levels of all 7 cardiovascular health metrics. The prevalence of 4 of the 7 cardiovascular health metrics was significantly lower among the total population of blacks than among whites, including a normal body mass index (20.8% vs 32.3%, P < .001), no history of diabetes (85.1% vs 91.3%, P < .001), no history of hypertension (53.9% vs 67.9%, P < .001), and physical activity (52.8% vs 62.2%, P < .001). The logistic regression models revealed significant race-by-sex interactions; differences between blacks and whites for normal body mass index, no history of diabetes mellitus, and no current smoking were found among women but not among men. Conclusion Cardiovascular health is poor among Mississippi adults overall, and racial differences exist. PMID:24262026

  12. Ethnic Pride and Cardiovascular Health Among Mexican American Adults Along the U.S.-Mexico Border

    PubMed Central

    Balcazar, Hector G; Cardenas, Victor; Rosenthal, Lee; Schulz, Leslie O

    2012-01-01

    This study addressed the association between items from the General Acculturation Index (GAI) and cardiovascular health. Specifically, we assessed whether ethnic pride was associated with health outcomes after controlling for items regarding language, place where the childhood was spent and ethnic interaction. The study was a cross sectional analysis of demographic and clinical data from a border population of Mexican American adults (n=316) at risk for cardiovascular disease (CVD). Outcomes included smoking and diabetes status, Framingham risk, and metabolic syndrome. Ethnic pride was associated with lower diabetes prevalence, lower Framingham risk, and fewer risk factors for metabolic syndrome, but was not associated with smoking status. Ethnic pride was not associated with the other acculturation items of the GAI. Among an at-risk border population, ethnic pride functioned independently of other acculturation indicators. Ethnic pride may act as a protective factor for diabetes, metabolic syndrome and CVD risk status. PMID:22610060

  13. The coronary angiogram and its seminal contributions to cardiovascular medicine over five decades.

    PubMed

    Ryan, Thomas J

    2002-01-01

    The selective hand injection of contrast media into the right coronary artery of a middle-aged male by Doctor F. Mason Sones on October 30, 1958 introduced a new era in Cardiovascular Medicine. It is the purpose of this presentation to portray the pivotal role the coronary angiogram has played in creating some of the epochal events and discoveries that have characterized the march of progress in the field of cardiology over the past five decades. As the first reliable in vivo marker for the presence of obstructing coronary lesions, the coronary angiogram importantly led to our first studies of the natural history of patients with CAD. The motion studies afforded by cineangiography also permitted dynamic visualization of the contracting ventricle which led to the concept of regional wall motion abnormalities being characteristic of CAD and provided some of our earliest understanding of left ventricular dysfunction. The coronary angiogram also provided the stimulus for the development of aorto-coronary bypass surgery that was introduced by Dr. Rene Favaloro in May 1967. Subsequently, Dr. Andreas Gruntzig astounded the cardiology world by reporting his new percutaneous method of achieving revascularization (PTCA). The coronary angiogram provided the road map necessary for the successful deployment and application of this balloon technology that was soon to rival CABG surgery. The thrombolytic era was heralded in July 1979 when Dr. Peter Rentrop documented the successful reperfusion of a coronary artery in a 57-year old man by first recanalizing the occluding thrombus with a guidewire and then infusing the proteolytic enzyme, streptokinase directly into the artery. Within a year, DeWood made the angiographic observation that spontaneous regression of the totally occluding thrombus occurred among patients undergoing coronary arteriography within the first 24 hours of the onset of symptoms of an acute myocardial infarction. This led to the earliest studies on clot lysis

  14. Status of cardiovascular health among adults in a rural area of Northwest China: Results from a cross-sectional study.

    PubMed

    Zhao, Yaling; Yan, Hong; Yang, Ruihai; Li, Qiang; Dang, Shaonong; Liu, Ruru; Pei, Leilei; Cao, Lei; Marshall, Roger J; Wang, Duolao

    2016-07-01

    The aim of this study was to assess the status of cardiovascular health among a rural population in Northwest China and to determine the associated factors for cardiovascular health.A population-based cross-sectional study was conducted in the rural areas of Hanzhong in Northwest China. Interview, physical examination, and fasting blood glucose and lipid measurements were completed for 2693 adults. The construct of cardiovascular health and the definitions of cardiovascular health metrics proposed by the American Heart Association were used to assess cardiovascular health. The proportions of subjects with cardiovascular health metrics were calculated, adjusting for age and sex. The multiple logistic regression model was used to evaluate the association between ideal cardiovascular health and its associated factors.Only 0.5% (0.0% in men vs 0.9% in women, P = 0.002) of the participants had ideal cardiovascular health, whereas 33.8% (18.0% in men vs 50.0% in women, P < 0.001) and 65.7% (82.0% in men vs 49.1% in women, P < 0.001) of the participants had intermediate and poor cardiovascular health, respectively. The prevalence of poor cardiovascular health increased with increasing age (P < 0.001 for trend). Participants fulfilled, on average, 4.4 (95% confidence interval: 4.2-4.7) of the ideal cardiovascular health metrics. Also, 22.2% of the participants presented with 3 or fewer ideal metrics. Only 19.4% of the participants presented with 6 or more ideal metrics. 24.1% of the participants had all 4 ideal health factors, but only 1.1% of the participants had all 4 ideal health behaviors. Women were more likely to have ideal cardiovascular health, whereas adults aged 35 years or over and those who had a family history of hypertension were less likely to have ideal cardiovascular health.The prevalence of ideal cardiovascular health was extremely low among the rural population in Northwest China. Most adults, especially men and the elderly, had a poor

  15. Prevalence and clustering of cardiovascular risk factors in adults in Northeast China

    PubMed Central

    Wang, Xin; Yang, Fang; Bots, Michiel L; Guo, Weiying; Zhao, Di; Hoes, Arno W; Vaartjes, Ilonca

    2014-01-01

    Aims To estimate the prevalence and clustering of major cardiovascular risk factors in adults in Northeast China. Methods In total, 37 141 individuals undergoing a health screening programme at the International Health Promotion Center at the 1st Hospital of Jilin University were enrolled. Height, weight, blood pressure, fasting serum glucose, total cholesterol (TC), triglyceride (TG), high-density lipoprotein and low-density lipoprotein were recorded. Results Compared with women, the age-standardised prevalence of overweight (44.0% vs 25.0%) and obesity (20.2% vs 7.1%), hypertension (33.7% vs 19.3%), dyslipidaemia (63.8% vs 42.3%), impaired fasting glucose (5.1% vs 4.2%) and diabetes mellitus (8.1% vs 3.5%) was higher in men. Overall, 69.1%, 32.7% and 10.0% of participants had ≥1, ≥2 and ≥3 major cardiovascular risk factors, respectively (obesity, hypertension, dyslipidaemia, diabetes mellitus). For men, the figures were 79.2%, 41.1% and 13.3%, respectively, and for women 53.4%, 19.8% and 5.0%, respectively. With increasing age and increasing body mass index, the prevalence of clustering of cardiovascular risk factors increased in both men and women. Conclusions There is a high prevalence of cardiovascular risk factors in adults in Northeast China: one out of three has at least two risk factors. Prevalence was higher in men than in women. Clustering of risk factors is more common with increasing age and body mass index in both men and women. Prevention of the development of risk factors should be an extremely high priority in this region. PMID:27326186

  16. Patient-Centred Care of Older Adults With Cardiovascular Disease and Multiple Chronic Conditions.

    PubMed

    Kim, Dae Hyun; Rich, Michael W

    2016-09-01

    Multimorbidity, defined as the presence of 2 or more chronic conditions, is common among older adults with cardiovascular disease. These individuals are at increased risk for poor health outcomes and account for a large proportion of health care utilization. Clinicians are challenged with the heterogeneity of this population, the complexity of the treatment regimen, limited high-quality evidence, and fragmented health care systems. Each treatment recommended by a clinical practice guideline for a single cardiovascular disease might be rational, but the combination of all evidence-based recommendations can be impractical or even harmful to individuals with multimorbidity. These challenges can be overcome with a patient-centred approach that incorporates the individual's preferences, relevant evidence, the overall and condition-specific prognosis, clinical feasibility of treatments, and interactions with other treatments and coexisting chronic conditions. The ultimate goal is to maximize benefits and minimize harms by optimizing adherence to the most essential treatments, while acknowledging trade-offs between treatments for different health conditions. It might be necessary to discontinue therapies that are not essential or potentially harmful to decrease the risk of drug-drug and drug-disease interactions from polypharmacy. A decision to initiate, withhold, or stop a treatment should be on the basis of the time horizon to benefits vs the individual's prognosis. In this review, we illustrate how cardiologists and general practitioners can adopt a patient-centred approach to focus on the aspects of cardiovascular and noncardiovascular health that have the greatest effect on functioning and quality of life in older adults with cardiovascular disease and multimorbidity. PMID:27378591

  17. Projected impact of polypill use among US adults: medication use, cardiovascular risk reduction and side effects

    PubMed Central

    Muntner, Paul; Mann, Devin; Wildman, Rachel P; Shimbo, Daichi; Fuster, Valentin; Woodward, Mark

    2011-01-01

    Background Polypills which include multiple medications for reducing cardiovascular disease (CVD) risk in a single pill have been proposed for population-wide use. The number of US adults eligible for polypills and potential benefits are unknown. Methods The National Health and Nutrition Examination Survey 2003-2004 and 2007-2008 were analyzed to estimate treatment rates for medications proposed for inclusion in polypills (aspirin, statin, an ACE-inhibitor, and a thiazide-type diuretic for those without, a beta-blocker for those with, a history of myocardial infarction) among US adults. The number of coronary heart disease (CHD) and stroke events potentially prevented through polypill use was projected by published meta-analyses and three large population-based cohort studies. Two polypill eligibility criteria were analyzed (1) US adults ≥ 55 years and (2) US adults with a history of CVD. Results There are 67.6 million US adults ≥ 55 years and 15.4 million US adults with a history of CVD and, thus, eligible for polypills using the two outlined criteria. In 2007-2008, 37.3% of US adults ≥ 55 years and 57.0% of those with a history of CVD were taking statins. Use of other polypill medications was also low. Polypill use by US adults age ≥ 55 years is projected to potentially prevent 3.2 million CHD events and 1.7 million strokes over 10 years. Amongst those with a history of CVD, the potential to prevent of 0.9 million CHD events and 0.5 million strokes is projected. Conclusions Polypills have the potential to lower CVD incidence substantially among US adults. PMID:21473971

  18. Medicines and You: A Guide for Older Adults = Las medicinas y usted: Guia para las personas mayores.

    ERIC Educational Resources Information Center

    National Coalition of Hispanic Health and Human Services Organizations.

    Most people over 65 take many prescription and nonprescription medicines. Because the body is changing and more medicines are taken, many older adults experience harmful reactions to the medicines they take. This booklet, written in both English and Spanish (on facing pages), was developed to help older adults learn more about medicines, recognize…

  19. Systolic blood pressure goals to reduce cardiovascular disease among older adults.

    PubMed

    Muntner, Paul; Bowling, C Barrett; Shimbo, Daichi

    2014-08-01

    The 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) was recently published. This guideline recommended that older adults (≥60 years) without diabetes or chronic kidney disease with systolic blood pressure (SBP) ≥150 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg be initiated on antihypertensive medication with a treatment goal SBP/DBP <150/90 mm Hg. In contrast, the previous 3 JNC guidelines recommended treatment for these individuals be initiated at SBP/DBP ≥140/90 mm Hg with goal SBP/DBP <140/90 mm Hg. In this article, we review randomized trials of antihypertensive medication and observational data on SBP and DBP with cardiovascular outcomes among older adults, possible explanations underlying the different findings from these randomized trials and observational studies, and contemporary antihypertensive treatment patterns among older U.S. adults. In closing, we highlight future research needs related to hypertension and outcomes among older adults. PMID:24978394

  20. Clinical correlates of obesity in an inner-city adult medicine clinic.

    PubMed

    Yassir, Shahla; Chopra, Ravi; Roush, George

    2013-04-01

    This cross-sectional study was done to assess the association of obesity with multiple conditions in an inner-city adult medicine clinic. Data were gathered to assess the relationship of obesity to multiple variables. Logistic regression was used to adjust for age, gender, ethnicity and tobacco use. Of 2,081 patients, 62% were minorities; 41% lacked insurance, and 38% had Medicaid. Forty-two percent were obese, with 9% morbidly obese. Out of 25 conditions, 20 had statistically significant correlations with obesity (two-sided P < 0.05): four cardiovascular, two pulmonary, three musculoskeletal, three metabolic syndrome conditions (metabolic syndrome is defined by the presence of three or more of the following: Fasting glucose > 110 mg/dL, BP > 130/85, Waist circumference in men > 40 inches or in women > 35 inches, HDL < 40 mg/dL in men or < 50 mg/dL in women, triglycerides > 150 mg/dL), four other clinical conditions, multiple ED visits, multiple clinic visits, unemployment, and disability. Body mass index (BMI) predicted coronary artery disease (P < 0.001), stroke (P = 0.011) and peripheral arterial disease (P = 0.013), but these associations were no longer statistically significant after adjustment for hypertension, diabetes and dyslipidemia. In conclusion, obesity was associated with many diseases, as well as with healthcare utilization, unemployment and disability in this predominantly minority inner-city population. PMID:23691735

  1. School burnout and cardiovascular functioning in young adult males: a hemodynamic perspective.

    PubMed

    May, Ross W; Sanchez-Gonzalez, Marcos A; Brown, Preston C; Koutnik, Andrew P; Fincham, Frank D

    2014-01-01

    This study investigated aortic and brachial hemodynamic functioning that may link school burnout to cardiovascular risk factors. Methodological improvements from previous research were implemented including (1) statistical control of depressive and anxiety symptoms (2) resting, stress-induced and cardiac recovery condition comparisons and (3) use of pulse wave analysis. Forty undergraduate young adult males completed self-report measures of school burnout, trait anxiety and depressive symptoms. Participants then completed a protocol consisting of a 10-min seated rest, 5-min baseline (BASE), 3-min cold pressor test (CPT) and a 3-min recovery period (REC). Indices of brachial and aortic hemodynamics were obtained by means of pulse wave analysis via applanation tonometry. Controlling for anxiety and depressive symptoms, planned contrasts identified no differences in cardiovascular parameters at BASE between participants in burnout and non-burnout groups. However, negative changes in hemodynamic indices occurred in burnout participants at CPT and REC as evidenced by increased aortic and brachial systolic and diastolic blood pressures, increased left ventricular work and increased myocardial oxygen consumption. Findings suggest that school burnout symptoms are associated with cardiac hyperactivity during conditions of cardiac stress and recovery and therefore may be associated with the early manifestations of cardiovascular disease. Future studies are suggested to reveal underlying autonomic mechanisms explaining hemodynamics functioning in individuals with school burnout symptomatology.

  2. State of complementary and alternative medicine in cardiovascular, lung, and blood research: executive summary of a workshop.

    PubMed

    Lin, M C; Nahin, R; Gershwin, M E; Longhurst, J C; Wu, K K

    2001-04-24

    The National Heart, Lung, and Blood Institute and the National Center for Complementary and Alternative Medicine recently cosponsored a workshop on the use of complementary and alternative medicine (CAM) in cardiovascular, lung, and blood research. In view of the increasing use of CAM by the general public, it is imperative to promote credible research by the established biomedical community. The goal of this workshop was to enhance the exchange of information and ideas between alternative medicine practitioners and scientists in cardiovascular, lung, and blood research and to foster collaborative research among these researchers. The workshop focused on 5 areas of research, including a historical and cultural perspective of CAM, methodological issues in clinical trials, herbal medicine, chelation therapy, mind/body (meditation) therapy, and acupuncture. CAM has become widely used without rigorously proven efficacy and safety. To protect the public, it was recommended that the fundamental mechanistic research for these CAM approaches be vigorously pursued and that any large-scale clinical trial be carefully executed to avoid any waste of resources and any unnecessary risk. It was felt that standardization of botanical products and procedure-based CAM intervention, such as acupuncture and meditation, is essential for meaningful basic and clinical research. Although botanical products properly consumed are perceived as generally safe, potential herb-drug interactions are a major safety concern. Clearly, many challenges need to be addressed by the scientific community before the public can be assured of the proper use of CAM.

  3. ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I - Assessment and Management of Various Cardiovascular Risk Factors.

    PubMed

    Wang, Angela Yee Moon; Brimble, K Scott; Brunier, Gillian; Holt, Stephen G; Jha, Vivekanand; Johnson, David W; Kang, Shin-Wook; Kooman, Jeroen P; Lambie, Mark; McIntyre, Chris; Mehrotra, Rajnish; Pecoits-Filho, Roberto

    2015-01-01

    Cardiovascular disease contributes significantly to the adverse clinical outcomes of peritoneal dialysis (PD) patients. Numerous cardiovascular risk factors play important roles in the development of various cardiovascular complications. Of these, loss of residual renal function is regarded as one of the key cardiovascular risk factors and is associated with an increased mortality and cardiovascular death. It is also recognized that PD solutions may incur significant adverse metabolic effects in PD patients. The International Society for Peritoneal Dialysis (ISPD) commissioned a global workgroup in 2012 to formulate a series of recommendations regarding lifestyle modification, assessment and management of various cardiovascular risk factors, as well as management of the various cardiovascular complications including coronary artery disease, heart failure, arrhythmia (specifically atrial fibrillation), cerebrovascular disease, peripheral arterial disease and sudden cardiac death, to be published in 2 guideline documents. This publication forms the first part of the guideline documents and includes recommendations on assessment and management of various cardiovascular risk factors. The documents are intended to serve as a global clinical practice guideline for clinicians who look after PD patients. The ISPD workgroup also identifies areas where evidence is lacking and further research is needed.

  4. Dietary patterns and cardiovascular disease-related risks in chinese older adults.

    PubMed

    Sun, Jing; Buys, Nicholas; Shen, Shuying

    2013-01-01

    Studies of Western populations demonstrate a relationship between dietary patterns and cardiovascular-related risk factors. Similar research regarding Chinese populations is limited. This study explored the dietary patterns of Chinese older adults and their association with cardiovascular-related risk factors, including hypertension, obesity, and metabolic syndrome. Data were collected using a 34-item Chinese food frequency questionnaire from 750 randomly selected older adults aged 50-88 who participated in the study in 2012. Factor analysis revealed four dietary patterns: a "traditional food pattern," consisting of vegetable, fruit, rice, pork, and fish; a "fast and processed food pattern" consisting of fast or processed food products, sugar, and confectionery; a "soybean, grain, and flour food pattern"; and a "dairy, animal liver, and other animal food pattern." These patterns explained 17.48, 9.52, 5.51, and 4.80% of the variances in food intake, respectively. This study suggests that specific dietary patterns are evident in Chinese older adults. Moderate intake of "traditional Chinese food" is associated with decreased blood pressure and cholesterol level. A dietary pattern rich in soybeans, grains, potatoes, and flour is associated with reduced metabolic factors including reduced triglycerides, fasting glucose, waist circumference, and waist-hip ratio, and a high level of dairy, animal liver, and other animal intake food pattern is associated with increased level of Body Mass Index. In conclusion, this study revealed identifiable dietary patterns among Chinese older adults that are significantly related to blood pressure and metabolic biomarkers. Further study using prospective cohort or intervention study should be used to confirm the association between dietary patterns and blood pressure and metabolic factors.

  5. Dietary Patterns and Cardiovascular Disease-Related Risks in Chinese Older Adults

    PubMed Central

    Sun, Jing; Buys, Nicholas; Shen, Shuying

    2013-01-01

    Studies of Western populations demonstrate a relationship between dietary patterns and cardiovascular-related risk factors. Similar research regarding Chinese populations is limited. This study explored the dietary patterns of Chinese older adults and their association with cardiovascular-related risk factors, including hypertension, obesity, and metabolic syndrome. Data were collected using a 34-item Chinese food frequency questionnaire from 750 randomly selected older adults aged 50–88 who participated in the study in 2012. Factor analysis revealed four dietary patterns: a “traditional food pattern,” consisting of vegetable, fruit, rice, pork, and fish; a “fast and processed food pattern” consisting of fast or processed food products, sugar, and confectionery; a “soybean, grain, and flour food pattern”; and a “dairy, animal liver, and other animal food pattern.” These patterns explained 17.48, 9.52, 5.51, and 4.80% of the variances in food intake, respectively. This study suggests that specific dietary patterns are evident in Chinese older adults. Moderate intake of “traditional Chinese food” is associated with decreased blood pressure and cholesterol level. A dietary pattern rich in soybeans, grains, potatoes, and flour is associated with reduced metabolic factors including reduced triglycerides, fasting glucose, waist circumference, and waist–hip ratio, and a high level of dairy, animal liver, and other animal intake food pattern is associated with increased level of Body Mass Index. In conclusion, this study revealed identifiable dietary patterns among Chinese older adults that are significantly related to blood pressure and metabolic biomarkers. Further study using prospective cohort or intervention study should be used to confirm the association between dietary patterns and blood pressure and metabolic factors. PMID:24350217

  6. Availability, price and affordability of cardiovascular medicines: A comparison across 36 countries using WHO/HAI data

    PubMed Central

    2010-01-01

    Background The global burden of cardiovascular disease (CVD) continues to rise. Successful treatment of CVD requires adequate pharmaceutical management. The aim was to examine the availability, pricing and affordability of cardiovascular medicines in developing countries using the standardized data collected according to the World Health Organization/Health Action International methodology. Methods The following medicines were included: atenolol, captopril, hydrochlorothiazide, losartan and nifedipine. Data from 36 countries were analyzed. Outcome measures were percentage availability, price ratios to international reference prices and number of day's wages needed by the lowest-paid unskilled government worker to purchase one month of chronic treatment. Patient prices were adjusted for inflation and purchasing power, procurement prices only for inflation. Data were analyzed for both generic and originator brand products and the public and private sector and summarized by World Bank Income Groups. Results For all measures, there was great variability across surveys. The overall availability of cardiovascular medicines was poor (mean 26.3% in public sector, 57.3% private sector). Procurement prices were very competitive in some countries, whereas others consistently paid high prices. Patient prices were generally substantially higher than international references prices; some countries, however, performed well. Chronic treatment with anti-hypertensive medication cost more than one day's wages in many cases. In particular when monotherapy is insufficient, treatment became unaffordable. Conclusions The results of this study emphasize the need of focusing attention and financing on making chronic disease medicines accessible, in particular in the public sector. Several policy options are suggested to reach this goal. PMID:20534118

  7. Herbal medicine use in adults who experience anxiety: A qualitative exploration.

    PubMed

    McIntyre, Erica; Saliba, Anthony J; Moran, Carmen C

    2015-01-01

    Herbal medicine use is widespread and has been reported to be as high as 21% in people with anxiety disorders. Critical thematic analysis was used to explore beliefs and attitudes towards herbal medicines in adults experiencing anxiety. In-depth interviews were conducted with eight adults who experienced anxiety and used herbal medicines. Three major themes were found: Herbal medicines being different from pharmaceuticals, evidence and effectiveness, and barriers to herbal medicine use. Within these themes people held beliefs about the safety of natural treatments, valued anecdotes from friends and family as a form of evidence for self-prescribing, and described confusion about herbal medicines and their cost as barriers to using them as a treatment option. The findings will inform future research and provide guidance for health practitioners. PMID:26680418

  8. Herbal medicine use in adults who experience anxiety: A qualitative exploration.

    PubMed

    McIntyre, Erica; Saliba, Anthony J; Moran, Carmen C

    2015-01-01

    Herbal medicine use is widespread and has been reported to be as high as 21% in people with anxiety disorders. Critical thematic analysis was used to explore beliefs and attitudes towards herbal medicines in adults experiencing anxiety. In-depth interviews were conducted with eight adults who experienced anxiety and used herbal medicines. Three major themes were found: Herbal medicines being different from pharmaceuticals, evidence and effectiveness, and barriers to herbal medicine use. Within these themes people held beliefs about the safety of natural treatments, valued anecdotes from friends and family as a form of evidence for self-prescribing, and described confusion about herbal medicines and their cost as barriers to using them as a treatment option. The findings will inform future research and provide guidance for health practitioners.

  9. Herbal medicine use in adults who experience anxiety: A qualitative exploration

    PubMed Central

    McIntyre, Erica; Saliba, Anthony J.; Moran, Carmen C.

    2015-01-01

    Herbal medicine use is widespread and has been reported to be as high as 21% in people with anxiety disorders. Critical thematic analysis was used to explore beliefs and attitudes towards herbal medicines in adults experiencing anxiety. In-depth interviews were conducted with eight adults who experienced anxiety and used herbal medicines. Three major themes were found: Herbal medicines being different from pharmaceuticals, evidence and effectiveness, and barriers to herbal medicine use. Within these themes people held beliefs about the safety of natural treatments, valued anecdotes from friends and family as a form of evidence for self-prescribing, and described confusion about herbal medicines and their cost as barriers to using them as a treatment option. The findings will inform future research and provide guidance for health practitioners. PMID:26680418

  10. Difficulty, effort and cardiovascular response to a working memory challenge: Older adults with and without mild cognitive impairment.

    PubMed

    Stewart, Christopher C; Wright, Rex A; Griffith, H Randall

    2016-06-01

    We presented cognitively healthy older adults and patients with mild cognitive impairment (MCI) three versions of a modified Sternberg memory task designed to range in difficulty from low to high. Among cognitively healthy older adults, blood pressure responses assessed during the work periods rose with difficulty. By contrast, among MCI patients, blood pressure responses assessed during the work periods were low irrespective of difficulty. Findings are discussed primarily in relation to a conceptual analysis concerned with ability determinants of effort (task engagement) and associated cardiovascular responses. They also are discussed in the context of other recent cardiovascular studies involving older adults and with regard to the potential for exaggerated cardiovascular responses to accelerate cognitive decline in advanced age. PMID:27109608

  11. Adults Eligible for Cardiovascular Disease Prevention Counseling and Participation in Aerobic Physical Activity - United States, 2013.

    PubMed

    Omura, John D; Carlson, Susan A; Paul, Prabasaj; Watson, Kathleen B; Loustalot, Fleetwood; Foltz, Jennifer L; Fulton, Janet E

    2015-09-25

    Cardiovascular disease (CVD) is the leading cause of death in the United States, and physical inactivity is a major risk factor (1). Health care professionals have a role in counseling patients about physical activity for CVD prevention. In August 2014, the U.S. Preventive Services Task Force (USPSTF) recommended that adults who are overweight or obese and have additional CVD risk factors be offered or referred to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. Although the USPSTF recommendation does not specify an amount of physical activity, the 2008 Physical Activity Guidelines for Americans state that for substantial health benefits adults should achieve ≥150 minutes per week of moderate-intensity aerobic physical activity or ≥75 minutes per week of vigorous-intensity aerobic activity, or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity. To assess the proportion of adults eligible for intensive behavioral counseling and not meeting the aerobic physical activity guideline, CDC analyzed data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS). This analysis indicated that 36.8% of adults were eligible for intensive behavioral counseling for CVD prevention. Among U.S. states and the District of Columbia (DC), the prevalence of eligible adults ranged from 29.0% to 44.6%. Nationwide, 19.9% of all adults were eligible and did not meet the aerobic physical activity guideline. These data can inform the planning and implementation of health care interventions for CVD prevention that are based on physical activity.

  12. Advance Care Planning and Goals of Care Communication in Older Adults with Cardiovascular Disease and Multi-Morbidity.

    PubMed

    Lum, Hillary D; Sudore, Rebecca L

    2016-05-01

    This article provides an approach to advance care planning (ACP) and goals of care communication in older adults with cardiovascular disease and multi-morbidity. The goal of ACP is to ensure that the medical care patients receive is aligned with their values and preferences. In this article, the authors outline common benefits and challenges to ACP for older adults with cardiovascular disease and multimorbidity. Recognizing that these patients experience diverse disease trajectories and receive care in multiple health care settings, the authors provide practical steps for multidisciplinary teams to integrate ACP into brief clinic encounters.

  13. Clinical decisions in patients with diabetes and other cardiovascular risk factors. A statement of the Spanish Society of Internal Medicine.

    PubMed

    Gómez-Huelgas, R; Pérez-Jiménez, F; Serrano-Ríos, M; González-Santos, P; Román, P; Camafort, M; Conthe, P; García-Alegría, J; Guijarro, R; López-Miranda, J; Tirado-Miranda, R; Valdivielso, P

    2014-05-01

    Although the mortality associated to cardiovascular diseases (CVD) has been reduced in the last decades, CVD remains the main cause of mortality in Spain and they are associated with an important morbidity and a huge economic burden. The increasing prevalence of obesity and diabetes could be slowing down the mortality reduction in Spain. Clinicians have often difficulty making clinical decisions due to the multiple clinical guidelines available. Moreover, in the current context of economic crisis it is critical to promote an efficient use of diagnostic and therapeutic proceedings to ensure the viability of public health care systems. The Spanish Society of Internal Medicine (SEMI) has coordinated a consensus document to answer questions of daily practice with the aim of facilitating physicians' decision-making in the management of diabetes and cardiovascular risk factors from a cost-efficiency point of view.

  14. Clinical decisions in patients with diabetes and other cardiovascular risk factors. A statement of the Spanish Society of Internal Medicine.

    PubMed

    Gómez-Huelgas, R; Pérez-Jiménez, F; Serrano-Ríos, M; González-Santos, P; Román, P; Camafort, M; Conthe, P; García-Alegría, J; Guijarro, R; López-Miranda, J; Tirado-Miranda, R; Valdivielso, P

    2014-05-01

    Although the mortality associated to cardiovascular diseases (CVD) has been reduced in the last decades, CVD remains the main cause of mortality in Spain and they are associated with an important morbidity and a huge economic burden. The increasing prevalence of obesity and diabetes could be slowing down the mortality reduction in Spain. Clinicians have often difficulty making clinical decisions due to the multiple clinical guidelines available. Moreover, in the current context of economic crisis it is critical to promote an efficient use of diagnostic and therapeutic proceedings to ensure the viability of public health care systems. The Spanish Society of Internal Medicine (SEMI) has coordinated a consensus document to answer questions of daily practice with the aim of facilitating physicians' decision-making in the management of diabetes and cardiovascular risk factors from a cost-efficiency point of view. PMID:24602600

  15. Sex- and gender-specific research priorities in cardiovascular resuscitation: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Resuscitation Research Workgroup.

    PubMed

    Wigginton, Jane G; Perman, Sarah M; Barr, Gavin C; McGregor, Alyson J; Miller, Andrew C; Napoli, Anthony M; Napoli, Anthony F; Safdar, Basmah; Weaver, Kevin R; Deutsch, Steven; Kayea, Tami; Becker, Lance

    2014-12-01

    Significant sex and gender differences in both physiology and psychology are readily acknowledged between men and women; however, data are lacking regarding differences in their responses to injury and treatment and in their ultimate recovery and survival. These variations remain particularly poorly defined within the field of cardiovascular resuscitation. A better understanding of the interaction between these important factors may soon allow us to dramatically improve outcomes in disease processes that currently carry a dismal prognosis, such as sudden cardiac arrest. As part of the 2014 Academic Emergency Medicine consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," our group sought to identify key research questions and knowledge gaps pertaining to both sex and gender in cardiac resuscitation that could be answered in the near future to inform our understanding of these important issues. We combined a monthly teleconference meeting of interdisciplinary stakeholders from largely academic institutions with a focused interest in cardiovascular outcomes research, an extensive review of the existing literature, and an open breakout session discussion on the recommendations at the consensus conference to establish a prioritization of the knowledge gaps and relevant research questions in this area. We identified six priority research areas: 1) out-of-hospital cardiac arrest epidemiology and outcome, 2) customized resuscitation drugs, 3) treatment role for sex steroids, 4) targeted temperature management and hypothermia, 5) withdrawal of care after cardiac arrest, and 6) cardiopulmonary resuscitation training and implementation. We believe that exploring these key topics and identifying relevant questions may directly lead to improved understanding of sex- and gender-specific issues seen in cardiac resuscitation and ultimately improved patient outcomes.

  16. Cardio-Oncology: How New Targeted Cancer Therapies and Precision Medicine Can Inform Cardiovascular Discovery.

    PubMed

    Bellinger, Andrew M; Arteaga, Carlos L; Force, Thomas; Humphreys, Benjamin D; Demetri, George D; Druker, Brian J; Moslehi, Javid J

    2015-12-01

    Cardio-oncology (the cardiovascular care of cancer patients) has developed as a new translational and clinical field based on the expanding repertoire of mechanism-based cancer therapies. Although these therapies have changed the natural course of many cancers, several may also lead to cardiovascular complications. Many new anticancer drugs approved over the past decade are "targeted" kinase inhibitors that interfere with intracellular signaling contributing to tumor progression. Unexpected cardiovascular and cardiometabolic effects of patient treatment with these inhibitors have provided unique insights into the role of kinases in human cardiovascular biology. Today, an ever-expanding number of cancer therapies targeting novel kinases and other specific cellular and metabolic pathways are being developed and tested in oncology clinical trials. Some of these drugs may affect the cardiovascular system in detrimental ways and others perhaps in beneficial ways. We propose that the numerous ongoing oncology clinical trials are an opportunity for closer collaboration between cardiologists and oncologists to study the cardiovascular and cardiometabolic changes caused by the modulation of these pathways in patients. In this regard, cardio-oncology represents an opportunity and a novel platform for basic and translational investigation and can serve as a potential avenue for optimization of anticancer therapies and for cardiovascular research and drug discovery.

  17. Prevalence of cardiovascular disease risk factors among older Puerto Rican adults living in Massachusetts.

    PubMed

    Van Rompay, Maria I; Castaneda-Sceppa, Carmen; McKeown, Nicola M; Ordovás, José M; Tucker, Katherine L

    2011-10-01

    There remains limited research on cardiovascular disease (CVD) risk factors in Puerto Rican adults. We compared lifestyle and CVD risk factors in Puerto Rican men and women with normal fasting glucose (NFG), impaired fasting glucose (IFG), or type 2 diabetes (T2D), and investigated achievement of American Diabetes Association (ADA) treatment goals in those with T2D. Baseline data from the Boston Puerto Rican Health Study were analyzed, which included 1,287 adults aged 45-75 years. Obesity, hyperglycemia, and dyslipidemia were prevalent and increased from NFG to IFG and T2D. In individuals without T2D, fasting insulin correlated significantly with body mass index. Achievement of ADA goals was poor; LDL cholesterol was most achieved (59.4%), followed by blood pressure (27.2%) and glycosylated hemoglobin (27.0%). Poverty, female sex, current alcohol use, and diabetes or anti-hypertensive medication use were associated with not meeting goals. Puerto Rican adults living in the Boston area showed several metabolic abnormalities and high CVD risk, likely due to pervasive obesity and socio-economic disparities.

  18. The lifecycle effects of nutrition and body size on adult adiposity, diabetes and cardiovascular disease.

    PubMed

    Yajnik, C S

    2002-08-01

    remarkably powerful, intergenerational effect on body size and total and central adiposity. Indians are highly susceptible to insulin resistance and cardiovascular risks, with babies being born small but relatively fat. Insulin resistance is amplified by rapid childhood growth. Dietary factors seem to have profound long-term metabolic influences in pregnancy. Overcrowding with infections and central obesity may amplify cytokine-induced insulin resistance and early diabetes in Indian adults with a low BMI.

  19. The lifecycle effects of nutrition and body size on adult adiposity, diabetes and cardiovascular disease.

    PubMed

    Yajnik, C S

    2002-08-01

    remarkably powerful, intergenerational effect on body size and total and central adiposity. Indians are highly susceptible to insulin resistance and cardiovascular risks, with babies being born small but relatively fat. Insulin resistance is amplified by rapid childhood growth. Dietary factors seem to have profound long-term metabolic influences in pregnancy. Overcrowding with infections and central obesity may amplify cytokine-induced insulin resistance and early diabetes in Indian adults with a low BMI. PMID:12164475

  20. Perceptions of Interns and General Medicine Examiners Regarding Cardiovascular Case Presentation in Practical Exams of General Medicine in Final MBBS Summative Examinations

    PubMed Central

    Nimbal, Naren; Rekha, M C; Patil, Giridhar; Padaki, Samata; Dambal, Amrut; Pise, Gajanan; Kalsad, S T

    2015-01-01

    Introduction Assessment of cardiovascular cases in practical exit exam is limited to simple history taking and physical examination. Standards of assessment are not uniform. This makes assessment less valid and reliable. Aim To explore the perceptions of Internees and General Medicine Examiners about current practices in Cardio Vascular system (CVS) case presentation in final MBBS exit exams and the necessity to change some of the practices. Materials and Methods A set questions pertaining to the preparation for exams, validity, reliability, feasibility and educational impact were prepared to guide in obtaining the perceptions of internees and internal medicine examiners. Focus group discussions were conducted. Data Analysis was done by immersion-crystallization process. Results Most of the internees admitted to feeling concerned because of difficulty in diagnosing murmurs by auscultation. Most of the examiners felt concerned about the logistics involved in arranging practical exams. Both admitted to the lack of uniform standards in assessment. Both agreed that the present system thrived as it was relatively feasible. Some internees suggested that the exam may be conducted in two parts by splitting the syllabus instead of once. Some internees suggested incorporating a student-doctor program to improve practical skills just like the on-going student nurse program. Conclusion There is a need for overhauling the assessment of cardiovascular system in final MBBS summative exams towards one aligned to the competencies as required in an Indian Medical Graduate. Blueprinting of practical assessment with due weightage assigned to epidemiologically important topics is the need of the hour. PMID:26816933

  1. Factor analysis of modifiable cardiovascular risk factors and prevalence of metabolic syndrome in adult Taiwanese.

    PubMed

    Tsai, Chung-Huang; Li, Tsai-Chung; Lin, Cheng-Chieh; Tsay, Hsin-Sheng

    2011-10-01

    To assess the clustering of modifiable cardiovascular risk factors among Taiwanese adults, we evaluated 579 healthy participants who underwent health examinations between May and December 2007. Exploratory factor analysis was used to examine risk factor clustering. Smoking, alcohol intake, exercise habits, body mass index, waist circumference, total cholesterol, triglycerides, high- and low-density lipoprotein cholesterol, fasting glucose, uric acid, serum hepatic enzymes, and mean arterial pressure were assessed. Separate factor analyses assessed total and low-density lipoprotein cholesterol. Principal components analysis identified five factors for a model without low-density lipoprotein cholesterol and four factors for a model without total cholesterol. Four common factors in both models explained between 51.1 and 51.8% of variance in the original 14 factors. Metabolic factors, hematological factors (white blood cells and platelets), lifestyle factors (smoking and alcohol consumption), and exercise habits and fasting blood glucose explained about 20, 11, 10, 10% of total variance, respectively. In the model without low-density lipoprotein cholesterol, total cholesterol factor explained 8.83% of variance. This study confirmed clustering of established metabolic syndrome components and revealed additional associated cardiovascular disease risk factors, including lifestyle factors, exercise and total cholesterol, which should be targeted in prevention efforts.

  2. Impaired cardiovascular structure and function in adult survivors of severe acute malnutrition.

    PubMed

    Tennant, Ingrid A; Barnett, Alan T; Thompson, Debbie S; Kips, Jan; Boyne, Michael S; Chung, Edward E; Chung, Andrene P; Osmond, Clive; Hanson, Mark A; Gluckman, Peter D; Segers, Patrick; Cruickshank, J Kennedy; Forrester, Terrence E

    2014-09-01

    Malnutrition below 5 years remains a global health issue. Severe acute malnutrition (SAM) presents in childhood as oedematous (kwashiorkor) or nonoedematous (marasmic) forms, with unknown long-term cardiovascular consequences. We hypothesized that cardiovascular structure and function would be poorer in SAM survivors than unexposed controls. We studied 116 adult SAM survivors, 54 after marasmus, 62 kwashiorkor, and 45 age/sex/body mass index-matched community controls who had standardized anthropometry, blood pressure, echocardiography, and arterial tonometry performed. Left ventricular indices and outflow tract diameter, carotid parameters, and pulse wave velocity were measured, with systemic vascular resistance calculated. All were expressed as SD scores. Mean (SD) age was 28.8±7.8 years (55% men). Adjusting for age, sex, height, and weight, SAM survivors had mean (SE) reductions for left ventricular outflow tract diameter of 0.67 (0.16; P<0.001), stroke volume 0.44 (0.17; P=0.009), cardiac output 0.5 (0.16; P=0.001), and pulse wave velocity 0.32 (0.15; P=0.03) compared with controls but higher diastolic blood pressures (by 4.3; 1.2-7.3 mm Hg; P=0.007). Systemic vascular resistance was higher in marasmus and kwashiorkor survivors (30.2 [1.2] and 30.8 [1.1], respectively) than controls 25.3 (0.8), overall difference 5.5 (95% confidence interval, 2.8-8.4 mm Hg min/L; P<0.0001). No evidence of large vessel or cardiac remodeling was found, except closer relationships between these indices in former marasmic survivors. Other parameters did not differ between SAM survivor groups. We conclude that adult SAM survivors had smaller outflow tracts and cardiac output when compared with controls, yet markedly elevated peripheral resistance. Malnutrition survivors are thus likely to develop excess hypertension in later life, especially when exposed to obesity.

  3. Prenatal Air Pollution Exposure and Early Cardiovascular Phenotypes in Young Adults.

    PubMed

    Breton, Carrie V; Mack, Wendy J; Yao, Jin; Berhane, Kiros; Amadeus, Milena; Lurmann, Fred; Gilliland, Frank; McConnell, Rob; Hodis, Howard N; Künzli, Nino; Avol, Ed

    2016-01-01

    Exposure to ambient air pollutants increases risk for adverse cardiovascular health outcomes in adults. We aimed to evaluate the contribution of prenatal air pollutant exposure to cardiovascular health, which has not been thoroughly evaluated. The Testing Responses on Youth (TROY) study consists of 768 college students recruited from the University of Southern California in 2007-2009. Participants attended one study visit during which blood pressure, heart rate and carotid artery arterial stiffness (CAS) and carotid artery intima-media thickness (CIMT) were assessed. Prenatal residential addresses were geocoded and used to assign prenatal and postnatal air pollutant exposure estimates using the U.S. Environmental Protection Agency's Air Quality System (AQS) database. The associations between CAS, CIMT and air pollutants were assessed using linear regression analysis. Prenatal PM10 and PM2.5 exposures were associated with increased CAS. For example, a 2 SD increase in prenatal PM2.5 was associated with CAS indices, including a 5% increase (β = 1.05, 95% CI 1.00-1.10) in carotid stiffness index beta, a 5% increase (β = 1.05, 95% CI 1.01-1.10) in Young's elastic modulus and a 5% decrease (β = 0.95, 95% CI 0.91-0.99) in distensibility. Mutually adjusted models of pre- and postnatal PM2.5 further suggested the prenatal exposure was most relevant exposure period for CAS. No associations were observed for CIMT. In conclusion, prenatal exposure to elevated air pollutants may increase carotid arterial stiffness in a young adult population of college students. Efforts aimed at limiting prenatal exposures are important public health goals.

  4. Analysis of Anaphylactic Shock Caused by 17 Types of Traditional Chinese Medicine Injections Used to Treat Cardiovascular and Cerebrovascular Diseases

    PubMed Central

    Guo, Yu-Jiao; Wang, De-Wang; Meng, Ling; Wang, Yong-Qing

    2015-01-01

    Several reports describing anaphylactic shock following treatment of cardiovascular and cerebrovascular diseases with Chinese herbal injections were described. Our analysis of these reports showed that anaphylactic shock caused by traditional Chinese medicine (TCM) injections for the treatment of cardiovascular and cerebrovascular diseases is common but also sometimes fatal. Therefore, we proposed the following four suggestions for improving the clinical safety of delivering Chinese herbal injections and reducing the occurrence of allergic shock. First, patients with cardiovascular and cerebrovascular diseases are at high risk, so they should only be given TCM injections after a doctor's diagnosis and approval. Second, people in allergic groups can suffer anaphylactic shock, so vigilance is important in the treatment of all age groups, although even more caution should be exercised when treating children or elderly people. In fact, TCM injections may not be appropriate for those age groups, so that they should be carefully considered before treatment. Third, no significant gender differences have been noted in patients with anaphylactic shock, so all patients should be carefully monitored, irrespective of gender. Fourth, the timeframe in which different drugs cause anaphylactic shock varies; thus, patients should be observed as long as possible. PMID:26000291

  5. [The organizational and methodological aspects of flight medicine expertise in cardiovascular diseases].

    PubMed

    Preobrazhenskiĭ, V N; Chviakin, V A; Matveev, A A; Merkulov, V M

    1995-01-01

    Among diseases causing pilot disqualification ahead of time the cardiovascular disorders amount to 60 percent. In this connection there has been generalized the experience of examining the Armed Forces Aviation pilots with cardiovascular disorders beginning from 1979 when by the order of the Ministry of Defence N 220 the Regulations of Aeromedical Examination of pilots have been come into force. The features of examining the pilots with cardiovascular disorders are presented. The present-day methods for the instrumental examination which have been tested in cardiology are systematized in an effort to use them during aeromedical examinations of the pilots. The algorithm of the examined pilots with cardiovascular disorders is set. For the first time the three main groups of approaches to the appraisal of partial or complete loss of the work capacity with known result of diseases. The proposed organization-and-methodologic approach to medical examination of the flying personnel with consideration for the features of stage diagnostics of cardiovascular disorders, individual assessment of their manifestations enables one to handle more qualitatively the aeromedical examination issues with the aim of maintaining the professional working capacity.

  6. Executive Cognitive Functioning and Cardiovascular Autonomic Regulation in a Population-Based Sample of Working Adults

    PubMed Central

    Stenfors, Cecilia U. D.; Hanson, Linda M.; Theorell, Töres; Osika, Walter S.

    2016-01-01

    Objective: Executive cognitive functioning is essential in private and working life and is sensitive to stress and aging. Cardiovascular (CV) health factors are related to cognitive decline and dementia, but there is relatively few studies of the role of CV autonomic regulation, a key component in stress responses and risk factor for cardiovascular disease (CVD), and executive processes. An emerging pattern of results from previous studies suggest that different executive processes may be differentially associated with CV autonomic regulation. The aim was thus to study the associations between multiple measures of CV autonomic regulation and measures of different executive cognitive processes. Method: Participants were 119 healthy working adults (79% women), from the Swedish Longitudinal Occupational Survey of Health. Electrocardiogram was sampled for analysis of heart rate variability (HRV) measures, including the Standard Deviation of NN, here heart beats (SDNN), root of the mean squares of successive differences (RMSSD), high frequency (HF) power band from spectral analyses, and QT variability index (QTVI), a measure of myocardial repolarization patterns. Executive cognitive functioning was measured by seven neuropsychological tests. The relationships between CV autonomic regulation measures and executive cognitive measures were tested with bivariate and partial correlational analyses, controlling for demographic variables, and mental health symptoms. Results: Higher SDNN and RMSSD and lower QTVI were significantly associated with better performance on cognitive tests tapping inhibition, updating, shifting, and psychomotor speed. After adjustments for demographic factors however (age being the greatest confounder), only QTVI was clearly associated with these executive tests. No such associations were seen for working memory capacity. Conclusion: Poorer CV autonomic regulation in terms of lower SDNN and RMSSD and higher QTVI was associated with poorer executive

  7. Genome-Wide Identification of Epigenetic Hotspots Potentially Related to Cardiovascular Risk in Adult Women after a Complicated Pregnancy

    PubMed Central

    Oudejans, Cees; Poutsma, Ankie; Michel, Omar; Mulders, Joyce; Visser, Allerdien; van Dijk, Marie; Nauta, Tessa; Bokslag, Anouk; Paulus, Walter; de Haas, Andreas; Koolwijk, Pieter; de Groot, Christianne J. M.

    2016-01-01

    Background The physiological demands of pregnancy on the maternal cardiovascular system can catapult women into a metabolic syndrome that predisposes to atherosclerosis in later life. We sought to identify the nature of the epigenomic changes associated with the increased cardiovascular disease (CVD) risk in adult women following pre-eclampsia. Findings We assessed the genome wide epigenetic profile by methyl-C sequencing of monozygotic parous twin sister pairs discordant for a severe variant of pre-eclampsia. In the adult twin sisters at risk for CVD as a consequence of a complicated pregnancy, a set of 12 differentially methylated regions with at least 50% difference in methylation percentage and the same directional change was found to be shared between the affected twin sisters and significantly different compared to their unaffected monozygous sisters. Conclusion The current epigenetic marker set will permit targeted analysis of differentially methylated regions potentially related to CVD risk in large cohorts of adult women following complicated pregnancies. PMID:26870946

  8. Position paper of the Cardiovascular Committee of the European Association of Nuclear Medicine (EANM) on PET imaging of atherosclerosis.

    PubMed

    Bucerius, Jan; Hyafil, Fabien; Verberne, Hein J; Slart, Riemer H J A; Lindner, Oliver; Sciagra, Roberto; Agostini, Denis; Übleis, Christopher; Gimelli, Alessia; Hacker, Marcus

    2016-04-01

    Cardiovascular diseases are the leading cause of death not only in Europe but also in the rest of the World. Preventive measures, however, often fail and cardiovascular disease may manifest as an acute coronary syndrome, stroke or even sudden death after years of silent progression. Thus, there is a considerable need for innovative diagnostic and therapeutic approaches to improve the quality of care and limit the burden of cardiovascular diseases. During the past 10 years, several retrospective and prospective clinical studies have been published using (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) to quantify inflammation in atherosclerotic plaques. However, the current variety of imaging protocols used for vascular (arterial) imaging with FDG PET considerably limits the ability to compare results between studies and to build large multicentre imaging registries. Based on the existing literature and the experience of the Members of the European Association of Nuclear Medicine (EANM) Cardiovascular Committee, the objective of this position paper was to propose optimized and standardized protocols for imaging and interpretation of PET scans in atherosclerosis. These recommendations do not, however, replace the individual responsibility of healthcare professionals to make appropriate decisions in the circumstances of the individual study protocols used and the individual patient, in consultation with the patient and, where appropriate and necessary, the patient's guardian or carer. These recommendations suffer from the absence of conclusive evidence on many of the recommendations. Therefore, they are not intended and should not be used as "strict guidelines" but should, as already mentioned, provide a basis for standardized clinical atherosclerosis PET imaging protocols, which are subject to further and continuing evaluation and improvement. However, this EANM position paper might indeed be a first step towards "official" guidelines on

  9. Position paper of the Cardiovascular Committee of the European Association of Nuclear Medicine (EANM) on PET imaging of atherosclerosis.

    PubMed

    Bucerius, Jan; Hyafil, Fabien; Verberne, Hein J; Slart, Riemer H J A; Lindner, Oliver; Sciagra, Roberto; Agostini, Denis; Übleis, Christopher; Gimelli, Alessia; Hacker, Marcus

    2016-04-01

    Cardiovascular diseases are the leading cause of death not only in Europe but also in the rest of the World. Preventive measures, however, often fail and cardiovascular disease may manifest as an acute coronary syndrome, stroke or even sudden death after years of silent progression. Thus, there is a considerable need for innovative diagnostic and therapeutic approaches to improve the quality of care and limit the burden of cardiovascular diseases. During the past 10 years, several retrospective and prospective clinical studies have been published using (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) to quantify inflammation in atherosclerotic plaques. However, the current variety of imaging protocols used for vascular (arterial) imaging with FDG PET considerably limits the ability to compare results between studies and to build large multicentre imaging registries. Based on the existing literature and the experience of the Members of the European Association of Nuclear Medicine (EANM) Cardiovascular Committee, the objective of this position paper was to propose optimized and standardized protocols for imaging and interpretation of PET scans in atherosclerosis. These recommendations do not, however, replace the individual responsibility of healthcare professionals to make appropriate decisions in the circumstances of the individual study protocols used and the individual patient, in consultation with the patient and, where appropriate and necessary, the patient's guardian or carer. These recommendations suffer from the absence of conclusive evidence on many of the recommendations. Therefore, they are not intended and should not be used as "strict guidelines" but should, as already mentioned, provide a basis for standardized clinical atherosclerosis PET imaging protocols, which are subject to further and continuing evaluation and improvement. However, this EANM position paper might indeed be a first step towards "official" guidelines on

  10. Management of cardiovascular disease risk factors in older adults with type 2 diabetes mellitus: 2002-2012 literature review.

    PubMed

    Moreno, Gerardo; Mangione, Carol M

    2013-11-01

    Type 2 diabetes mellitus (DM) is one of the most common chronic conditions in older adults and is often accompanied by comorbidities and geriatric syndromes. The management of cardiovascular disease risk factors in older adults with DM is important to clinicians. The literature was reviewed from 2002 to 2012 to provide an American Geriatrics Society expert panel with an evidence base for updating and making new recommendations for improving the care of older adults with type 2 DM. This review includes only the domains of the management of blood pressure, lipid control, glycemic control, and use of aspirin. Over the last 10 years, new randomized controlled trials (RCT) designed to study different blood pressure treatment targets did not find evidence that intensive systolic blood pressure control (<130 mmHg) resulted in lower rates of myocardial infarction and mortality than less-intensive control. There are risks of side effects with achieving systolic blood pressure of less than 120 mmHg. Lipid-lowering statins are effective in reducing cardiovascular events in middle-aged and older adults, but data on niacin and fibrates is limited. Trials of statins and other lipid-lowering agents do not evaluate the cardiovascular effects on outcomes from treating lipids to different low-density lipoprotein cholesterol targets. No RCTs of lipid-lowering drugs enrolled significant numbers of adults aged 80 and older with or without DM. Three major RCTs that investigated intensive glycemic control did not find reductions in primary cardiovascular endpoints, and one study reported greater mortality with glycosylated hemoglobin of less than 6%. Two recently published RCTs were designed to study the cardiovascular benefits of aspirin use by individuals with DM. Neither trial found significantly fewer primary cardiovascular endpoints with aspirin than in control groups. Overall, RCTs enrolled few adults aged 80 and older or with significant comorbidities. More research is needed for

  11. Adolescent and young adult medicine is a special and specific area of medical practice.

    PubMed

    Steinbeck, Kate; Towns, Susan; Bennett, David

    2014-06-01

    Adolescent and young adult medicine is a concept that has gained traction in the last decade or so. The medical literature has come primarily from oncology. Advances in neuroscience that document continuing brain development into the third decade, and research that shows risk behaviours associated with adolescence both remain and may increase in the third decade, have been two of the drivers in the conversation around linking these two age groups together as a medical practice group. A third driver of importance is transition care in chronic illness, where older adolescents and young adults continue to have difficulties making effective linkages with adult care. The case for specific training in adolescent and young adult medicine, including the developmental concepts behind it, the benefits of the delineation and the particular challenges in the Australian health-care system, are discussed. On balance, there is a strong case for managing the health issues of adolescents and young adults together. This scenario does not fit easily with the age demarcations that are in place in acute care facilities. However, this is less the case in community services and can work in focused private practice. Such a situation suggests that both paediatric and adult physicians might be interested in adolescent and young adult medicine training and practice.

  12. [From cardiovascular prevention to anti-aging medicine: influence on telomere and cell aging].

    PubMed

    Gleichmann, U; Gleichmann, U-S; Gleichmann, S

    2011-09-01

    The most important cardiovascular risk factors (hypercholesterolemia , hypertension, diabetes, chronic stress, physical inactivity, smoking, adipositas) were evaluated in the second half of the last century using placebo controlled trials. The mechanismen of action was not fully understood or remained unclear. In some studies not only the risk of atherosclerosis was reduced but life expectancy was improved. The length of telomeres is influenced by many of the cardiovascular risk factors and is a biomarker of age. Reduced telomere length are found in higher age, atherosclerosis, hypertension, adipositas, diabetes, smoking, physical inactivity, heart failure, maltreatment in childhood, exposure to traffic pollution, chronic infection, single life and dementia. A positive effect on telomerase and telomere length is found with increased physical activity, statins for treatment of hypercholesterolemia, and higher blood levels of omega-3 fatty acids. The probable mechanismen for this is an activation of telomerase activity. Many of the cardiovascular risk factors influence the cellular DNA by telomere shortening. These effects could be reduced by life style measures with prudent diet and drugs for good somatic fitness and healthy aging. By this mechanism cardiovascular prevention not only reduces the risk of atherosclerosis but also improves life exspectancy by anti-aging effects. PMID:21915807

  13. Diabetic indicators are the strongest predictors for cardiovascular disease risk in African American adults

    PubMed Central

    Carter, Ashley N; Ralston, Penny A; Young-Clark, Iris; Ilich, Jasminka Z

    2016-01-01

    African Americans have higher risk of developing type 2 diabetes and cardiovascular disease (CVD) compared to other racial groups. Modifiable and non-modifiable factors play a role in the development of both diseases. This study assessed diabetes indicators in relation to other CVD risk factors taking into account confounders, among African American adults. This was a cross-sectional study in mid-life and older African Americans (≥45 years) who were recruited from the local churches. Fasting blood was collected and serum analyzed for diabetes indicators, apolipoproteins, adipokines, and lipid profile. CVD risk scores were determined using the American Heart Association and Framingham Risk Score assessments. Homeostasis Model Assessments (HOMAs) were calculated using glucose and insulin concentrations. Confounding variables were assessed by questionnaires. Data were analyzed using SPSS software, version 21, and p<0.05 was deemed significant. Descriptive statistics was used to analyze continuous variables. Frequencies and percentages were used to examine categorical variables. T-tests compared different groups while Pearson correlations provided preliminary relationships and determined variables for multiple regression analyses. A total of n=79 participants were evaluated (69% women), 59.3±9.2 years, BMI=34.7±8.3 (mean ± SD). As expected, AA men had higher fasting blood glucose than women (123.6±54.9 mg/dL versus 99.0±21.8 mg/dL), and AA women had higher insulin (11.8±13.1 mg/dL versus 7.6±6.0 mg/dL). Our study confirmed that it is likely for AA men to have significantly lower adiponectin concentrations in comparison to AA women. Based on the CVD risk assessments, men had a significantly higher risk of developing CVD than women, which has been shown previously. Apolipoproteins, adipokines, and lipid profile also negatively influenced the cardiovascular health outcomes in men. Dietary intake, probably by influencing participants’ weight

  14. Diabetic indicators are the strongest predictors for cardiovascular disease risk in African American adults

    PubMed Central

    Carter, Ashley N; Ralston, Penny A; Young-Clark, Iris; Ilich, Jasminka Z

    2016-01-01

    African Americans have higher risk of developing type 2 diabetes and cardiovascular disease (CVD) compared to other racial groups. Modifiable and non-modifiable factors play a role in the development of both diseases. This study assessed diabetes indicators in relation to other CVD risk factors taking into account confounders, among African American adults. This was a cross-sectional study in mid-life and older African Americans (≥45 years) who were recruited from the local churches. Fasting blood was collected and serum analyzed for diabetes indicators, apolipoproteins, adipokines, and lipid profile. CVD risk scores were determined using the American Heart Association and Framingham Risk Score assessments. Homeostasis Model Assessments (HOMAs) were calculated using glucose and insulin concentrations. Confounding variables were assessed by questionnaires. Data were analyzed using SPSS software, version 21, and p<0.05 was deemed significant. Descriptive statistics was used to analyze continuous variables. Frequencies and percentages were used to examine categorical variables. T-tests compared different groups while Pearson correlations provided preliminary relationships and determined variables for multiple regression analyses. A total of n=79 participants were evaluated (69% women), 59.3±9.2 years, BMI=34.7±8.3 (mean ± SD). As expected, AA men had higher fasting blood glucose than women (123.6±54.9 mg/dL versus 99.0±21.8 mg/dL), and AA women had higher insulin (11.8±13.1 mg/dL versus 7.6±6.0 mg/dL). Our study confirmed that it is likely for AA men to have significantly lower adiponectin concentrations in comparison to AA women. Based on the CVD risk assessments, men had a significantly higher risk of developing CVD than women, which has been shown previously. Apolipoproteins, adipokines, and lipid profile also negatively influenced the cardiovascular health outcomes in men. Dietary intake, probably by influencing participants’ weight

  15. Diabetic indicators are the strongest predictors for cardiovascular disease risk in African American adults.

    PubMed

    Carter, Ashley N; Ralston, Penny A; Young-Clark, Iris; Ilich, Jasminka Z

    2016-01-01

    African Americans have higher risk of developing type 2 diabetes and cardiovascular disease (CVD) compared to other racial groups. Modifiable and non-modifiable factors play a role in the development of both diseases. This study assessed diabetes indicators in relation to other CVD risk factors taking into account confounders, among African American adults. This was a cross-sectional study in mid-life and older African Americans (≥45 years) who were recruited from the local churches. Fasting blood was collected and serum analyzed for diabetes indicators, apolipoproteins, adipokines, and lipid profile. CVD risk scores were determined using the American Heart Association and Framingham Risk Score assessments. Homeostasis Model Assessments (HOMAs) were calculated using glucose and insulin concentrations. Confounding variables were assessed by questionnaires. Data were analyzed using SPSS software, version 21, and p<0.05 was deemed significant. Descriptive statistics was used to analyze continuous variables. Frequencies and percentages were used to examine categorical variables. T-tests compared different groups while Pearson correlations provided preliminary relationships and determined variables for multiple regression analyses. A total of n=79 participants were evaluated (69% women), 59.3±9.2 years, BMI=34.7±8.3 (mean ± SD). As expected, AA men had higher fasting blood glucose than women (123.6±54.9 mg/dL versus 99.0±21.8 mg/dL), and AA women had higher insulin (11.8±13.1 mg/dL versus 7.6±6.0 mg/dL). Our study confirmed that it is likely for AA men to have significantly lower adiponectin concentrations in comparison to AA women. Based on the CVD risk assessments, men had a significantly higher risk of developing CVD than women, which has been shown previously. Apolipoproteins, adipokines, and lipid profile also negatively influenced the cardiovascular health outcomes in men. Dietary intake, probably by influencing participants' weight/adiposity, contributed

  16. Diabetic indicators are the strongest predictors for cardiovascular disease risk in African American adults.

    PubMed

    Carter, Ashley N; Ralston, Penny A; Young-Clark, Iris; Ilich, Jasminka Z

    2016-01-01

    African Americans have higher risk of developing type 2 diabetes and cardiovascular disease (CVD) compared to other racial groups. Modifiable and non-modifiable factors play a role in the development of both diseases. This study assessed diabetes indicators in relation to other CVD risk factors taking into account confounders, among African American adults. This was a cross-sectional study in mid-life and older African Americans (≥45 years) who were recruited from the local churches. Fasting blood was collected and serum analyzed for diabetes indicators, apolipoproteins, adipokines, and lipid profile. CVD risk scores were determined using the American Heart Association and Framingham Risk Score assessments. Homeostasis Model Assessments (HOMAs) were calculated using glucose and insulin concentrations. Confounding variables were assessed by questionnaires. Data were analyzed using SPSS software, version 21, and p<0.05 was deemed significant. Descriptive statistics was used to analyze continuous variables. Frequencies and percentages were used to examine categorical variables. T-tests compared different groups while Pearson correlations provided preliminary relationships and determined variables for multiple regression analyses. A total of n=79 participants were evaluated (69% women), 59.3±9.2 years, BMI=34.7±8.3 (mean ± SD). As expected, AA men had higher fasting blood glucose than women (123.6±54.9 mg/dL versus 99.0±21.8 mg/dL), and AA women had higher insulin (11.8±13.1 mg/dL versus 7.6±6.0 mg/dL). Our study confirmed that it is likely for AA men to have significantly lower adiponectin concentrations in comparison to AA women. Based on the CVD risk assessments, men had a significantly higher risk of developing CVD than women, which has been shown previously. Apolipoproteins, adipokines, and lipid profile also negatively influenced the cardiovascular health outcomes in men. Dietary intake, probably by influencing participants' weight/adiposity, contributed

  17. A Use Case to Support Precision Medicine for Frequently Hospitalized Older Adults with Polypharmacy

    PubMed Central

    Cabrera, Manuel; Finkelstein, Joseph

    2016-01-01

    Polypharmacy in older adults results in multiple negative clinical consequences including increased risk of hospital readmissions. Precision medicine may provide tools to optimize complex medication regimens however its potential in older adults with polypharmacy is unknown. We carried out pharmacogenetic testing in an older adult with multiple chronic conditions and polypharmacy who was concerned about frequent readmissions despite receiving guideline-concordant care and being adherent to medication regimen. The testing identified patients’ CYP2D6 rapid metabolizer status. This may have resulted in decreased exposure to Carvedilol which was primary drug for CHF management in this patient. Additional nine drug-drug interactions were identified during personalized drug regimen review. We concluded that, though precision medicine has enormous potential in older adults with polypharmacy, the complexity of pharmacogenetic information requires innovative informatics solutions to support optimal workflows, decision support, and medication optimization and management in order to fully utilize its potential in routine clinical care. PMID:27570642

  18. A Use Case to Support Precision Medicine for Frequently Hospitalized Older Adults with Polypharmacy.

    PubMed

    Cabrera, Manuel; Finkelstein, Joseph

    2016-01-01

    Polypharmacy in older adults results in multiple negative clinical consequences including increased risk of hospital readmissions. Precision medicine may provide tools to optimize complex medication regimens however its potential in older adults with polypharmacy is unknown. We carried out pharmacogenetic testing in an older adult with multiple chronic conditions and polypharmacy who was concerned about frequent readmissions despite receiving guideline-concordant care and being adherent to medication regimen. The testing identified patients' CYP2D6 rapid metabolizer status. This may have resulted in decreased exposure to Carvedilol which was primary drug for CHF management in this patient. Additional nine drug-drug interactions were identified during personalized drug regimen review. We concluded that, though precision medicine has enormous potential in older adults with polypharmacy, the complexity of pharmacogenetic information requires innovative informatics solutions to support optimal workflows, decision support, and medication optimization and management in order to fully utilize its potential in routine clinical care. PMID:27570642

  19. A Use Case to Support Precision Medicine for Frequently Hospitalized Older Adults with Polypharmacy.

    PubMed

    Cabrera, Manuel; Finkelstein, Joseph

    2016-01-01

    Polypharmacy in older adults results in multiple negative clinical consequences including increased risk of hospital readmissions. Precision medicine may provide tools to optimize complex medication regimens however its potential in older adults with polypharmacy is unknown. We carried out pharmacogenetic testing in an older adult with multiple chronic conditions and polypharmacy who was concerned about frequent readmissions despite receiving guideline-concordant care and being adherent to medication regimen. The testing identified patients' CYP2D6 rapid metabolizer status. This may have resulted in decreased exposure to Carvedilol which was primary drug for CHF management in this patient. Additional nine drug-drug interactions were identified during personalized drug regimen review. We concluded that, though precision medicine has enormous potential in older adults with polypharmacy, the complexity of pharmacogenetic information requires innovative informatics solutions to support optimal workflows, decision support, and medication optimization and management in order to fully utilize its potential in routine clinical care.

  20. Practising family medicine for adults with intellectual disabilities

    PubMed Central

    Baumbusch, Jennifer; Phinney, Alison; Baumbusch, Sarah

    2014-01-01

    Abstract Objective To explore the perspectives of adults with intellectual disabilities (IDs) on helpful interactions with their family physicians. Design Exploratory, qualitative study. Setting Vancouver, BC. Participants Purposive sample of 11 community-dwelling adults with IDs. Methods In-depth, semistructured interviews were conducted face to face with participants. Interviews were audiorecorded and transcribed verbatim. Research team members read the transcripts, which were then coded into categories and subcategories and discussed at collective analysis meetings. The main study themes were generated through this iterative, collective process. Main findings Two themes about helpful interactions were identified: helping patients understand and helping patients navigate the health care system. The first theme reflected helpful ways of communicating with patients with IDs. These approaches focused on plain-language communication and other strategies developed jointly by the patients and their physicians. The second theme reflected ways in which the family physicians helped adults with IDs manage their health needs despite the complex constraints of their socioeconomic situations. Conclusion Adults with IDs want to play an active role in managing their health as they age, and helpful interactions with family physicians make this possible. PMID:25022654

  1. Generation of tissue constructs for cardiovascular regenerative medicine: from cell procurement to scaffold design.

    PubMed

    Tandon, Vishal; Zhang, Boyang; Radisic, Milica; Murthy, Shashi K

    2013-01-01

    The ability of the human body to naturally recover from coronary heart disease is limited because cardiac cells are terminally differentiated, have low proliferation rates, and low turn-over rates. Cardiovascular tissue engineering offers the potential for production of cardiac tissue ex vivo, but is currently limited by several challenges: (i) Tissue engineering constructs require pure populations of seed cells, (ii) Fabrication of 3-D geometrical structures with features of the same length scales that exist in native tissue is non-trivial, and (iii) Cells require stimulation from the appropriate biological, electrical and mechanical factors. In this review, we summarize the current state of microfluidic techniques for enrichment of subpopulations of cells required for cardiovascular tissue engineering, which offer unique advantages over traditional plating and FACS/MACS-based enrichment. We then summarize modern techniques for producing tissue engineering scaffolds that mimic native cardiac tissue.

  2. Comparison of aortic elasticity determined by cardiovascular magnetic resonance imaging in obese versus lean adults.

    PubMed

    Danias, Peter G; Tritos, Nicholas A; Stuber, Matthias; Botnar, Rene M; Kissinger, Kraig V; Manning, Warren J

    2003-01-15

    The vascular properties of large vessels in the obese have not been adequately studied. We used cardiovascular magnetic resonance imaging to quantify the cross-sectional area and elastic properties of the ascending thoracic and abdominal aorta in 21 clinically healthy obese young adult men and 25 men who were age-matched lean controls. Obese subjects had greater maximal cross-sectional area of the ascending thoracic aorta (984 +/- 252 vs 786 +/- 109 mm(2), p <0.01) and of the abdominal aorta (415 +/- 71 vs 374 +/- 51 mm(2), p <0.05). When indexed for height the differences persisted, but when indexed for body surface area, a significant difference between groups was found only for the maximal abdominal aortic cross-sectional area. The obese subjects also had decreased abdominal aortic elasticity, characterized by 24% lower compliance (0.0017 +/- 0.0004 vs 0.0021 +/- 0.0005 mm(2)/kPa/mm, p <0.01), 22% higher stiffness index beta (6.0 +/- 1.5 vs 4.9 +/- 0.7, p <0.005), and 41% greater pressure-strain elastic modulus (72 +/- 25 vs 51 +/- 9, p <0.005). At the ascending thoracic aorta, only the pressure-strain elastic modulus was different between obese and lean subjects (85 +/- 42 vs 65 +/- 26 kPa, respectively; p <0.05), corresponding to a 31% difference-but arterial compliance and stiffness index were not significantly different between groups. In clinically healthy young adult obese men, obesity is associated with increased cross-sectional aortic area and decreased aortic elasticity.

  3. Place of birth and adult cardiovascular disease: the British Regional Heart Study.

    PubMed

    Shaper, A G; Elford, J

    1991-01-01

    Coronary heart disease (CHD) is almost certainly a nutritional disorder related to the quality and quantity of dietary fats and mediated by blood and tissue lipid concentrations. There is current controversy as to when the underlying process of atherosclerosis is initiated and whether the critical susceptibility to CHD may be established in utero or infancy. Blood pressure and hypertension may also be nutritionally based, and the age at which the rate of rise in blood pressure with age is determined is also controversial. The British Regional Heart Study (BRHS) involves 7,735 middle-aged men from 24 towns in England, Wales and Scotland and reveals that average blood cholesterol levels in these towns show no relationship to CHD mortality but all are high by international standards. Blood pressure levels vary markedly between the 24 towns and relate strongly to CHD mortality patterns, which are highest in Scotland and lowest in the South of England. The hypothesis relating adult blood pressures and CHD mortality to foetal and infant life circumstances has been examined using the data on birthplace and place of examination of the BRHS men. Regardless of where they were born, men living and examined in the South had lower mean blood pressures than men living in Scotland. The highest mean blood pressures were observed in Scotland, irrespective of where the men had been born. For CHD, regardless of their place of birth, men living in the South had a lower risk of CHD than men living elsewhere. The geographic zone of examination appeared to be more important than the zone of birth in determining the risk of CHD and the level of blood pressure. While patterns of nutrition during pregnancy, in infancy and childhood may be of importance for some outcomes, such as height, it seems that exposure to risk factors during adult life predominantly determine the outcome in cardiovascular disease.

  4. Restrictive pattern on spirometry: association with cardiovascular risk and level of physical activity in asymptomatic adults

    PubMed Central

    Sperandio, Evandro Fornias; Arantes, Rodolfo Leite; Matheus, Agatha Caveda; da Silva, Rodrigo Pereira; Lauria, Vinícius Tonon; Romiti, Marcello; Gagliardi, Antônio Ricardo de Toledo; Dourado, Victor Zuniga

    2016-01-01

    Objective : To determine whether a restrictive pattern on spirometry is associated with the level of physical activity in daily life (PADL), as well as with cardiovascular disease (CVD) risk factors, in asymptomatic adults. Methods : A total of 374 participants (mean age, 41 ± 14 years) underwent spirometry, which included the determination of FVC and FEV1. A restrictive pattern on spirometry was defined as an FEV1/FVC ratio > 0.7 and an FVC < 80% of the predicted value. After conducting demographic, anthropometric, and CVD risk assessments, we evaluated body composition, muscle function, and postural balance, as well as performing cardiopulmonary exercise testing and administering the six-minute walk test. The PADL was quantified with a triaxial accelerometer. Results : A restrictive pattern on spirometry was found in 10% of the subjects. After multivariate logistic regression, adjusted for confounders (PADL and cardiorespiratory fitness), the following variables retained significance (OR; 95% CI) as predictors of a restrictive pattern: systemic arterial hypertension (17.5; 1.65-184.8), smoking (11.6; 1.56-87.5), physical inactivity (8.1; 1.43-46.4), larger center-of-pressure area while standing on a force platform (1.34; 1.05-1.71); and dyslipidemia (1.89; 1.12-1.98). Conclusions : A restrictive pattern on spirometry appears to be common in asymptomatic adults. We found that CVD risk factors, especially systemic arterial hypertension, smoking, and physical inactivity, were directly associated with a restrictive pattern, even when the analysis was adjusted for PADL and cardiorespiratory fitness. Longitudinal studies are needed in order to improve understanding of the etiology of a restrictive pattern as well as to aid in the design of preventive strategies. PMID:26982037

  5. Risk Factors for Cardiovascular Disease and Their Clustering among Adults in Jilin (China)

    PubMed Central

    Yu, Jianxing; Ma, Yonghui; Yang, Sen; Pang, Kai; Yu, Yaqin; Tao, Yuchun; Jin, Lina

    2015-01-01

    Background: Clustering of cardiovascular disease (CVD) risk factors constitutes a major public health challenge. Although a number of researchers have investigated the CVD risk factor clusters in China, little is known about the related prevalence and clustering associated with demographics in Jilin Province in China; this study aims to reveal that relationship. Methods: A cross-sectional survey based on a sample of 16,834 adults aged 18 to 79 years was conducted in Jilin in 2012. The prevalence and clustering of CVD risk factors were analysed through complex weighted computation. Quantitative variables were compared by the t test, and categorical variables were compared by the Rao-Scott-χ2 test. Finally, multivariable logistic regression analysis was used to evaluate the CVD risk factor clusters associated with demographics. Results: The prevalences of hypertension, diabetes, dyslipidemia, overweight and smoking were 37.3%, 8.2%, 36.8%, 47.3%, and 31.0%, respectively, and these risk factors were associated with gender, education level, age, occupation and family income (p < 0.05). Overall, compared with females, the adjusted ORs of ≥1, ≥2 and ≥3 risk factors clusters in males were 3.70 (95%CI 3.26 to 4.20), 4.66 (95%CI 4.09 to 5.31), and 5.76 (95%CI 5.01 to 6.63), respectively. In particular, the adjusted ORs of ≥1, ≥2 and ≥3 risk factors increased with age. Conclusions: CVD risk factor clusters are common among adults in northeast China, and they constitute a major public health challenge. More effective attention and interventions should be directed toward the elderly and toward persons with lower incomes and low levels of education. PMID:26703706

  6. Managing Overweight and Obesity in Adults to Reduce Cardiovascular Disease Risk

    PubMed Central

    Ebbert, Jon O.; Elrashidi, Muhamad Y.

    2014-01-01

    Obesity is a leading preventable cause of death and disability worldwide. Obesity increases the risk for clinically identifiable risk factors for cardiovascular disease (CVD) as well as a host of other metabolic, sleep, and orthopedic disorders. Coordinated and systematic interventions are needed to manage obesity and reduce these risks. The Obesity 2 Expert Panel updated previous guidelines and produced the “Guideline for the Management of Overweight and Obesity in Adults.” The Panel used data from publications from years 1999 to 2011 to address five critical questions, provide evidence statements, and recommend creation of a treatment algorithm to guide decision making about clinical care. The current review discusses the evidence statements pertaining to CVD risk in the assessment and management of patients who are overweight and obese. We summarize the FDA-approved medications for the treatment of overweight and obesity and their impact on CVD risk and risk factors, as well as ongoing clinical trials which will further inform clinical practice. PMID:25092581

  7. Adult stem cells applied to tissue engineering and regenerative medicine.

    PubMed

    Cuenca-López, M D; Zamora-Navas, P; García-Herrera, J M; Godino, M; López-Puertas, J M; Guerado, E; Becerra, J; Andrades, J A

    2008-01-01

    Regeneration takes place in the body at a moment or another throughout life. Bone, cartilage, and tendons (the key components of the structure and articulation in the body) have a limited capacity for self-repair and, after traumatic injury or disease, the regenerative power of adult tissue is often insufficient. When organs or tissues are irreparably damaged, they may be replaced by an artificial device or by a donor organ. However, the number of available donor organs is considerably limited. Generation of tissue-engineered replacement organs by extracting stem cells from the patient, growing them and modifying them in clinical conditions after re-introduction in the body represents an ideal source for corrective treatment. Mesenchymal stem cells (MSCs) are the multipotential progenitors that give rise to skeletal cells, vascular smooth muscle cells, muscle (skeletal and cardiac muscle), adipocytes (fat tissue) and hematopoietic (blood)-supportive stromal cells. MSCs are found in multiple connective tissues, in adult bone marrow, skeletal muscles and fat pads. The wide representation in adult tissues may be related to the existence of a circulating blood pool or that MSCs are associated to the vascular system.

  8. Cardiovascular risks and brain function: a functional magnetic resonance imaging study of executive function in older adults.

    PubMed

    Chuang, Yi-Fang; Eldreth, Dana; Erickson, Kirk I; Varma, Vijay; Harris, Gregory; Fried, Linda P; Rebok, George W; Tanner, Elizabeth K; Carlson, Michelle C

    2014-06-01

    Cardiovascular (CV) risk factors, such as hypertension, diabetes, and hyperlipidemia are associated with cognitive impairment and risk of dementia in older adults. However, the mechanisms linking them are not clear. This study aims to investigate the association between aggregate CV risk, assessed by the Framingham general cardiovascular risk profile, and functional brain activation in a group of community-dwelling older adults. Sixty participants (mean age: 64.6 years) from the Brain Health Study, a nested study of the Baltimore Experience Corps Trial, underwent functional magnetic resonance imaging using the Flanker task. We found that participants with higher CV risk had greater task-related activation in the left inferior parietal region, and this increased activation was associated with poorer task performance. Our results provide insights into the neural systems underlying the relationship between CV risk and executive function. Increased activation of the inferior parietal region may offer a pathway through which CV risk increases risk for cognitive impairment.

  9. Rapid Estimate of Adult Literacy in Medicine (REALM): A Quick Reading Test for Patients.

    ERIC Educational Resources Information Center

    Murphy, Peggy W.; And Others

    1993-01-01

    Describes a reading recognition test called Rapid Estimate of Adult Literacy in Medicine (REALM) that is designed to identify low literacy levels in patients. Notes that information thus obtained is useful in directing patient-physician communications and in promoting patient understanding of commonly used oral and written medical information. (SR)

  10. High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults.

    PubMed

    Wu, Chen-Yi; Hu, Hsiao-Yun; Chou, Yiing-Jenq; Huang, Nicole; Chou, Yi-Chang; Li, Chung-Pin

    2015-11-01

    Although hypertension is common among older adults, the optimal blood pressure (BP) for survival in older adults remains unclear. We attempt to use a large cohort to assess the relationship between BP and mortality and to gain insight into what level of BP is required for optimal survival in older adults.A total of 77,389 community-dwelling adults, aged ≥65 years, were followed between 2006 and 2010. Mortality was determined using matching cohort identifications with national death files. Cox proportional hazards regression models were used to evaluate the relationship of BP with all-cause, cardiovascular disease (CVD), and expanded-CVD mortalities.The mortality risks of the stage 2-3 hypertension group were substantial (all-cause mortality: hazard ratio [HR]: 1.23; 95% confidence interval [CI]: 1.10-1.37; CVDs mortality: HR: 1.31; 95% CI: 1.05-1.64; expanded-CVDs mortality: HR: 1.40; 95% CI: 1.15-1.71). The cardiovascular and expanded-cardiovascular mortality risks were lowest when systolic blood pressures were 120 to 129 mm Hg, and increased significantly when systolic blood pressures (SBPs) were ≥160 mm Hg or diastolic BPs were ≥90 mm Hg. A J-curve phenomenon for SBP on CVD and expanded-CVD mortality was observed. The impacts of stage 2-3 hypertension on mortality risks were significantly increased among women. The mortality risks of hypertension were not attenuated with older age.This study provides insight for identifying the optimal BP for survival in older adults, and extends the knowledge of the impacts of hypertension on mortality risks among women and the older adults.

  11. High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults

    PubMed Central

    Wu, Chen-Yi; Hu, Hsiao-Yun; Chou, Yiing-Jenq; Huang, Nicole; Chou, Yi-Chang; Li, Chung-Pin

    2015-01-01

    Abstract Although hypertension is common among older adults, the optimal blood pressure (BP) for survival in older adults remains unclear. We attempt to use a large cohort to assess the relationship between BP and mortality and to gain insight into what level of BP is required for optimal survival in older adults. A total of 77,389 community-dwelling adults, aged ≥65 years, were followed between 2006 and 2010. Mortality was determined using matching cohort identifications with national death files. Cox proportional hazards regression models were used to evaluate the relationship of BP with all-cause, cardiovascular disease (CVD), and expanded-CVD mortalities. The mortality risks of the stage 2–3 hypertension group were substantial (all-cause mortality: hazard ratio [HR]: 1.23; 95% confidence interval [CI]: 1.10–1.37; CVDs mortality: HR: 1.31; 95% CI: 1.05–1.64; expanded-CVDs mortality: HR: 1.40; 95% CI: 1.15–1.71). The cardiovascular and expanded-cardiovascular mortality risks were lowest when systolic blood pressures were 120 to 129 mm Hg, and increased significantly when systolic blood pressures (SBPs) were ≥160 mm Hg or diastolic BPs were ≥90 mm Hg. A J-curve phenomenon for SBP on CVD and expanded-CVD mortality was observed. The impacts of stage 2–3 hypertension on mortality risks were significantly increased among women. The mortality risks of hypertension were not attenuated with older age. This study provides insight for identifying the optimal BP for survival in older adults, and extends the knowledge of the impacts of hypertension on mortality risks among women and the older adults. PMID:26632749

  12. Change in Medication Adherence and Beliefs in Medicines Over Time in Older Adults

    PubMed Central

    Unni, Elizabeth J; Shiyanbola, Olayinka O; Farris, Karen B

    2016-01-01

    Objective: The temporal component of medication adherence is important while designing interventions to improve medication adherence. Thus, the objective of this study was to determine how medication adherence and beliefs in medicines change over time in older adults. Methods: A two-year longitudinal internet-based survey among adults 65+ years was used to collect data on medication adherence (Morisky 4-item scale) and beliefs in medicines (Beliefs about Medicines Questionnaire). Paired t-test and one-way ANOVA determined if a change in beliefs in medicines and medication adherence over time was significant. A multiple linear regression was used to determine the significant predictors of change in medication adherence over time. Results: 436 respondents answered both baseline and follow-up surveys. Among all respondents, there was no significant change in adherence (0.58 ± 0.84 vs. 0.59 ± 0.84; p > 0.05), necessity beliefs (17.13 ± 4.31 vs. 17.10 ± 4.29; p > 0.05), or concern beliefs (11.70 ± 3.73 vs. 11.68 ± 3.77; p > 0.05) over time. For older adults with lower baseline adherence, there was a statistically significant improvement in adherence (1.45 ± 0.70 vs. 0.99 ± 0.97; p < 0.05); but no change in beliefs in medicines over time. The significant predictors of change in medication adherence over time were baseline adherence and baseline concern beliefs in medicines. Conclusion: With baseline adherence and baseline concern beliefs in medicines playing a significant role in determining change in adherence behavior over time, especially in individuals with lower adherence, it is important to alleviate medication concerns at the beginning of therapy for better adherence. PMID:26652095

  13. Overview of the 79th Annual Scientific Meeting of the Japanese Circulation Society – Late-Breaking Cardiovascular Medicine From Japan.

    PubMed

    Hokimoto, Seiji; Yasuda, Satoshi; Sueta, Daisuke; Tsujita, Kenichi; Sakamoto, Kenji; Yamamuro, Megumi; Izumiya, Yasuhiro; Arima, Yuichiro; Usuku, Hiroki; Sumida, Yoko; Kojima, Sunao; Kaikita, Koichi; Kanazawa, Hisanori; Yamabe, Hiroshige; Ogawa, Hisao

    2015-01-01

    The 79th Annual Scientific Meeting of the Japanese Circulation Society was held in Osaka on April 24-26, 2015. The main theme was "Late-breaking Cardiovascular Medicine from Japan". Recently, optimal medical treatment has been guided by evidence-based medicine. We aim to emphasize the research findings and advances in cardiology from Japan, in the hope that Japan will become one of the leaders in the field worldwide. Unlike previous meetings, this annual scientific meeting was held in late April. Approximately 18,000 people, including medical doctors, healthcare professionals, and management staff, attended. The meeting was successfully completed, and included discussions on state-of-the art medicine.

  14. Adult mesenchymal stem cells for tissue engineering versus regenerative medicine.

    PubMed

    Caplan, Arnold I

    2007-11-01

    Adult mesenchymal stem cells (MSCs) can be isolated from bone marrow or marrow aspirates and because they are culture-dish adherent, they can be expanded in culture while maintaining their multipotency. The MSCs have been used in preclinical models for tissue engineering of bone, cartilage, muscle, marrow stroma, tendon, fat, and other connective tissues. These tissue-engineered materials show considerable promise for use in rebuilding damaged or diseased mesenchymal tissues. Unanticipated is the realization that the MSCs secrete a large spectrum of bioactive molecules. These molecules are immunosuppressive, especially for T-cells and, thus, allogeneic MSCs can be considered for therapeutic use. In this context, the secreted bioactive molecules provide a regenerative microenvironment for a variety of injured adult tissues to limit the area of damage and to mount a self-regulated regenerative response. This regenerative microenvironment is referred to as trophic activity and, therefore, MSCs appear to be valuable mediators for tissue repair and regeneration. The natural titers of MSCs that are drawn to sites of tissue injury can be augmented by allogeneic MSCs delivered via the bloodstream. Indeed, human clinical trials are now under way to use allogeneic MSCs for treatment of myocardial infarcts, graft-versus-host disease, Crohn's Disease, cartilage and meniscus repair, stroke, and spinal cord injury. This review summarizes the biological basis for the in vivo functioning of MSCs through development and aging. PMID:17620285

  15. Microtissues in Cardiovascular Medicine: Regenerative Potential Based on a 3D Microenvironment

    PubMed Central

    Günter, Julia; Wolint, Petra; Bopp, Annina; Steiger, Julia; Cambria, Elena; Hoerstrup, Simon P.; Emmert, Maximilian Y.

    2016-01-01

    More people die annually from cardiovascular diseases than from any other cause. In particular, patients who suffer from myocardial infarction may be affected by ongoing adverse remodeling processes of the heart that may ultimately lead to heart failure. The introduction of stem and progenitor cell-based applications has raised substantial hope for reversing these processes and inducing cardiac regeneration. However, current stem cell therapies using single-cell suspensions have failed to demonstrate long-lasting efficacy due to the overall low retention rate after cell delivery to the myocardium. To overcome this obstacle, the concept of 3D cell culture techniques has been proposed to enhance therapeutic efficacy and cell engraftment based on the simulation of an in vivo-like microenvironment. Of great interest is the use of so-called microtissues or spheroids, which have evolved from their traditional role as in vitro models to their novel role as therapeutic agents. This review will provide an overview of the therapeutic potential of microtissues by addressing primarily cardiovascular regeneration. It will accentuate their advantages compared to other regenerative approaches and summarize the methods for generating clinically applicable microtissues. In addition, this review will illustrate the unique properties of the microenvironment within microtissues that makes them a promising next-generation therapeutic approach. PMID:27073399

  16. Systems-Pharmacology Dissection of Traditional Chinese Medicine Compound Saffron Formula Reveals Multi-scale Treatment Strategy for Cardiovascular Diseases.

    PubMed

    Liu, Jianling; Mu, Jiexin; Zheng, Chunli; Chen, Xuetong; Guo, Zihu; Huang, Chao; Fu, Yingxue; Tian, Guihua; Shang, Hongcai; Wang, Yonghua

    2016-01-01

    Cardiovascular diseases (CVDs) have been regarding as "the world's first killer" of human beings in recent years owing to the striking morbidity and mortality, the involved molecular mechanisms are extremely complex and remain unclear. Traditional Chinese medicine (TCM) adheres to the aim of combating complex diseases from an integrative and holistic point of view, which has shown effectiveness in CVDs therapy. However, system-level understanding of such a mechanism of multi-scale treatment strategy for CVDs is still difficult. Here, we developed a system pharmacology approach with the purpose of revealing the underlying molecular mechanisms exemplified by a famous compound saffron formula (CSF) in treating CVDs. First, by systems ADME analysis combined with drug targeting process, 103 potential active components and their corresponding 219 direct targets were retrieved and some key interactions were further experimentally validated. Based on this, the network relationships among active components, targets and diseases were further built to uncover the pharmacological actions of the drug. Finally, a "CVDs pathway" consisted of several regulatory modules was incorporated to dissect the therapeutic effects of CSF in different pathological features-relevant biological processes. All this demonstrates CSF has multi-scale curative activity in regulating CVD-related biological processes, which provides a new potential way for modern medicine in the treatment of complex diseases. PMID:26813334

  17. Systems-Pharmacology Dissection of Traditional Chinese Medicine Compound Saffron Formula Reveals Multi-scale Treatment Strategy for Cardiovascular Diseases

    PubMed Central

    Liu, Jianling; Mu, Jiexin; Zheng, Chunli; Chen, Xuetong; Guo, Zihu; Huang, Chao; Fu, Yingxue; Tian, Guihua; Shang, Hongcai; Wang, Yonghua

    2016-01-01

    Cardiovascular diseases (CVDs) have been regarding as “the world’s first killer” of human beings in recent years owing to the striking morbidity and mortality, the involved molecular mechanisms are extremely complex and remain unclear. Traditional Chinese medicine (TCM) adheres to the aim of combating complex diseases from an integrative and holistic point of view, which has shown effectiveness in CVDs therapy. However, system-level understanding of such a mechanism of multi-scale treatment strategy for CVDs is still difficult. Here, we developed a system pharmacology approach with the purpose of revealing the underlying molecular mechanisms exemplified by a famous compound saffron formula (CSF) in treating CVDs. First, by systems ADME analysis combined with drug targeting process, 103 potential active components and their corresponding 219 direct targets were retrieved and some key interactions were further experimentally validated. Based on this, the network relationships among active components, targets and diseases were further built to uncover the pharmacological actions of the drug. Finally, a “CVDs pathway” consisted of several regulatory modules was incorporated to dissect the therapeutic effects of CSF in different pathological features-relevant biological processes. All this demonstrates CSF has multi-scale curative activity in regulating CVD-related biological processes, which provides a new potential way for modern medicine in the treatment of complex diseases. PMID:26813334

  18. Clinical holistic medicine: the Dean Ornish program ("opening the heart") in cardiovascular disease.

    PubMed

    Ventegodt, Søren; Merrick, Efrat; Merrick, Joav

    2006-02-02

    Dean Ornish of the Preventive Medicine Research Institute in Sausalito, California has created an intensive holistic treatment for coronary heart patients with improved diet (low fat, whole foods, plant based), exercise, stress management, and social support that has proven to be efficient. In this paper, we analyze the rationale behind his cure in relation to contemporary holistic medical theory. In spite of a complex treatment program, the principles seem to be simple and in accordance with holistic medical theories, like the Antonovsky concept of rehabilitating the sense of coherence and the life mission theory for holistic medicine. We believe there is a need for the allocation of resources for further research into the aspects of holistic health and its methods, where positive and significant results have been proven and reproduced at several sites.

  19. Physiology in medicine: acute altitude exposure in patients with pulmonary and cardiovascular disease.

    PubMed

    Seccombe, Leigh M; Peters, Matthew J

    2014-03-01

    Travel is more affordable and improved high-altitude airports, railways, and roads allow rapid access to altitude destinations without acclimatization. The physiology of exposure to altitude has been extensively described in healthy individuals; however, there is a paucity of data pertaining to those who have reduced reserve. This Physiology in Medicine article discusses the physiological considerations relevant to the safe travel to altitude and by commercial aircraft in patients with pulmonary and/or cardiac disease.

  20. Cardiovascular medicine at face value: a qualitative pilot study on clinical axiology

    PubMed Central

    2013-01-01

    Introduction Cardiology is characterized by its state-of-the-art biomedical technology and the predominance of Evidence-Based Medicine. This predominance makes it difficult for healthcare professionals to deal with the ethical dilemmas that emerge in this subspecialty. This paper is a first endeavor to empirically investigate the axiological foundations of the healthcare professionals in a cardiology hospital. Our pilot study selected, as the target population, cardiology personnel not only because of their difficult ethical deliberations but also because of the stringent conditions in which they have to make them. Therefore, there is an urgent need to reconsider clinical ethics and Value-Based Medicine. This study proposes a qualitative analysis of the values and the virtues of healthcare professionals in a cardiology hospital in order to establish how the former impact upon the medical and ethical decisions made by the latter. Results We point out the need for strengthening the roles of healthcare personnel as educators and guidance counselors in order to meet the ends of medicine, as well as the need for an ethical discernment that is compatible with our results, namely, that the ethical values developed by healthcare professionals stem from their life history as well as their professional education. Conclusion We establish the kind of actions, communication skills and empathy that are required to build a stronger patient-healthcare professional relationship, which at the same time improves prognosis, treatment efficiency and therapeutic adhesion. PMID:23531271

  1. Effects of Cardiovascular Disease on Compliance with Cervical and Breast Cancer Screening Recommendations Among Adult Women

    PubMed Central

    Guo, Fangjian; Hirth, Jacqueline M.

    2015-01-01

    Abstract Background: Cardiovascular disease (CVD) is common among women and is a leading cause of death in the United States. This study assessed the impact of CVD on compliance with the US Preventive Services Task Force guidelines for cervical and breast cancer screening among U.S. adult women. Methods: A cross-sectional study was conducted on 17,408 women using data from the National Health Interview Survey 2013. A total of 11,788 respondents (21–65 years old) with complete information on Pap smear and 11,409 women (40+ years old) with complete information on mammography compliance were included. Multivariate logistic regression models were used to assess the impact of CVD on cervical and breast cancer screening practices. Results: Women with CVD were marginally more likely to have had a mammogram in accordance with guidelines (odds ratio 1.17; 95% confidence interval 1.04–1.31) than those without CVD. However, compliance with Pap tests was similar (80.6% vs 82.3%, p>0.05) between the two groups. Myocardial infarction was associated with reduced odds of Pap smear compliance (odds ratio: 0.30; 95% confidence interval 0.18–0.51). Conclusions: Women with prior myocardial infarction should be encouraged to continue receiving regular Pap smears. More research is needed to assess whether observed differences in Pap testing between patients with and without a history of myocardial infarction result from lack of provider recommendation or from patient noncompliance with their recommendations. PMID:26263281

  2. Association of Objectively Measured Physical Activity With Cardiovascular Risk in Mobility‐limited Older Adults

    PubMed Central

    Fitzgerald, Jodi D.; Johnson, Lindsey; Hire, Don G.; Ambrosius, Walter T.; Anton, Stephen D.; Dodson, John A.; Marsh, Anthony P.; McDermott, Mary M.; Nocera, Joe R.; Tudor‐Locke, Catrine; White, Daniel K.; Yank, Veronica; Pahor, Marco; Manini, Todd M.; Buford, Thomas W.

    2015-01-01

    Background Data are sparse regarding the impacts of habitual physical activity (PA) and sedentary behavior on cardiovascular (CV) risk in older adults with mobility limitations. Methods and Results This study examined the baseline, cross‐sectional association between CV risk and objectively measured PA among participants in the Lifestyle Interventions and Independence for Elders (LIFE) study. The relationship between accelerometry measures and predicted 10‐year Hard Coronary Heart Disease (HCHD) risk was modeled by using linear regression, stratified according to CVD history. Participants (n=1170, 79±5 years) spent 642±111 min/day in sedentary behavior (ie, <100 accelerometry counts/min). They also spent 138±43 min/day engaging in PA registering 100 to 499 accelerometry counts/min and 54±37 min/day engaging in PA ≥500 counts/min. Each minute per day spent being sedentary was associated with increased HCHD risk among both those with (0.04%, 95% CI 0.02% to 0.05%) and those without (0.03%, 95% CI 0.02% to 0.03%) CVD. The time spent engaging in activities 100 to 499 as well as ≥500 counts/min was associated with decreased risk among both those with and without CVD (P<0.05). The mean number of counts per minute of daily PA was not significantly associated with HCHD risk in any model (P>0.05). However, a significant interaction was observed between sex and count frequency (P=0.036) for those without CVD, as counts per minute was related to HCHD risk in women (β=−0.94, −1.48 to −0.41; P<0.001) but not in men (β=−0.14, −0.59 to 0.88; P=0.704). Conclusions Daily time spent being sedentary is positively associated with predicted 10‐year HCHD risk among mobility‐limited older adults. Duration, but not intensity (ie, mean counts/min), of daily PA is inversely associated with HCHD risk score in this population—although the association for intensity may be sex specific among persons without CVD. Clinical Trial Registration URL: www

  3. Ultrasound Contrast Materials in Cardiovascular Medicine: from Perfusion Assessment to Molecular Imaging

    PubMed Central

    Klibanov, Alexander L

    2013-01-01

    Ultrasound imaging is widely used in cardiovascular diagnostics. Contrast agents expand the range of tasks that ultrasound can perform. In the clinic in US, endocardial border delineation and left ventricle opacification have been an approved indication for more than a decade. However, myocardial perfusion contrast ultrasound studies are still at the clinical trials stage. Blood pool contrast and perfusion in other tissues might be an easier indication to achieve: general blood pool ultrasound contrast is in wider use in Europe, Canada, Japan, and China. Targeted (molecular) contrast microbubbles will be the next generation of ultrasound imaging probes, capable of specific delineation of the areas of disease by adherence to molecular targets. The shell of targeted microbubbles (currently in the preclinical research and early stage clinical trials) is decorated with the ligands (antibodies, peptides or mimetics, hormones, carbohydrates) that ensure firm binding to the molecular markers of disease. PMID:23913363

  4. Plasma Free Fatty Acids, Fatty Acid-binding Protein 4, and Mortality in Older Adults (From the Cardiovascular Health Study)

    PubMed Central

    Miedema, Michael D.; Maziarz, Marlena; Biggs, Mary L.; Zieman, Susan J.; Kizer, Jorge R.; Ix, Joachim H.; Mozaffarian, Dariush; Tracy, Russell P.; Psaty, Bruce M.; Siscovick, David S.; Mukamal, Kenneth J.; Djousse, Luc

    2014-01-01

    Plasma free fatty acids (FFA) are largely derived from adipose tissue. Elevated levels of FFA and fatty acid-binding protein 4 (FABP4), a key cytoplasmic chaperone of fatty acids, have been associated with adverse cardiovascular outcomes but limited data are available on the relation of these biomarkers with cardiovascular and total mortality. We studied 4,707 participants with a mean age of 75 years who had plasma FFA and FABP4 measured in 1992–1993 as part of the Cardiovascular Health Study, an observational cohort of community dwelling older adults. Over a median follow-up of 11.8 years, 3,555 participants died. Cox proportional hazard regression was used to determine the association between FFA, FABP4, and mortality. In fully adjusted models, FFA were associated with dose-dependent significantly higher total mortality (hazard ratio (HR) per standard deviation (SD): 1.14, 95% confidence interval (CI) 1.09–1.18), but FABP4 levels were not (HR 1.04, 95% CI 0.98–1.09). In a cause-specific mortality analysis, higher concentrations of FFA were associated with significantly higher risk of death due to cardiovascular disease, dementia, infection, and respiratory causes, but not cancer or trauma. We did not find evidence of an interaction between FFA and FABP4 (p=0.45), but FABP4 appeared to be associated with total mortality differentially among men and women (HR 1.17 (1.08–1.26) for men, HR 1.02 (0.96–1.07) for women, interaction p-value <0.001). In conclusion, in a cohort of community-dwelling older individuals, elevated plasma concentrations of FFA, but not FABP4, were associated with cardiovascular and non-cardiovascular mortality. PMID:25073566

  5. Dietary Soy Intake Is Not Associated with Risk of Cardiovascular Disease Mortality in Singapore Chinese Adults123

    PubMed Central

    Talaei, Mohammad; Koh, Woon-Puay; van Dam, Rob M.; Yuan, Jian-Min; Pan, An

    2014-01-01

    Although soy food has been recommended because of its presumed cardiovascular benefits, the long-term prospective association between habitual soy food intake and cardiovascular disease mortality remains unclear. This study aimed to evaluate the relation of soy protein and isoflavone intake with the risk of cardiovascular disease mortality in middle-aged and older Chinese adults residing in Singapore. The Singapore Chinese Health Study is a population-based study that recruited 63,257 Chinese adults aged 45–74 y from 1993 to 1998. Usual diet was measured at recruitment by using a validated semiquantitative food-frequency questionnaire, and mortality information was identified via registry linkage until 31 December 2011. Cox proportional hazards models were used to calculate HRs, with adjustment for potential confounders. The median intake was 5.2 g/d for soy protein, 15.8 mg/d for soy isoflavones, and 87.4 g/d for soy expressed as tofu equivalents. We documented 4780 cardiovascular deaths during 890,473 person-years of follow-up. After adjustment for sociodemographic, lifestyle, and other dietary factors, soy protein intake was not significantly associated with cardiovascular disease mortality: HRs (95% CIs) were 1.00 (reference), 1.02 (0.94, 1.11), 1.02 (0.93, 1.11), and 1.06 (0.97, 1.17) for increasing quartiles of soy protein (P-trend = 0.24). Similarly, no significant association was observed for soy isoflavones and total tofu equivalents and when deaths from coronary heart disease (n = 2697) and stroke (n = 1298) were considered separately. When stratified by sex, HRs for cardiovascular disease mortality across quartiles of soy protein were 1.00, 1.00, 1.05, and 1.16 (95% CI: 1.03, 1.31) in men (P-trend = 0.02) and 1.00, 1.01, 0.96, and 0.95 (95% CI: 0.81, 1.10) in women (P-trend = 0.31), although the interaction was not significant (P-interaction = 0.12). In conclusion, soy intake was not significantly associated with risk of cardiovascular disease

  6. 2010 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Training Standards and Maintenance of Competency in Adult Clinical Cardiac Electrophysiology.

    PubMed

    Green, Martin S; Guerra, Peter G; Krahn, Andrew D

    2011-01-01

    The last guidelines on training for adult cardiac electrophysiology (EP) were published by the Canadian Cardiovascular Society in 1996. Since then, substantial changes in the knowledge and practice of EP have mandated a review of the previous guidelines by the Canadian Heart Rhythm Society, an affiliate of the Canadian Cardiovascular Society. Novel tools and techniques also now allow electrophysiologists to map and ablate increasingly complex arrhythmias previously managed with pharmacologic or device therapy. Furthermore, no formal attempt had previously been made to standardize EP training across the country. The 2010 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Training Standards and Maintenance of Competency in Adult Clinical Cardiac Electrophysiology represent a consensus arrived at by panel members from both societies, as well as EP program directors across Canada and other select contributors. In describing program requirements, the technical and cognitive skills that must be acquired to meet training standards, as well as the minimum number of procedures needed in order to acquire these skills, the new guidelines provide EP program directors and committee members with a template to develop an appropriate curriculum for EP training for cardiology fellows here in Canada.

  7. Ideal cardiovascular health in young adult populations from the United States, Finland, and Australia and its association with cIMT: The International Childhood Cardiovascular Cohort Consortium

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The goals for cardiovascular disease prevention were set by the American Heart Association in 2010 for the concept of cardiovascular health. Ideal cardiovascular health is defined by senen cardiovascular health metrics: blood pressure, glucose, cholesterol, body mass index, and physical activity on ...

  8. Can arterial wave augmentation in young adults help account for variability of cardiovascular risk in different British ethnic groups?

    PubMed Central

    Faconti, Luca; Silva, Maria J.; Molaodi, Oarabile R.; Enayat, Zinat E.; Cassidy, Aidan; Karamanos, Alexis; Nanino, Elisa; Read, Ursula M.; Dall, Philippa; Stansfield, Ben; Harding, Seeromanie; Cruickshank, Kennedy J.

    2016-01-01

    Objective: Traditional cardiovascular risk factors do not fully account for ethnic differences in cardiovascular disease. We tested if arterial function indices, particularly augmentation index (AIx), and their determinants from childhood could underlie such ethnic variability among young British adults in the ‘DASH’ longitudinal study. Methods: DASH, at http://dash.sphsu.mrc.ac.uk/, includes representative samples of six main British ethnic groups. Pulse wave velocity (PWV) and AIx were recorded using the Arteriograph device at ages 21–23 years in a subsample (n = 666); psychosocial, anthropometric, and blood pressure (BP) measures were collected then and in two previous surveys at ages 11–13 years and 14–16 years. For n = 334, physical activity was measured over 5 days (ActivPal). Results: Unadjusted values and regression models for PWVs were similar or lower in ethnic minority than in White UK young adults, whereas AIx was higher – Caribbean (14.9, 95% confidence interval 12.3–17.0%), West African (15.3, 12.9–17.7%), Indian (15.1, 13.0–17.2%), and Pakistani/Bangladeshi (15.7, 13.7–17.7%), compared with White UK (11.9, 10.2–13.6%). In multivariate models, adjusted for sex, central SBP, height, and heart rate, Indian and Pakistani/Bangladeshi young adults had higher AIx (β = 3.35, 4.20, respectively, P < 0.01) than White UK with a similar trend for West Africans and Caribbeans but not statistically significant. Unlike PWV, physical activity, psychosocial or deprivation measures were not associated with AIx, with borderline associations from brachial BP but no other childhood variables. Conclusion: Early adult AIx, but not arterial stiffness, may be a useful tool for testing components of excess cardiovascular risk in some ethnic minority groups. PMID:27490950

  9. Incorporating Geriatric Medicine Providers into the Care of the Older Adult with Cancer.

    PubMed

    Magnuson, Allison; Canin, Beverly; van Londen, G J; Edwards, Beatrice; Bakalarski, Pamela; Parker, Ira

    2016-11-01

    A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum. In this article, we review the role of geriatric assessment in the care of older cancer patients, highlight specific case scenarios in which GMPs may offer additional understanding and insight in the care of older adults with cancer, and discuss specific mechanisms for incorporating GMPs into oncology care. PMID:27613166

  10. [Access to medicines prescribed for acute health conditions in adults in South and Northeast Brazil].

    PubMed

    Paniz, Vera Maria Vieira; Cechin, Isabel Carolina Coelho Flores; Fassa, Anaclaudia Gastal; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Facchini, Luiz Augusto

    2016-01-01

    This was a cross-sectional study within Brazil's Project for the Expansion and Consolidation of Family Health, 2005, with the objective of universal and free access to the medication prescribed in the last medical appointment for acute health problems and to estimate the degree to which access may have improved with inclusion of the medicines in prevailing policies and programs. The sample included 4,060 adults living in the area of primary health care units in 41 municipalities in South and Northeast Brazil. Access was greater in the South (83.2%) than in the Northeast (71%), and free access was similar (37%), with a greater share by the Family Health Program (FHP) when compared to the traditional model, especially in the Northeast. Some 60% of prescribed medicines and 50% of those on the National List of Essential Medicines (RENAME) were paid for. No variation was observed in the proportion of medicines present on the prevailing RENAME list and access. However, 40% of the medicines that were paid for can currently be obtained through the Popular Pharmacy Program. The latter program appears to emerge as a new way to guarantee access to medicines prescribed in the health system.

  11. Taking control: Complementary and alternative medicine in diabetes and cardiovascular disease management.

    PubMed

    Warren, Narelle; Canaway, Rachel; Unantenne, Nalika; Manderson, Lenore

    2013-07-01

    The chronicity of chronic disease, and its associated uncertainties and fluctuations in health status, pain and/or discomfort, often leaves those so diagnosed feeling that they have lost control. Treatment can exacerbate this sense of loss of control, as people surrender to the expertise of their biomedical providers and interventions. In principle, self-management aims to return control to the individual, but its promotion is as much motivated by cost-containment as patient autonomy, and is advocated in an environment largely shaped by policy makers and biomedical providers. In this article, we examine how Australians with type 2 diabetes and/or cardiovascular disease supplement medical with complementary and alternative medical (CAM) care. Drawing on in-depth interviews with 69 participants collected in 2009-2010, we illustrate how people rely on medical providers and pharmaceuticals to manage their diabetes, but concurrently consulted with CAM practitioners and used non-biomedical therapies to enhance well-being. In explaining this, participants framed CAM use in the context of reclaiming relative personal and bodily control.

  12. The clinical significance of whole blood viscosity in (cardio)vascular medicine

    PubMed Central

    Pop, G.A.M.; Duncker, D.J.; Gardien, M.; Vranckx, P.; Versluis, S.; Hasan, D.; Slager, C.J.

    2002-01-01

    Whole blood is a non-Newtonian fluid, which means that its viscosity depends on shear rate. At low shear, blood cells aggregate, which induces a sharp increase in viscosity, whereas at higher shear blood cells disaggregate, deform and align in the direction of flow. Other important determinants of blood viscosity are the haematocrit, the presence of macro-molecules in the medium, temperature and, especially at high shear, the deformability of red blood cells. At the sites of severe atherosclerotic obstructions or at vasospastic locations, when change of vessel diameter is limited, blood viscosity contributes to stenotic resistance thereby jeopardising tissue perfusion. However, blood viscosity plays its most important role in the microcirculation where it contributes significantly to peripheral resistance and may cause sludging in the postcapillary venules. Apart from the direct haemodynamic significance, an increase in blood viscosity at low shear by red blood cell aggregation is also associated with increased thrombotic risk, as has been demonstrated in atrial fibrillation. Furthermore, as increased red blood cell aggregation is a reflection of inflammation, hyperviscosity has been shown to be a marker of inflammatory activity. Thus, because of its potential role in haemodynamics, thrombosis and inflammation, determination of whole blood viscosity could provide useful information for diagnostics and therapy of (cardio)vascular disease. ImagesFigure 3 PMID:25696056

  13. An extended theory of planned behavior intervention for older adults with type 2 diabetes and cardiovascular disease.

    PubMed

    White, Katherine M; Terry, Deborah J; Troup, Carolyn; Rempel, Lynn A; Norman, Paul; Mummery, Kerry; Riley, Malcolm; Posner, Natasha; Kenardy, Justin

    2012-07-01

    A randomized controlled trial evaluated the effectiveness of a 4-wk extended theory of planned behavior (TPB) intervention to promote regular physical activity and healthy eating among older adults diagnosed with Type 2 diabetes or cardiovascular disease (N = 183). Participants completed TPB measures of attitude, subjective norm, perceived behavioral control, and intention, as well as planning and behavior, at preintervention and 1 wk and 6 wk postintervention for each behavior. No significant time-by-condition effects emerged for healthy eating. For physical activity, significant time-by-condition effects were found for behavior, intention, planning, perceived behavioral control, and subjective norm. In particular, compared with control participants, the intervention group showed short-term improvements in physical activity and planning, with further analyses indicating that the effect of the intervention on behavior was mediated by planning. The results indicate that TPB-based interventions including planning strategies may encourage physical activity among older people with diabetes and cardiovascular disease.

  14. An extended theory of planned behavior intervention for older adults with type 2 diabetes and cardiovascular disease.

    PubMed

    White, Katherine M; Terry, Deborah J; Troup, Carolyn; Rempel, Lynn A; Norman, Paul; Mummery, Kerry; Riley, Malcolm; Posner, Natasha; Kenardy, Justin

    2012-07-01

    A randomized controlled trial evaluated the effectiveness of a 4-wk extended theory of planned behavior (TPB) intervention to promote regular physical activity and healthy eating among older adults diagnosed with Type 2 diabetes or cardiovascular disease (N = 183). Participants completed TPB measures of attitude, subjective norm, perceived behavioral control, and intention, as well as planning and behavior, at preintervention and 1 wk and 6 wk postintervention for each behavior. No significant time-by-condition effects emerged for healthy eating. For physical activity, significant time-by-condition effects were found for behavior, intention, planning, perceived behavioral control, and subjective norm. In particular, compared with control participants, the intervention group showed short-term improvements in physical activity and planning, with further analyses indicating that the effect of the intervention on behavior was mediated by planning. The results indicate that TPB-based interventions including planning strategies may encourage physical activity among older people with diabetes and cardiovascular disease. PMID:22190336

  15. Update on the important new drug target in cardiovascular medicine - the vascular glycocalyx.

    PubMed

    Drake-Holland, A J; Noble, M I M

    2012-09-01

    We reviewed this subject in 2009, pointing out that, to the process of atherothrombosis, glycocalyx dysfunction and damage must be added to the previous known causitive factors. Glycocalyx dysfunction is possibly the very first step in the process of atherothrombosis, being a protective layer between the endothelial cells and the blood. We emphasise the unique feature of glycocalyx mediated vasodilatation in that it is initiated purely by mechanical changes, i.e., changes in vascular wall shear stress, allowing conduit arteries to adjust diameter to demanded blood flow rate. The predeliction of atheroma to sites of low shear stress, the inhibition of the shear response by lumenal hyperglycaemia, and the fact that the response is mediated by nitric oxide (NO), an anti-atheromatous agent has led to the hypothesis that impairment of this pathway is pro-atherogenic. In the microcirculation it has been shown that the glycocalyx must be added to the factors involved in the Starling hypothesis of tissue fluid generation and exchange. As a consequence glycoalyx dysfunction in hyperglycaemia has been postulated to cause oedema and microalbinuria. We suggested that perhaps the arterial glycocalyx will become the most important for future early prevention of people at risk of cardiovascular disease. The advances in this subject since 2009 are the subject of the present review. What has struck us when searching the literature is that research into the glycocalyx has increased very much and now comes from many disciplines; e.g., diabetes, hypertension, bioengineering, physiology, critical care, cardiology, shock. This update is by no means exhaustive, but hopes, again, to bring to the attention of the pharmaceutical industry, the need for grants in the appropriate experimental models.

  16. Cardiovascular effects of the South American medicinal plant Cecropia pachystachya (ambay) on rats.

    PubMed

    Consolini, Alicia E; Migliori, Graciela N

    2005-01-15

    Cecropia pachystachya is used in South America for relieving cough and asthma. In Argentina it is known as "ambay" and grows in the neotropical forests (Ntr C.p.) and in temperate hilly regions (Tp C.p.). To evaluate their cardiovascular profile, the effect of extracts obtained from plants growing in the neotropical region as well as in temperate areas were compared by i.v. administration in normotensive rats. The following parameters were measured: blood pressure (BP) and heart rate (HR). The hypotensive effect was stronger for Ntr C.p., which aqueous extract decreased BP at doses between 90 and 300 mg lyophilised/kg until 46.2 +/- 12% of basal. The extract of Tp C.p. reduced BP to 86.1 +/- 11% of basal (p < 0.05 respect to Ntr C.p.) at 180 mg/kg, but increased HR at 90 and 180 mg/kg (until 133.6 +/- 10.8% of basal, p < 0.05) and produced death by respiratory paralysis at 320 mg/kg (about 3g dry leaves/kg). The hypotensive effects, but not the chronotropic ones, were attenuated by pretreatment with reserpine (5 mg/kg). The plant extracts had not diuretic activity by oral administration in conscious rats, nor produced vasodilation of perfused hindquarters arterial bed precontracted with high-[K] or 100 microM phenylephrine. The results suggest that neotropical ambay is more hypotensive than the one from the temperate hilly region. When it reaches plasma, it could produce hypotension (by central blockade of sympathic innervation of vessels) and tachycardia (by central cholinergic inhibition of heart), although it happens at doses higher than the oral ethnotherapeutic (about 340 mg dried leaves/kg).

  17. DDAH2 mRNA Expression Is Inversely Associated with Some Cardiovascular Risk-Related Features in Healthy Young Adults

    PubMed Central

    Puchau, Blanca; Hermsdorff, Helen Hermana M.; Zulet, M. Ángeles; Martínez, J. Alfredo

    2009-01-01

    The purpose of this study was to evaluate whether the mRNA expression profiles of three genes (PRMT1, DDAH2 and NOS3) are related to ADMA metabolism and signalling, and the potential relationships with anthropometrical, biochemical, lifestyle and inflammatory indicators in healthy young adults. An emphasis on the putative effect of different mRNA expression on cardiovascular risk-related features was paid. Anthropometrical measurements as well as lifestyle features were analyzed in 120 healthy young adults. Fasting blood samples were collected for the measurement of glucose and lipid profiles as well as the concentrations of selected inflammatory markers. Profiles of mRNA expression were assessed for PRMT1, DDAH2 and NOS3 genes from peripheral blood mononuclear cells. Regarding inflammatory biomarkers, DDAH2 was inversely associated with IL-6 and TNF-α. Moreover, subjects in the highest quintile of DDAH2 mRNA expression showed a reduced risk to have higher values of waist circumference, and to be more prone to show higher values of HDL-c. Interestingly, DDAH2 gene expression seemed to be related with some anthropometrical, biochemical, lifestyle and inflammatory indicators linked to cardiovascular risk in apparently healthy young adults, emerging as a potential disease marker. PMID:19822957

  18. Interactions between beta-2 adrenoceptor gene variation, cardiovascular control and dietary sodium in healthy young adults.

    PubMed

    Eisenach, John H; Schroeder, Darrell R; Pavey, Emily S; Penheiter, Alan R; Knutson, Jean N; Turner, Stephen T; Joyner, Michael J

    2014-12-01

    Dietary sodium affects function of the beta-2 adrenoceptor (ADRB2). We tested the hypothesis that haplotype variation in the ADRB2 gene would influence the cardiovascular and regional vasodilator responses to sympathoexcitatory manoeuvres following low, normal and high sodium diets, and ADRB2-mediated forearm vasodilation in the high sodium condition. Seventy-one healthy young adults were grouped by double homozygous haplotypes: Arg16+Gln27 (n = 31), the rare Gly16+Gln27 (n = 10) and Gly16+Glu27 (n = 30). Using a randomized cross-over design, subjects were studied following 5 days of controlled low, normal and high sodium with 1 month or longer between diets (and low hormone phase of the menstrual cycle). All three visits utilized ECG and finger plethysmography for haemodynamic measures, and the high sodium visit included a brachial arterial catheter for forearm vasodilator responses to isoprenaline with plethysmography. Lymphocytes were sampled for ex vivo analysis of ADRB2 density and binding conformation. We found a main effect of haplotype on ADRB2 density (P = 0.03) with the Gly16+Glu27 haplotype having the greatest density (low, normal, high sodium: 12.9 ± 0.9, 13.5 ± 0.9 and 13.6 ± 0.8 fmol mg(-1) protein, respectively) and Arg16+Gln27 having the least (9.3 ± 0.6, 10.1 ± 0.5 and 10.3 ± 0.6  fmol mg(-1) protein, respectively), but there were no sodium or haplotype effects on receptor binding conformation. In the mental stress trial, there was a main effect of haplotype on cardiac output (P = 0.04), as Arg16+Gln27 had the lowest responses. Handgrip and forearm vasodilation yielded no haplotype differences, and no correlations were present for ADRB2 density and haemodynamics. Our findings support cell-based evidence that ADRB2 haplotype influences ADRB2 protein expression independent of dietary sodium, yet the haemodynamic consequences appear modest in healthy humans.

  19. Health-Related Quality of Life and Cardiovascular Disease Risk in Korean Adults

    PubMed Central

    Ko, Hyeon-Young; Shin, Jin-Young; Jo, Euni

    2015-01-01

    Background Health-related quality of life (HRQoL) is considered an important outcome measure in chronic diseases, in particular cardiovascular disease (CVD), which is known to be associated with impaired HRQoL. However, few studies have examined HRQoL in individuals at high risk of CVD. Methods Using the Fifth Korea National Health and Nutrition Examination Survey 2010-2012, we analyzed data from 10,307 adults aged ≥30 years. The study subjects were stratified into 3 groups on the basis of their Framingham risk score-a 10-year estimate of CVD risk: <10.0% (low risk), 10.0%-19.9% (moderate risk), and ≥20.0% (high risk). The EuroQol-5D (EQ-5D) was used to evaluate HRQoL. Results A significantly higher proportion of high-risk subjects than low-risk participants had impaired HRQoL (defined as the lowest quartile of the EQ-5D index); this held true even after adjustment for confounding factors in multivariable logistic regression analysis (men: odds ratio [OR], 1.62; 95% confidence interval [CI], 1.24-2.11; women: OR, 1.46; 95% CI, 1.02-2.08). In terms of the 5 EQ-5D dimensions, a 10-year CVD risk ≥20.0% was significantly associated with self-reported problems of mobility in men (OR, 3.15; 95% CI, 2.02-4.90), and of mobility (OR, 1.56; 95% CI, 1.09-2.24), self-care (OR, 2.14; 95% CI, 1.09-4.22), and usual activity problems (OR, 1.80; 95% CI, 1.17-2.78) in women. Conclusion A high CVD risk is associated with impaired HRQoL. After adjustment for demographic and clinical factors, a 10-year CVD risk ≥20.0% is an independent predictor of impaired HRQoL in the general population; in particular, of mobility problems in men, and of mobility, self-care, and usual activity problems in women. PMID:26634104

  20. Cotinine-assessed second-hand smoke exposure and risk of cardiovascular disease in older adults

    PubMed Central

    Lawlor, D A; Ebrahim, S; Wannamethee, S G; Feyerabend, C; Doig, M; McMeekin, L; Cook, D G; Whincup, P H

    2010-01-01

    Objectives To examine whether second-hand smoke (SHS) exposure measured by serum cotinine is associated with increased coronary heart disease (CHD) and stroke risk among contemporary older British adults. Design Prospective population-based study with self-reported medical history and health behaviours. Fasting blood samples were analysed for serum cotinine and cardiovascular disease (CVD) risk markers. Setting Primary care centres in 25 British towns in 1998–2001. Patients 8512 60–79-year-old men and women selected from primary care registers. Main outcome measures Fatal and non-fatal myocardial infarction (MI; n=445) and stroke (n=386) during median 7.8-year follow-up. Main exposure Observational study of serum cotinine assayed from fasting blood sample using liquid chromatography tandem mass spectrometry method, and self-reported smoking history. Results Among 5374 non-smokers without pre-existing CVD, geometric mean cotinine was 0.15 ng/ml (IQR 0.05–0.30). Compared with non-smokers with cotinine ≤0.05 ng/ml, higher cotinine levels (0.06–0.19, 0.2–0.7 and 0.71–15.0 ng/ml) showed little association with MI; adjusted HRs were 0.92 (95% CI 0.63 to 1.35), 1.07 (0.73 to 1.55) and 1.09 (0.69 to 1.72), p(trend)=0.69. Equivalent HRs for stroke were 0.82 (0.55 to 1.23), 0.74 (0.48 to 1.13) and 0.69 (0.41 to 1.17), p(trend)=0.065. The adjustment for sociodemographic, behavioural and CVD risk factors had little effect on the results. The HR of MI for smokers (1–9 cigarettes/day) compared with non-smokers with cotinine ≤0.05 ng/ml was 2.14 (1.39 to 3.52) and 1.03 (0.52 to 2.04) for stroke. Conclusions In contemporary older men and women, SHS exposure (predominantly at low levels) was not related to CHD or stroke risks, but we cannot rule out the possibility of modest effects at higher exposure levels. PMID:20478864

  1. Candy consumption in childhood is not predictive of weight, adiposity measures or cardiovascular risk factors in young adults: the Bogalusa Heart Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There are limited data available on the longitudinal relationship between candy consumption by children on weight and other cardiovascular risk factors (CVRF) in young adults. The present study investigated whether candy consumption in children was predictive of weight and CVRF in young adults. A lo...

  2. Childhood to Early-Midlife Systolic Blood Pressure Trajectories: Early-Life Predictors, Effect Modifiers, and Adult Cardiovascular Outcomes.

    PubMed

    Theodore, Reremoana F; Broadbent, Jonathan; Nagin, Daniel; Ambler, Antony; Hogan, Sean; Ramrakha, Sandhya; Cutfield, Wayne; Williams, Michael J A; Harrington, HonaLee; Moffitt, Terrie E; Caspi, Avshalom; Milne, Barry; Poulton, Richie

    2015-12-01

    Previous studies examining blood pressure change over time have modeled an average population trajectory. Recent research among older adults suggests there may be subgroups with different blood pressure trajectories. Identifying subgroups at risk of developing adult hypertension early in life can inform effective risk reduction efforts. We sought to identify different systolic blood pressure trajectories from childhood, their correlated risk factors, and early-midlife cardiovascular outcomes. Blood pressure data at ages 7, 11, 18, 26, 32, and 38 years from a longitudinal, representative birth cohort study (n=975) were used to identify 4 distinct trajectory groups via group-based trajectory modeling: normal (21.8%), high-normal (43.3%), prehypertensive (31.6%), and hypertensive (4.2%). The categories refer to blood pressure beginning at the age of 7 years and most recently measured at the age of 38 years. Family history of high blood pressure (odds ratio [OR], 43.23; 95% confidence interval [CI], 5.27-354.65), male sex (OR, 109.48; 95% CI, 26.82-446.96), being first born (OR, 2.5; 95% CI, 1.00-8.69) and low birth weight (OR, 2.79; 95% CI, 2.49-3.09) were associated with hypertensive group membership (compared with the normal group). Higher body mass index and cigarette smoking resulted in increasing blood pressure across trajectories, particularly for the higher blood pressure groups. Prehypertensive and hypertensive trajectory groups had worse cardiovascular outcomes by early midlife. Harmful blood pressure trajectories are identifiable in childhood, associated with both antecedent and modifiable risk factors over time, and predict adult cardiovascular disease risk. Early detection and subsequent targeted prevention and intervention may reduce the lifecourse burden associated with higher blood pressure. PMID:26558818

  3. Childhood to Early-Midlife Systolic Blood Pressure Trajectories: Early-Life Predictors, Effect Modifiers, and Adult Cardiovascular Outcomes.

    PubMed

    Theodore, Reremoana F; Broadbent, Jonathan; Nagin, Daniel; Ambler, Antony; Hogan, Sean; Ramrakha, Sandhya; Cutfield, Wayne; Williams, Michael J A; Harrington, HonaLee; Moffitt, Terrie E; Caspi, Avshalom; Milne, Barry; Poulton, Richie

    2015-12-01

    Previous studies examining blood pressure change over time have modeled an average population trajectory. Recent research among older adults suggests there may be subgroups with different blood pressure trajectories. Identifying subgroups at risk of developing adult hypertension early in life can inform effective risk reduction efforts. We sought to identify different systolic blood pressure trajectories from childhood, their correlated risk factors, and early-midlife cardiovascular outcomes. Blood pressure data at ages 7, 11, 18, 26, 32, and 38 years from a longitudinal, representative birth cohort study (n=975) were used to identify 4 distinct trajectory groups via group-based trajectory modeling: normal (21.8%), high-normal (43.3%), prehypertensive (31.6%), and hypertensive (4.2%). The categories refer to blood pressure beginning at the age of 7 years and most recently measured at the age of 38 years. Family history of high blood pressure (odds ratio [OR], 43.23; 95% confidence interval [CI], 5.27-354.65), male sex (OR, 109.48; 95% CI, 26.82-446.96), being first born (OR, 2.5; 95% CI, 1.00-8.69) and low birth weight (OR, 2.79; 95% CI, 2.49-3.09) were associated with hypertensive group membership (compared with the normal group). Higher body mass index and cigarette smoking resulted in increasing blood pressure across trajectories, particularly for the higher blood pressure groups. Prehypertensive and hypertensive trajectory groups had worse cardiovascular outcomes by early midlife. Harmful blood pressure trajectories are identifiable in childhood, associated with both antecedent and modifiable risk factors over time, and predict adult cardiovascular disease risk. Early detection and subsequent targeted prevention and intervention may reduce the lifecourse burden associated with higher blood pressure.

  4. A System-Level Investigation into the Mechanisms of Chinese Traditional Medicine: Compound Danshen Formula for Cardiovascular Disease Treatment

    PubMed Central

    Li, Xiuxiu; Xu, Xue; Wang, Jinan; Yu, Hua; Wang, Xia; Yang, Hongjun; Xu, Haiyu; Tang, Shihuan; Li, Yan; Yang, Ling; Huang, Luqi; Wang, Yonghua; Yang, Shengli

    2012-01-01

    Compound Danshen Formula (CDF) is a widely used Traditional Chinese Medicine (TCM) which has been extensively applied in clinical treatment of cardiovascular diseases (CVDs). However, the underlying mechanism of clinical administrating CDF on CVDs is not clear. In this study, the pharmacological effect of CDF on CVDs was analyzed at a systemic point of view. A systems-pharmacological model based on chemical, chemogenomics and pharmacological data is developed via network reconstruction approach. By using this model, we performed a high-throughput in silico screen and obtained a group of compounds from CDF which possess desirable pharmacodynamical and pharmacological characteristics. These compounds and the corresponding protein targets are further used to search against biological databases, such as the compound-target associations, compound-pathway connections and disease-target interactions for reconstructing the biologically meaningful networks for a TCM formula. This study not only made a contribution to a better understanding of the mechanisms of CDF, but also proposed a strategy to develop novel TCM candidates at a network pharmacology level. PMID:22962593

  5. Vasoactive and antioxidant activities of plants used in Mexican traditional medicine for the treatment of cardiovascular diseases.

    PubMed

    Ibarra-Alvarado, C; Rojas, A; Mendoza, S; Bah, M; Gutiérrez, D M; Hernández-Sandoval, L; Martínez, M

    2010-07-01

    This study demonstrated that the aqueous extracts of plants employed in Mexican traditional medicine for the treatment of cardiovascular diseases are able to modify the tone of arterial smooth muscle. Agastache mexicana (Kunth) Lint & Epling (Labiatae), Chenopodium murale L. (Chenopodiaceae), Chirantodendron pentadactylon Larreat (Sterculiaceae), Dracocephalum moldavica L. (Labiatae), Psittacanthus calyculatus G. Don (Loranthaceae), Prunus serotina ssp. capuli (Cav. ex Spreng) McVaugh (Rosaceae), and Sechium edule Sw. (Cucurbitaceae) contain secondary metabolites that promote vascular relaxation and display antioxidant activities. As expected, their antioxidant effects showed a significant correlation with the polyphenolics content. However, a lower correlation was found between the antioxidant activity and the maximum vasodilatory effect, suggesting that the vasodilatation elicited by the plant extracts could be only partly attributed to their antioxidant properties. The extract of P. calyculatus, which displayed a maximum vasorelaxant effect that was higher than that of acetylcholine, induced endothelium-dependent vasodilatation. Futhermore, the vasorelaxant response to the P. calyculatus extract was reduced after adding an inhibitor of soluble guanylate cyclase activity, providing evidence that the NO/cGMP pathway is involved. On the other hand, the extracts of Bocconia frutescens L. (Papaveraceae), Magnolia grandiflora L. (Magnoliaceae), and Solanum rostratum Dunal (Solanaceae) induced concentration-dependent contraction of rat aortic rings, suggesting that these plants have potential health benefits for the treatment of ailments such as venous insufficiency. The pharmacological activities of the extracts studied provide scientific support for their ethnomedical use. PMID:20645769

  6. Vasoactive and antioxidant activities of plants used in Mexican traditional medicine for the treatment of cardiovascular diseases.

    PubMed

    Ibarra-Alvarado, C; Rojas, A; Mendoza, S; Bah, M; Gutiérrez, D M; Hernández-Sandoval, L; Martínez, M

    2010-07-01

    This study demonstrated that the aqueous extracts of plants employed in Mexican traditional medicine for the treatment of cardiovascular diseases are able to modify the tone of arterial smooth muscle. Agastache mexicana (Kunth) Lint & Epling (Labiatae), Chenopodium murale L. (Chenopodiaceae), Chirantodendron pentadactylon Larreat (Sterculiaceae), Dracocephalum moldavica L. (Labiatae), Psittacanthus calyculatus G. Don (Loranthaceae), Prunus serotina ssp. capuli (Cav. ex Spreng) McVaugh (Rosaceae), and Sechium edule Sw. (Cucurbitaceae) contain secondary metabolites that promote vascular relaxation and display antioxidant activities. As expected, their antioxidant effects showed a significant correlation with the polyphenolics content. However, a lower correlation was found between the antioxidant activity and the maximum vasodilatory effect, suggesting that the vasodilatation elicited by the plant extracts could be only partly attributed to their antioxidant properties. The extract of P. calyculatus, which displayed a maximum vasorelaxant effect that was higher than that of acetylcholine, induced endothelium-dependent vasodilatation. Futhermore, the vasorelaxant response to the P. calyculatus extract was reduced after adding an inhibitor of soluble guanylate cyclase activity, providing evidence that the NO/cGMP pathway is involved. On the other hand, the extracts of Bocconia frutescens L. (Papaveraceae), Magnolia grandiflora L. (Magnoliaceae), and Solanum rostratum Dunal (Solanaceae) induced concentration-dependent contraction of rat aortic rings, suggesting that these plants have potential health benefits for the treatment of ailments such as venous insufficiency. The pharmacological activities of the extracts studied provide scientific support for their ethnomedical use.

  7. "Beauty is a light in the heart": the transformative potential of optogenetics for clinical applications in cardiovascular medicine.

    PubMed

    Boyle, Patrick M; Karathanos, Thomas V; Trayanova, Natalia A

    2015-02-01

    Optogenetics is an exciting new technology in which viral gene or cell delivery is used to inscribe light sensitivity in excitable tissue to enable optical control of bioelectric behavior. Initial progress in the fledgling domain of cardiac optogenetics has included in vitro expression of various light-sensitive proteins in cell monolayers and transgenic animals to demonstrate an array of potentially useful applications, including light-based pacing, silencing of spontaneous activity, and spiral wave termination. In parallel to these developments, the cardiac modeling community has developed a versatile computational framework capable of realistically simulating optogenetics in biophysically detailed, patient-specific representations of the human heart, enabling the exploration of potential clinical applications in a predictive virtual platform. Toward the ultimate goal of assessing the feasibility and potential impact of optogenetics-based therapies in cardiovascular medicine, this review provides (1) a detailed synopsis of in vivo, in vitro, and in silico developments in the field and (2) a critical assessment of how existing clinical technology for gene/cell delivery and intra-cardiac illumination could be harnessed to achieve such lofty goals as light-based arrhythmia termination.

  8. High technology in medicine: lessons from cardiovascular innovations and future perspective.

    PubMed

    Beyar, Rafael

    2013-04-01

    Four decades of innovations in the field of interventional cardiology are presented as an example for the great growth of high technology in medicine, side by side with the development of general technology and science. The field of percutaneous coronary intervention (PCI) was enabled by the development of X-ray systems, allowing us to view the pathology, and was critically dependent on courageous and imaginative physicians and scientists who developed percutaneous transluminal coronary angioplasty (PTCA), stents, and transarterial aortic valve replacement (TAVR). Today, outstanding research continues to progress, with stem cell research and IPC technologies presenting new challenges and yet taller mountains to climb. The rapid development we have witnessed was due to tight collaborations between clinical and academic institutions and industry. The combination of all these elements, with a proper mechanism to handle conflict of interest, is an essential linkage for any progress in this field. We will continue to see exponential growth of innovations and must be prepared with appropriate bodies to encourage such developments and to provide early-stage funding and support for novel ideas. PMID:23908859

  9. High technology in medicine: lessons from cardiovascular innovations and future perspective.

    PubMed

    Beyar, Rafael

    2013-04-01

    Four decades of innovations in the field of interventional cardiology are presented as an example for the great growth of high technology in medicine, side by side with the development of general technology and science. The field of percutaneous coronary intervention (PCI) was enabled by the development of X-ray systems, allowing us to view the pathology, and was critically dependent on courageous and imaginative physicians and scientists who developed percutaneous transluminal coronary angioplasty (PTCA), stents, and transarterial aortic valve replacement (TAVR). Today, outstanding research continues to progress, with stem cell research and IPC technologies presenting new challenges and yet taller mountains to climb. The rapid development we have witnessed was due to tight collaborations between clinical and academic institutions and industry. The combination of all these elements, with a proper mechanism to handle conflict of interest, is an essential linkage for any progress in this field. We will continue to see exponential growth of innovations and must be prepared with appropriate bodies to encourage such developments and to provide early-stage funding and support for novel ideas.

  10. High Technology in Medicine: Lessons from Cardiovascular Innovations and Future Perspective

    PubMed Central

    Beyar, Rafael

    2013-01-01

    Four decades of innovations in the field of interventional cardiology are presented as an example for the great growth of high technology in medicine, side by side with the development of general technology and science. The field of percutaneous coronary intervention (PCI) was enabled by the development of X-ray systems, allowing us to view the pathology, and was critically dependent on courageous and imaginative physicians and scientists who developed percutaneous transluminal coronary angioplasty (PTCA), stents, and transarterial aortic valve replacement (TAVR). Today, outstanding research continues to progress, with stem cell research and IPC technologies presenting new challenges and yet taller mountains to climb. The rapid development we have witnessed was due to tight collaborations between clinical and academic institutions and industry. The combination of all these elements, with a proper mechanism to handle conflict of interest, is an essential linkage for any progress in this field. We will continue to see exponential growth of innovations and must be prepared with appropriate bodies to encourage such developments and to provide early-stage funding and support for novel ideas. PMID:23908859

  11. Application of infrared thermal imaging in the study of preventing cardiovascular and cerebrovascular diseases with Chinese medicine health food

    NASA Astrophysics Data System (ADS)

    Li, Ziru; Zhang, Xusheng

    2009-08-01

    To explore the assessing technique which could objectively reflect the characteristics of Chinese medicine in the prevention of cardiovascular and cerebrovascular diseases, four balance features of infrared thermal images (ITI) corresponding to the up and down, left and right, proximal and distal balance of blood circulation of human body were studied. First, the ITI features of the middle-aged and elderly people with lipid abnormality history were compared with those of the healthy youth. It was found that the balance state of the youth was significantly better than that of the middle-aged and elderly, P<=0.01 for all the balance features. For the youth, the balance state of females was better than that of the males. But this sexual difference disappeared for the middle-aged and elderly group. Second, a double-blind randomized trial was carried out to study the influences of Shengyi capsule, a Chinese medicine health food with the function of helping to decrease serum lipid, on the balance features. The subjects were middle-aged and elderly people with lipid abnormality history. Shengyi capsule was taken by the trial group while Xuezhikang capsule (with lovastatin as the main effective component) by the control group for 108 days. The balance features of ITI showed that Shengyi was significantly better than Xuezhikang in improving the whole body balance of blood circulation (including the up and down, left and right, proximal and distal balance). The relative efficacy rate was 81.0% for the trial group and 33.3% for the control group, there was significant difference between the two groups (P=0.002). Shengyi could effectively decrease the low density lipoprotein cholesterol (LDL-C) but the effect of Xuezhikang in decreasing total cholesterol (TC) and LDL-C was better than Shengyi. Though the lipid-lowering effect of Shengyi was not as good as Xuezhikang, ITI reflected the obvious advantage of Shengyi in improving the whole body balance of blood circulation which

  12. Use of beat-to-beat cardiovascular variability data to determine the validity of sham therapy as the placebo control in osteopathic manipulative medicine research.

    PubMed

    Henley, Charles E; Wilson, Thad E

    2014-11-01

    Osteopathic manipulative medicine researchers often use sham therapy as the placebo control during clinical trials. Optimally, the sham therapy should be a hands-on procedure that is perceptually indistinguishable from osteopathic manipulative treatment, does not create an effect on its own, and is not a treatment intervention. However, the sham therapy itself may often influence the outcome. The use of cardiovascular variability (eg, beat-to-beat heart rate variability) as a surrogate for the autonomic nervous system is one objective method by which to identify such an effect. By monitoring cardiovascular variability, investigators can assess autonomic nervous system activity as a response to the sham therapy and quickly determine whether or not the selected sham therapy is a true placebo control. The authors provide evidence for assessment of beat-to-beat heart rate variability as one method for assuring objectivity of sham therapy as a placebo control in osteopathic manipulative medicine research.

  13. Trait anxiety mimics age-related cardiovascular autonomic modulation in young adults.

    PubMed

    Sanchez-Gonzalez, M A; Guzik, P; May, R W; Koutnik, A P; Hughes, R; Muniz, S; Kabbaj, M; Fincham, F D

    2015-04-01

    Anxiety produces maladaptive cardiovascular changes and accelerates biological aging. We evaluated cardiovascular reactivity in young and middle-aged individuals with varying anxiety scores to test the hypothesis that anxiety mimics cardiovascular aging by influencing cardiovascular autonomic modulation. The State-Trait Anxiety Inventory was used to classify healthy young individuals (20-29 years) into high (YHA, n=22;10 men) and low (YLA, n=21;10 men) anxiety, and to identify middle-aged individuals (50-60 years) with low anxiety (MLA, n=22;11 men). Heart rate, blood pressure (BP) and their variability (HRV and BPV, respectively) and baroreflex function were analyzed from beat-to-beat finger BP and electrocardiogram recordings collected during 5-min baseline, 6-min speech task (ST) and 3-min post ST recovery. Analyses of covariance showed significant differences (P<0.05) at baseline for HRV, BPV and barorelfex, and low-frequency power of systolic BP variability (LFSBP) was lower, whereas baroreflex and high frequency (HF) normalized units were higher in the YLA compared with YHA and MLA groups. Compared with YLA, YHA and MLA displayed attenuated vagal withdraw response (HF) to ST. BP and LFSBP responses to ST in YHA and MLA were higher compared with the YLA group. These findings suggest that anxiety could be linked to cardiovascular aging as it attenuates cardiac reactivity and exaggerates vascular responses to stress.

  14. Staying Young at Heart: Cardiovascular Disease Prevention in Adolescents and Young Adults

    PubMed Central

    Chung, Richard J.; Touloumtzis, Currie

    2016-01-01

    OPINION STATEMENT Approaches to the prevention and management of cardiovascular disease (CVD) are often too narrow in scope and initiated too late. While the majority of adolescents are free of CVD, far fewer are free of CVD risk factors, especially lifestyle factors such as poor exercise and dietary habits. Most clinicians are familiar with behavioral and pharmacologic strategies for modifying these and other traditional CVD risk factors such as hypertension, hypercholesterolemia, and diabetes. In this review, we highlight those strategies most applicable to teens and also propose a fundamental reframing that recognizes the importance of early choices and life experiences to achieving cardiovascular health. Population- and individual-level approaches that support the establishment of positive health behaviors early in life are the foundation of preserving ideal cardiovascular health and promoting positive cardiovascular outcomes. The Positive Youth Development movement supports a frame shift away from seeing young people as merely the sum of their risk factors and instead as developmentally dynamic youth capable of making healthy choices. Informed by the Positive Youth Development framework, our approach to cardiovascular prevention among adolescents is both broad-based and proactive, paying heed as early as possible to social, familial, and developmental factors that underlie health behaviors, and employing evidence- based behavioral, pharmacologic, and surgical treatments when needed. PMID:26511137

  15. Usefulness of Left Ventricular Mass and Geometry for Determining 10-Year Prediction of Cardiovascular Disease in Adults Aged >65 Years (from the Cardiovascular Health Study).

    PubMed

    Desai, Chintan S; Bartz, Traci M; Gottdiener, John S; Lloyd-Jones, Donald M; Gardin, Julius M

    2016-09-01

    Left ventricular (LV) mass and geometry are associated with risk of cardiovascular disease (CVD). We sought to determine whether LV mass and geometry contribute to risk prediction for CVD in adults aged ≥65 years of the Cardiovascular Health Study. We indexed LV mass to body size, denoted as LV mass index (echo-LVMI), and we defined LV geometry as normal, concentric remodeling, and eccentric or concentric LV hypertrophy. We added echo-LVMI and LV geometry to separate 10-year risk prediction models containing traditional risk factors and determined the net reclassification improvement (NRI) for incident coronary heart disease (CHD), CVD (CHD, heart failure [HF], and stroke), and HF alone. Over 10 years of follow-up in 2,577 participants (64% women, 15% black, mean age 72 years) for CHD and CVD, the adjusted hazards ratios for a 1-SD higher echo-LVMI were 1.25 (95% CI 1.14 to 1.37), 1.24 (1.15 to 1.33), and 1.51 (1.40 to 1.62), respectively. Addition of echo-LVMI to the standard model for CHD resulted in an event NRI of -0.011 (95% CI -0.037 to 0.028) and nonevent NRI of 0.034 (95% CI 0.008 to 0.076). Addition of echo-LVMI and LV geometry to the standard model for CVD resulted in an event NRI of 0.013 (95% CI -0.0335 to 0.0311) and a nonevent NRI of 0.043 (95% CI 0.011 to 0.09). The nonevent NRI was also significant with addition of echo-LVMI for HF risk prediction (0.10, 95% CI 0.057 to 0.16). In conclusion, in adults aged ≥65 years, echo-LVMI improved risk prediction for CHD, CVD, and HF, driven primarily by improved reclassification of nonevents.

  16. Patterns of cardiovascular disease in a group of HIV-infected adults in Yaoundé, Cameroon

    PubMed Central

    Menanga, Alain Patrick; Ngomseu, Christelle Kougang; Jingi, Ahmadou M.; Mfangam, Brigitte Molu; Gweth, Marie Ntep; Blackett, Kathleen Ngu; Kingue, Samuel

    2015-01-01

    Background Cardiovascular disease is an increasingly important issue in human immunodeficiency viral (HIV)-infected individuals. There is dearth of information on the patterns of cardiovascular disease especially in sub-Saharan Africa (SSA) patients. This study reports on the clinical, biological, electrocardiographic and echocardiographic characteristics of a group of HIV-infected patients presenting with symptoms of heart disease in Yaoundé, Cameroon. Methods This was a cross-sectional study conducted at the Yaoundé Central Hospital and Jamot Hospital. Consenting HIV-infected adults aged ≥18 years with symptoms suggestive of heart disease were consecutively recruited between February and July 2014. All participants underwent a complete clinical examination; biological analyses including CD4 cell counts, fasting blood glucose, and serum lipids, resting electrocardiography and cardiac ultrasound, and a venous ultrasound where necessary. Results Forty four subjects (21 men) were included. Their mean age was 48 (SD 13) years. Thirty patients (68.2%) were in WHO clinical stages 3 and 4 of HIV infection, 27 (61.4%) had a CD4 cell count <200/mm3, and 31 (70.5%) were on antiretroviral therapy (ART). Hypertension (43.2%, n=19) was the most frequent cardiovascular risk factor; and dyslipidemia which was found in 17 subjects (38.6%) was significantly associated with ART (48.4% vs. 15.4%, P=0.04). Only men where smokers (23% vs. 0%, P=0.019). Exertional dyspnea (86.4%, n=38) and cough (59.1%, n=26) were the most frequent symptoms, and the clinical presentation was dominated by heart failure (75%, n=33). The most frequent echocardiographic abnormalities were pericardial effusion (45.5%, n=20) and dilated cardiomyopathy (22.7%, n=10). Dilated cardiomyopathy was significantly associated with CD4 cell counts <200/mm3 (100%, P=0.003). Primary pulmonary hypertension (PH) rate was 11.4% (n=5) and all cases occurred at CD4 cell counts ≥200/mm3 (P=0.005). The most frequent

  17. Multi-modal intervention to reduce cardiovascular risk among hypertensive older adults: Design of a randomized clinical trial

    PubMed Central

    Buford, Thomas W.; Anton, Stephen D.; Bavry, Anthony; Carter, Christy S.; Daniels, Michael J.; Pahor, Marco

    2015-01-01

    Persons aged over 65 years account for over 75% of healthcare expenditures and deaths attributable to cardiovascular disease (CVD). Accordingly, reducing CVD risk among older adults is an important public health priority. Functional status, determined by measures of physical performance, is an important predictor of cardiovascular outcomes in older adults and declines more rapidly in seniors with hypertension. To date, physical exercise is the primary strategy for attenuating declines in functional status. Yet despite the general benefits of training, exercise alone appears to be insufficient for preventing this decline. Thus, alternative or adjuvant strategies are needed to preserve functional status among seniors with hypertension. Prior data suggest that angiotensin converting enzyme inhibitors (ACEi) may be efficacious in enhancing exercise-derived improvements in functional status yet this hypothesis has not been tested in a randomized controlled trial. The objective of this randomized, double-masked pilot trial is to gather preliminary efficacy and safety data necessary for conducting a full-scale trial to test this hypothesis. Sedentary men and women ≥ 65 years of age with functional limitations and hypertension are being recruited into this 24 week intervention study. Participants are randomly assigned to one of three conditions: (1) ACEi plus exercise training, (2) thiazide diuretic plus exercise training, or (3) AT1 receptor antagonist plus exercise training. The primary outcome is change in walking speed and secondary outcomes consist of other indices of CV risk including exercise capacity, body composition, as well as circulating indices of metabolism, inflammation and oxidative stress. PMID:26115878

  18. Ideal Cardiovascular Health and the Prevalence and Progression of Coronary Artery Calcification in Adults With and Without Type 1 Diabetes

    PubMed Central

    Alman, Amy C.; Maahs, David M.; Rewers, Marian J.; Snell-Bergeon, Janet K.

    2014-01-01

    OBJECTIVE In 2010, the American Heart Association defined seven metrics (smoking, BMI, physical activity, diet, total cholesterol, blood pressure, and fasting plasma glucose) for ideal cardiovascular health (ICH). Subsequent studies have shown that the prevalence of achieving these metrics is very low in the general population. Adults with type 1 diabetes are at increased risk of cardiovascular disease (CVD), but no studies to date have been published on the prevalence of ICH in this population. RESEARCH DESIGN AND METHODS Data for this analysis were collected as part of the prospective Coronary Artery Calcification in Type 1 Diabetes study. This analysis involved 546 subjects with type 1 diabetes and 631 subjects without diabetes who had complete information for calculating the ICH metrics. RESULTS Overall, the prevalence of ICH was low in this population, with none meeting the ideal criteria for all seven metrics. The prevalence of ideal physical activity (10.0%) and diet (1.1%) were particularly low. ICH was significantly associated with both decreased prevalence (odds ratio [OR] 0.70; 95% CI 0.62–0.80) and progression (OR 0.77; 95% CI 0.66–0.90) of coronary artery calcification (CAC). CONCLUSIONS ICH is significantly associated with decreased prevalence and progression of CAC; however, prevalence of ICH metrics was low in adults both with and without type 1 diabetes. Efforts to increase the prevalence of ICH could have a significant impact on reducing the burden of CVD. PMID:24130360

  19. Multi-modal intervention to reduce cardiovascular risk among hypertensive older adults: Design of a randomized clinical trial.

    PubMed

    Buford, Thomas W; Anton, Stephen D; Bavry, Anthony A; Carter, Christy S; Daniels, Michael J; Pahor, Marco

    2015-07-01

    Persons aged over 65 years account for over 75% of healthcare expenditures and deaths attributable to cardiovascular disease (CVD). Accordingly, reducing CVD risk among older adults is an important public health priority. Functional status, determined by measures of physical performance, is an important predictor of cardiovascular outcomes in older adults and declines more rapidly in seniors with hypertension. To date, physical exercise is the primary strategy for attenuating declines in functional status. Yet despite the general benefits of training, exercise alone appears to be insufficient for preventing this decline. Thus, alternative or adjuvant strategies are needed to preserve functional status among seniors with hypertension. Prior data suggest that angiotensin converting enzyme inhibitors (ACEi) may be efficacious in enhancing exercise-derived improvements in functional status yet this hypothesis has not been tested in a randomized controlled trial. The objective of this randomized, double-masked pilot trial is to gather preliminary efficacy and safety data necessary for conducting a full-scale trial to test this hypothesis. Sedentary men and women ≥ 65 years of age with functional limitations and hypertension are being recruited into this 24 week intervention study. Participants are randomly assigned to one of three conditions: (1) ACEi plus exercise training, (2) thiazide diuretic plus exercise training, or (3) AT1 receptor antagonist plus exercise training. The primary outcome is change in walking speed and secondary outcomes consist of other indices of CV risk including exercise capacity, body composition, as well as circulating indices of metabolism, inflammation and oxidative stress. PMID:26115878

  20. [2013 Ambulatory blood pressure monitoring recommendations for the diagnosis of adult hypertension, assessment of cardiovascular and other hypertension-associated risk, and attainment of therapeutic goals (summary). Joint recommendations from the International Society for Chronobiology (ISC), American Association of Medical Chronobiology and Chronotherapeutics (AAMCC), Spanish Society of Applied Chronobiology, Chronotherapy, and Vascular Risk (SECAC), Spanish Society of Atherosclerosis (SEA), and Romanian Society of Internal Medicine (RSIM)].

    PubMed

    Hermida, Ramón C; Smolensky, Michael H; Ayala, Diana E; Portaluppi, Francesco; Crespo, Juan J; Fabbian, Fabio; Haus, Erhard; Manfredini, Roberto; Mojón, Artemio; Moyá, Ana; Piñeiro, Luis; Ríos, María T; Otero, Alfonso; Balan, Horia; Fernández, José R

    2013-01-01

    Correlation between systolic (SBP) and diastolic (DBP) blood pressure (BP) level and target organ damage, cardiovascular disease (CVD) risk, and long-term prognosis is much greater for ambulatory BP monitoring (ABPM) than daytime office measurements. The 2013 ABPM guidelines specified herein are based on ABPM patient outcomes studies and constitute a substantial revision of current knowledge. The asleep SBP mean and sleep-time relative SBP decline are the most significant predictors of CVD events, both individually as well as jointly when combined with other ABPM-derived prognostic markers. Thus, they should be preferably used to diagnose hypertension and assess CVD and other associated risks. Progressive decrease by therapeutic intervention in the asleep BP mean is the most significant predictor of CVD event-free interval. The 24 h BP mean is not recommended to diagnose hypertension because it disregards the more valuable clinical information pertaining to the features of the 24 h BP pattern. Persons with the same 24 h BP mean may display radically different 24 h BP patterns, ranging from extreme-dipper to riser types, representative of markedly different risk states. Classification of individuals by comparing office with either the 24 h or awake BP mean as "masked normotensives" (elevated clinic BP but normal ABPM), which should replace the terms of "isolated office" or "white-coat hypertension", and "masked hypertensives" (normal clinic BP but elevated ABPM) is misleading and should be avoided because it disregards the clinical significance of the asleep BP mean. Outcome-based ABPM reference thresholds for men, which in the absence of compelling clinical conditions are 135/85 mmHg for the awake and 120/70 mmHg for the asleep SBP/DBP means, are lower by 10/5 mmHg for SBP/DBP in uncomplicated, low-CVD risk, women and lower by 15/10 mmHg for SBP/DBP in male and female high-risk patients, e.g., with diabetes, chronic kidney disease (CKD), and/or past CVD events. In

  1. The Development of a Model for Adult Education in Nutrition and Cardiovascular Disease.

    ERIC Educational Resources Information Center

    Walker, Susan K.; Villano, Maurice W.

    Two nutrition education modules were developed on cardiovascular disease and fat-controlled diet consisting of a self-instruction leader's guide and teaching package to conduct learning sessions for the participants. The sessions consisted of an audio-visual presentation, situations related to the module topic, group discussion, role-playing,…

  2. Ethnic Pride and Cardiovascular Health among Mexican American Adults along the U.S.-Mexico Border

    ERIC Educational Resources Information Center

    de Heer, Hendrik Dirk; Balcazar, Hector G; Lee Rosenthal, E.; Cardenas, Victor M; Schulz, Leslie O.

    2011-01-01

    This study addressed the association between items from the General Acculturation Index (GAI) and cardiovascular health. Specifically, we assessed whether ethnic pride was associated with health outcomes after controlling for items regarding language, place where the childhood was spent, and ethnic interaction. The study was a cross-sectional…

  3. [Cardiovascular disease prevention in adults with type 2 diabetes mellitus according to the recent statement from the American Heart Association/American Diabetes Association].

    PubMed

    Avogaro, Angelo

    2016-03-01

    There is a clear epidemiologic association between glycemic control and cardiovascular disease. There is strong evidence of a microvascular benefit by lowering glycated hemoglobin <7% while acknowledging lack of proven macrovascular benefits. It is therefore relevant, in all diabetic patients, to control all major cardiovascular risk factors such as obesity, hypertension, and dyslipidemia. These risk factors, easily measurable, account for 90% of acute myocardial infarction. In this review, the update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus from the American Heart Association and the American Diabetes Association is discussed and commented.

  4. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    MedlinePlus

    ... volunteer group of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, ...

  5. Access to Diagnostic Tests and Essential Medicines for Cardiovascular Diseases and Diabetes Care: Cost, Availability and Affordability in the West Region of Cameroon

    PubMed Central

    Jingi, Ahmadou M.; Noubiap, Jean Jacques N.; Ewane Onana, Arnold; Nansseu, Jobert Richie N.; Wang, Binhuan; Kingue, Samuel; Kengne, André Pascal

    2014-01-01

    Objective To assess the availability and affordability of medicines and routine tests for cardiovascular disease (CVD) and diabetes in the West region of Cameroon, a low-income setting. Methods A survey was conducted on the availability and cost of twelve routine tests and twenty medicines for CVD and diabetes in eight health districts (four urban and four rural) covering over 60% of the population of the region (1.8 million). We analyzed the percentage of tests and medicines available, the median price against the international reference price (median price ratio) for the medicines, and affordability in terms of the number of days’ wages it would cost the lowest-paid unskilled government worker for initial investigation tests and procurement for one month of treatment. Results The availability of tests varied between 10% for the ECG to 100% for the fasting blood sugar. The average cost for the initial investigation using the minimum tests cost 29.76 days’ wages. The availability of medicines varied from 36.4% to 59.1% in urban and from 9.1% to 50% in rural settings. Only metformin and benzathine-benzylpenicilline had a median price ratio of ≤1.5, with statins being largely unaffordable (at least 30.51 days’ wages). One month of combination treatment for coronary heart disease costs at least 40.87 days’ wages. Conclusion The investigation and management of patients with medium-to-high cardiovascular risk remains largely unavailable and unaffordable in this setting. An effective non-communicable disease program should lay emphasis on primary prevention, and improve affordable access to essential medicines in public outlets. PMID:25369455

  6. Clinical and Pre-clinical Applications of the Transcendental Meditation Program in the Prevention and Treatment of Essential Hypertension and Cardiovascular Disease in Youth and Adults.

    PubMed

    Barnes, Vernon A; Orme-Johnson, David W

    2006-08-01

    Acute and chronic environmental and psychosocial stress contributes to the pathogenesis and progression of cardiovascular diseases (CVD). Stress reduction via Transcendental Meditation (TM)® has been shown to lower blood pressure (BP) levels and reduce CVD risk in adults and adolescents. This article reviews recent findings indicating a beneficial BP-lowering impact of TM in hypertensive adults at rest and in pre-hypertensive adolescents at rest, during acute laboratory stress and during normal daily activity. These findings have important implications for inclusion of TM in efforts to prevent and treat cardiovascular diseases and its clinical consequences.

  7. Clinical and Pre-clinical Applications of the Transcendental Meditation Program® in the Prevention and Treatment of Essential Hypertension and Cardiovascular Disease in Youth and Adults

    PubMed Central

    Barnes, Vernon A.; Orme-Johnson, David W.

    2012-01-01

    Acute and chronic environmental and psychosocial stress contributes to the pathogenesis and progression of cardiovascular diseases (CVD). Stress reduction via Transcendental Meditation (TM)® has been shown to lower blood pressure (BP) levels and reduce CVD risk in adults and adolescents. This article reviews recent findings indicating a beneficial BP-lowering impact of TM in hypertensive adults at rest and in pre-hypertensive adolescents at rest, during acute laboratory stress and during normal daily activity. These findings have important implications for inclusion of TM in efforts to prevent and treat cardiovascular diseases and its clinical consequences. PMID:22383899

  8. Use of complementary and alternative medicine by older adults – a cross-sectional survey

    PubMed Central

    2014-01-01

    Background Very little is known about complementary and alternative medicine (CAM) use by older adults in Germany. The aim of this study was to investigate the use of CAM and other health promoting substances (e.g., herbal teas) by older adults of at least 70 years of age. Methods A cross-sectional questionnaire study was conducted among persons of ≥70 years from metropolitan Berlin and rural parts of Brandenburg, Germany. Recorded were: demographics, current use of CAM, medical diagnoses, users’ opinions and preferences. Results A total of 400 older adults, living as ‘self-reliant’ (n = 154), ‘home care service user’ (n = 97), or ‘in nursing home’ (n = 149), and with the legal status ‘without guardian’ (n = 355) or ‘with guardian’ (n = 45) were included (mean age 81.8 ± 7.4 years, 78.5% female). Any type of CAM used 61.3% of respondents (dietary supplements 35.5%, herbal medicines 33.3%, and external preparations 26.8%); 3.0% used drug-interaction causing preparations. Usage was based on recommendations (total 30.3%; in 20.0% by friends or family and 10.4% by pharmacists), own initiative (27.3%), and doctors’ prescription (25.8%). Participants with legal guardian took almost solely prescribed dietary supplements. Of the others, only half (58.7%) informed their general practitioner (GP) of their CAM use. Participants expected significant (44.9%) or moderate (37.1%) improvement; half of them perceived a good effect (58.7%) and two-thirds (64.9%) generally preferred a combination of CAM and conventional medicine. More than half (57.9%) stated that they could neither assess whether their CAM preparations have side effects, nor assess what the side effects might be. Strongest predictors for CAM use were two treatment preferences (vs. ‘conventional only’: ‘CAM only’, OR = 3.98, p = 0.0042 and ‘CAM + conventional’, 3.02, 0.0028) and the type of health insurance (‘statutory’ vs. ‘private’, 3.57, 0.0356); against CAM use two

  9. The relation of leptin and insulin with obesity-related cardiovascular risk factors in US adults.

    PubMed

    Reis, Jared P; Macera, Caroline A; Wingard, Deborah L; Araneta, Maria Rosario G; Lindsay, Suzanne P; Marshall, Simon J

    2008-09-01

    Previous studies of leptin with cardiovascular disease (CVD) risk factors have been limited by clinical samples or lack of representation of the general population. This cross-sectional study, designed to examine whether leptin or insulin may mediate the endogenous relation of obesity with metabolic, inflammatory, and thrombogenic cardiovascular risk factors, included 522 men and 514 women aged >or=40 years who completed a physical examination during the third National Health and Nutrition Examination Survey. Participants were free of existing CVD, cancer (except non-melanoma skin cancer), diabetes, or respiratory disease. In multivariable analyses adjusted for race/ethnicity and lifestyle factors, waist circumference (WC) was positively associated with blood pressure, triglyceride, LDL cholesterol, total cholesterol:HDL ratio, apolipoprotein B, C-reactive protein (CRP), and fibrinogen concentrations, and negatively associated with HDL cholesterol and apolipoprotein A1 levels. The associations of WC with the metabolic CVD risk factors were largely attenuated after adjustment for insulin levels, while the associations of WC with the inflammatory and thrombogenic factors (CRP and fibrinogen, respectively) were largely explained by adjustment for leptin concentrations. However, leptin levels were not independently associated with CRP and fibrinogen in men and CRP in women when adjusted for WC. Positive associations of leptin and insulin with fibrinogen in women, independent of WC, were noted. These results suggest that insulin may be an important mediator of the association of obesity with metabolic but not inflammatory or thrombogenic CVD risk factors, while leptin does not appear to influence cardiovascular risk through a shared association with these risk factors. However, we cannot rule out the possibility that leptin and insulin influence cardiovascular risk in women through independent effects on fibrinogen concentrations. PMID:18160070

  10. Role of the kidney in the fetal programming of adult cardiovascular disease: an update.

    PubMed

    Singh, Reetu R; Denton, Kate M

    2015-04-01

    It is well established that an adverse in utero environment can impinge upon fetal development and place the offspring on a track leading to future cardiovascular disease. Significantly, this may occur in the absence of any outward manifestations at birth. In this brief review, we focus on potential renal mechanisms that lead to adaptations in glomerular and tubular function that initiate hypertension of developmental origin and examine potential therapeutic interventions. This report updates recent data in this field. PMID:25588322

  11. Using Photovoice to Understand Barriers to and Facilitators of Cardiovascular Health Among African American Adults and Adolescents, North Carolina, 2011–2012

    PubMed Central

    Woods-Jaeger, Briana; Lomas, Jesse; Taggart, Tamara; Thayer, Linden; Sutton, Sussie; Lightfoot, Alexandra F.

    2015-01-01

    Introduction Cardiovascular disease is the leading cause of death in the United States, and mortality rates are higher among African Americans than among people of other races/ethnicities. We aimed to understand how African American adults and adolescents conceptualize cardiovascular health and perceive related barriers and facilitators. Methods This qualitative study was conducted as formative research for a larger study, Heart Healthy Lenoir, which aimed to reduce cardiovascular disease disparities among African Americans in eastern North Carolina, part of the widely-known “stroke belt” that runs through the southeastern United States. Using photovoice, a community-based participatory research method, we conducted eight 90-minute photovoice sessions with 6 adults and 9 adolescents in Lenoir County, North Carolina. Topics for each discussion were selected by participants and reflected themes related to cardiovascular health promotion. All sessions were transcribed and coded using a data-driven, inductive approach. Results Participants conceptualized cardiovascular health to have mental, spiritual, and social health dimensions. Given these broad domains, participants acknowledged many ecological barriers to cardiovascular health; however, they also emphasized the importance of personal responsibility. Facilitators for cardiovascular health included using social health (eg, family/community relationships) and spiritual health dimensions (eg, understanding one’s body and purpose) to improve health behaviors. Conclusion The perspectives of African American adults and adolescents elicited through this formative research provided a strong foundation for Heart Healthy Lenoir’s ongoing engagement of community members in Lenoir County and development and implementation of its intervention to prevent cardiovascular disease. PMID:26425868

  12. Effect of anger and trait forgiveness on cardiovascular risk in young adult females.

    PubMed

    May, Ross W; Sanchez-Gonzalez, Marcos A; Hawkins, Kirsten A; Batchelor, Wayne B; Fincham, Frank D

    2014-07-01

    High trait anger is linked to adverse cardiovascular outcomes. A potential antidote to the cardiotoxic influence of anger is trait forgiveness (TF), as it has shown associations with improved blood pressure (BP) and cardiovagal tone regulation in cardiac patients. However, it has yet to be determined if anger and forgiveness independently predict cardiovascular parameters. Trait anger (State-Trait Anger Expression Inventory-2) and TF (Tendency to Forgive Scale) were evaluated in 308 (M = 21.11years ± SD = 2.52) healthy female volunteers allocated to 3 related, yet distinct, studies. Hierarchical multiple regressions tested the incremental contribution of TF after accounting for anger. Study 1 assessed autonomic modulation through beat-to-beat BP and spectral analysis to examine sympathovagal balance and baroreflex functioning. Study 2 used tonometry and pulse wave analysis for aortic hemodynamics. Study 3 assessed 24-hour ambulatory BP and ambulatory arterial stiffness index. Hierarchical models demonstrated that anger was significantly associated with increased sympathovagal tone, increased hemodynamic indices, high ambulatory BPs, and attenuated BP variability and baroreflex. In contrast, TF was associated with more favorable hemodynamic effects (i.e., decreased ventricular work and myocardial oxygen consumption). In conclusion, these results demonstrate divergent cardiovascular effects of anger and forgiveness, such that anger is associated with a more cardiotoxic autonomic and hemodynamic profile, whereas TF is associated with a more cardioprotective profile. These findings suggest that interventions aimed at decreasing anger while increasing forgiveness may be clinically relevant.

  13. Transitioning adolescents with HIV to adult care: Lessons learned from twelve adolescent medicine clinics

    PubMed Central

    Tanner, Amanda E.; Philbin, Morgan M.; DuVal, Anna; Ellen, Jonathan; Kapogiannis, Bill; Fortenberry, J. Dennis

    2016-01-01

    Purpose To maximize positive health outcomes for youth with HIV as they transition from youth to adult care, clinical staff need strategies and protocols to help youth maintain clinic engagement and medication adherence. Accordingly, this paper describe transition processes across twelve clinics within the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) to provide lessons learned and inform the development of transition protocols to improve health outcomes as youth shift from adolescent to adult HIV care. Design and Methods During a large multi-method Care Initiative program evaluation, three annual visits were completed at each site from 2010–2012 and conducted 174 semi-structured interviews with clinical and program staff (Baseline n=64, Year 1 n=56, Year 2=54). Results The results underscore the value of adhering to recent American Academy of Pediatrics (AAP) transition recommendations, including: developing formal transition protocols, preparing youth for transition, facilitating youth’s connection to the adult clinic, and identifying necessary strategies for transition evaluation. Conclusions Transitioning youth with HIV involves targeting individual-, provider-, and system-level factors. Acknowledging and addressing key barriers is essential for developing streamlined, comprehensive, and context-specific transition protocols. Practice Implications Adolescent and adult clinic involvement in transition is essential to reduce service fragmentation, provide coordinated and continuous care, and support individual and community level health. PMID:27133767

  14. 2010 Canadian Cardiovascular Society/Canadian Society of Echocardiography Guidelines for Training and Maintenance of Competency in Adult Echocardiography.

    PubMed

    Burwash, Ian G; Basmadjian, Arsene; Bewick, David; Choy, Jonathan B; Cujec, Bibiana; Jassal, Davinder S; MacKenzie, Scott; Nair, Parvathy; Rudski, Lawrence G; Yu, Eric; Tam, James W

    2011-01-01

    Guidelines for the provision of echocardiography in Canada were jointly developed and published by the Canadian Cardiovascular Society and the Canadian Society of Echocardiography in 2005. Since their publication, recognition of the importance of echocardiography to patient care has increased, along with the use of focused, point-of-care echocardiography by physicians of diverse clinical backgrounds and variable training. New guidelines for physician training and maintenance of competence in adult echocardiography were required to ensure that physicians providing either focused, point-of-care echocardiography or comprehensive echocardiography are appropriately trained and proficient in their use of echocardiography. In addition, revision of the guidelines was required to address technological advances and the desire to standardize echocardiography training across the country to facilitate the national recognition of a physician's expertise in echocardiography. This paper summarizes the new Guidelines for Physician Training and Maintenance of Competency in Adult Echocardiography, which are considerably more comprehensive than earlier guidelines and address many important issues not previously covered. These guidelines provide a blueprint for physician training despite different clinical backgrounds and help standardize physician training and training programs across the country. Adherence to the guidelines will ensure that physicians providing echocardiography have acquired sufficient expertise required for their specific practice. The document will also provide a framework for other national societies to standardize their training programs in echocardiography and will provide a benchmark by which competency in adult echocardiography may be measured.

  15. FDA regulation of adult stem cell therapies as used in sports medicine.

    PubMed

    Chirba, Mary Ann; Sweetapple, Berkley; Hannon, Charles P; Anderson, John A

    2015-02-01

    In sports medicine, adult stem cells are the subject of great interest. Several uses of stem cells are under investigation including cartilage repair, meniscal regeneration, anterior cruciate ligament reconstruction, and tendinopathy. Extensive clinical and basic science research is warranted as stem cell therapies become increasingly common in clinical practice. In the United States, the Food and Drug Administration (FDA) is responsible for regulating the use of stem cells through its "Human Cells, Tissues, and Cellular and Tissue-Based Products" regulations. This report provides a brief overview of FDA regulation of adult stem cells. Several common clinical case scenarios are then presented that highlight how stem cells are currently being used in sports medicine and how current FDA regulations are likely to affect the physicians who use them. In the process, it explains how a variety of factors in sourcing and handling these cells, particularly the extent of cell manipulation, will affect what a physician can and cannot do without first obtaining the FDA's express approval.

  16. The Use of Complementary and Alternative Medicine among Lebanese Adults: Results from a National Survey

    PubMed Central

    Naja, F.; Alameddine, M.; Itani, L.; Shoaib, H.; Hariri, D.; Talhouk, S.

    2015-01-01

    Objective. To examine the prevalence and correlates of Complementary and Alternative Medicine (CAM) use in Lebanon. Methods. A cross-sectional survey was conducted through face to face interviews on a nationally representative sample of 1,475 Lebanese adults. The survey questionnaire explored the sociodemographic and health related characteristics as well as the types and modes of CAM use. The main outcome in this study was the use of CAM during the last 12 months. Results. Prevalence of CAM use was 29.87% with “folk herbs” being the most commonly used (75%). Two out of five CAM users indicated using it as alternative to conventional therapies and only 28.4% of users disclosed the use of CAM to their physician. CAM use was significantly associated with higher income, presence of a chronic disease, and lack of access to needed health care. Lower odds of CAM use were observed among older adults and those with a higher education level. Conclusions. This study revealed a high prevalence of CAM use in Lebanon. Health policy and decision makers need to facilitate proper regulation and integration of CAM into mainstream medicine and educate health care providers and the public alike on the safe and effective use of CAM therapies. PMID:26106436

  17. Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults

    PubMed Central

    Knowles, K. M.; Paiva, L. L.; Sanchez, S. E.; Revilla, L.; Lopez, T.; Yasuda, M. B.; Yanez, N. D.; Gelaye, B.; Williams, M. A.

    2011-01-01

    Objectives. To examine the extent to which measures of adiposity can be used to predict selected components of metabolic syndrome (MetS) and elevated C-reactive protein (CRP). Methods. A total of 1,518 Peruvian adults were included in this study. Waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), and visceral adiposity index (VAI) were examined. The prevalence of each MetS component was determined according to tertiles of each anthropometric measure. ROC curves were used to evaluate the extent to which measures of adiposity can predict cardiovascular risk. Results. All measures of adiposity had the strongest correlation with triglyceride concentrations (TG). For both genders, as adiposity increased, the prevalence of Mets components increased. Compared to individuals with low-BMI and low-WC, men and women with high-BMI and high- WC had higher odds of elevated fasting glucose, blood pressure, TG, and reduced HDL, while only men in this category had higher odds of elevated CRP. Overall, the ROCs showed VAI, WC, and WHtR to be the best predictors for individual MetS components. Conclusions. The results of our study showed that measures of adiposity are correlated with cardiovascular risk although no single adiposity measure was identified as the best predictor for MetS. PMID:21331161

  18. Association between Noninvasive Fibrosis Markers and Cardio-Vascular Organ Damage among Adults with Hepatic Steatosis

    PubMed Central

    Sesti, Giorgio; Sciacqua, Angela; Fiorentino, Teresa Vanessa; Perticone, Maria; Succurro, Elena; Perticone, Francesco

    2014-01-01

    Evidence suggests that advanced fibrosis, as determined by the noninvasive NAFLD fibrosis score (NFS), is a predictor of cardiovascular mortality in individuals with ultrasonography-diagnosed NAFLD. Whether the severity of histology (i.e., fibrosis stage) is associated with more pronounced cardiovascular organ damage is unsettled. In this study, we analyzed the clinical utility of NFS in assessing increased carotid intima-media thickness (cIMT), and left ventricular mass index (LVMI). In this cross-sectional study NFS, cIMT and LVMI were assessed in 400 individuals with ultrasonography-diagnosed steatosis. As compared with individuals at low probability of liver fibrosis, individuals both at high and at intermediate probability of fibrosis showed an unfavorable cardio-metabolic risk profile having significantly higher values of waist circumference, insulin resistance, high sensitivity C-reactive protein (hsCRP), fibrinogen, cIMT, and LVMI, and lower insulin-like growth factor-1 (IGF-1) levels. The differences in cIMT and LVMI remained significant after adjustment for smoking and metabolic syndrome. In a logistic regression model adjusted for age, gender, smoking, and diagnosis of metabolic syndrome, individuals at high probability of fibrosis had a 3.9-fold increased risk of vascular atherosclerosis, defined as cIMT>0.9 mm, (OR 3.95, 95% CI 1.12–13.87) as compared with individuals at low probability of fibrosis. Individuals at high probability of fibrosis had a 3.5-fold increased risk of left ventricular hypertrophy (LVH) (OR 3.55, 95% CI 1.22–10.34) as compared with individuals at low probability of fibrosis. In conclusion, advanced fibrosis, determined by noninvasive fibrosis markers, is associated with cardiovascular organ damage independent of other known factors. PMID:25111713

  19. Designing and standardizing a questionnaire for evaluating knowledge, attitude, and practice of Iranian adults with cardiovascular diseases about oral health

    PubMed Central

    Rasouli-Ghahroudi, Amir Alireza; Rokn, Amir Reza; Khorsand, Afshin; Aghajani, Hasan; Amini, Afshin; Shamshiri, Ahmad Reza; Rahimi, Hamed; Kabir, Ali

    2013-01-01

    BACKGROUND Cardiovascular diseases are the most common cause of death in Iran. Moreover, periodontal diseases are very common in our country. In this study, we have designed a standardized questionnaire for evaluating knowledge, attitude, and practice (KAP) of Iranian adult patients with cardiovascular diseases about oral health. METHODS For designing and standardizing a self-administered questionnaire, we performed a cross-sectional pilot study on 51 cases with periodontal complaints. A dentist carried out the physical examination to determine oral health indicators. Twelve experts and ten lay people of the target population answered questions about validity. Cronbach’s alpha, factor analysis, and Pearson correlation coefficients were used in the analysis. RESULTS The cases of this pilot study were middle aged, with moderate financial and health status, but low oral health and educational level. Debris score was correlated with all other physical exam findings except decay, missing, and filled (DMF). Reliability was 0.826 according to Cronbach’s alpha score. Face validity was higher than 80%. Content validities of the whole of the questionnaire were 85.98% for clarity, 78.05% for relevancy, 85.16% for simplicity, and 82.32% for consistency of each question with the question set. Factor analysis showed that 15 components explain 74% of the total variance. CONCLUSION This questionnaire is culturally adjusted and appropriate for our community, valid and reliable, and sufficiently estimates the variance of the oral health status. It can be used as a standard tool in further studies in adult population of the Iranian middle aged patients with low level of education and moderate socioeconomic status. PMID:24575138

  20. Adult stem cells: simply a tool for regenerative medicine or an additional piece in the puzzle of human aging?

    PubMed

    Tollervey, James R; Lunyak, Victoria V

    2011-12-15

    Adult stem cells have taken center stage in current research related to regenerative medicine and pharmacogenomic studies seeking new therapeutic interventions. As we learn more about these cells, it is becoming apparent that the next big leap in our understanding of adult stem cell biology and adult stem cell aging will depend on the integration of approaches from various disciplines. Major advances and technological breakthroughs at the crossroad of fields such as biomaterials, genomics, epigenomics, and proteomics will enable the design of better tools to model human diseases, and warrant safe usage of adult stem cells in the clinic.

  1. Congenital cardiovascular disease in Turner syndrome.

    PubMed

    Bondy, Carolyn A

    2008-01-01

    Turner syndrome (TS), or monosomy X, occurs in approximately 1/2000 live born females. Intelligence is normal and short stature is the most obvious and consistent feature of the syndrome. Congenital cardiovascular disease affects approximately 50% of individuals and is the major cause of premature mortality in adults. Unfortunately, this most important aspect of the syndrome has received little attention outside of pediatric medicine, and adult cardiological follow-up is seriously lacking. This review describes the spectrum of cardiovascular defects with particular attention to identifying risk factors for aortic dissection/rupture. X-chromosome genetic pathways implicated in Turner cardiovascular disease, including premature coronary artery disease, are discussed. Recent guidelines for diagnosis and treatment of girls and women with TS are reviewed.

  2. Tree nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in U.S adults: NHANES 2005-2010

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Previous research has shown inconsistencies in the association of tree nut consumption with risk factors for cardiovascular disease (CVD) and metabolic syndrome (MetS). To determine the association of tree nut consumption with risk factors for CVD and for MetS in adults. NHANES 2005-2010 data were u...

  3. Diet Quality of Urban Older Adults Aged 60-99: The Cardiovascular Health of Seniors and Built Environment Study

    PubMed Central

    Deierlein, Andrea L.; Morland, Kimberly B.; Scanlin, Kathleen; Wong, Sally; Spark, Arlene

    2013-01-01

    There are few studies that evaluate dietary intakes and predictors of diet quality in older adults. The objectives of this study were to describe nutrient intakes and examine associations between demographic, economic, behavioral, social environment, and health status factors and diet quality. Cross-sectional data was from Black, White, and Hispanic adults ages 60-99 years, living independently in New York City and participating in the Cardiovascular Health of Seniors and the Built Environment Study, 2009-2011 (n=1306). Multivariable log-linear regression estimated associations between selected factors and good diet quality, defined as a Healthy Eating Index score based on the 2005 Dietary Guidelines for Americans (HEI-2005)>80. Dietary intakes were similar for men and women; intakes of energy, fiber, and the majority of micronutrients were below recommendations, while intakes of fats, added sugar, and sodium were within the upper range or exceeded recommendations. Hispanic ethnicity (Relative Risk, RR=1.37; 95% Confidence Interval, CI, 1.07-1.75), caloric intake <~1500 calories/day (RR=1.93; 95%CI, 1.37-2.71), adherence to a special diet (RR=1.23; 95%CI: 1.02-1.50), purchasing food at supermarkets at least once/week (RR=1.34; 95%CI, 1.04-1.74), and being married/living with a partner (RR=1.37; 95%CI, 1.10-1.71) were positively associated with HEI-2005>80. Consuming at least restaurant one meal/day was negatively associated with HEI-2005>80 (RR=0.69; 95%CI, 0.50-0.94). These findings identify specific groups of older adults, such as Blacks or those who live alone, who may benefit from dietary interventions, as well as specific modifiable behaviors among older adults, such as eating restaurant meals or shopping at supermarkets, which may be targeted through interventions. PMID:24262516

  4. Sex Differences in the Use of Complementary and Alternative Medicine among Adults with Multiple Chronic Conditions

    PubMed Central

    Alwhaibi, Monira; Sambamoorthi, Usha

    2016-01-01

    Objective. To examine sex differences in complementary and alternative medicine (CAM) use among adults with multiple chronic conditions. Methods. This study used a cross-sectional design with data from the 2012 National Health Interview Survey. The participants were interviewed in 2012 and the reference period for the questions in the survey varied from 1 week to 12 months prior to the interview date. The study included adults (age > 21 years) with no missing data on CAM use variables and who had multiple chronic conditions. Multivariable regression analyses were used to examine the association between sex and CAM use. Results. A significantly higher percentage of women compared to men had ever used CAM (51.5% versus 44.3%); women were more likely to have ever used CAM (AOR = 1.49, 95% CI = 1.35–1.65). Among CAM users, a higher percentage of women compared to men used CAM in the past 12 months (53.5% vs. 42.7%); women were more likely to use CAM in the past 12 months (AOR = 1.71, 95% CI = 1.49–1.97). Factors associated with CAM use in the past 12 months were different for men and women; income and obesity were associated with CAM use in the past 12 months among women and not among men. Conclusion. Among adults with multiple chronic conditions, women were more likely to use CAM as compared to men. PMID:27239207

  5. Differences in Cardiovascular Disease Risk between Nondiabetic Adults with Mental Retardation with and without Down Syndrome.

    ERIC Educational Resources Information Center

    Draheim, Christopher C.; McCubbin, Jeffrey A.; Williams, Daniel P.

    2002-01-01

    A study compared components of insulin resistance syndrome between 75 adults with Down syndrome and 70 with mental retardation. Women with Down syndrome had lower fasting plasma glucose and lower systolic blood pressure than comparison women. Men with Down syndrome had lower systolic and diastolic blood pressure than comparison men. (Contains…

  6. Metabolic and Cardiovascular Responses during Aquatic Exercise in Water at Different Temperatures in Older Adults

    ERIC Educational Resources Information Center

    Bergamin, Marco; Ermolao, Andrea; Matten, Sonia; Sieverdes, John C.; Zaccaria, Marco

    2015-01-01

    Purpose: The aim of this study was to investigate the physiological responses during upper-body aquatic exercises in older adults with different pool temperatures. Method: Eleven older men (aged 65 years and older) underwent 2 identical aquatic exercise sessions that consisted of 3 upper-body exercises using progressive intensities (30, 35, and 40…

  7. Effects of Physical Training on Cardiovascular Fitness and Behavior Patterns of Mentally Retarded Adults.

    ERIC Educational Resources Information Center

    Schurrer, Rob; And Others

    1985-01-01

    Five mentally retarded adults participated in an ongoing walk-jogging program for 23 weeks. Assessments for maximal oxygen comsumption (VO2 max) and body weight changes before and after training revealed Ss's body weight was reduced by 3.6 kg and VO2 max increased 43 percent. Favorable behavior changes were also noted. (CL)

  8. Telmisartan to Reduce Cardiovascular Risk in Older HIV-Infected Adults: A Pilot Study

    PubMed Central

    2015-01-01

    Background HIV-infected persons are at increased cardiovascular disease (CVD) risk, but traditional CVD therapies are understudied in this population. Telmisartan is an angiotensin receptor blocker and PPAR-γ agonist that improves endothelial function and cardiovascular mortality in HIV-uninfected populations. We assessed the effects of telmisartan on endothelial function in older HIV-infected persons at risk for CVD in a small pilot study. Methods HIV-infected individuals ≥50 years old on suppressive antiretroviral therapy (ART) with ≥1 traditional CVD risk factor received open label telmisartan 80 mg daily for six weeks. Brachial artery flow-mediated dilation (FMD) measured endothelial function. The primary endpoint was six-week change in maximum relative FMD. Results Seventeen participants enrolled; 16 completed all evaluations (88% men, 65% non-White, median age 60 years, CD4+ T lymphocyte count 625 cells/mm3). ART included 71% PI, 29% NNRTI, 29% integrase inhibitor, 65% tenofovir and 29% abacavir. CVD risk factor prevalence included 76% hyperlipidemia, 65% hypertension, 18% smoking and 12% diabetes mellitus. After six weeks, statistically significant blood pressure changes were observed (systolic −16.0 mmHg, diastolic −6.0 mmHg) without significant changes in FMD. In subset analyses, FMD increased more among abacavir-treated, PI-treated and non-smoking participants. Conclusions No significant FMD changes were observed after six weeks of telmisartan therapy; however, abacavir- and PI-treated participants and non-smokers showed greater FMD increases. Additional studies are needed to explore the effects of telmisartan on endothelial function among HIV-infected individuals with traditional CVD and/or ART-specific risk factors. PMID:26360501

  9. Strengthening psychology's workforce for older adults: Implications of the Institute of Medicine's report to Congress.

    PubMed

    Hoge, Michael A; Karel, Michele J; Zeiss, Antonette M; Alegria, Margarita; Moye, Jennifer

    2015-04-01

    Professional psychology faces an urgent crisis, which the following facts paint in stark relief. Adults over age 65 will rise to 20% of the U.S. population over the next 15 years and already account for a third of the country's health care expenditures. Up to 8 million older adults experience mental health and substance use conditions in a given year, yet most psychologists receive no training in their assessment and treatment. No more than an estimated 4%, or 3,000, psychologists nationwide specialize in geropsychology; a ratio approaching 3,000 to 1. A small group of advocates within the profession have sounded the alarm and worked to strengthen geropsychology as a specialty, but this has had very limited impact on the actual supply of psychologists qualified to provide services to this population. In 2012, an Institute of Medicine (IOM) committee released a report on the crisis regarding the mental health and substance use workforce for older adults. Drawing on that report, a team composed of geropsychologists, along with psychologists who served on the IOM committee, identifies in this article priority areas for workforce development. The authors assess the progress of psychology in each of these areas and offer a set of recommendations for future efforts by this profession to develop its own workforce and to strengthen the ability of other caregivers to address the behavioral health needs of older adults. Strengthening its own workforce and responding to the needs of this population is imperative if psychology is to maintain its relevance as a health profession and meet its ethical obligations to an increasingly diverse society. PMID:25844650

  10. Translating personality psychology to help personalize preventive medicine for young adult patients.

    PubMed

    Israel, Salomon; Moffitt, Terrie E; Belsky, Daniel W; Hancox, Robert J; Poulton, Richie; Roberts, Brent; Thomson, W Murray; Caspi, Avshalom

    2014-03-01

    The rising number of newly insured young adults brought on by health care reform will soon increase demands on primary care physicians. Physicians will face more young adult patients, which presents an opportunity for more prevention-oriented care. In the present study, we evaluated whether brief observer reports of young adults' personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Following the cohort of 1,000 individuals from the Dunedin Multidisciplinary Health and Development Study (Moffitt, Caspi, Rutter, & Silva, 2001), we show that very brief measures of young adults' personalities predicted their midlife physical health across multiple domains (metabolic abnormalities, cardiorespiratory fitness, pulmonary function, periodontal disease, and systemic inflammation). Individuals scoring low on the traits of Conscientiousness and Openness to Experience went on to develop poorer health even after accounting for preexisting differences in education, socioeconomic status, smoking, obesity, self-reported health, medical conditions, and family medical history. Moreover, personality ratings from peer informants who knew participants well, and from a nurse and receptionist who had just met participants for the first time, predicted health decline from young adulthood to midlife despite striking differences in level of acquaintance. Personality effect sizes were on par with other well-established health risk factors such as socioeconomic status, smoking, and self-reported health. We discuss the potential utility of personality measurement to function as an inexpensive and accessible tool for health care professionals to personalize preventive medicine. Adding personality information to existing health care electronic infrastructures could also advance personality theory by generating opportunities to examine how personality processes influence doctor-patient communication, health service use, and patient

  11. Bariatric and Metabolic Surgery in Adolescents: a Path to Decrease Adult Cardiovascular Mortality.

    PubMed

    Beamish, Andrew James; Olbers, Torsten

    2015-09-01

    Obesity is a major health problem across all age groups and has escalated to pandemic proportions. The proportion of children with overweight or obesity has risen rapidly over recent decades, and it is recognized that most obese children become obese adults. Furthermore, BMI is the strongest CV risk factor to track from childhood into adulthood. As well as BMI, multiple CV risk factors begin in childhood and strong associations between these factors and BMI are evident. Clear evidence exists for the CV benefits of reversing obesity in adults, much of which examines the effects of bariatric surgery. The capacity of bariatric surgery to reliably achieve safe and lasting improvement in BMI is unparalleled, and the emerging evidence base in adolescent bariatric surgery has so far concurred. In the absence of effective alternatives, it appears that the increase in use of bariatric surgery in adolescents will continue.

  12. Medicines

    MedlinePlus

    ... better. In the United States, the Food and Drug Administration is in charge of assuring the safety ... prescription and over-the-counter medicines. Even safe drugs can cause unwanted side effects or interactions with ...

  13. Importance and Repercussions of Renal and Cardiovascular Pathology on Stroke in Young Adults: An Anatomopathologic Study of 52 Clinical Necropsies

    PubMed Central

    Arismendi-Morillo, Gabriel; Fernández-Abreu, Mary; Cardozo-Duran, José; Vilchez-Barrios, Gustavo

    2008-01-01

    INTRODUCTION Stroke in young adults has seldom been studied in a necropsy series. The objective of the present clinical necropsy-based investigation was to analyze stroke and its relationship with cardiovascular and renal pathology in young adults. MATERIALS AND METHODS The protocols of 52 clinical necropsies with diagnoses of stroke in patients aged 18 – 49 years, performed between the years 1990–2006, were reviewed. RESULTS Hemorrhagic stroke was diagnosed in 36 patients (69.3%), whereas the remaining 16 (30.7%) had ischemic stroke. Hypertensive cardiopathy was evident in 88.4% of the cases. Chronic renal pathology, directly or indirectly related to hypertension, was observed in 55.7% of the patients. Ischemic stroke as a result of occlusive atherosclerotic disease was seen in 50% of cases. Cardiogenic emboli were found in 25% of the cadavers. Hemorrhagic stroke was associated with hypertension in 43% of the cases, with ruptured vascular malformations in 29%, and coagulopathies in 17% of the cases. Hypertensive cardiopathy was present in patients with either ischemic or hemorrhagic stroke (81.2% and 91.6%, respectively). The most frequently observed renal ailments were chronic pyelonephritis (23%) and nephrosclerosis (21.1%). These were associated with ischemic stroke in 43.7%, and 12.5% of the cases, respectively, and with 13.8% and 25% of the hemorrhagic stroke cases. DISCUSSION Hypertensive cardiopathy, occlusive atherosclerotic disease, chronic pyelonephritis and nephrosclerosis are among the pathophysiologycal mechanisms that apparently and eventually interact to induce a significant number of cases of stroke in young adults. A chronic systemic inflammatory state appears to be an important related condition because it possibly constitutes an accelerant of the pathophysiologycal process. PMID:18297202

  14. Predictive Medicine: Recombinant DNA Technology and Adult-Onset Genetic Disorders

    PubMed Central

    Hayden, Michael

    1988-01-01

    Genetic factors are of great importance in common adult-onset disorders such as atherosclerosis, cancer, and neuro-degenerative diseases. Advances in DNA technology now allow identification of persons at high-risk of developing some of these diseases. This advance is leading to predictive medicine. In some genetic disorders, such as those leading to atherosclerosis and cancer, identification of high-risk individuals allows intervention which alters the natural history of the disorder. In other diseases, for which there is no treatment, such as Huntington's disease, the application of this technology provides information that relieves uncertainty and may affect quality of life, but does not alter the course of the illness. General implementation of predictive testing programs awaits the results of pilot projects, which will demonstrate the needs, appropriate levels of support, and guidelines for delivery of such testing. PMID:21253100

  15. [Attention-deficit hyperactivity disorder in adults: implications to forensic medicine].

    PubMed

    Guerreiro, Diogo Frasquilho; Vieira, Fernando; Costa-Santos, Jorge

    2011-01-01

    Attention-deficit hyperactivity disorder (ADHD) in adults has been associated to a higher probability of problems with justice. Studies in prison populations disclosed higher prevalence of this disturbance. ADHD association with personality disorders and higher substance abuse could partially help in the explanation of this phenomenon. Based in a literature review, the authors present a reflection on the possible implications of the ADHD diagnosis to Forensic Medicine. After a brief review of the clinical aspects, epidemiology, etiology and nosology of ADHD, its repercussions in the sphere of justice are analysed, namely the prevalence of associated criminality, risk factors and the co-morbidity with personality disorders and substance abuse. These elements are used as a base to the discussion of the results and to a subsequent reflection on the question of (in)imputability related with this disorder.

  16. Is prevention a fantasy, or the future of medicine? A panoramic view of recent data, status, and direction in cardiovascular prevention.

    PubMed

    Kones, Richard

    2011-02-01

    Americans are under assault by a fierce epidemic of obesity, diabetes, and cardiovascular disease, of their own doing. Lowered death rates from heart disease and reduced rates of smoking are seriously threatened by the inexorable rise in overweight and obesity. Latest data indicate that 32% of children are overweight or obese, and fewer than 17% exercise sufficiently. Over 68% of adults are overweight, 35% are obese, nearly 40% fulfill criteria for the metabolic syndrome, 8-13% have diabetes, 34% have hypertension, 36% have prehypertension, 29% have prediabetes, 15% of the population with either diabetes, hypertension, or dyslipidemia are undiagnosed, 59% engage in no vigorous activity, and fewer than 5% of the US population qualifies for the American Heart Association (AHA) definition of ideal cardiovascular health. Health, nutrition, and exercise illiteracy is prevalent, while misinformation and unrealistic expectations are the norm. Half of American adults have at least one cardiovascular risk factor. Up to 65% do not have their conventional risk biomarkers under control. Of those patients with multiple risk factors, fewer than 10% have all of them adequately controlled. Even when patients are treated according to evidence-based protocols, about 70% of cardiac events remain unaddressed. Undertreatment is also common. Poor patient adherence, probably well below 50%, adds further difficulty in reducing cardiovascular risk. Available data indicate that only a modest fraction of the total cardiovascular risk burden in the population is actually now being eliminated. A fresh view of these issues, a change in current philosophy, leading to new and different, multimechanistic methods of prevention may be needed. Adherence to published guidelines will improve substantially outcomes in both primary and secondary prevention. Primordial prevention, which does not allow risk values to appear in a population, affords more complete protection than subsequent partial reversal

  17. Is prevention a fantasy, or the future of medicine? A panoramic view of recent data, status, and direction in cardiovascular prevention.

    PubMed

    Kones, Richard

    2011-02-01

    Americans are under assault by a fierce epidemic of obesity, diabetes, and cardiovascular disease, of their own doing. Lowered death rates from heart disease and reduced rates of smoking are seriously threatened by the inexorable rise in overweight and obesity. Latest data indicate that 32% of children are overweight or obese, and fewer than 17% exercise sufficiently. Over 68% of adults are overweight, 35% are obese, nearly 40% fulfill criteria for the metabolic syndrome, 8-13% have diabetes, 34% have hypertension, 36% have prehypertension, 29% have prediabetes, 15% of the population with either diabetes, hypertension, or dyslipidemia are undiagnosed, 59% engage in no vigorous activity, and fewer than 5% of the US population qualifies for the American Heart Association (AHA) definition of ideal cardiovascular health. Health, nutrition, and exercise illiteracy is prevalent, while misinformation and unrealistic expectations are the norm. Half of American adults have at least one cardiovascular risk factor. Up to 65% do not have their conventional risk biomarkers under control. Of those patients with multiple risk factors, fewer than 10% have all of them adequately controlled. Even when patients are treated according to evidence-based protocols, about 70% of cardiac events remain unaddressed. Undertreatment is also common. Poor patient adherence, probably well below 50%, adds further difficulty in reducing cardiovascular risk. Available data indicate that only a modest fraction of the total cardiovascular risk burden in the population is actually now being eliminated. A fresh view of these issues, a change in current philosophy, leading to new and different, multimechanistic methods of prevention may be needed. Adherence to published guidelines will improve substantially outcomes in both primary and secondary prevention. Primordial prevention, which does not allow risk values to appear in a population, affords more complete protection than subsequent partial reversal

  18. Prevention and Treatment of Cardiovascular Disease in Adolescents and Adults through the Transcendental Meditation® Program: A Research Review Update

    PubMed Central

    Barnes, Vernon A.; Orme-Johnson, David W.

    2012-01-01

    The pathogenesis and progression of cardiovascular diseases are thought to be exacerbated by stress. Basic research indicates that the Transcendental Meditation® technique produces acute and longitudinal reductions in sympathetic tone and stress reactivity. In adolescents at risk for hypertension, the technique has been found to reduce resting and ambulatory blood pressure, left ventricular mass, cardiovascular reactivity, and to improve school behavior. Research on adults with mild or moderate essential hypertension has reported decreased blood pressure and reduced use of anti-hypertensive medication. The technique has also been reported to decrease symptoms of angina pectoris and carotid atherosclerosis, to reduce cardiovascular risk factors, including alcohol and tobacco use, to markedly reduce medical care utilization for cardiovascular diseases, and to significantly decrease cardiovascular and all-cause morbidity and mortality. These findings have important implications for inclusion of the Transcendental Meditation program in efforts to prevent and treat cardiovascular diseases and their clinical consequences. ®Transcendental Meditation and TM are trademarks registered in the US. Patent and Trademark Office, licensed to Maharishi Vedic Education Development Corporation and are used with permission. PMID:23204989

  19. Risks and Population Burden of Cardiovascular Diseases Associated with Diabetes in China: A Prospective Study of 0.5 Million Adults

    PubMed Central

    Bragg, Fiona; Li, Liming; Yang, Ling; Guo, Yu; Chen, Yiping; Bian, Zheng; Chen, Junshi; Collins, Rory; Peto, Richard; Dong, Caixia; Pan, Rong; Xu, Xin; Chen, Zhengming

    2016-01-01

    681,202) cardiovascular deaths annually in China. Conclusions Among Chinese adults, diabetes is associated with significantly increased risks of major cardiovascular diseases. The increasing prevalence and younger age of onset of diabetes foreshadow greater diabetes-attributable disease burden in China. PMID:27379518

  20. Adult Medication-Free Schizophrenic Patients Exhibit Long-Chain Omega-3 Fatty Acid Deficiency: Implications for Cardiovascular Disease Risk

    PubMed Central

    McNamara, Robert K.; Jandacek, Ronald; Rider, Therese; Tso, Patrick; Dwivedi, Yogesh; Pandey, Ghanshyam N.

    2013-01-01

    Deficiency in long-chain omega-3 (LCn − 3) fatty acids, eicosapentaenoic acid (EPA, 20:5n − 3) and docosahexaenoic acid (DHA, 22:6n − 3), has been implicated in the pathoetiology of cardiovascular disease, a primary cause of excess premature mortality in patients with schizophrenia (SZ). In the present study, we determined erythrocyte EPA + DHA levels in adult medication-free patients SZ (n = 20) and age-matched healthy controls (n = 24). Erythrocyte EPA + DHA composition exhibited by SZ patients (3.5%) was significantly lower than healthy controls (4.5%, −22%, P = 0.007). The majority of SZ patients (72%) exhibited EPA+DHA levels ≤4.0% compared with 37% of controls (Chi-square, P = 0.001). In contrast, the omega-6 fatty acid arachidonic acid (AA, 20:4n − 6) (+9%, P = 0.02) and the AA:EPA + DHA ratio (+28%, P = 0.0004) were significantly greater in SZ patients. Linoleic acid (18:2n − 6) was significantly lower (−12%, P = 0.009) and the erythrocyte 20:3/18:2 ratio (an index of delta6-desaturase activity) was significantly elevated in SZ patients. Compared with same-gender controls, EPA + DHA composition was significantly lower in male (−19%, P = 0.04) but not female (−13%, P = 0.33) SZ patients, whereas the 20:3/18:2 ratio was significantly elevated in both male (+22%, P = 0.008) and female (+22%, P = 0.04) SZ patients. These results suggest that the majority of SZ patients exhibit low LCn − 3 fatty acid levels which may place them at increased risk for cardiovascular morbidity and mortality. PMID:23533712

  1. Complementary and Alternative Medicine Use as Health Self-Management: Rural Older Adults With Diabetes

    PubMed Central

    Arcury, Thomas A.; Bell, Ronny A.; Snively, Beverly M.; Smith, Shannon L.; Skelly, Anne H.; Wetmore, Lindsay K.; Quandt, Sara A.

    2006-01-01

    Objectives This study describes complementary and alternative medicine (CAM) use among rural older adults with diabetes, delineates the relationship of health self-management predictors to CAM therapy use, and furthers conceptual development of CAM use within a health self-management framework. Methods Survey interview data were collected from a random sample of 701 community dwelling African American, Native American, and White elders residing in two rural North Carolina counties. We summarize CAM use for general use and for diabetes care and use multiple logistic modeling to estimate the effects of health self-management predictors on use of CAM therapies. Results The majority of respondents used some form of CAM for general purpose, whereas far fewer used CAM for diabetes care. The most widely used CAM categories were food home remedies, other home remedies, and vitamins. The following health self-management predictors were related to the use of different categories of CAM therapies: personal characteristics (ethnicity), health status (number of health conditions), personal resources (education), and financial resources (economic status). Discussion CAM is a widely used component of health self-management among rural among older adults with diabetes. Research on CAM use will benefit from theory that considers the specific behavior and cognitive characteristics of CAM therapies. PMID:16497962

  2. Characteristics relevant to cardiovascular disease among adults of African and Indian origin in Guyana

    PubMed Central

    Ashcroft, M. T.; Beadnell, H. M. S. G.; Bell, R.; Miller, G. J.

    1970-01-01

    Characteristics relevant to cardiovascular disease, including anthropometry, arterial blood pressure, serum cholesterol levels, chest radiography and electrocardiography, were investigated in a survey of 843 men and women aged 35-54 years of African and Indian origin living in 2 communities in Guyana. Clinical experience suggested a high incidence of hypertension and a low incidence of ischaemic heart disease. Africans were taller and heavier than Indians but their other characteristics were, in general, similar except that their mean blood pressure levels and R amplitudes in certain ECG leads were consistently higher. Hypertension was common and was significantly correlated with obesity and, probably independently, with body size. Serum cholesterol levels, with mean values of about 200 mg/100 ml, were strongly correlated with factors associated with obesity in men but not in women. Cardiothoracic ratios, measured from chest films, were greater than values regarded as normal for Europeans because of a relative narrowness of thoracic diameters. Prevalence of S-T-segment and T-wave defects in ECGs classified by the Minnesota Code was as high as reported from communities where ischaemic heart disease is clinically more frequent. Hypertension, cardiac enlargement, obesity and cholesteraemia were more prevalent when defects involved lateral leads (I, aVL, V5 and V6) than in subjects with normal ECGs, suggesting that the majority of important abnormalities occurred primarily in the left ventricle and were probably related to hypertension rather than to coronary insufficiency without hypertension. Analysis of S-T and T-wave defects, both by blood pressure and by lead position, might show meaningful differences between populations which, by present methods of presentation, appear to have surprisingly similar prevalences of ECG abnormalities. PMID:4246109

  3. Diet quality of urban older adults age 60 to 99 years: the Cardiovascular Health of Seniors and Built Environment Study.

    PubMed

    Deierlein, Andrea L; Morland, Kimberly B; Scanlin, Kathleen; Wong, Sally; Spark, Arlene

    2014-02-01

    There are few studies that evaluate dietary intakes and predictors of diet quality in older adults. The objectives of this study were to describe nutrient intakes and examine associations between demographic, economic, behavioral, social environment, and health status factors and diet quality. Cross-sectional data were from black, white, and Hispanic adults, age 60 to 99 years, living independently in New York City and participating in the Cardiovascular Health of Seniors and the Built Environment Study, 2009-2011 (n=1,306). Multivariable log-linear regression estimated associations between selected factors and good diet quality, defined as a Healthy Eating Index score more than 80 (based on the 2005 Dietary Guidelines for Americans [HEI-2005]). Dietary intakes were similar for men and women; intakes of energy, fiber, and the majority of micronutrients were less than recommendations, whereas intakes of fats, added sugar, and sodium were within the upper range or exceeded recommendations. Hispanic ethnicity (relative risk [RR]=1.37; 95% CI 1.07 to 1.75), energy intake <∼ 1,500 kcal/day (RR=1.93; 95% CI, 1.37 to 2.71), adherence to a special diet (RR=1.23; 95% CI: 1.02 to 1.50), purchasing food at supermarkets at least once/week (RR=1.34; 95% CI, 1.04 to 1.74), and being married/living with a partner (RR=1.37; 95% CI, 1.10 to 1.71) were positively associated with HEI-2005 score more than 80. Consuming at least one restaurant meal/day was negatively associated with HEI-2005 score more than 80 (RR=0.69; 95%CI, 0.50-0.94). These findings identify specific groups of older adults, such as blacks or those who live alone, who may benefit from dietary interventions, as well as specific modifiable behaviors among older adults, such as eating restaurant meals or shopping at supermarkets, which may be targeted through interventions.

  4. Cardiovascular risk factors in young, overweight, and obese European adults and associations with physical activity and omega-3 index.

    PubMed

    Ramel, Alfons; Pumberger, Christina; Martinéz, Alfredo J; Kiely, Mairead; Bandarra, Narcisa M; Thorsdottir, Inga

    2009-05-01

    Excess body fat is associated with increased cardiovascular disease (CVD) risk. The hypothesis of the study was that physical activity and omega-3 index, a marker of past long chain n-3 polyunsaturated fatty acids consumption, counteract the negative associations between fatness and CVD risk factors in young overweight and obese adults. A total of 324 subjects (20-40 years, body mass index [BMI], 27.5-32.5 kg/m(2), from Iceland, Spain, and Ireland) were investigated cross-sectionally. Dietary intake, anthropometric measurements, blood pressure, CVD risk factors, and fatty acids in erythrocyte membrane were analyzed. Information on physical activity was collected. Linear models were constructed to find out the associations of BMI, physical activity (quartiles), and omega-3 index with CVD risk factors. The most frequently increased risk factors were blood lipids (41.4%) and blood pressure (32.1%); fewer participants experienced disturbed glucose metabolism (11.8%). Body mass index was significantly associated with increased CVD risk factors (P = .001-.029), with the exception of total cholesterol, low-density lipoprotein, and high-density lipoprotein. The highest physical activity quartile had a lower fat mass (P = .005, at a given BMI), leptin (P = .008, in male participants only), and interleukin 6 (P = .021) but higher high-density lipoprotein (P = .020) than other quartiles; however, an approximate dose-response relationship could only be observed for leptin. The omega-3 index was not associated with lower low-density lipoprotein (P = .056), but docosahexaenoic acid in erythrocyte membrane was associated to it (P = .016). It is concluded that physical activity and docosahexaenoic acid diminish some of the negative health effects associated with overweight and obesity; however, body fatness remains the most important variable associated with increased CVD risk factors in young overweight and obese adults. PMID:19555811

  5. Inclusion of Atlantic salmon in the Chinese diet reduces cardiovascular disease risk markers in dyslipidemic adult men.

    PubMed

    Zhang, Jian; Wang, Chunrong; Li, Lixiang; Man, Qingqing; Song, Pengkun; Meng, Liping; Du, Zhen-Yu; Frøyland, Livar

    2010-07-01

    Although the beneficial effects of n-3 fatty acids on several physiologic functions have been widely reported, information about the effects of oily fish in the Asian diet on cardiovascular disease (CVD) risk is diminutive. We hypothesize that daily inclusion of oily fish for 8 weeks in the Chinese diet will elevate serum eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels and reduce CVD risk markers in dyslipidemic adult men, comparable with the effects generally observed by inclusion of oily fish in the Western diet. In this 8-week randomized, parallel-arm, food-based intervention study, lunches were prepared with 500 g pork/chicken/beef, typically consumed fish (hairtail and freshwater carp), or oily fish (salmon). Male subjects aged between 35 and 70 years with hyperlipidemia were randomly assigned to eat lunches with pork/chicken/beef (n = 30 subjects at 8 weeks), freshwater fish (n = 30), or oily fish (n = 32). Circulating markers were measured at baseline and at 8 weeks. In the oily fish diet, dietary EPA and DHA levels were significantly increased as compared with other diets; and the n-6:n-3 polyunsaturated fatty acid ratio was decreased (P < .05). Thus, the oily fish diet significantly elevated serum EPA and DHA concentrations (P < .01) and lowered serum n-6:n-3 ratio at 8 weeks (P < .05). Furthermore, oily fish intake significantly reduced serum levels of triglycerides (P < .05) and interleukin-6 (P < .01) and increased levels of high-density lipoprotein cholesterol (P < .01). In conclusion, daily inclusion of oily fish as part of the Chinese diet for 8 weeks is sufficient to significantly increase the serum content of long-chain n-3 polyunsaturated fatty acids and reduce levels of CVD risk markers in dyslipidemic adult men. PMID:20797476

  6. Inclusion of Atlantic salmon in the Chinese diet reduces cardiovascular disease risk markers in dyslipidemic adult men.

    PubMed

    Zhang, Jian; Wang, Chunrong; Li, Lixiang; Man, Qingqing; Song, Pengkun; Meng, Liping; Du, Zhen-Yu; Frøyland, Livar

    2010-07-01

    Although the beneficial effects of n-3 fatty acids on several physiologic functions have been widely reported, information about the effects of oily fish in the Asian diet on cardiovascular disease (CVD) risk is diminutive. We hypothesize that daily inclusion of oily fish for 8 weeks in the Chinese diet will elevate serum eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels and reduce CVD risk markers in dyslipidemic adult men, comparable with the effects generally observed by inclusion of oily fish in the Western diet. In this 8-week randomized, parallel-arm, food-based intervention study, lunches were prepared with 500 g pork/chicken/beef, typically consumed fish (hairtail and freshwater carp), or oily fish (salmon). Male subjects aged between 35 and 70 years with hyperlipidemia were randomly assigned to eat lunches with pork/chicken/beef (n = 30 subjects at 8 weeks), freshwater fish (n = 30), or oily fish (n = 32). Circulating markers were measured at baseline and at 8 weeks. In the oily fish diet, dietary EPA and DHA levels were significantly increased as compared with other diets; and the n-6:n-3 polyunsaturated fatty acid ratio was decreased (P < .05). Thus, the oily fish diet significantly elevated serum EPA and DHA concentrations (P < .01) and lowered serum n-6:n-3 ratio at 8 weeks (P < .05). Furthermore, oily fish intake significantly reduced serum levels of triglycerides (P < .05) and interleukin-6 (P < .01) and increased levels of high-density lipoprotein cholesterol (P < .01). In conclusion, daily inclusion of oily fish as part of the Chinese diet for 8 weeks is sufficient to significantly increase the serum content of long-chain n-3 polyunsaturated fatty acids and reduce levels of CVD risk markers in dyslipidemic adult men.

  7. Prevalence of Major Cardiovascular Risk Factors and Coronary Heart Disease in a Sample of Greek Adults: The Saronikos Study

    PubMed Central

    Gikas, Aristofanis; Lambadiari, Vaia; Sotiropoulos, Alexios; Panagiotakos, Demosthenes; Pappas, Stavros

    2016-01-01

    Background: Comprehensive data regarding prevalence of coronary heart disease (CHD) and associated factors in different geographical regions are very important to our understanding of global distribution and evolution of CHD. The aim of this study was to assess the current prevalence of self-reported risk factors and CHD in Greek adult population. Methods: A community-based cross-sectional study was conducted in May 2014, during an election day, among residents of Saronikos municipality (Attica region). Data were collected from face-to-face interviews. The study sample included 2636 subjects (men, 49.5%; mean age, 50.5; range 20-95 years), with similar age and sex distribution to the target population. Results: The age-standardized prevalence rates of five major risk factors were as follows: type 2 diabetes 11.1%, hypercholesterolemia (cholesterol>240 mg/dl or using cholesterol-lowering medication) 23.8%, hypertension 27.2%, current smoking 38.9% and physical inactivity 43%. Of the participants, only 21% were free of any of these factors. Clustering of two to five risk factors was more frequent among persons aged 50 years and older as compared with younger ones (60% vs 27%, P=0.000). The age-adjusted prevalence of CHD was 6.3% (in men, 8.9%; in women, 3.8%) and that of myocardial infarction was 3.6% (in men, 5.2%; in women, 2.1%). According to multivariate analysis age, gender, education level, obesity, diabetes, hypercholesterolemia, hypertension and ever smoking were strongly associated with CHD. Conclusion: Classic risk factors are highly prevalent and frequently clustered, especially in adults aged 50 years and older. These findings raise concerns about future trends of already increased rates of CHD. Multifactorial and integrated population-based interventions need to be applied to reduce the burden of cardiovascular conditions. PMID:27429668

  8. Predicted Long-Term Cardiovascular Risk Among Young Adults in the National Longitudinal Study of Adolescent Health

    PubMed Central

    Alonso, Alvaro; Spencer, Rachael A.; Pencina, Michael; Williams, Ken; Everson-Rose, Susan A.

    2014-01-01

    Objectives. We estimated the distribution of predicted long-term cardiovascular disease (CVD) risk among young adults in the United States. Methods. Our data were derived from National Longitudinal Study of Adolescent Health participants (n = 14 333; average age: 28.9 years). We used a Framingham-derived risk prediction function to calculate 30-year risks of “hard” and “general” CVD by gender and race/ethnicity. Results. Average 30-year risks for hard and general CVD were 10.4% (95% confidence interval [CI] = 10.1%, 10.7%) and 17.3% (95% CI = 17.0%, 17.7%) among men and 4.4% (95% CI = 4.3%, 4.6%) and 9.2% (95% CI = 8.9%, 9.5%) among women. Average age-adjusted risks of hard and general CVD were higher among Blacks and American Indians than among Whites and lower among Asian/Pacific Islander women than White women. American Indian men continued to have a higher risk of general CVD after adjustment for socioeconomic status. Four percent of women (95% CI = 3.6%, 5.0%) and 26.2% of men (95% CI = 24.7%, 27.8%) had a 20% or higher risk of general CVD. Racial differences were detected but were not significant after adjustment for socioeconomic status. Conclusions. Average CVD risk among young adults is high. Population-based prevention strategies and improved detection and treatment of high-risk individuals are needed to reduce the future burden of CVD. PMID:25322295

  9. Therapeutic Strategies for Oxidative Stress-Related Cardiovascular Diseases: Removal of Excess Reactive Oxygen Species in Adult Stem Cells

    PubMed Central

    Yun, Jisoo

    2016-01-01

    Accumulating evidence indicates that acute and chronic uncontrolled overproduction of oxidative stress-related factors including reactive oxygen species (ROS) causes cardiovascular diseases (CVDs), atherosclerosis, and diabetes. Moreover ROS mediate various signaling pathways underlying vascular inflammation in ischemic tissues. With respect to stem cell-based therapy, several studies clearly indicate that modulating antioxidant production at cellular levels enhances stem/progenitor cell functionalities, including proliferation, long-term survival in ischemic tissues, and complete differentiation of transplanted cells into mature vascular cells. Recently emerging therapeutic strategies involving adult stem cells, including endothelial progenitor cells (EPCs), for treating ischemic CVDs have highlighted the need to control intracellular ROS production, because it critically affects the replicative senescence of ex vivo expanded therapeutic cells. Better understanding of the complexity of cellular ROS in stem cell biology might improve cell survival in ischemic tissues and enhance the regenerative potentials of transplanted stem/progenitor cells. In this review, we will discuss the nature and sources of ROS, drug-based therapeutic strategies for scavenging ROS, and EPC based therapeutic strategies for treating oxidative stress-related CVDs. Furthermore, we will discuss whether primed EPCs pretreated with natural ROS-scavenging compounds are crucial and promising therapeutic strategies for vascular repair. PMID:27668035

  10. Prenatal famine exposure and adult mortality from cancer, cardiovascular disease, and other causes through age 63 years.

    PubMed

    Ekamper, Peter; van Poppel, Frans; Stein, Aryeh D; Bijwaard, Govert E; Lumey, L H

    2015-02-15

    Nutritional conditions in early life may affect adult health, but prior studies of mortality have been limited to small samples. We evaluated the relationship between pre-/perinatal famine exposure during the Dutch Hunger Winter of 1944-1945 and mortality through age 63 years among 41,096 men born in 1944-1947 and examined at age 18 years for universal military service in the Netherlands. Of these men, 22,952 had been born around the time of the Dutch famine in 6 affected cities; the remainder served as unexposed controls. Cox proportional hazards models were used to estimate hazard ratios for death from cancer, heart disease, other natural causes, and external causes. After 1,853,023 person-years of follow-up, we recorded 1,938 deaths from cancer, 1,040 from heart disease, 1,418 from other natural causes, and 523 from external causes. We found no increase in mortality from cancer or cardiovascular disease after prenatal famine exposure. However, there were increases in mortality from other natural causes (hazard ratio = 1.24, 95% confidence interval: 1.03, 1.49) and external causes (hazard ratio = 1.46, 95% confidence interval: 1.09, 1.97) after famine exposure in the first trimester of gestation. Further follow-up of the cohort is needed to provide more accurate risk estimates of mortality from specific causes of death after nutritional disturbances during gestation and very early life.

  11. Therapeutic Strategies for Oxidative Stress-Related Cardiovascular Diseases: Removal of Excess Reactive Oxygen Species in Adult Stem Cells

    PubMed Central

    Yun, Jisoo

    2016-01-01

    Accumulating evidence indicates that acute and chronic uncontrolled overproduction of oxidative stress-related factors including reactive oxygen species (ROS) causes cardiovascular diseases (CVDs), atherosclerosis, and diabetes. Moreover ROS mediate various signaling pathways underlying vascular inflammation in ischemic tissues. With respect to stem cell-based therapy, several studies clearly indicate that modulating antioxidant production at cellular levels enhances stem/progenitor cell functionalities, including proliferation, long-term survival in ischemic tissues, and complete differentiation of transplanted cells into mature vascular cells. Recently emerging therapeutic strategies involving adult stem cells, including endothelial progenitor cells (EPCs), for treating ischemic CVDs have highlighted the need to control intracellular ROS production, because it critically affects the replicative senescence of ex vivo expanded therapeutic cells. Better understanding of the complexity of cellular ROS in stem cell biology might improve cell survival in ischemic tissues and enhance the regenerative potentials of transplanted stem/progenitor cells. In this review, we will discuss the nature and sources of ROS, drug-based therapeutic strategies for scavenging ROS, and EPC based therapeutic strategies for treating oxidative stress-related CVDs. Furthermore, we will discuss whether primed EPCs pretreated with natural ROS-scavenging compounds are crucial and promising therapeutic strategies for vascular repair.

  12. Social Cognitive Changes Following Weight Loss and Physical Activity Interventions in Obese, Older Adults in Poor Cardiovascular Health

    PubMed Central

    Brawley, Lawrence; Gaukstern, Jill E.; Ambrosius, Walter T.

    2013-01-01

    Background The study objectives were to determine (a) the effects of group-mediated cognitive–behavioral interventions on change in performance self-efficacy, satisfaction with function, and with appearance among older, overweight/obese adults in poor cardiovascular health and (b) whether self-efficacy mediated change in 400-m walk time. Methods This translational, randomized controlled trial of physical activity and weight loss was conducted within community Cooperative Extension Centers. Participants were randomized to three intervention arms: Physical Activity, Weight Loss+ Physical Activity, or a Successful Aging education control. Results Across 18 months, the Weight Loss+Physical Activity intervention demonstrated greater improvements in self-efficacy, satisfaction with function, and appearance versus other trial arms. Physical Activity intervention participants also experienced significant improvements in self-efficacy and satisfaction with function versus those in Successful Aging. Self-efficacy mediated 400-m walk time at 18 months. Conclusions Both group-mediated cognitive–behavioral interventions yielded desirable improvements in social cognitions and preserved mobility improvements post-intervention. PMID:22773225

  13. “More than I Expected”: Perceived Benefits of Yoga Practice among Older Adults at Risk for Cardiovascular Disease

    PubMed Central

    Alexander, Gina K.; Innes, Kim E.; Selfe, Terry K.; Brown, Cynthia J.

    2012-01-01

    Objective This study was conducted with participants from trials examining the effects of an Iyengar yoga program on cardiovascular disease risk. The objective of the current study was to evaluate the perceived benefits of yoga in a population of older, predominantly overweight adults participating in a gentle 8-week yoga program. Design This study used a constructivist-interpretive approach to naturalistic inquiry. Setting A total of 42 participants completed the intervention and met the inclusion criteria for the current qualitative study. Intervention The 8-week Iyengar yoga program included two 90-minute yoga classes and five 30-minute home sessions per week. Participants completed weekly logs and an exit questionnaire at the end of the study. Main Outcome Measures Qualitative data from weekly logs and exit questionnaires were compiled and conventional content analysis performed with the use of ATLAS.ti to facilitate the process. Results Four broad themes emerged from content analysis: Practicing yoga improved overall physical function and capacity (for 83% of participants); practicing yoga reduced stress/anxiety and enhanced calmness (83% of participants); practicing yoga enriched the quality of sleep (21% of participants); and practicing yoga supported efforts toward dietary improvements (14% of participants). Conclusions These results suggest that yoga may have ancillary benefits in terms of improved physical function, enhanced mental/emotional state, enriched sleep quality, and improved lifestyle choices, and may be useful as a health promotion strategy in the prevention and management of chronic disease. PMID:23374201

  14. Circulating and Dietary Trans Fatty Acids and Incident Type 2 Diabetes in Older Adults: The Cardiovascular Health Study

    PubMed Central

    Imamura, Fumiaki; Ma, Wenjie; Wang, Molin; Lemaitre, Rozenn N.; King, Irena B.; Song, Xiaoling; Biggs, Mary L.; Delaney, Joseph A.; Mukamal, Kenneth J.; Djousse, Luc; Siscovick, David S.; Mozaffarian, Dariush

    2015-01-01

    OBJECTIVE To investigate the effects of trans fatty acids (TFAs) on type 2 diabetes mellitus (DM) by specific TFA subtype or method of assessment. RESEARCH DESIGN AND METHODS In the Cardiovascular Health Study, plasma phospholipid trans (t)-16:1n9, t-18:1, and cis (c)/t-, t/c-, and t/t-18:2 were measured in blood drawn from 2,919 adults aged 74 ± 5 years and free of prevalent DM in 1992. Dietary TFA was estimated among 4,207 adults free of prevalent DM when dietary questionnaires were initially administered in 1989 or 1996. Incident DM was defined through 2010 by medication use or blood glucose levels. Risks were assessed by Cox proportional hazards. RESULTS In biomarker analyses, 287 DM cases occurred during 30,825 person-years. Both t-16:1n9 (extreme quartile hazard ratio 1.59 [95% CI 1.04–2.42], P-trend = 0.04) and t-18:1 (1.91 [1.20–3.03], P-trend = 0.01) levels were associated with higher incident DM after adjustment for de novo lipogenesis fatty acids. In dietary analyses, 407 DM cases occurred during 50,105 person-years. Incident DM was positively associated with consumption of total TFAs (1.38 [1.03–1.86], P-trend = 0.02), t-18:1 (1.32 [1.00–1.76], P-trend = 0.04), and t-18:2 (1.41 [1.05–1.89], P-trend = 0.02). After further adjustment for other dietary habits, however, the associations of estimated dietary TFA with DM were attenuated, and only nonsignificant positive trends remained. CONCLUSIONS Among older adults, plasma phospholipid t-16:1n9 and t-18:1 levels were positively related to DM after adjustment for de novo lipogenesis fatty acids. Estimated dietary TFA was not significantly associated with DM. These findings highlight the need for further observational, interventional, and experimental studies of the effects TFA on DM. PMID:25784660

  15. Racial and Ethnic Profiles of Complementary and Alternative Medicine Use Among Young Adults in the United States: Findings From the National Longitudinal Study of Adolescent Health.

    PubMed

    Upchurch, Dawn M; Wexler Rainisch, Bethany K

    2012-10-01

    This study describes complementary and alternative medicine use among a national sample of young adults, with an emphasis on characterizing racial and ethnic differences, highlighting variation across subgroups of Hispanics. The authors examined young adults ages 18 to 27 years (n = 14 128) from wave III (2001-2002) of the National Longitudinal Study of Adolescent Health. Prevalence estimates and logistic regression results were weighted and adjusted for complex sample design. The study examined recent complementary and alternative medicine use in the past 12 months, recent use for each of 15 specific complementary and alternative medicine modalities, and the 5 most commonly used modalities (herbs, massage, chiropractic, relaxation, and vitamins). Results showed that 29% of young adults aged 18 to 27 years recently used complementary and alternative medicine. Prevalence was highest among Cuban Americans (42%) and lowest among blacks (22%). Young adults used a diversity of complementary and alternative medicine modalities and there were substantial differences in use across racial and ethnic groups.

  16. Contributions of maternal and paternal adiposity and smoking to adult offspring adiposity and cardiovascular risk: the Midspan Family Study

    PubMed Central

    Han, T S; Hart, C L; Haig, C; Logue, J; Upton, M N; Watt, G C M; Lean, M E J

    2015-01-01

    Objective Obesity has some genetic basis but requires interaction with environmental factors for phenotypic expression. We examined contributions of gender-specific parental adiposity and smoking to adiposity and related cardiovascular risk in adult offspring. Design Cross-sectional general population survey. Setting Scotland. Participants 1456 of the 1477 first generation families in the Midspan Family Study: 2912 parents (aged 45–64 years surveyed between 1972 and 1976) who had 1025 sons and 1283 daughters, aged 30–59 years surveyed in 1996. Main measures Offspring body mass index (BMI), waist circumference (WC), cardiometabolic risk (lipids, blood pressure and glucose) and cardiovascular disease as outcome measures, and parental BMI and smoking as determinants. All analyses adjusted for age, socioeconomic status and family clustering and offspring birth weight. Results Regression coefficients for BMI associations between father–son (0.30) and mother–daughter (0.33) were greater than father–daughter (0.23) or mother–son (0.22). Regression coefficient for the non-genetic, shared-environment or assortative-mating relationship between BMIs of fathers and mothers was 0.19. Heritability estimates for BMI were greatest among women with mothers who had BMI either <25 or ≥30 kg/m2. Compared with offspring without obese parents, offspring with two obese parents had adjusted OR of 10.25 (95% CI 6.56 to 13.93) for having WC ≥102 cm for men, ≥88 cm women, 2.46 (95% CI 1.33 to 4.57) for metabolic syndrome and 3.03 (95% CI 1.55 to 5.91) for angina and/or myocardial infarct (p<0.001). Neither parental adiposity nor smoking history determined adjusted offspring individual cardiometabolic risk factors, diabetes or stroke. Maternal, but not paternal, smoking had significant effects on WC in sons (OR=1.50; 95% CI 1.13 to 2.01) and daughters (OR=1.42; 95% CI 1.10 to 1.84) and metabolic syndrome OR=1.68; 95% CI 1.17 to 2.40) in sons. Conclusions There are

  17. Translating Personality Psychology to Help Personalize Preventive Medicine for Young-Adult Patients

    PubMed Central

    Israel, Salomon; Moffitt, Terrie E.; Belsky, Daniel W.; Hancox, Robert J.; Poulton, Richie; Roberts, Brent; Thomson, W. Murray; Caspi, Avshalom

    2014-01-01

    The rising number of newly insured young adults brought on by healthcare reform will soon increase demands on primary-care physicians. Physicians will face more young-adult patients which presents an opportunity for more prevention-oriented care. In the current study, we evaluated whether brief observer reports of young adults’ personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Following the Dunedin Study cohort of 1,000 individuals, we show that very brief measures of young adults’ personalities predicted their midlife physical health across multiple domains (metabolic abnormalities, cardiorespiratory fitness, pulmonary function, periodontal disease, and systemic inflammation). Individuals scoring low on the traits of Conscientiousness and Openness-to-Experience went on to develop poorer health even after accounting for preexisting differences in education, socioeconomic status, smoking, obesity, self-reported health, medical conditions, and family medical history. Moreover, personality ratings from peer informants who knew participants well, and from a nurse and receptionist who had just met participants for the first time, predicted health decline from young adulthood to midlife despite striking differences in level of acquaintance. Personality effect sizes were on par with other well-established health-risk factors such as socioeconomic status, smoking, and self-reported health. We discuss the potential utility of personality measurement to function as an inexpensive and accessible tool for healthcare professionals to personalize preventive medicine. Adding personality information to existing healthcare electronic infrastructures could also advance personality theory by generating opportunities to examine how personality processes influence doctor-patient communication, health service use, and patient outcomes. PMID:24588093

  18. [Preoperative evaluation of adult patients prior to elective, non-cardiac surgery. Joint recommendations of German Society of Anesthesiology and Intensive Care Medicine, German Society of Surgery and German Society of Internal Medicine].

    PubMed

    2011-09-01

    Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e.g. blood chemistry, ECG, spirometry, chest-x-ray) can contribute to a reduction of perioperative risk is often not very well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication. Therefore, the German Scientific Societies of Anesthesiology and Intensive Care Medicine (DGAI), Internal Medicine (DGIM) and Surgery (DGCH) have joined to elaborate and publish recommendations on the preoperative evaluation of adult patients prior to elective, non-cardiac and non-lung resection surgery. In the first part the general principles of preoperative evaluation are described (part A). The current concepts for extended evaluation of patients with known or suspected major cardiovascular disease are presented in part B. Finally, the perioperative management of patients' long-term medication is discussed (part C). The concepts proposed in these interdisciplinary recommendations endorsed by the DGAI, DGIM and DGCH provide a common basis for a structured preoperative risk assessment and management. These recommendations aim to ensure that surgical patients undergo a rational preoperative assessment and at the same time to avoid unnecessary, costly and potentially dangerous testing. The joint recommendations reflect the current state-of-the-art knowledge as well as expert opinions because scientific-based evidence is not always available. These recommendations will be subject to regular re-evaluation and updating when new validated evidence becomes available.

  19. [Changes in the prescription of cardiovascular prevention drugs in France between 1995 and 2003: factors influencing the gap between evidence base medicine and clinical practice].

    PubMed

    Philippe, François; Cambou, Jean-Pierre; Danchin, Nicolas; Thomas, Daniel

    2005-12-01

    Dramatic progresses have occurred during the past 10 years in the field of cardiovascular secondary prevention. Many randomized trials have established the efficacy of statins, antiplatelet agents, beta-blockers and ACE inhibitors for reducing cardiovascular mortality, myocardial infarction and stroke in patients with coronary heart disease. Since 2002, American and European guidelines have emphasized the importance of optimal utilization of those four main therapeutic classes. Nevertheless, drugs prescription registries conducted in France since 1995 revealed a persistent gap between evidence based medicine and clinical practice, only a minority of patient received an optimal treatment. Some factors associated with lower rate prescription have been identified: elderly patients, female gender, missing of LDL-cholesterol measurement, history of peripheral artery disease or stroke, and finally the difficulty of observance. At this time, optimization of management of these patients require a systematic measurement of LDL-cholestererol level for all patients with CAD, PAD or history of stroke, a larger prescription of statins in female patients and in elderly particularly for secondary prevention. Increasing observance which is the main challenge could involved the utilization of fixed drugs associations.

  20. Precision test for precision medicine: opportunities, challenges and perspectives regarding pre-eclampsia as an intervention window for future cardiovascular disease

    PubMed Central

    Zhou, Xin; Niu, Jian-Min; Ji, Wen-Jie; Zhang, Zhuoli; Wang, Peizhong P; Ling, Xue-Feng B; Li, Yu-Ming

    2016-01-01

    Hypertensive disorders of pregnancy (HDP) comprise a spectrum of syndromes that range in severity from gestational hypertension and pre-eclamplsia (PE) to eclampsia, as well as chronic hypertension and chronic hypertension with superimposed PE. HDP occur in 2% to 10% of pregnant women worldwide, and impose a substantial burden on maternal and fetal/infant health. Cardiovascular disease (CVD) is the leading cause of death in women. The high prevalence of non-obstructive coronary artery disease and the lack of an efficient diagnostic workup make the identification of CVD in women challenging. Accumulating evidence suggests that a previous history of PE is consistently associated with future CVD risk. Moreover, PE as a maladaptation to pregnancy-induced hemodynamic and metabolic stress may also be regarded as a “precision” testing result that predicts future cardiovascular risk. Therefore, the development of PE provides a tremendous, early opportunity that may lead to changes in maternal and infant future well-being. However, the underlying pathogenesis of PE is not precise, which warrants precision medicine-based approaches to establish a more precise definition and reclassification. In this review, we proposed a stage-specific, PE-targeted algorithm, which may provide novel hypotheses that bridge the gap between Big Data-generating approaches and clinical translational research in terms of PE prediction and prevention, clinical treatment, and long-term CVD management. PMID:27347303

  1. Precision test for precision medicine: opportunities, challenges and perspectives regarding pre-eclampsia as an intervention window for future cardiovascular disease.

    PubMed

    Zhou, Xin; Niu, Jian-Min; Ji, Wen-Jie; Zhang, Zhuoli; Wang, Peizhong P; Ling, Xue-Feng B; Li, Yu-Ming

    2016-01-01

    Hypertensive disorders of pregnancy (HDP) comprise a spectrum of syndromes that range in severity from gestational hypertension and pre-eclamplsia (PE) to eclampsia, as well as chronic hypertension and chronic hypertension with superimposed PE. HDP occur in 2% to 10% of pregnant women worldwide, and impose a substantial burden on maternal and fetal/infant health. Cardiovascular disease (CVD) is the leading cause of death in women. The high prevalence of non-obstructive coronary artery disease and the lack of an efficient diagnostic workup make the identification of CVD in women challenging. Accumulating evidence suggests that a previous history of PE is consistently associated with future CVD risk. Moreover, PE as a maladaptation to pregnancy-induced hemodynamic and metabolic stress may also be regarded as a "precision" testing result that predicts future cardiovascular risk. Therefore, the development of PE provides a tremendous, early opportunity that may lead to changes in maternal and infant future well-being. However, the underlying pathogenesis of PE is not precise, which warrants precision medicine-based approaches to establish a more precise definition and reclassification. In this review, we proposed a stage-specific, PE-targeted algorithm, which may provide novel hypotheses that bridge the gap between Big Data-generating approaches and clinical translational research in terms of PE prediction and prevention, clinical treatment, and long-term CVD management. PMID:27347303

  2. Four-year analysis of cardiovascular disease risk factors, depression symptoms, and antidepressant medicine use in the Look AHEAD (Action for Health in Diabetes) clinical trial of weight loss in diabetes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    OBJECTIVE To study the association of depressive symptoms or antidepressant medicine (ADM) use with subsequent cardiovascular disease (CVD) risk factor status in the Look AHEAD (Action for Health in Diabetes) trial of weight loss in type 2 diabetes. RESEARCH DESIGN AND METHODS Participants (n = 5,1...

  3. [Pathophysiological and clinical correlations between endocrine and cardiovascular systems. An inter-systemic model of internal medicine].

    PubMed

    Andreoli, Mario

    2006-12-01

    This review focuses on the mechanisms by which thyroid hormones affect the regulation of the cardiovascular system and the thermogenic and hemodynamic variation induced by thyroid disfunction. It is also stressed the hormonal role of the cardiac myocytes realising natriuretic peptides, involved in plasma volume homeostasis and cardiovascular remodelling; its rapid measurement is a useful clinical tool, in the diagnostic and prognostic of left ventricular dysfunction, correlating with the degree of the clinical symptoms. The endothelial layer is a receptor-effector endocrine organ that produces substances that maintain vasomotor balance and vascular-tissue homeostasis. Cardiovascular risk factors causes oxidative stress that alter endothelial function and leads to endothelial dysfunction. On the basis of the present body of evidence there is no doubt that endothelial dysfunction contributes to the initiation, and progression, of atherosclerotic disease and that it could be considered an independent vascular risk factor for the micro- and macrovascular damages in the diabetes disease. In several extrathyroidal pathological condition, as well as in heart failure, the main alteration of the thyroid function is referred to as "low T3 syndrome". This syndrome is due to an adaptative reaction of the metabolic pathway of thyroxine, producing an increased amount of rT3, metabolically inactive, thus decreasing the detrimental metabolic effects of T3, in conditions of critically impaired hemodynamic and metabolic efficiency. Preliminary clinical trials, in heart failure, suggest the prognostic value of the level of circulating T3, as well as usefulness of T3, or of thyromimetic derivatives (DITPA), in chronic treatment of the heart ventricular dysfunction.

  4. Experimental animal models of myocardial damage in regenerative medicine studies involving adult bone marrow derived stem cells: ethical and methodological implications.

    PubMed

    Ciulla, Michele M; Acquistapace, Giulia; Toffetti, Laura; Magrini, Fabio; Paliotti, Roberta

    2009-06-01

    Cardiac performance after myocardial infarction is compromised by ventricular remodeling, which represents a major cause of late infarct-related chronic heart failure and death. In recent years, the scientists' interest has focused on the hypothesis that the administration of bone marrow progenitors, following myocardial infarction, could ameliorate left ventricular remodeling by continuing to differentiate along the haematopoietic lineage. This approach has been developed minding to the consolidated use of transfusions to restore lost or depleted blood components and, therefore, as an enriched dose of various progenitors, generally autologous, injected peripherally or directly in the infarcted area. Since the safety of this therapy was not yet established, for ethical reasons pioneering researchers involved in these studies used animal models as surrogate of the human biologic system. Herein this hypothesis of therapy resulted in an increased use of living animals and in the reappraisal of models of myocardial damage with limited discussion on the theoretical basis of animal models applied to cell-based therapies. Recently, the European Union and its commission for surveillance of laboratory animals advanced a new proposal to restrict the use of living animals. This review will focus on the history of models utilization in biomedicine, with particular attention to animal models, and delineate an operative comparison between the two best known models of myocardial injury, namely coronary ligation and cryodamage, in the perspective of adult stem cell research applied to cardiovascular regenerative medicine.

  5. Impact of diabetes mellitus on risk of cardiovascular disease and all-cause mortality: Evidence on health outcomes and antidiabetic treatment in United States adults

    PubMed Central

    Liu, Longjian; Simon, Barbara; Shi, Jinggaofu; Mallhi, Arshpreet Kaur; Eisen, Howard J

    2016-01-01

    AIM To examine the epidemic of diabetes mellitus (DM) and its impact on mortality from all-cause and cardiovascular disease (CVD), and to test the effect of antidiabetic therapy on the mortality in United States adults. METHODS The analysis included a randomized population sample of 272149 subjects ages ≥ 18 years who participated in the National Health Interview Surveys (NHIS) in 2000-2009. Chronic conditions (hypertension, DM and CVD) were classified by participants’ self-reports of physician diagnosis. NHIS-Mortality Linked Files, and NHIS-Medical Expenditure Panel Survey Linkage Files on prescribed medicines for patients with DM were used to test the research questions. χ2, Poisson and Cox’s regression models were applied in data analysis. RESULTS Of all participants, 22305 (8.2%) had DM. The prevalence of DM significantly increased from 2000 to 2009 in all age groups (P < 0.001). Within an average 7.39 (SD = 3) years of follow-up, male DM patients had 1.56 times higher risk of death from all-cause (HR = 1.56, 95%CI: 1.49-1.64), 1.72 times higher from heart disease [1.72 (1.53-1.93)], 1.48 times higher from cerebrovascular disease [1.48 (1.18-1.85)], and 1.67 times higher from CVD [1.67 (1.51-1.86)] than subjects without DM, respectively. Similar results were observed in females. In males, 10% of DM patients did not use any antidiabetic medications, 38.1% used antidiabetic monotherapy, and 51.9% used ≥ 2 antidiabetic medications. These corresponding values were 10.3%, 40.4% and 49.4% in females. A significant protective effect of metformin monotherapy or combination therapy (except for insulin) on all-cause mortality and a protective but non-significant effect on CVD mortality were observed. CONCLUSION This is the first study using data from multiple linkage files to confirm a significant increased prevalence of DM in the last decade in the United States. Patients with DM have significantly higher risk of death from all-cause and CVD than those without

  6. Bad marriage, broken heart? Age and gender differences in the link between marital quality and cardiovascular risks among older adults.

    PubMed

    Liu, Hui; Waite, Linda

    2014-12-01

    Working from a life course perspective, we develop hypotheses about age and gender differences in the link between marital quality and cardiovascular risk and test them using data from the first two waves of the National Social Life, Health, and Aging Project. The analytic sample includes 459 married women and 739 married men (aged 57-85 in the first wave) who were interviewed in both waves. We apply Heckman-type corrections for selection bias due to mortality and marriage. Cardiovascular risk is measured as hypertension, rapid heart rate, C-reactive protein, and general cardiovascular events. Results suggest that changes in marital quality and cardiovascular risk are more closely related for older married people than for their younger counterparts and that the link between marital quality and cardiovascular risk is more pronounced among women than among men at older ages. These findings fit with the gendered life course perspective and cumulative disadvantage framework.

  7. Bad Marriage, Broken Heart? Age and Gender Differences in the Link between Marital Quality and Cardiovascular Risks among Older Adults

    PubMed Central

    Liu, Hui; Waite, Linda

    2015-01-01

    Working from a life course perspective, we develop hypotheses about age and gender differences in the link between marital quality and cardiovascular risk and test them using data from the first two waves of the National Social Life, Health, and Aging Project. The analytic sample includes 459 married women and 739 married men (aged 57–85 in the first wave) who were interviewed in both waves. We apply Heckman-type corrections for selection bias due to mortality and marriage. Cardiovascular risk is measured as hypertension, rapid heart rate, C-reactive protein, and general cardiovascular events. Results suggest that changes in marital quality and cardiovascular risk are more closely related for older married people than for their younger counterparts; and that the link between marital quality and cardiovascular risk is more pronounced among women than among men at older ages. These findings fit with the gendered life course perspective and cumulative disadvantage framework. PMID:25413802

  8. Bad marriage, broken heart? Age and gender differences in the link between marital quality and cardiovascular risks among older adults.

    PubMed

    Liu, Hui; Waite, Linda

    2014-12-01

    Working from a life course perspective, we develop hypotheses about age and gender differences in the link between marital quality and cardiovascular risk and test them using data from the first two waves of the National Social Life, Health, and Aging Project. The analytic sample includes 459 married women and 739 married men (aged 57-85 in the first wave) who were interviewed in both waves. We apply Heckman-type corrections for selection bias due to mortality and marriage. Cardiovascular risk is measured as hypertension, rapid heart rate, C-reactive protein, and general cardiovascular events. Results suggest that changes in marital quality and cardiovascular risk are more closely related for older married people than for their younger counterparts and that the link between marital quality and cardiovascular risk is more pronounced among women than among men at older ages. These findings fit with the gendered life course perspective and cumulative disadvantage framework. PMID:25413802

  9. Cardiovascular disease risks in adult Native and Mexican Americans with a history of alcohol use disorders: association with cardiovascular autonomic control.

    PubMed

    Criado, José R; Gilder, David A; Kalafut, Mary A; Ehlers, Cindy L

    2016-04-01

    Hypertension and obesity are serious health problems that have been associated with an increased risk of cardiovascular disease (CVD). We recently showed a relationship between hypertension, obesity and cardiovagal control in a sample of Native and Mexican Americans at high risk of alcohol use disorders (AUD). While studies have shown that Native and Mexican Americans exhibit high rates of AUD, the consequences of AUD on CVD risk factors and their relationship with cardiovascular autonomic control is not well understood in these ethnic groups. This study investigated whether an association could be demonstrated between cardiovascular autonomic control and several CVD risk factors in Native and Mexican American men and women (n = 228) who are literate in English and are residing legally in San Diego County. Participants with lifetime history of AUD showed higher rates of systolic and diastolic hypertension and obesity than participants without lifetime AUD. Lifetime AUD was significantly associated with reduced HR response to deep breathing (HRDB) measure of cardiovagal control, higher current drinking quantity, and obesity. Reduced HRDB was also associated with increased systolic pre-hypertension or hypertension (pre-/hypertension) and with higher diastolic blood pressure in a linear regression model that included several diagnostic and demographic variables. HRDB and time- and frequency-domain measures of cardiovagal control were significantly reduced in participants with diastolic pre-/hypertension. These data suggest that lower cardiovagal control may play a role in the prevalence of systolic and diastolic pre-/hypertension in a community sample with a history of alcohol and substance use disorders.

  10. Cardiovascular disease risks in adult Native and Mexican Americans with a history of alcohol use disorders: association with cardiovascular autonomic control.

    PubMed

    Criado, José R; Gilder, David A; Kalafut, Mary A; Ehlers, Cindy L

    2016-04-01

    Hypertension and obesity are serious health problems that have been associated with an increased risk of cardiovascular disease (CVD). We recently showed a relationship between hypertension, obesity and cardiovagal control in a sample of Native and Mexican Americans at high risk of alcohol use disorders (AUD). While studies have shown that Native and Mexican Americans exhibit high rates of AUD, the consequences of AUD on CVD risk factors and their relationship with cardiovascular autonomic control is not well understood in these ethnic groups. This study investigated whether an association could be demonstrated between cardiovascular autonomic control and several CVD risk factors in Native and Mexican American men and women (n = 228) who are literate in English and are residing legally in San Diego County. Participants with lifetime history of AUD showed higher rates of systolic and diastolic hypertension and obesity than participants without lifetime AUD. Lifetime AUD was significantly associated with reduced HR response to deep breathing (HRDB) measure of cardiovagal control, higher current drinking quantity, and obesity. Reduced HRDB was also associated with increased systolic pre-hypertension or hypertension (pre-/hypertension) and with higher diastolic blood pressure in a linear regression model that included several diagnostic and demographic variables. HRDB and time- and frequency-domain measures of cardiovagal control were significantly reduced in participants with diastolic pre-/hypertension. These data suggest that lower cardiovagal control may play a role in the prevalence of systolic and diastolic pre-/hypertension in a community sample with a history of alcohol and substance use disorders. PMID:26758567

  11. Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

    PubMed

    Rich, Michael W; Chyun, Deborah A; Skolnick, Adam H; Alexander, Karen P; Forman, Daniel E; Kitzman, Dalane W; Maurer, Mathew S; McClurken, James B; Resnick, Barbara M; Shen, Win K; Tirschwell, David L

    2016-05-24

    The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients aged ≥75 years have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older patients with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in a nursing home or assisted living facility. As a result, current guidelines are unable to provide evidence-based recommendations for diagnosis and treatment of older patients typical of those encountered in routine clinical practice. The objectives of this scientific statement are to summarize current guideline recommendations as they apply to older adults, identify critical gaps in knowledge that preclude informed evidence-based decision making, and recommend future research to close existing knowledge gaps. To achieve these objectives, we conducted a detailed review of current American College of Cardiology/American Heart Association and American Stroke Association guidelines to identify content and recommendations that explicitly targeted older patients. We found that there is a pervasive lack of evidence to guide clinical decision making in older patients with cardiovascular disease, as well as a paucity of data on the impact of diagnostic and therapeutic interventions on key outcomes that are particularly important to older patients, such as quality of life, physical function, and maintenance of independence. Accordingly, there is a critical need for a multitude of large population-based studies and clinical trials that include a broad spectrum of older patients representative of those seen in clinical practice and that incorporate relevant outcomes important to older patients in the study design. The

  12. Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

    PubMed

    Rich, Michael W; Chyun, Deborah A; Skolnick, Adam H; Alexander, Karen P; Forman, Daniel E; Kitzman, Dalane W; Maurer, Mathew S; McClurken, James B; Resnick, Barbara M; Shen, Win K; Tirschwell, David L

    2016-05-24

    The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients aged ≥75 years have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older patients with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in a nursing home or assisted living facility. As a result, current guidelines are unable to provide evidence-based recommendations for diagnosis and treatment of older patients typical of those encountered in routine clinical practice. The objectives of this scientific statement are to summarize current guideline recommendations as they apply to older adults, identify critical gaps in knowledge that preclude informed evidence-based decision making, and recommend future research to close existing knowledge gaps. To achieve these objectives, we conducted a detailed review of current American College of Cardiology/American Heart Association and American Stroke Association guidelines to identify content and recommendations that explicitly targeted older patients. We found that there is a pervasive lack of evidence to guide clinical decision making in older patients with cardiovascular disease, as well as a paucity of data on the impact of diagnostic and therapeutic interventions on key outcomes that are particularly important to older patients, such as quality of life, physical function, and maintenance of independence. Accordingly, there is a critical need for a multitude of large population-based studies and clinical trials that include a broad spectrum of older patients representative of those seen in clinical practice and that incorporate relevant outcomes important to older patients in the study design. The

  13. Systematic review of randomised controlled trials of over the counter cough medicines for acute cough in adults

    PubMed Central

    Schroeder, Knut; Fahey, Tom

    2002-01-01

    Objectives To determine whether over the counter cough medicines are effective for acute cough in adults. Design Systematic review of randomised controlled trials. Data sources Search of the Cochrane Acute Respiratory Infections Group specialised register, Cochrane Controlled Trials Register, Medline, Embase, and the UK Department of Health National Research Register in all languages. Included studies All randomised controlled trials that compared oral over the counter cough preparations with placebo in adults with acute cough due to upper respiratory tract infection in ambulatory settings and that had cough symptoms as an outcome. Results 15 trials involving 2166 participants met all the inclusion criteria. Antihistamines seemed to be no better than placebo. There was conflicting evidence on the effectiveness of antitussives, expectorants, antihistamine-decongestant combinations, and other drug combinations compared with placebo. Conclusion Over the counter cough medicines for acute cough cannot be recommended because there is no good evidence for their effectiveness. Even when trials had significant results, the effect sizes were small and of doubtful clinical relevance. Because of the small number of trials in each category, the results have to be interpreted cautiously. What is already know on this topicThe NHS encourages self treatment of acute self limiting illnessesOver the counter cough medicines are commonly used as first line treatment for acute coughWhat this study addsThere is little evidence for or against the effectiveness of over the counter cough medicinesAlthough cough medicines are generally well tolerated, they may be an unnecessary expenseRecommendation of over the counter cough medicines to patients is not justified by current evidence PMID:11834560

  14. Inhaled corticosteroid beliefs, complementary and alternative medicine and uncontrolled asthma in urban minority adults

    PubMed Central

    George, Maureen; Topaz, Maxim; Rand, Cynthia; Sommers, Marilyn (Lynn) Sawyer; Glanz, Karen; Pantalon, Michael V.; Mao, Jun J.; Shea, Judy A.

    2014-01-01

    Background Many factors contribute to uncontrolled asthma; negative inhaled corticosteroid (ICS) beliefs and complementary and alternative medicine (CAM) endorsement are two that are more prevalent in Black as compared to White adults. Objectives This mixed methods study 1) developed and psychometrically tested a brief self-administered tool with low literacy demands to identify negative ICS beliefs and CAM endorsement and; 2) evaluated the clinical utility of the tool as a communication prompt in primary care. Methods Comprehensive literature reviews and content experts identified candidate items for our instrument that was distributed to 304 individuals for psychometric testing. In the second phase, content analysis of 33 audio recorded primary care visits provided a preliminary evaluation of the instrument's clinical utility. Results Psychometric testing of the instrument identified 17 items representing ICS beliefs (α .59) and CAM endorsement (α .68). Test-retest analysis demonstrated a high level of reliability (ICC .77 for CAM items and .79 for ICS items). We found high rates of CAM endorsement (93%), negative ICS beliefs (68%), and uncontrolled asthma (69%). CAM endorsement was significantly associated with uncontrolled asthma (p=.04). Qualitative data analysis provided preliminary evidence for the instrument's clinical utility in that knowledge of ICS beliefs and CAM endorsement prompted providers to initiate discussions with patients. Conclusion Negative ICS beliefs and CAM endorsement were common and were associated with uncontrolled asthma. A brief self-administered instrument that identifies beliefs and behaviors that likely undermine ICS adherence may be a leveraging tool to change the content of communication during clinic visits. PMID:25218286

  15. Complementary and Alternative Medicine Use in the US Adult Low Back Pain Population

    PubMed Central

    Johnson, Pamela Jo; Evans, Roni L.; Kreitzer, Mary Jo

    2016-01-01

    Background: Many people suffering from low back pain (LBP) have found conventional medical treatments to be ineffective for managing their LBP and are increasingly turning to complementary and alternative medicine (CAM) to find pain relief. A comprehensive picture of CAM use in the LBP population, including all of the most commonly used modalities, is needed. Study Objective: To examine prevalence and perceived benefit of CAM use within the US LBP population by limiting vs nonlimiting LBP and to evaluate the odds of past year CAM use within the LBP population Methods: Data are from the 2012 National Health Interview Survey, Alternative Health Supplement. We examined a nationally representative sample of US adults with LBP (N=9665 unweighted). Multiple logistic regression was used to estimate the odds of past year CAM use. Results: In all, 41.2% of the LBP population used CAM in the past year, with higher use reported among those with limiting LBP. The most popular therapies used in the LBP population included herbal supplements, chiropractic manipulation, and massage. The majority of the LBP population used CAM specifically to treat back pain, and 58.1% of those who used CAM for their back pain perceived a great deal of benefit. Conclusion: The results are indicative of CAM becoming an increasingly important component of care for people with LBP. Additional understanding of patterns of CAM use among the LBP population will help health professionals make more informed care decisions and guide investigators in development of future back pain–related CAM research. PMID:26937316

  16. Standard procedures for adults in accredited sleep medicine centres in Europe.

    PubMed

    Fischer, Jürgen; Dogas, Zoran; Bassetti, Claudio L; Berg, Søren; Grote, Ludger; Jennum, Poul; Levy, Patrick; Mihaicuta, Stefan; Nobili, Lino; Riemann, Dieter; Puertas Cuesta, F Javier; Raschke, Friedhart; Skene, Debra J; Stanley, Neil; Pevernagie, Dirk

    2012-08-01

    The present paper describes standardized procedures within clinical sleep medicine. As such, it is a continuation of the previously published European guidelines for the accreditation of sleep medicine centres and European guidelines for the certification of professionals in sleep medicine, aimed at creating standards of practice in European sleep medicine. It is also part of a broader action plan of the European Sleep Research Society, including the process of accreditation of sleep medicine centres and certification of sleep medicine experts, as well as publishing the Catalogue of Knowledge and Skills for sleep medicine experts (physicians, non-medical health care providers, nurses and technologists), which will be a basis for the development of relevant educational curricula. In the current paper, the standard operational procedures sleep medicine centres regarding the diagnostic and therapeutic management of patients evaluated at sleep medicine centres, accredited according to the European Guidelines, are based primarily on prevailing evidence-based medicine principles. In addition, parts of the standard operational procedures are based on a formalized consensus procedure applied by a group of Sleep Medicine Experts from the European National Sleep Societies. The final recommendations for standard operational procedures are categorized either as 'standard practice', 'procedure that could be useful', 'procedure that is not useful' or 'procedure with insufficient information available'. Standard operational procedures described here include both subjective and objective testing, as well as recommendations for follow-up visits and for ensuring patients' safety in sleep medicine. The overall goal of the actual standard operational procedures is to further develop excellence in the practice and quality assurance of sleep medicine in Europe.

  17. Potential herb-drug interaction in the prevention of cardiovascular diseases during integrated traditional and Western medicine treatment.

    PubMed

    Wang, Xiao-Long

    2015-01-01

    The combination of herbs and drugs is one of the most important approaches in the prevention and treatment of diseases in the integrated traditional and Western medicine (ITWM). While most medical practices have proved that the combination of herbs and drugs led to a clinical efficacy that was often superior to merely using only one of them; results from some studies have triggered adverse reactions to such an approach. Since few herb-drug interaction studies were carried out during treatments combining herbs and drugs, it really restricts the development of treatment and treatment theory of the combination of herbs and drugs. Given that herb-drug interactions may occur through the main pathway of cytochrome P450 enzymes and transporters; then to exhaustively study the role and impact of herbs in drug metabolism, as well as to establish a corresponding database, is of great significance for guiding the rational combination of herbs and drugs. When the herb-drug interaction information platform is implemented, we would get at ease a reasonable herb-drug prescription to achieve a better outcome, reduce dosage of some expensive drugs preserving the same efficacy, or even reduce some side effects of particular drugs; which might also promote the dynamic combination of Chinese and Western medicine, and accelerate the theory development of ITWM.

  18. Plasma phospholipid very-long-chain saturated fatty acids and incident diabetes in older adults: the Cardiovascular Health Study1234

    PubMed Central

    Lemaitre, Rozenn N; Fretts, Amanda M; Sitlani, Colleen M; Biggs, Mary L; Mukamal, Kenneth; King, Irena B; Song, Xiaoling; Djoussé, Luc; Siscovick, David S; McKnight, Barbara; Sotoodehnia, Nona; Kizer, Jorge R; Mozaffarian, Dariush

    2015-01-01

    Background: Circulating saturated fatty acids (SFAs) are integrated biomarkers of diet and metabolism that may influence the pathogenesis of diabetes. In epidemiologic studies, circulating levels of palmitic acid (16:0) are associated with diabetes; however, very-long-chain SFAs (VLSFAs), with 20 or more carbons, differ from palmitic acid in their biological activities, and little is known of the association of circulating VLSFA with diabetes. Objective: By using data from the Cardiovascular Health Study, we examined the associations of plasma phospholipid VLSFA levels measured at baseline with subsequent incident diabetes. Design: A total of 3179 older adults, with a mean age of 75 y at study baseline (1992–1993), were followed through 2011. We used multiple proportional hazards regression to examine the associations of arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) with diabetes. Results: Baseline levels of each VLSFA were cross-sectionally associated with lower triglyceride levels and lower circulating palmitic acid. We identified 284 incident diabetes cases during follow-up. Compared with the lowest quartile, levels of arachidic acid in the highest quartile of the fatty acid distribution were associated with a 47% lower risk of diabetes (95% CI: 23%, 63%; P-trend: <0.001), after adjustment for demographics, lifestyle factors, and clinical conditions. In analogous comparisons, levels of behenic and lignoceric acid were similarly associated with 33% (95% CI: 6%, 53%; P-trend: 0.02) and 37% (95% CI: 11%, 55%; P-trend: 0.01) lower diabetes risk, respectively. Adjustment for triglycerides and palmitic acid attenuated the associations toward the null, and only the association of arachidic acid remained statistically significant (32% lower risk for fourth vs. first quartile; P-trend: 0.04). Conclusions: These results suggest that circulating VLSFAs are associated with a lower risk of diabetes, and these associations may be mediated by lower

  19. The Periconceptional Environment and Cardiovascular Disease: Does In Vitro Embryo Culture and Transfer Influence Cardiovascular Development and Health?

    PubMed Central

    Padhee, Monalisa; Zhang, Song; Lie, Shervi; Wang, Kimberley C.; Botting, Kimberley J.; McMillen, I. Caroline; MacLaughlin, Severence M.; Morrison, Janna L.

    2015-01-01

    Assisted Reproductive Technologies (ARTs) have revolutionised reproductive medicine; however, reports assessing the effects of ARTs have raised concerns about the immediate and long-term health outcomes of the children conceived through ARTs. ARTs include manipulations during the periconceptional period, which coincides with an environmentally sensitive period of gamete/embryo development and as such may alter cardiovascular development and health of the offspring in postnatal life. In order to identify the association between ARTs and cardiovascular health outcomes, it is important to understand the events that occur during the periconceptional period and how they are affected by procedures involved in ARTs. This review will highlight the emerging evidence implicating adverse cardiovascular outcomes before and after birth in offspring conceived through ARTs in both human and animal studies. In addition, it will identify the potential underlying causes and molecular mechanisms responsible for the congenital and adult cardiovascular dysfunctions in offspring whom were conceived through ARTs. PMID:25699984

  20. The Effects of Chunghyul-Dan (A Korean Medicine Herbal Complex) on Cardiovascular and Cerebrovascular Diseases: A Narrative Review

    PubMed Central

    Jung, Woo-Sang; Kwon, Seungwon; Cho, Seung-Yeon; Park, Seong-Uk; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Cho, Ki-Ho

    2016-01-01

    Chunghyul-dan (CHD) is a herbal complex containing 80% ethanol extract and is composed of Scutellariae Radix, Coptidis Rhizoma, Phellodendri Cortex, Gardeniae Fructus, and Rhei Rhizoma. We have published several experimental and clinical research articles on CHD. It has shown antilipidemic, antihypertensive, antiatherosclerotic, and inhibitory effects on ischemic stroke recurrence with clinical safety in the previous studies. The antilipidemic effect of CHD results from 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase and pancreatic lipase-inhibitory activity. The antihypertensive effect likely results from the inhibitory effect on endogenous catecholamine(s) release and harmonization of all components showing the antihypertensive effects. Furthermore, anti-inflammatory and antioxidant effects on endothelial cells are implicated to dictate the antiatherosclerotic effects of CHD. It also showed neuroprotective effects on cerebrovascular and parkinsonian models. These effects of CHD could be helpful for the prevention of the recurrence of ischemic stroke. Therefore, we suggest that CHD could be a promising medication for treating and preventing cerebrovascular and cardiovascular diseases. However, to validate and better understand these findings, well-designed clinical studies are required. PMID:27340412

  1. The Effects of Chunghyul-Dan (A Korean Medicine Herbal Complex) on Cardiovascular and Cerebrovascular Diseases: A Narrative Review.

    PubMed

    Jung, Woo-Sang; Kwon, Seungwon; Cho, Seung-Yeon; Park, Seong-Uk; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Cho, Ki-Ho

    2016-01-01

    Chunghyul-dan (CHD) is a herbal complex containing 80% ethanol extract and is composed of Scutellariae Radix, Coptidis Rhizoma, Phellodendri Cortex, Gardeniae Fructus, and Rhei Rhizoma. We have published several experimental and clinical research articles on CHD. It has shown antilipidemic, antihypertensive, antiatherosclerotic, and inhibitory effects on ischemic stroke recurrence with clinical safety in the previous studies. The antilipidemic effect of CHD results from 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase and pancreatic lipase-inhibitory activity. The antihypertensive effect likely results from the inhibitory effect on endogenous catecholamine(s) release and harmonization of all components showing the antihypertensive effects. Furthermore, anti-inflammatory and antioxidant effects on endothelial cells are implicated to dictate the antiatherosclerotic effects of CHD. It also showed neuroprotective effects on cerebrovascular and parkinsonian models. These effects of CHD could be helpful for the prevention of the recurrence of ischemic stroke. Therefore, we suggest that CHD could be a promising medication for treating and preventing cerebrovascular and cardiovascular diseases. However, to validate and better understand these findings, well-designed clinical studies are required. PMID:27340412

  2. Increased cardiovascular reactivity to acute stress and salt-loading in adult male offspring of fat fed non-obese rats.

    PubMed

    Rudyk, Olena; Makra, Péter; Jansen, Eugene; Shattock, Michael J; Poston, Lucilla; Taylor, Paul D

    2011-01-01

    Diet-induced obesity in rat pregnancy has been shown previously to be associated with consistently raised blood pressure in the offspring, attributed to sympathetic over-activation, but the relative contributions to this phenotype of maternal obesity versus raised dietary fat is unknown. Sprague-Dawley female rats were fed either a control (4.3% fat, n = 11) or lard-enriched (23.6% fat, n = 16) chow 10 days prior to mating, throughout pregnancy and lactation. In conscious adult (9-month-old) offspring cardiovascular parameters were measured (radiotelemetry). The short period of fat-feeding did not increase maternal weight versus controls and the baseline blood pressure was similar in offspring of fat fed dams (OF) and controls (OC). However, adult male OF showed heightened cardiovascular reactivity to acute restraint stress (p<0.01; Δ systolic blood pressure (SBP) and Δheart rate (HR)) with a prolonged recovery time compared to male OC. α1/β-adrenergic receptor blockade normalised the response. Also, after dietary salt-loading (8%-NaCl ad libitum for 1 week) male OF demonstrated higher SBP (p<0.05) in the awake phase (night-time) and increased low/high frequency ratio of power spectral density of HR variability versus OC. Baroreflex gain and basal power spectral density components of the heart rate or blood pressure were similar in male OF and OC. Minor abnormalities were evident in female OF. Fat feeding in the absence of maternal obesity in pregnant rats leads to altered sympathetic control of cardiovascular function in adult male offspring, and hypertension in response to stressor stimuli.

  3. Gender-specific research for emergency diagnosis and management of ischemic heart disease: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

    PubMed

    Safdar, Basmah; Nagurney, John T; Anise, Ayodola; DeVon, Holli A; D'Onofrio, Gail; Hess, Erik P; Hollander, Judd E; Legato, Mariane J; McGregor, Alyson J; Scott, Jane; Tewelde, Semhar; Diercks, Deborah B

    2014-12-01

    Coronary artery disease (CAD) is the most common cause of death for both men and women. However, over the years, emergency physicians, cardiologists, and other health care practitioners have observed varying outcomes in men and women with symptomatic CAD. Women in general are 10 to 15 years older than men when they develop CAD, but suffer worse postinfarction outcomes compared to age-matched men. This article was developed by the cardiovascular workgroup at the 2014 Academic Emergency Medicine (AEM) consensus conference to identify sex- and gender-specific gaps in the key themes and research questions related to emergency cardiac ischemia care. The workgroup had diverse stakeholder representation from emergency medicine, cardiology, critical care, nursing, emergency medical services, patients, and major policy-makers in government, academia, and patient care. We implemented the nominal group technique to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Through three rounds of nomination and refinement, followed by an in-person meeting on May 13, 2014, we achieved consensus on five priority themes and 30 research questions. The overarching themes were as follows: 1) the full spectrum of sex-specific risk as well as presentation of cardiac ischemia may not be captured by our standard definition of CAD and needs to incorporate other forms of ischemic heart disease (IHD); 2) diagnosis is further challenged by sex/gender differences in presentation and variable sensitivity of cardiac biomarkers, imaging, and risk scores; 3) sex-specific pathophysiology of cardiac ischemia extends beyond conventional obstructive CAD to include other causes such as microvascular dysfunction, takotsubo, and coronary artery dissection, better recognized as IHD; 4) treatment and prognosis are influenced by sex-specific variations in biology, as well as patient

  4. Gender-specific research for emergency diagnosis and management of ischemic heart disease: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

    PubMed

    Safdar, Basmah; Nagurney, John T; Anise, Ayodola; DeVon, Holli A; D'Onofrio, Gail; Hess, Erik P; Hollander, Judd E; Legato, Mariane J; McGregor, Alyson J; Scott, Jane; Tewelde, Semhar; Diercks, Deborah B

    2014-12-01

    Coronary artery disease (CAD) is the most common cause of death for both men and women. However, over the years, emergency physicians, cardiologists, and other health care practitioners have observed varying outcomes in men and women with symptomatic CAD. Women in general are 10 to 15 years older than men when they develop CAD, but suffer worse postinfarction outcomes compared to age-matched men. This article was developed by the cardiovascular workgroup at the 2014 Academic Emergency Medicine (AEM) consensus conference to identify sex- and gender-specific gaps in the key themes and research questions related to emergency cardiac ischemia care. The workgroup had diverse stakeholder representation from emergency medicine, cardiology, critical care, nursing, emergency medical services, patients, and major policy-makers in government, academia, and patient care. We implemented the nominal group technique to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Through three rounds of nomination and refinement, followed by an in-person meeting on May 13, 2014, we achieved consensus on five priority themes and 30 research questions. The overarching themes were as follows: 1) the full spectrum of sex-specific risk as well as presentation of cardiac ischemia may not be captured by our standard definition of CAD and needs to incorporate other forms of ischemic heart disease (IHD); 2) diagnosis is further challenged by sex/gender differences in presentation and variable sensitivity of cardiac biomarkers, imaging, and risk scores; 3) sex-specific pathophysiology of cardiac ischemia extends beyond conventional obstructive CAD to include other causes such as microvascular dysfunction, takotsubo, and coronary artery dissection, better recognized as IHD; 4) treatment and prognosis are influenced by sex-specific variations in biology, as well as patient

  5. Obesity and cardiovascular disease.

    PubMed

    Jokinen, E

    2015-02-01

    Cardiovascular disease is the most common cause of mortality in rich countries and today it has the same meaning for health care as the epidemics of past centuries had for medicine in earlier times: 50% of the population in these countries die of cardiovascular disease. The amount of cardiovascular disease is also increasing in the developing countries together with economic growth. By 2015 one in three deaths will globally be due to cardiovascular diseases. Coronary heart disease is a chronic disease that starts in childhood, even if the symptoms first occur in the middle age. The risks for coronary heart disease are well-known: lipid disorders, especially high serum LDL-cholesterol concentration, high blood pressure, tobacco smoking, obesity, diabetes, male gender and physical inactivity. Obesity is both an independent risk factor for cardiovascular disease but is also closely connected with several other risk factors. This review focuses on the connection between overweight or obesity and cardiovascular disease. PMID:25387321

  6. The use of mind-body medicine and prayer among adult patients with chronic hepatitis C.

    PubMed

    Richmond, Jacqueline A; Bailey, Donald E; McHutchison, John G; Muir, Andrew J

    2010-01-01

    The use of mind-body medicine by patients with chronic hepatitis C has not been reported. The prevalence and reasons for using mind-body medicine and prayer among a cohort of patients with chronic hepatitis C are described. Use of mind-body medicine and prayer was investigated as a component of a larger exploratory, descriptive study of the use of complementary and alternative medicine by patients with hepatitis C attending a tertiary healthcare facility in the United States. An investigator-designed self-administered questionnaire (n = 149) and semistructured interview (n = 28) were completed by participants. Eighty-eight percent (n = 105) of participants had used mind-body medicine in the past 12 months. The most commonly used therapies were prayer for health reasons (90%), deep breathing (29%), and meditation (29%). Mind-body medicine was most commonly used to relieve tension and promote general well-being. The use of mind-body medicine was widespread among patients with chronic hepatitis C. To provide patient-centered healthcare, health providers need to be aware of the alternative support strategies, including mind-body medicine, used by patients.

  7. Perspectives of induced pluripotent stem cells for cardiovascular system regeneration.

    PubMed

    Csöbönyeiová, Mária; Polák, Štefan; Danišovič, L'uboš

    2015-05-01

    Induced pluripotent stem cells (iPSCs) hold great promise for basic research and regenerative medicine. They offer the same advantages as embryonic stem cells (ESCs) and moreover new perspectives for personalized medicine. iPSCs can be generated from adult somatic tissues by over-expression of a few defined transcription factors, including Oct4, Sox2, Klf4, and c-myc. For regenerative medicine in particular, the technology provides great hope for patients with incurable diseases or potentially fatal disorders such as heart failure. The endogenous regenerative potentials of adult hearts are extremely limited and insufficient to compensate for myocardial loss occurring after myocardial infarction. Recent discoveries have demonstrated that iPSCs have the potential to significantly advance future cardiovascular regenerative therapies. Moreover, iPSCs can be generated from somatic cells of patients with genetic basis for their disease. This human iPSC derivates offer tremendous potential for new disease models. This paper reviews current applications of iPSCs in cardiovascular regenerative medicine and discusses progress in modeling cardiovascular diseases using iPSCs-derived cardiac cells.

  8. Perspectives of induced pluripotent stem cells for cardiovascular system regeneration

    PubMed Central

    Csöbönyeiová, Mária; Polák, Štefan

    2015-01-01

    Induced pluripotent stem cells (iPSCs) hold great promise for basic research and regenerative medicine. They offer the same advantages as embryonic stem cells (ESCs) and moreover new perspectives for personalized medicine. iPSCs can be generated from adult somatic tissues by over-expression of a few defined transcription factors, including Oct4, Sox2, Klf4, and c-myc. For regenerative medicine in particular, the technology provides great hope for patients with incurable diseases or potentially fatal disorders such as heart failure. The endogenous regenerative potentials of adult hearts are extremely limited and insufficient to compensate for myocardial loss occurring after myocardial infarction. Recent discoveries have demonstrated that iPSCs have the potential to significantly advance future cardiovascular regenerative therapies. Moreover, iPSCs can be generated from somatic cells of patients with genetic basis for their disease. This human iPSC derivates offer tremendous potential for new disease models. This paper reviews current applications of iPSCs in cardiovascular regenerative medicine and discusses progress in modeling cardiovascular diseases using iPSCs-derived cardiac cells. PMID:25595188

  9. From the α to the ω-3: Breaking the link between impaired fetal growth and adult cardiovascular disease.

    PubMed

    Skilton, Michael R; Phang, Melinda

    2016-01-01

    Atherosclerotic vascular disease is an important cause of premature morbidity and mortality. An extensive body of epidemiologic data links impaired fetal growth, evidenced by reductions in birth weight, with a higher risk for cardiovascular disease in adulthood. This association appears to be at least partially independent of established cardiovascular risk factors, such as hypertension and type 2 diabetes. There is currently no clinically established strategy to prevent cardiovascular events secondary to being born with poor fetal growth. This review summarizes recent evidence that suggests that ω-3 polyunsaturated fatty acids may be beneficial for this indication; in particular being associated with more marked reductions in blood pressure and subclinical atherosclerosis in people who were born with poor fetal growth, than in those with healthy birth weight. Possible mechanisms, and the evidence base required to support the implementation of dietary guidelines specific to people born with impaired fetal growth are also described.

  10. From the α to the ω-3: Breaking the link between impaired fetal growth and adult cardiovascular disease.

    PubMed

    Skilton, Michael R; Phang, Melinda

    2016-01-01

    Atherosclerotic vascular disease is an important cause of premature morbidity and mortality. An extensive body of epidemiologic data links impaired fetal growth, evidenced by reductions in birth weight, with a higher risk for cardiovascular disease in adulthood. This association appears to be at least partially independent of established cardiovascular risk factors, such as hypertension and type 2 diabetes. There is currently no clinically established strategy to prevent cardiovascular events secondary to being born with poor fetal growth. This review summarizes recent evidence that suggests that ω-3 polyunsaturated fatty acids may be beneficial for this indication; in particular being associated with more marked reductions in blood pressure and subclinical atherosclerosis in people who were born with poor fetal growth, than in those with healthy birth weight. Possible mechanisms, and the evidence base required to support the implementation of dietary guidelines specific to people born with impaired fetal growth are also described. PMID:27025974

  11. The acute and sub-chronic effects of cocoa flavanols on mood, cognitive and cardiovascular health in young healthy adults: a randomized, controlled trial

    PubMed Central

    Massee, Laura A.; Ried, Karin; Pase, Matthew; Travica, Nikolaj; Yoganathan, Jaesshanth; Scholey, Andrew; Macpherson, Helen; Kennedy, Greg; Sali, Avni; Pipingas, Andrew

    2015-01-01

    Cocoa supplementation has been associated with benefits to cardiovascular health. However, cocoa's effects on cognition are less clear. A randomized, placebo-controlled, double-blind clinical trial (n = 40, age M = 24.13 years, SD = 4.47 years) was conducted to investigate the effects of both acute (same-day) and sub-chronic (daily for four-weeks) 250 mg cocoa supplementation on mood and mental fatigue, cognitive performance and cardiovascular functioning in young, healthy adults. Assessment involved repeated 10-min cycles of the Cognitive Demand Battery (CDB) encompassing two serial subtraction tasks (Serial Threes and Sevens), a Rapid Visual Information Processing task, and a mental fatigue scale over the course of half an hour. The Swinburne University Computerized Cognitive Assessment Battery (SUCCAB) was also completed to evaluate cognition. Cardiovascular function included measuring both peripheral and central blood pressure and cerebral blood flow. At the acute time point, consumption of cocoa significantly improved self-reported mental fatigue and performance on the Serial Sevens task in cycle one of the CDB. No other significant effects were found. This trial was registered with the Australian and New Zealand Clinical Trial Registry (Trial ID: ACTRN12613000626763). Accessible via http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12613000626763&ddlSearch=Registered. PMID:26042037

  12. The clinical significance and costs of herbs and food supplements used by complementary and alternative medicine for the treatment of cardiovascular diseases and hypertension.

    PubMed

    Chrysant, S G

    2016-01-01

    Complementary and alternative medicine (CAM) is widely used by people in the United States and other countries for the treatment of health conditions that include hypertension (HTN), cardiovascular disease (CVD), heart failure, hyperlipidemia and other condtions. The visits to CAM practitioners result in significant out-of-pocket expenses, as CAM is not covered by health insurance in the majority of cases. The reasons for this are that the products used are not closely regulated by governmental regulatory agencies and lack scientific evidence about their effectiveness and safety. The people regard these products as being 'natural' and, consequently, safe. However, there is evidence that these products can be contaminated and adulterated with other substances and could cause harm to the persons who take them. The responsibility falls on the health professionals, who should become familiar with the various CAM products, inquire their patients whether they taking any of these products and advise them accordingly. This review is based on a recent statement issued by the American Medical for the use of CAM for the treatment of HTN. For its preparation, a Medline search of the English language literature was performed between 2010 and 2014 restricted in the use of CAM for CVD and HTN, and from the 88 abstracts reviewed, 23 pertinent papers were selected. These papers together with collateral literature will be discussed in this review regarding CAM and CAM products on their effectiveness and safety for the treatment of CVD and HTN.

  13. Clinical use of quantitative cardiac perfusion PET: rationale, modalities and possible indications. Position paper of the Cardiovascular Committee of the European Association of Nuclear Medicine (EANM).

    PubMed

    Sciagrà, Roberto; Passeri, Alessandro; Bucerius, Jan; Verberne, Hein J; Slart, Riemer H J A; Lindner, Oliver; Gimelli, Alessia; Hyafil, Fabien; Agostini, Denis; Übleis, Christopher; Hacker, Marcus

    2016-07-01

    Until recently, PET was regarded as a luxurious way of performing myocardial perfusion scintigraphy, with excellent image quality and diagnostic capabilities that hardly justified the additional cost and procedural effort. Quantitative perfusion PET was considered a major improvement over standard qualitative imaging, because it allows the measurement of parameters not otherwise available, but for many years its use was confined to academic and research settings. In recent years, however, several factors have contributed to the renewal of interest in quantitative perfusion PET, which has become a much more readily accessible technique due to progress in hardware and the availability of dedicated and user-friendly platforms and programs. In spite of this evolution and of the growing evidence that quantitative perfusion PET can play a role in the clinical setting, there are not yet clear indications for its clinical use. Therefore, the Cardiovascular Committee of the European Association of Nuclear Medicine, starting from the experience of its members, decided to examine the current literature on quantitative perfusion PET to (1) evaluate the rationale for its clinical use, (2) identify the main methodological requirements, (3) identify the remaining technical difficulties, (4) define the most reliable interpretation criteria, and finally (5) tentatively delineate currently acceptable and possibly appropriate clinical indications. The present position paper must be considered as a starting point aiming to promote a wider use of quantitative perfusion PET and to encourage the conception and execution of the studies needed to definitely establish its role in clinical practice.

  14. “Beauty is a Light in the Heart”1: The Transformative Potential of Optogenetics for Clinical Applications in Cardiovascular Medicine

    PubMed Central

    Boyle, Patrick M.; Karathanos, Thomas V.; Trayanova, Natalia A.

    2014-01-01

    Optogenetics is an exciting new technology in which viral gene or cell delivery is used to inscribe light sensitivity in excitable tissue to enable optical control of bioelectric behavior. Initial progress in the fledgling domain of cardiac optogenetics has included in vitro expression of various light-sensitive proteins in cell monolayers and transgenic animals to demonstrate an array of potentially useful applications, including light-based pacing, silencing of spontaneous activity, and spiral wave termination. In parallel to these developments, the cardiac modeling community has developed a versatile computational framework capable of realistically simulating optogenetics in biophysically detailed, patient-specific representations of the human heart, enabling the exploration of potential clinical applications in a predictive virtual platform. Towards the ultimate goal of assessing the feasibility and potential impact of optogenetics-based therapies in cardiovascular medicine, this review provides (1) a detailed synopsis of in vivo, in vitro, and in silico developments in the field and (2) a critical assessment of how existing clinical technology for gene/cell delivery and intra-cardiac illumination could be harnessed to achieve such lofty goals as light-based arrhythmia termination. PMID:25453984

  15. Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey.

    PubMed

    Stussman, Barbara J; Bethell, Christina D; Gray, Caroline; Nahin, Richard L

    2013-11-23

    The 2002, 2007, and 2012 complementary medicine questionnaires fielded on the National Health Interview Survey provide the most comprehensive data on complementary medicine available for the United States. They filled the void for large-scale, nationally representative, publicly available datasets on the out-of-pocket costs, prevalence, and reasons for use of complementary medicine in the U.S. Despite their wide use, this is the first article describing the multi-faceted and largely qualitative processes undertaken to develop the surveys. We hope this in-depth description enables policy makers and researchers to better judge the content validity and utility of the questionnaires and their resultant publications.

  16. Cardiovascular Risk Factors of Adults Age 20–49 Years in the United States, 1971–2012: A Series of Cross-Sectional Studies

    PubMed Central

    Casagrande, Sarah S.; Menke, Andy; Cowie, Catherine C.

    2016-01-01

    Background The health of younger adults in the U.S. has important public health and economic-related implications. However, previous literature is insufficient to fully understand how the health of this group has changed over time. This study examined generational differences in cardiovascular risk factors of younger adults over the past 40 years. Methods Data were from 6 nationally representative cross-sectional National Health and Nutrition Examination Surveys (1971–2012; N = 44,670). Participants were adults age 20–49 years who self-reported sociodemographic characteristics and health conditions, and had examination/laboratory measures for hypertension, hyperlipidemia, diabetes, obesity, and chronic kidney disease. Prevalences of sociodemographic characteristics and health status were determined by study period. Logistic regression was used to determine the odds [odds ratio (OR), 95% confidence interval] of health conditions by study period: models adjusted only for age, sex, and race, and fully adjusted models additionally adjusted for socioeconomic characteristics, smoking, BMI, diabetes, and/or hypertension (depending on the outcome) were assessed. Results Participants in 2009–2012 were significantly more likely to be obese and have diabetes compared to those in 1971–1975 (OR = 4.98, 3.57–6.97; OR = 3.49, 1.59–7.65, respectively, fully adjusted). Participants in 2009–2012 vs. 1988–1994 were significantly more likely to have had hypertension but uncontrolled hypertension was significantly less likely (OR = 0.67, 0.52–0.86, fully adjusted). There was no difference over time for high cholesterol, but uncontrolled high cholesterol was significantly less likely in 2009–2012 vs. 1988–1994 (OR = 0.80, 0.68–0.94, fully adjusted). The use of hypertensive and cholesterol medications increased while chronic kidney and cardiovascular diseases were relatively stable. Conclusions Cardiovascular risk factors of younger U.S. adults have worsened over

  17. Slow breathing and cardiovascular disease.

    PubMed

    Chaddha, Ashish

    2015-01-01

    Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine. PMID:26170595

  18. Slow breathing and cardiovascular disease

    PubMed Central

    Chaddha, Ashish

    2015-01-01

    Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine. PMID:26170595

  19. Six-month changes in ideal cardiovascular health vs. Framingham 10-year coronary heart disease risk among young adults enrolled in a weight loss intervention.

    PubMed

    Gibbs, Bethany Barone; King, Wendy C; Belle, Steven H; Jakicic, John M

    2016-05-01

    The Framingham Risk equation uses sex, age, smoking, total cholesterol, high-density lipoprotein (HDL) cholesterol and systolic blood pressure to predict 10-year risk of coronary heart disease (FR-10). The American Heart Association's Ideal Cardiovascular Health (IDEAL) score uses smoking, total cholesterol, fasting glucose, blood pressure, body mass index (BMI), diet, and physical activity to encourage a healthy cardiovascular phenotype. This study aimed to compare 6-month changes in the FR-10 vs. IDEAL score among young adults with BMI ≥25 to <40kg/m(2) enrolled in a behavioral weight loss intervention at the University of Pittsburgh (2010-12). Medians [25th, 75th percentiles] are reported. Weight decreased by 8kg [-12, -4] among 335 participants. Of 7 possible points, IDEAL score was 4 [3, 4] at baseline, improved (i.e., increased) by 1 [0, 2] over 6months, and improved in 64.2% and worsened in 6.6% of participants (p<0.001). IDEAL classification of BMI, physical activity, total cholesterol, blood pressure and glucose improved (all p<0.001), but not of smoking or diet (both p≥0.05). FR-10 was <1% at baseline for 88.1% of participants and changed in few participants (improved, i.e. decreased, in 7.5%, worsened in 1.8%, p<0.001). Among young adults with overweight or obesity enrolled in a weight loss intervention, IDEAL detected positive changes in a majority of participants while the FR-10 did not. These findings suggest that IDEAL score may be more sensitive to positive cardiovascular health changes resulting from a behavioral intervention in this population. PMID:26923555

  20. Six-month changes in ideal cardiovascular health vs. Framingham 10-year coronary heart disease risk among young adults enrolled in a weight loss intervention.

    PubMed

    Gibbs, Bethany Barone; King, Wendy C; Belle, Steven H; Jakicic, John M

    2016-05-01

    The Framingham Risk equation uses sex, age, smoking, total cholesterol, high-density lipoprotein (HDL) cholesterol and systolic blood pressure to predict 10-year risk of coronary heart disease (FR-10). The American Heart Association's Ideal Cardiovascular Health (IDEAL) score uses smoking, total cholesterol, fasting glucose, blood pressure, body mass index (BMI), diet, and physical activity to encourage a healthy cardiovascular phenotype. This study aimed to compare 6-month changes in the FR-10 vs. IDEAL score among young adults with BMI ≥25 to <40kg/m(2) enrolled in a behavioral weight loss intervention at the University of Pittsburgh (2010-12). Medians [25th, 75th percentiles] are reported. Weight decreased by 8kg [-12, -4] among 335 participants. Of 7 possible points, IDEAL score was 4 [3, 4] at baseline, improved (i.e., increased) by 1 [0, 2] over 6months, and improved in 64.2% and worsened in 6.6% of participants (p<0.001). IDEAL classification of BMI, physical activity, total cholesterol, blood pressure and glucose improved (all p<0.001), but not of smoking or diet (both p≥0.05). FR-10 was <1% at baseline for 88.1% of participants and changed in few participants (improved, i.e. decreased, in 7.5%, worsened in 1.8%, p<0.001). Among young adults with overweight or obesity enrolled in a weight loss intervention, IDEAL detected positive changes in a majority of participants while the FR-10 did not. These findings suggest that IDEAL score may be more sensitive to positive cardiovascular health changes resulting from a behavioral intervention in this population.

  1. A Path Analysis of a Randomized "Promotora de Salud" Cardiovascular Disease-Prevention Trial among At-Risk Hispanic Adults

    ERIC Educational Resources Information Center

    de Heer, Hendrik Dirk; Balcazar, Hector G.; Castro, Felipe; Schulz, Leslie

    2012-01-01

    This study assessed effectiveness of an educational community intervention taught by "promotoras de salud" in reducing cardiovascular disease (CVD) risk among Hispanics using a structural equation modeling (SEM) approach. Model development was guided by a social ecological framework proposing CVD risk reduction through improvement of protective…

  2. Cerebro- and Cardio-vascular Responses to Energy Drink in Young Adults: Is there a Gender Effect?

    PubMed Central

    Monnard, Cathríona R.; Montani, Jean-Pierre; Grasser, Erik K.

    2016-01-01

    Background and Purpose: Energy drinks (EDs) are suspected to induce potential adverse cardiovascular effects and have recently been shown to reduce cerebral blood flow velocity (CBFV) in young, healthy subjects. Gender differences in CBFV in response to EDs have not previously been investigated, despite the fact that women are more prone to cardiovascular disturbances such as neurocardiogenic syncope than men. Therefore, the aim of this study was to explore gender differences in cerebrovascular and cardiovascular responses to EDs. Methods: We included 45 subjects in a retrospective analysis of pooled data from two previous randomized trials carried out in our laboratory with similar protocols. Beat-to-beat blood pressure, impedance cardiography, transcranial Doppler, and end-tidal carbon dioxide (etCO2) measurements were made for at least 20 min baseline and for 80 min following the ingestion of 355 mL of a sugar-sweetened ED. Gender and time differences in cerebrovascular and cardiovascular parameters were investigated. Results: CBFV was significantly reduced in response to ED, with the greatest reduction observed in women compared with men (−12.3 ± 0.8 vs. −9.7 ± 0.8%, P < 0.05). Analysis of variance indicated significant time (P < 0.01) and gender × time (P < 0.01) effects. The percentage change in CBFV in response to ED was independent of body weight and etCO2. No significant gender difference in major cardiovascular parameters in response to ED was observed. Conclusions: ED ingestion reduced CBFV over time, with a greater reduction observed in women compared with men. Our results have potential implications for women ED consumers, as well as high-risk individuals. PMID:27559316

  3. "A spoonful of sugar helps the medicine go down": bitter masking by sucrose among children and adults.

    PubMed

    Mennella, Julie A; Reed, Danielle R; Mathew, Phoebe S; Roberts, Kristi M; Mansfield, Corrine J

    2015-01-01

    Sweeteners are often added to liquid formulations of drugs but whether they merely make them better tasting or actually reduce the perception of bitterness remains unknown. In a group of children and adults, we determined whether adding sucrose to urea, caffeine, denatonium benzoate, propylthiouracil (PROP), and quinine would reduce their bitterness using a forced-choice method of paired comparisons. To better understand individual differences, adults also rated each solution using a more complex test (general Labeled Magnitude Scale [gLMS]) and were genotyped for the sweet taste receptor gene TAS1R3 and the bitter receptor TAS2R38. Sucrose suppressed the bitterness of each agent in children and adults. In adults, sucrose was effective in reducing the bitterness ratings from moderate to weak for all compounds tested, but those with the sensitive form of the sweet receptor reported greater reduction for caffeine and quinine. For PROP, sucrose was most effective for those who were genetically the most sensitive, although this did not attain statistical significance. Not only is the paired comparison method a valid tool to study how sucrose improves the taste of pediatric medicines among children but knowledge gleaned from basic research in bitter taste and how to alleviate it remains an important public health priority.

  4. “A Spoonful of Sugar Helps the Medicine Go Down”: Bitter Masking by Sucrose Among Children and Adults

    PubMed Central

    Reed, Danielle R.; Mathew, Phoebe S.; Roberts, Kristi M.; Mansfield, Corrine J.

    2015-01-01

    Sweeteners are often added to liquid formulations of drugs but whether they merely make them better tasting or actually reduce the perception of bitterness remains unknown. In a group of children and adults, we determined whether adding sucrose to urea, caffeine, denatonium benzoate, propylthiouracil (PROP), and quinine would reduce their bitterness using a forced-choice method of paired comparisons. To better understand individual differences, adults also rated each solution using a more complex test (general Labeled Magnitude Scale [gLMS]) and were genotyped for the sweet taste receptor gene TAS1R3 and the bitter receptor TAS2R38. Sucrose suppressed the bitterness of each agent in children and adults. In adults, sucrose was effective in reducing the bitterness ratings from moderate to weak for all compounds tested, but those with the sensitive form of the sweet receptor reported greater reduction for caffeine and quinine. For PROP, sucrose was most effective for those who were genetically the most sensitive, although this did not attain statistical significance. Not only is the paired comparison method a valid tool to study how sucrose improves the taste of pediatric medicines among children but knowledge gleaned from basic research in bitter taste and how to alleviate it remains an important public health priority. PMID:25381313

  5. [Immunization strategy of hepatitis B vaccine among adults in China: evidence based-medicine and consideration].

    PubMed

    Xu, A Q; Zhang, L

    2016-06-01

    With the effective control of hepatitis B infection among children, the adults especial the young ones become the main population for new hepatitis B virus infection. Now the adults receive hepatitis B vaccination voluntarily and at their own expense in China and the coverage is low. The high immunogenicity of hepatitis B vaccine has been proven among healthy adults. Although the safety of hepatitis B vaccination has been documented among high-risk population such as HIV-infected people, injecting drug users and patients with chronic hepatitis disease, their antibody seroconversion rate after hepatitis B vaccination is lower than the healthy adults. Hepatitis B vaccination is recommended to population at high risk officially in many countries and some effects have been achieved. It is urgent to improve the strategy of hepatitis B vaccination among adults to fasten the control of hepatitis B in China, along with the researches about the long-term efficacy of hepatitis B vaccine among adults, the immunogenicity of hepatitis B vaccination among high-risk adults and the economical evaluation about different adult immunization strategy of hepatitis B.

  6. [Analysis of characteristics of using traditional Chinese and western medicine on type 1 diabetes adult patients based on electronic medical records].

    PubMed

    Zhang, Hong-Hong; Xie, Yan-Ming; Yang, Wei; Wang, Yong-Yan; Yi, Dan-Hui; Zhuang, Yan

    2014-09-01

    To understand the kinds and the characteristics of combination of traditional Chinese medicines and western medicines using on adults with type 1 diabetes in general hospitals,This research brings into 4 602 hospitalized adult patients with type 1 diabetes from hospital information system (HIS) of 13 third class A hospitals. These research objects were hospitalized in December 2003-July 2011. The research analyzes the operating frequency and associated usage of western medicines and traditional Chinese medicines by the method of frequency statistics and association rules. Through the analysis, the research says that in the clinical treatment of adult patients with type 1 diabetes, the western medicine used most frequently is insulin, a total of 1 539 cases, accounted for 8.47%; the traditional Chinese medicine used most frequently is oral agents of pseudo-ginseng, a total of 183 cases, accounting for 6.25%; the combinations of Chinese and western medicines commonly used include Huoxue Huayu Tongmai Shuluo decoction + vasodilator, support degree is 45.93%, followed by Huoxue Huayu Tongmai Shuluo decoction + vasodilator + hypoglycemic drugs, support degree is 45.50%; Huoxue Huayu Tongmai Shuluo decoction + vasodilator + nutritional agent, support degree is 36.29%.

  7. Cardiovascular and Renal Outcomes of Renin–Angiotensin System Blockade in Adult Patients with Diabetes Mellitus: A Systematic Review with Network Meta-Analyses

    PubMed Central

    Catalá-López, Ferrán; Macías Saint-Gerons, Diego; González-Bermejo, Diana; Rosano, Giuseppe M.; Davis, Barry R.; Ridao, Manuel; Zaragoza, Abel; Montero-Corominas, Dolores; Tobías, Aurelio; de la Fuente-Honrubia, César; Tabarés-Seisdedos, Rafael; Hutton, Brian

    2016-01-01

    Background Medications aimed at inhibiting the renin–angiotensin system (RAS) have been used extensively for preventing cardiovascular and renal complications in patients with diabetes, but data that compare their clinical effectiveness are limited. We aimed to compare the effects of classes of RAS blockers on cardiovascular and renal outcomes in adults with diabetes. Methods and Findings Eligible trials were identified by electronic searches in PubMed/MEDLINE and the Cochrane Database of Systematic Reviews (1 January 2004 to 17 July 2014). Interventions of interest were angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and direct renin (DR) inhibitors. The primary endpoints were cardiovascular mortality, myocardial infarction, and stroke—singly and as a composite endpoint, major cardiovascular outcome—and end-stage renal disease [ESRD], doubling of serum creatinine, and all-cause mortality—singly and as a composite endpoint, progression of renal disease. Secondary endpoints were angina pectoris and hospitalization for heart failure. In all, 71 trials (103,120 participants), with a total of 14 different regimens, were pooled using network meta-analyses. When compared with ACE inhibitor, no other RAS blocker used in monotherapy and/or combination was associated with a significant reduction in major cardiovascular outcomes: ARB (odds ratio [OR] 1.02; 95% credible interval [CrI] 0.90–1.18), ACE inhibitor plus ARB (0.97; 95% CrI 0.79–1.19), DR inhibitor plus ACE inhibitor (1.32; 95% CrI 0.96–1.81), and DR inhibitor plus ARB (1.00; 95% CrI 0.73–1.38). For the risk of progression of renal disease, no significant differences were detected between ACE inhibitor and each of the remaining therapies: ARB (OR 1.10; 95% CrI 0.90–1.40), ACE inhibitor plus ARB (0.97; 95% CrI 0.72–1.29), DR inhibitor plus ACE inhibitor (0.99; 95% CrI 0.65–1.57), and DR inhibitor plus ARB (1.18; 95% CrI 0.78–1.84). No significant

  8. Use of Non-Steroidal Anti-Inflammatory Drugs That Elevate Cardiovascular Risk: An Examination of Sales and Essential Medicines Lists in Low-, Middle-, and High-Income Countries

    PubMed Central

    McGettigan, Patricia; Henry, David

    2013-01-01

    Background Certain non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., rofecoxib [Vioxx]) increase the risk of heart attack and stroke and should be avoided in patients at high risk of cardiovascular events. Rates of cardiovascular disease are high and rising in many low- and middle-income countries. We studied the extent to which evidence on cardiovascular risk with NSAIDs has translated into guidance and sales in 15 countries. Methods and Findings Data on the relative risk (RR) of cardiovascular events with individual NSAIDs were derived from meta-analyses of randomised trials and controlled observational studies. Listing of individual NSAIDs on Essential Medicines Lists (EMLs) was obtained from the World Health Organization. NSAID sales or prescription data for 15 low-, middle-, and high-income countries were obtained from Intercontinental Medical Statistics Health (IMS Health) or national prescription pricing audit (in the case of England and Canada). Three drugs (rofecoxib, diclofenac, etoricoxib) ranked consistently highest in terms of cardiovascular risk compared with nonuse. Naproxen was associated with a low risk. Diclofenac was listed on 74 national EMLs, naproxen on just 27. Rofecoxib use was not documented in any country. Diclofenac and etoricoxib accounted for one-third of total NSAID usage across the 15 countries (median 33.2%, range 14.7–58.7%). This proportion did not vary between low- and high-income countries. Diclofenac was by far the most commonly used NSAID, with a market share close to that of the next three most popular drugs combined. Naproxen had an average market share of less than 10%. Conclusions Listing of NSAIDs on national EMLs should take account of cardiovascular risk, with preference given to low risk drugs. Diclofenac has a risk very similar to rofecoxib, which was withdrawn from worldwide markets owing to cardiovascular toxicity. Diclofenac should be removed from EMLs. Please see later in the article for the Editors' Summary

  9. Type of Multimorbidity and Complementary and Alternative Medicine Use among Adults

    PubMed Central

    Alwhaibi, Monira; Sambamoorthi, Usha

    2015-01-01

    Objective. To examine the association between type of multimorbidity and CAM use among adults with multimorbidity. Methods. The current study used a cross-sectional design with retrospective data from 2012 National Health Interview Survey. Multimorbidity was classified into two groups: (1) adults with coexisting physical and mental illnesses and (2) adults with two or more chronic physical illnesses only. CAM use was measured using a set of 18 variables. Logistic regression and multinomial logistic regressions were used to assess the association between the type of multimorbidity and ever used CAM, CAM use in the past 12 months, and type of CAM. Results. Overall, 31.2% of adults with coexisting physical and mental illnesses and 20.1% of adults with only physical illnesses used CAM in the past 12 months. Adults with coexisting physical and mental illnesses were more likely to ever use CAM (AOR = 1.68, 95% CI = 1.49, 1.90), use CAM in the past 12 months (AOR = 1.32, 95% CI = 1.15, 1.52), and use mind-body therapies in the past 12 months (AOR = 1.36, 95% CI = 1.16, 1.59) compared to adults with only physical illnesses. Conclusion. Multimorbidity of chronic physical and mental illnesses was associated with higher CAM use. PMID:25648169

  10. The Role of Neighborhood Environment in Promoting Risk Factors of Cardiovascular Disease among Young Adults: Data from Middle to High Income Population in an Asian Megacity

    PubMed Central

    Baig, Mirza Zain; Noor, Arish; Aqil, Amash; Bham, Nida Shahab; Khan, Mohammad Ali; Hassan, Irfan Nazir; Kadir, M. Masood

    2015-01-01

    Background Modifiable risk factors of cardiovascular diseases (CVD) have their triggers in the neighborhood environments of communities. Studying the environmental triggers for CVD risk factors is important to understand the situation in a broader perspective. Young adults are influenced the most by the environment profile around them hence it is important to study this subset of the population. Methods This was a descriptive study conducted using the EPOCH research tool designed by the authors of the PURE study. The study population consisted of young adults aged 18-25 in two areas of Karachi. The study setting was busy shopping malls frequented by young adults in the particular community being studied. Results Our total sample size was 120 individuals, who consented to be interviewed by our interviewers. Less than 50% of the population recognized some form of restriction regarding smoking in their communities. The largest contributor to tobacco advertising was actors smoking in movies and TV shows with 89% responses from both communities. Only 11.9% of the individuals disapproved of smoking cigarettes among men with wide acceptance of ‘sheesha’ across all age groups. Advertising for smoking and junk food was more frequent as compared to smoking cessation, healthy diet and exercise in both the areas. Unhealthy food items were more easily available in contrast to healthier options. The cost of healthy snack food options including vegetables and fruits was higher than sugary drinks and foods. Conclusion This assessment showed that both communities were exposed to environments that promote risk factors for cardiovascular diseases. PMID:25946006

  11. Effects of Exercise and Diet on Body Composition and Cardiovascular Fitness in Adults with Severe Mental Retardation.

    ERIC Educational Resources Information Center

    Croce, Ronald V.

    1990-01-01

    The study evaluated the effects of an aerobic fitness program and dietary intervention with external control components on three obese adults with severe mental retardation. Results indicated severely retarded adults respond to a program of progressive aerobic exercise and caloric restriction much the same way as nonretarded persons. (Author/DB)

  12. Effects of commuting mode on air pollution exposure and cardiovascular health among young adults in Taipei, Taiwan.

    PubMed

    Liu, Wen-Te; Ma, Chih-Ming; Liu, I-Jung; Han, Bor-Cheng; Chuang, Hsiao-Chi; Chuang, Kai-Jen

    2015-05-01

    The association between traffic-related air pollution and adverse cardiovascular effects has been well documented; however, little is known about whether different commuting modes can modify the effects of air pollution on the cardiovascular system in human subjects in urban areas with heavy traffic. We recruited 120 young, healthy subjects in Taipei, Taiwan. Each participant was classified with different commuting modes according to his/her own commuting style. Three repeated measurements of heart rate variability (HRV) indices {standard deviation of NN intervals (SDNN) and the square root of the mean of the sum of the squares of differences between adjacent NN intervals (r-MSSD)}, particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5), temperature, humidity and noise level were conducted for each subject during 1-h morning commutes (0900-1000 h) in four different commuting modes, including an electrically powered subway, a gas-powered bus, a gasoline-powered car, and walking. Linear mixed-effects models were used to investigate the association of PM2.5 with HRV indices. The results showed that decreases in the HRV indices were associated with increased levels of PM2.5. The personal exposure levels to PM2.5 were the highest in the walking mode. The effects of PM2.5 on cardiovascular endpoints were the lowest in the subway mode compared to the effects in the walking mode. The participants in the car and bus modes had reduced effects on their cardiovascular endpoints compared to the participants in the walking mode. We concluded that traffic-related PM2.5 is associated with autonomic alteration. Commuting modes can modify the effects of PM2.5 on HRV indices among young, healthy subjects. PMID:25638696

  13. Effects of commuting mode on air pollution exposure and cardiovascular health among young adults in Taipei, Taiwan.

    PubMed

    Liu, Wen-Te; Ma, Chih-Ming; Liu, I-Jung; Han, Bor-Cheng; Chuang, Hsiao-Chi; Chuang, Kai-Jen

    2015-05-01

    The association between traffic-related air pollution and adverse cardiovascular effects has been well documented; however, little is known about whether different commuting modes can modify the effects of air pollution on the cardiovascular system in human subjects in urban areas with heavy traffic. We recruited 120 young, healthy subjects in Taipei, Taiwan. Each participant was classified with different commuting modes according to his/her own commuting style. Three repeated measurements of heart rate variability (HRV) indices {standard deviation of NN intervals (SDNN) and the square root of the mean of the sum of the squares of differences between adjacent NN intervals (r-MSSD)}, particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5), temperature, humidity and noise level were conducted for each subject during 1-h morning commutes (0900-1000 h) in four different commuting modes, including an electrically powered subway, a gas-powered bus, a gasoline-powered car, and walking. Linear mixed-effects models were used to investigate the association of PM2.5 with HRV indices. The results showed that decreases in the HRV indices were associated with increased levels of PM2.5. The personal exposure levels to PM2.5 were the highest in the walking mode. The effects of PM2.5 on cardiovascular endpoints were the lowest in the subway mode compared to the effects in the walking mode. The participants in the car and bus modes had reduced effects on their cardiovascular endpoints compared to the participants in the walking mode. We concluded that traffic-related PM2.5 is associated with autonomic alteration. Commuting modes can modify the effects of PM2.5 on HRV indices among young, healthy subjects.

  14. Descriptive data on cardiovascular and metabolic risk factors in ambulatory and non-ambulatory adults with cerebral palsy.

    PubMed

    McPhee, P G; Gorter, J W; Cotie, L M; Timmons, B W; Bentley, T; MacDonald, M J

    2015-12-01

    Forty-two participants with cerebral palsy were recruited for a study examining traditional and novel indicators of cardiovascular risk (McPhee et al., 2015 [1]). Data pertaining to the prevalence of obesity, smoking, hypertension, and metabolic risk are provided. These data are presented along with the scoring methods used in evaluation of the study participants. Percentages are included for comparative purposes with the existing literature. PMID:26759816

  15. Cardiovascular complications of pediatric chronic kidney disease

    PubMed Central

    2006-01-01

    Cardiovascular disease (CVD) mortality is a leading cause of death in adult chronic kidney disease (CKD), with exceptionally high rates in young adults, according to the Task Force on Cardiovascular Disease. Recent data indicate that cardiovascular complications are already present in children with CKD. This review summarizes the current literature on cardiac risk factors, mortality and morbidity in children with CKD. PMID:17120060

  16. Regenerative medicine using adult neural stem cells: the potential for diabetes therapy and other pharmaceutical applications.

    PubMed

    Kuwabara, Tomoko; Asashima, Makoto

    2012-06-01

    Neural stem cells (NSCs), which are responsible for continuous neurogenesis during the adult stage, are present in human adults. The typical neurogenic regions are the hippocampus and the subventricular zone; recent studies have revealed that NSCs also exist in the olfactory bulb. Olfactory bulb-derived neural stem cells (OB NSCs) have the potential to be used in therapeutic applications and can be easily harvested without harm to the patient. Through the combined influence of extrinsic cues and innate programming, adult neurogenesis is a finely regulated process occurring in a specialized cellular environment, a niche. Understanding the regulatory mechanisms of adult NSCs and their cellular niche is not only important to understand the physiological roles of neurogenesis in adulthood, but also to provide the knowledge necessary for developing new therapeutic applications using adult NSCs in other organs with similar regulatory environments. Diabetes is a devastating disease affecting more than 200 million people worldwide. Numerous diabetic patients suffer increased symptom severity after the onset, involving complications such as retinopathy and nephropathy. Therefore, the development of treatments for fundamental diabetes is important. The utilization of autologous cells from patients with diabetes may address challenges regarding the compatibility of donor tissues as well as provide the means to naturally and safely restore function, reducing future risks while also providing a long-term cure. Here, we review recent findings regarding the use of adult OB NSCs as a potential diabetes cure, and discuss the potential of OB NSC-based pharmaceutical applications for neuronal diseases and mental disorders.

  17. Managing Osteoarthritis Pain with Medicines: A Review of the Research for Adults

    MedlinePlus

    ... to you, like Advil ® , Motrin ® , Aleve ® , and Celebrex ® . Skin creams: Common brand names include BenGay ® , Aspercreme ® , or Theragen ® . ... these medicines reduce pain better than acetaminophen. Diclofenac skin cream works as well as NSAID pills. All of ...

  18. HERMES European Accreditation of Training Centres in Adult Respiratory Medicine: criteria validation and revision.

    PubMed

    Sutter, Sandy; Stolz, Daiana; Karg, Ortrud; Mitchell, Sharon; Niculescu, Alexandra; Noël, Julie-Lyn; Powell, Pippa; Skoczyński, Szymon; Verbraecken, Johan; Rohde, Gernot

    2016-03-01

    Four respiratory medicine disease categories appear in the global top 10 causes of mortality [1], resulting in 600 000 people dying from respiratory disease in Europe each year. The economic burden of respiratory diseases in Europe exceeds 380 billion euros. In a fast-developing environment, new clinical challenges have arisen for pulmonary specialists; techniques and procedures have evolved and become more complex.

  19. Altered cardiovascular reactivity and osmoregulation during hyperosmotic stress in adult rats developmentally exposed to polybrominated diphenyl ethers (PBDEs)

    SciTech Connect

    Shah, Ashini; Coburn, Cary G.; Watson-Siriboe, Abena; Whitley, Rebecca; Shahidzadeh, Anoush; Gillard, Elizabeth R.; Nichol, Robert; Leon-Olea, Martha; Gaertner, Mark; Kodavanti, Prasada Rao S.

    2011-10-15

    Polybrominated diphenyl ethers (PBDEs) and the structurally similar chemicals polychlorinated biphenyls (PCBs) disrupt the function of multiple endocrine systems. PCBs and PBDEs disrupt the secretion of vasopressin (VP) from the hypothalamus during osmotic activation. Since the peripheral and central vasopressinergic axes are critical for osmotic and cardiovascular regulation, we examined whether perinatal PBDE exposure could impact these functions during physiological activation. Rats were perinatally dosed with a commercial PBDE mixture, DE-71. Dams were given 0 (corn oil control), 1.7 (low dose) or 30.6 mg/kg/day (high dose) in corn oil from gestational day (GD) 6 through postnatal day (PND) 21 by oral gavage. In the male offspring exposed to high dose PBDE plasma thyroxine and triiodothyronine levels were reduced at PND 21 and recovered to control levels by PND 60 when thyroid stimulating hormone levels were elevated. At 14-18 months of age, cardiovascular responses were measured in four groups of rats: Normal (Oil, normosmotic condition), Hyper (Oil, hyperosmotic stress), Hyper PBDE low (1.7 mg/kg/day DE-71 perinatally, hyperosmotic stress), and Hyper PBDE high (30.6 mg/kg/day DE-71 perinatally, hyperosmotic stress). Systolic blood pressure (BP), diastolic BP, and heart rate (HR) were determined using tail cuff sphygmomanometry and normalized to pretreatment values (baseline) measured under basal conditions. Hyperosmotic treatment yielded significant changes in systolic BP in PBDE exposed rats only. Hyper PBDE low and high dose rats showed 36.1 and 64.7% greater systolic BP responses at 3 h post hyperosmotic injection relative to pretreatment baseline, respectively. No treatment effects were measured for diastolic BP and HR. Hyper and Hyper PBDE rats showed increased mean plasma osmolality values by 45 min after injection relative to normosmotic controls. In contrast to Hyper rats, Hyper PBDE (high) rats showed a further increase in mean plasma osmolality at 3

  20. Racial Disparities in Health Care Access and Cardiovascular Disease Indicators in Black and White Older Adults in the Health ABC Study

    PubMed Central

    ROOKS, RONICA N.; SIMONSICK, ELEANOR M.; HARRIS, TAMARA B.; KLESGES, LISA M.; NEWMAN, ANNE B.; AYONAYON, HILSA

    2009-01-01

    Black adults consistently exhibit higher rates and poorer outcomes of cardiovascular disease (CVD) relative to other racial groups, even after accounting for differences in socioeconomic status (SES). Whether factors related to health care access can further explain racial disparities in CVD have not been thoroughly examined. Using logistic regression we examined racial and health care [i.e. health insurance and access to care] associations with CVD indicators [i.e. hypertension, low ankle-arm index, and left ventricular hypertrophy] in the Health, Aging, and Body Composition study, a longitudinal study of 3,075 well-functioning adults aged 70–79 in 1997. We found older Black versus White adults had significantly worse health care. Overall, health care only slightly reduced the significant association between being Black and CVD, while race remained strongly associated with CVD after adjusting for demographics, SES, body mass index, and comorbidity. Research on health care quality may contribute to our understanding of these disparities. PMID:18625758

  1. Eating competence of elderly Spanish adults is associated with a healthy diet and a favorable cardiovascular disease risk profile.

    PubMed

    Lohse, Barbara; Psota, Tricia; Estruch, Ramón; Zazpe, Itziar; Sorli, José V; Salas-Salvadó, Jordi; Serra, Mercè; Krall, Jodi Stotts; Márquez, Fabiola; Ros, Emilio

    2010-07-01

    Eating competence (EC), a bio-psychosocial model for intrapersonal approaches to eating and food-related behaviors, is associated with less weight dissatisfaction, lower BMI, and increased HDL-cholesterol in small U.S. studies, but its relationship to nutrient quality and overall cardiovascular risk have not been examined. Prevención con Dieta Mediterránea (PREDIMED) is a 5-y controlled clinical trial evaluating Mediterranean diet efficacy on the primary prevention of cardiovascular diseases (CVD) in Spain. In a cross-sectional study, 638 PREDIMED participants (62% women, mean age 67 y) well phenotyped for cardiovascular risk factors were assessed for food intake and EC using validated questionnaires. Overall, 45.6% were eating-competent. EC was associated with being male and energy intake (P < 0.01). After gender and energy adjustment, participants with EC compared with those without showed higher fruit intake and greater adherence to the Mediterranean diet (P < 0.05) and tended to consume more fish (P = 0.076) and fewer dairy products (P = 0.054). EC participants tended to have a lower BMI (P = 0.057) and had a lower fasting blood glucose concentration and serum LDL-:HDL-cholesterol ratio (P < 0.05) and a higher HDL-cholesterol concentration (P = 0.025) after gender adjustment. EC participants had lower odds ratios (OR) of having a blood glucose concentration >5.6 mmol/L (0.71; 95% CI 0.51-0.98) and HDL-cholesterol <1.0 mmol/L (0.70; 95% CI 0.68-1.00). The OR of actively smoking, being obese, or having a serum LDL-cholesterol concentration > or =3.4 mmol/L were <1.0, but the 95% CI included the 1.0 (P > 0.1). Our findings support further examination of EC as a strategy for enhancing diet quality and CVD prevention. PMID:20505016

  2. A controversial step forward: a commentary on the 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults

    PubMed Central

    Ades, Philip A.

    2014-01-01

    The 2013 ACC/AHA guidelines on the treatment of blood cholesterol in adults is a major step forward in the field of preventive cardiology but it is not without controversy. It should be well accepted that in individuals with established atherosclerotic vascular disease, individuals with a low-density lipoprotein cholesterol of greater than 190 mg/dl and individuals with diabetes, treatment with an appropriate fixed dose of a statin, without titration to a specific low-density lipoprotein goal, will provide substantial protection against future atherosclerotic vascular disease events. More controversial is the utilization of a risk calculator in primary care to determine which individuals will require a statin. For as long as these risk calculators are in question, primary care practitioners will struggle to make treatment decisions. Factors such as cardiovascular fitness, measures of adiposity, and details of the family history will aid in treatment decisions. PMID:24518291

  3. Insurance covered and non-covered complementary and alternative medicine utilisation among adults in Taiwan.

    PubMed

    Shih, Shu-Fang; Lew-Ting, Chih-Yin; Chang, Hsing-Yi; Kuo, Ken N

    2008-10-01

    Complementary and alternative medicine (CAM) has been characterized by prevalence, cost, and patterns of use. Factors determining its utilization have also been analyzed, either generally or for specific diseases, but few studies have considered the determinants of its frequency of use. Taiwan's pluralistic health care system and comprehensive insurance program covering Western medicine and traditional Chinese medicine (TCM) provide an interesting case to explore what forms of CAM people use, why and how often they use them. By using Taiwan's 2001 National Health Interview Survey and linking it with National Health Insurance (NHI) claims data, this study aims to investigate the socio-demographic, economic, behavioral and health determinants of use and frequency of use for both non-covered and covered CAM in Taiwan. The former consists of services practiced by non-regulated or non-NHI contracted practitioners and the latter includes those TCM covered by NHI. Our study showed that the determinants of using non-covered and covered CAM differ with respect to socio-demographic and behavioral factors, and health needs. Our evidence suggests that future CAM research must delineate between use and frequency of use to better understand the underlying factors contributing to initiation and continuity of CAM use.

  4. Optimal waist circumference cutoff points for the determination of abdominal obesity and detection of cardiovascular risk factors among adult Egyptian population

    PubMed Central

    Assaad-Khalil, Samir H.; Mikhail, Magued M.; Aati, Talaat Abdel; Zaki, Adel; Helmy, Myriam A.; Megallaa, Magdy H.; Hassanien, Rehab; Rohoma, Kamel H.

    2015-01-01

    Objective: To determine the best anthropometric measurement of obesity, and its optimal cutoff, that best predicts the presence of cardiovascular risk factors among adult Egyptian population. Methods: This is a cross-sectional study including a representative randomly chosen sample of the adult Egyptian population from all Alexandria Districts (the second largest governorate in Egypt) based on the multistage random technique. It included 3209 subjects (1567 men, 1642 women) aged 18–80 years from urban and rural areas. The response rate was 80.2%. History, blood pressure, and anthropometric measurements were taken. Laboratory investigations included fasting lipid profile, fasting plasma glucose, and serum uric acid. Different criteria of metabolic syndrome were used and compared. Receiver operator characteristic curve and Youden index were used to determine predictability and cutoffs. Results: Waist circumference (WC) is the best to predict at least two other components of the metabolic syndrome as defined by the International Diabetes Federation (IDF). The optimal WC cutoffs were 100.5 and 96.25 cm for Egyptian men and women, respectively. The Joint Interim Statement definition (JIS) of metabolic syndrome was the best to predict cardiovascular disease in both genders and diabetes mellitus in women. The prevalence of metabolic syndrome and abdominal obesity was 42.5%, 61%, respectively (ATPIII definition); 43.8%, 61% (American Heart Association definition); 44.3%, 76.4% (IDF definition); 33.8%, 51.7% (IDF definition with Egyptian cutoffs); and 41.5%, 51.7% (JIS with Egyptian cutoffs). Conclusion: WC cutoffs in Egyptians differ from those currently recommended. Prevalence of metabolic syndrome and abdominal obesity is high in Egypt, despite being lower on using the Egyptian cutoffs. PMID:26693432

  5. Violence and Cardiovascular Health

    PubMed Central

    Suglia, Shakira F.; Sapra, Katherine J.; Koenen, Karestan C.

    2014-01-01

    Context Violence, experienced in either childhood or adulthood, has been associated with physical health outcomes including cardiovascular disease. However, the consistency of the existing literature has not been evaluated. Evidence acquisition In 2013, the authors conducted a PubMed and Web of Science review of peer reviewed articles published prior to August 2013 on the relation between violence exposure, experienced in either childhood or adulthood, and cardiovascular outcomes. To meet inclusion criteria, articles had to present estimates for the relation between violence exposure and cardiovascular outcomes (hypertension, blood pressure, stroke, coronary disease, or myocardial infarction) adjusted for demographic factors. Articles focusing on violence from TV, video games, natural disasters, terrorism, or war were excluded. Evidence synthesis The initial search yielded 2,273 articles; after removing duplicates and applying inclusion and exclusion criteria, 30 articles were selected for review. A consistent positive relation was noted on the association between violence experienced during childhood and cardiovascular outcomes in adulthood (i.e., hypertension, coronary heart disease, and myocardial infarction). Associations across genders with varying types of violence exposure were also noted. By contrast, findings were mixed on the relation between adult violence exposure and cardiovascular outcome. Conclusions Despite varying definitions of violence exposure and cardiovascular endpoints, a consistent relation exists between childhood violence exposure, largely assessed retrospectively, and cardiovascular endpoints. Findings are mixed for the adult violence–cardiovascular health relation. The cross-sectional nature of most adult studies and the reliance of self-reported outcomes can potentially be attributed to the lack of findings among adult violence exposure studies. PMID:25599905

  6. Becoming Old as a "Pharmaceutical Person": Negotiation of Health and Medicines among Ethnoculturally Diverse Older Adults

    ERIC Educational Resources Information Center

    Ballantyne, Peri J.; Mirza, Raza M.; Austin, Zubin; Boon, Heather S.; Fisher, Judith E.

    2011-01-01

    Because medication prescribing and use have become a normative aspect of health care for older adults, we seek to understand how individuals navigate prescribed-medication use within the context of aging. We reasoned that, for those who are ambulatory, medication use is likely influenced by ethnocultural meanings of health and experiences with…

  7. Design of a Randomized Controlled Trial of a Web-Based Intervention to Reduce Cardiovascular Disease Risk Factors among Remote Reservation-Dwelling American Indian Adults with Type 2 Diabetes

    ERIC Educational Resources Information Center

    Henderson, Jeffrey A.; Chubak, Jessica; O'Connell, Joan; Ramos, Maria C.; Jensen, Julie; Jobe, Jared B.

    2012-01-01

    We describe a randomized controlled trial, the Lakota Oyate Wicozani Pi Kte (LOWPK) trial, which was designed to determine whether a Web-based diabetes and nutritional intervention can improve risk factors related to cardiovascular disease (CVD) among a group of remote reservation-dwelling adult American Indian men and women with type 2 diabetes…

  8. On the Validity of the Rapid Estimate of Adult Literacy in Medicine (REALM) Scale as a Measure of Health Literacy

    PubMed Central

    Dumenci, Levent; Matsuyama, Robin K.; Kuhn, Laura; Perera, Robert A.; Siminoff, Laura A.

    2013-01-01

    Originally developed to measure the literacy level of patients, the Rapid Estimate of Adult Literacy in Medicine (REALM) scale is one of the most widely used instruments to measure the construct of health literacy. This article critically examines the validity of the REALM as a measure of health literacy. Logical analysis of content coverage led to the conclusion that scores on the REALM should not be used to make inferences about a person's level of health literacy. Rather, the REALM should be used to make inferences about the ability of a person to read and pronounce health related terms. Evidence from an analysis of a sample of 1,037 respondents to the REALM with a cancer diagnosis supports the quality of the REALM as a measure of reading and pronunciation ability. Other uses of the REALM in health literacy research are discussed. PMID:23935770

  9. Cardiovascular medicine at high altitude.

    PubMed

    Whayne, Thomas F

    2014-07-01

    Altitude physiology began with Paul Bert in 1878. Chronic mountain sickness (CMS) was defined by Carlos Monge in the 1940s in the Peruvian Andes as consisting of excess polycythemia. Hurtado et al performed studies in the Peruvian Andes in the 1950s to 1960s which defined acclimatization in healthy altitude natives, including polycythemia, moderate pulmonary hypertension, and low systemic blood pressure (BP). Electrocardiographic changes of right ventricular hypertrophy (RVH) were noted. Acclimatization of newcomers to altitude involves hyperventilation stimulated by hypoxia and is usually benign. Acute mountain sickness (AMS) in travelers to altitude is characterized by hypoxia-induced anorexia, dyspnea, headache, insomnia, and nausea. The extremes of AMS are high-altitude cerebral edema and high-altitude pulmonary edema. The susceptible high-altitude resident can lose their tolerance to altitude and develop CMS, also referred to as Monge disease. The CMS includes extreme polycythemia, severe RVH, excess pulmonary hypertension, low systemic BP, arterial oxygen desaturation, and hypoventilation. PMID:23892441

  10. Cardiovascular medicine at high altitude.

    PubMed

    Whayne, Thomas F

    2014-07-01

    Altitude physiology began with Paul Bert in 1878. Chronic mountain sickness (CMS) was defined by Carlos Monge in the 1940s in the Peruvian Andes as consisting of excess polycythemia. Hurtado et al performed studies in the Peruvian Andes in the 1950s to 1960s which defined acclimatization in healthy altitude natives, including polycythemia, moderate pulmonary hypertension, and low systemic blood pressure (BP). Electrocardiographic changes of right ventricular hypertrophy (RVH) were noted. Acclimatization of newcomers to altitude involves hyperventilation stimulated by hypoxia and is usually benign. Acute mountain sickness (AMS) in travelers to altitude is characterized by hypoxia-induced anorexia, dyspnea, headache, insomnia, and nausea. The extremes of AMS are high-altitude cerebral edema and high-altitude pulmonary edema. The susceptible high-altitude resident can lose their tolerance to altitude and develop CMS, also referred to as Monge disease. The CMS includes extreme polycythemia, severe RVH, excess pulmonary hypertension, low systemic BP, arterial oxygen desaturation, and hypoventilation.

  11. Beliefs About Asthma and Complementary and Alternative Medicine in Low-Income Inner-City African-American Adults

    PubMed Central

    George, Maureen; Birck, Kathleen; Hufford, David J; Jemmott, Loretta Sweet; Weaver, Terri E

    2006-01-01

    BACKGROUND The gap in asthma prevalence, morbidity, and mortality is increasing in low-income racial/ethnic minority groups as compared with Caucasians. In order to address these disparities, alternative beliefs and behaviors need to be identified. OBJECTIVE To identify causal models of asthma and the context of conventional prescription versus complementary and alternative medicine (CAM) use in low-income African-American (AA) adults with severe asthma. DESIGN Qualitative analysis of 28 in-depth interviews. PARTICIPANTS Twenty-six women and 2 men, aged 21 to 48, who self-identified as being AA, low-income, and an inner-city resident. APPROACH Transcripts of semi-structured in-depth qualitative interviews were inductively analyzed using the constant comparison approach. RESULTS Sixty-four percent of participants held biologically correct causal models of asthma although 100% reported the use of at least 1 CAM for asthma. Biologically based therapies, humoral balance, and prayer were the most popular CAM. While most subjects trusted prescription asthma medicine, there was a preference for integration of CAM with conventional asthma treatment. Complementary and alternative medicine was considered natural, effective, and potentially curative. Sixty-three percent of participants reported nonadherence to conventional therapies in the 2 weeks before the research interview. Neither CAM nor nonmedical causal models altered most individuals (93%) willingness to use prescription medication. Three possibly dangerous CAM were identified. CONCLUSIONS Clinicians should be aware of patient-generated causal models of asthma and use of CAM in this population. Discussing patients' desire for an integrated approach to asthma management and involving social networks are 2 strategies that may enhance patient-provider partnerships and treatment fidelity. PMID:16995890

  12. Potential utility of precision medicine for older adults with polypharmacy: a case series study

    PubMed Central

    Finkelstein, Joseph; Friedman, Carol; Hripcsak, George; Cabrera, Manuel

    2016-01-01

    Pharmacogenomic (PGx) testing has been increasingly used to optimize drug regimens; however, its potential in older adults with polypharmacy has not been systematically studied. In this hypothesis-generating study, we employed a case series design to explore potential utility of PGx testing in older adults with polypharmacy and to highlight barriers in implementing this methodology in routine clinical practice. Three patients with concurrent chronic heart and lung disease aged 74, 78, and 83 years and whose medication regimen comprised 26, 17, and 18 drugs, correspondingly, served as cases for this study. PGx testing identified major genetic polymorphisms in the first two cases. The first case was identified as “CYP3A4/CYP3A5 poor metabolizer”, which affected metabolism of eleven prescribed drugs. The second case had “CYP2D6 rapid metabolizer” status affecting three prescribed medications, two of which were key drugs for managing this patient’s chronic conditions. Both these patients also had VKORC1 allele *A, resulting in higher sensitivity to warfarin. All cases demonstrated a significant number of potential drug–drug interactions. Both patients with significant drug–gene interactions had a history of frequent hospitalizations (six and 23, respectively), whereas the person without impaired cytochrome P450 enzyme activity had only two acute episodes in the last 5 years, although he was older and had multiple comorbidities. Since all patients received guideline-concordant therapy from the same providers and were adherent to their drug regimen, we hypothesized that genetic polymorphism may represent an additional risk factor for higher hospitalization rates in older adults with polypharmacy. However, evidence to support or reject this hypothesis is yet to be established. Studies evaluating clinical impact of PGx testing in older adults with polypharmacy are warranted. For practical implementation of pharmacogenomics in routine clinical care, besides

  13. Potential utility of precision medicine for older adults with polypharmacy: a case series study.

    PubMed

    Finkelstein, Joseph; Friedman, Carol; Hripcsak, George; Cabrera, Manuel

    2016-01-01

    Pharmacogenomic (PGx) testing has been increasingly used to optimize drug regimens; however, its potential in older adults with polypharmacy has not been systematically studied. In this hypothesis-generating study, we employed a case series design to explore potential utility of PGx testing in older adults with polypharmacy and to highlight barriers in implementing this methodology in routine clinical practice. Three patients with concurrent chronic heart and lung disease aged 74, 78, and 83 years and whose medication regimen comprised 26, 17, and 18 drugs, correspondingly, served as cases for this study. PGx testing identified major genetic polymorphisms in the first two cases. The first case was identified as "CYP3A4/CYP3A5 poor metabolizer", which affected metabolism of eleven prescribed drugs. The second case had "CYP2D6 rapid metabolizer" status affecting three prescribed medications, two of which were key drugs for managing this patient's chronic conditions. Both these patients also had VKORC1 allele *A, resulting in higher sensitivity to warfarin. All cases demonstrated a significant number of potential drug-drug interactions. Both patients with significant drug-gene interactions had a history of frequent hospitalizations (six and 23, respectively), whereas the person without impaired cytochrome P450 enzyme activity had only two acute episodes in the last 5 years, although he was older and had multiple comorbidities. Since all patients received guideline-concordant therapy from the same providers and were adherent to their drug regimen, we hypothesized that genetic polymorphism may represent an additional risk factor for higher hospitalization rates in older adults with polypharmacy. However, evidence to support or reject this hypothesis is yet to be established. Studies evaluating clinical impact of PGx testing in older adults with polypharmacy are warranted. For practical implementation of pharmacogenomics in routine clinical care, besides providing

  14. Potential utility of precision medicine for older adults with polypharmacy: a case series study.

    PubMed

    Finkelstein, Joseph; Friedman, Carol; Hripcsak, George; Cabrera, Manuel

    2016-01-01

    Pharmacogenomic (PGx) testing has been increasingly used to optimize drug regimens; however, its potential in older adults with polypharmacy has not been systematically studied. In this hypothesis-generating study, we employed a case series design to explore potential utility of PGx testing in older adults with polypharmacy and to highlight barriers in implementing this methodology in routine clinical practice. Three patients with concurrent chronic heart and lung disease aged 74, 78, and 83 years and whose medication regimen comprised 26, 17, and 18 drugs, correspondingly, served as cases for this study. PGx testing identified major genetic polymorphisms in the first two cases. The first case was identified as "CYP3A4/CYP3A5 poor metabolizer", which affected metabolism of eleven prescribed drugs. The second case had "CYP2D6 rapid metabolizer" status affecting three prescribed medications, two of which were key drugs for managing this patient's chronic conditions. Both these patients also had VKORC1 allele *A, resulting in higher sensitivity to warfarin. All cases demonstrated a significant number of potential drug-drug interactions. Both patients with significant drug-gene interactions had a history of frequent hospitalizations (six and 23, respectively), whereas the person without impaired cytochrome P450 enzyme activity had only two acute episodes in the last 5 years, although he was older and had multiple comorbidities. Since all patients received guideline-concordant therapy from the same providers and were adherent to their drug regimen, we hypothesized that genetic polymorphism may represent an additional risk factor for higher hospitalization rates in older adults with polypharmacy. However, evidence to support or reject this hypothesis is yet to be established. Studies evaluating clinical impact of PGx testing in older adults with polypharmacy are warranted. For practical implementation of pharmacogenomics in routine clinical care, besides providing

  15. [Risk management of cardiovascular disease through milk enriched with sterols in a young-adult population; randomized controlled clinical trial].

    PubMed

    San Mauro Martín, Ismael; Collado Yurrita, Luis; Ciudad Cabañas, María José; Cuadrado Cenzual, María Ángeles; Hernández Cabria, Marta; Calle Purón, María Elisa

    2014-10-01

    Introducción: La hipercolesterolemia es uno de los factores de riesgo relevantes en la enfermedad cardiovascular, siendo el uso de esteroles vegetales una de las estrategias con mayor evidencia. Objetivos: Determinar la eficacia de una leche enriquecida en fitoesteroles para la disminución de marcadores de enfermedad cardiovascular en población joven adulta. Métodos: Ensayo clínico, controlado, aletorizado, doble ciego y cruzado. Los esteroles (2,24 g diarios) fueron ingeridos a través de una leche comercial, administrada en dos fases de 3 semanas respectivamente y separadas por un periodo de lavado de 2 semanas, para aquellos sujetos durante la fase de “leche de estudio”, y la misma cantidad de leche desnatada, sin esteroles, para el placebo. Al inicio y al final de cada fase se realizaron extracciones de sangre. Se recopilaron datos antropométricos, hábitos de salud y marcadores analíticos sanguíneos: perfil lipídico, hematológico, inflamación, etc. Resultados: Diecinueve personas culminaron el estudio de con una edad media de 34,68 años (±6,91). La diferencia entre los marcadores basales y finales para el colesterol- LDL, el Colesterol total y Triglicéridos fueron de 19,47 (±29,10) mg/dl, 24,47 (±30,68) mg/dl, 14,36 (±44,16) mg/dl, respectivamente. Sin cambios considerables en las fracciones de colesterol-HDL. Existen diferencias significativas, entre el placebo y la leche con esteroles para colesterol-LDL (p=0,009) y Colesterol total (p=0,003). Conclusiones: Los esteroles vegetales suministrados en un alimento de consumo habitual, como la leche, pueden ser una estrategia terapéutica no farmacológica de la hipoercolesterolemia y, por ello, una herramienta en la prevención del riesgo cardiovascular a nivel global.

  16. Data Mining as a Powerful Tool for Creating Novel Drugs in Cardiovascular Medicine: The Importance of a "Back-and-Forth Loop" Between Clinical Data and Basic Research.

    PubMed

    Kitakaze, Masafumi; Asakura, Masanori; Nakano, Atsushi; Takashima, Seiji; Washio, Takashi

    2015-06-01

    Cardiovascular diseases, which lead to cardiovascular events including death, progress with many deleterious pathophysiological sequels. If a cause-and-effect relationship follows a one-to-one relation, we can focus on a cause to treat an effect, but such a relation cannot be applied in cardiovascular diseases. To identify novel drugs in the cardiovascular field, we generally adopt two different strategies: induction and deduction. In the cardiovascular field, it is difficult to use deduction because cardiovascular diseases are caused by many factors, leading us to use induction. In this method, we consider all clinical data, such as medical records or genetic data, and identify a few candidates. Recent computational and mathematical advances enable us to use data-mining methods to uncover hidden relationships between many parameters and clinical outcomes. However, because these candidates are not identified as promoting or inhibiting factors, or as causal or consequent factors of cardiovascular diseases, we need to test them in basic research, and bring them back to the clinical field to test their efficacy in clinical trials. With such a "back-and-forth loop" between clinical observation and basic research, data-mining methods may provide novel strategies leading to new tools for clinicians, basic findings for researchers, and better outcomes for patients.

  17. Behavioral and Cardiovascular Responses to Frustration during Simulated Driving Tasks in Young Adults with and without Attention Disorder Symptoms

    ERIC Educational Resources Information Center

    Oliver, Michele L.; Nigg, Joel T.; Cassavaugh, Nicholas D.; Backs, Richard W.

    2012-01-01

    Objective: The present study examined the role of negative emotions on driving performance in relation to ADHD, by comparing young adults scoring high on measures of ADHD (n = 20) with a control group (n = 22). Method: The authors used cardiorespiratory physiological measures, simulated driving behavior, and self-report to examine how participants…

  18. Exercise Is Medicine Initiative: Physical Activity as a Vital Sign and Prescription in Adult Rehabilitation Practice.

    PubMed

    Cowan, Rachel E

    2016-09-01

    To support rehabilitation health care professionals' efforts to increase physical activity levels among their outpatient rehabilitation and postdischarge patients, we review the Exercise is Medicine (EIM) initiative. The EIM initiative was launched in 2007 jointly by the American College of Sports Medicine and American Medical Association. Three principles underlie the EIM initiative. First, physical activity should be monitored as a vital sign; second, physical activity is an effective medical modality and should be prescribed; and third, success of their vision requires top down and bottom up efforts by 3 key stakeholder groups: health care providers, exercise professionals, and the community. The target weekly physical activity level is 150 minutes of moderate-to-vigorous physical activity, as established by the Centers for Disease Control and Prevention and World Health Organization. Persons falling below the weekly target physical activity level should be prescribed physical activity and/or referred to an exercise professional for implementation support. Selection of an exercise professional for referral is based on the patient's risk stratification and need to participate in clinically supervised physical activity. PMID:27470321

  19. Young Adult Exposure to Cardiovascular Risk Factors and Risk of Events Later in Life: The Framingham Offspring Study

    PubMed Central

    Pletcher, Mark J.; Vittinghoff, Eric; Thanataveerat, Anusorn; Bibbins-Domingo, Kirsten

    2016-01-01

    Background It is unclear whether coronary heart disease (CHD) risk factor exposure during early adulthood contributes to CHD risk later in life. Our objective was to analyze whether extent of early adult exposures to systolic and diastolic blood pressure (SBP, DBP) and low-and high-density lipoprotein cholesterol (LDL, HDL) are independent predictors of CHD events later in life. Methods and Findings We used all available measurements of SBP, DBP, LDL, and HDL collected over 40 years in the Framingham Offspring Study to estimate risk factor trajectories, starting at age 20 years, for all participants. Average early adult (age 20–39) exposure to each risk factor was then estimated, and used to predict CHD events (myocardial infarction or CHD death) after age 40, with adjustment for risk factor exposures later in life (age 40+). 4860 participants contributed an average of 6.3 risk factor measurements from in-person examinations and 24.5 years of follow-up after age 40, and 510 had a first CHD event. Early adult exposures to high SBP, DBP, LDL or low HDL were associated with 8- to 30-fold increases in later life CHD event rates, but were also strongly correlated with risk factor levels later in life. After adjustment for later life levels and other risk factors, early adult DBP and LDL remained strongly associated with later life risk. Compared with DBP≤70 mmHg, adjusted hazard ratios (HRs) were 2.1 (95% confidence interval: 0.8–5.7) for DBP = 71–80, 2.6 (0.9–7.2) for DBP = 81–90, and 3.6 (1.2–11) for DBP>90 (p-trend = 0.019). Compared with LDL≤100 mg/dl, adjusted HRs were 1.5 (0.9–2.6) for LDL = 101–130, 2.2 (1.2–4.0) for LDL = 131–160, and 2.4 (1.2–4.7) for LDL>160 (p-trend = 0.009). While current levels of SBP and HDL were also associated with CHD events, we did not detect an independent association with early adult exposure to either of these risk factors. Conclusions Using a mixed modeling approach to estimation of young adult exposures

  20. Benefits of Regular Exercise on Inflammatory and Cardiovascular Risk Markers in Normal Weight, Overweight and Obese Adults

    PubMed Central

    Gutierrez, Fernanda Almeida; Martins, Patricia Fátima de Oliveira; Passos, Maria Elizabeth Pereira; Momesso, Cesar Miguel; Santos, Vinicius Coneglian; Gorjão, Renata; Pithon-Curi, Tania Cristina; Cury-Boaventura, Maria Fernanda

    2015-01-01

    Obesity is a worldwide epidemic that increases the risk of several well-known co-morbidities. There is a complicated relationship between adipokines and low-grade inflammation in obesity and cardiovascular disease (CVD). Physical activity practices have beneficial health effects on obesity and related disorders such as hypertension and dyslipidemia. We investigated the effects of 6 and 12 months of moderate physical training on the levels of adipokines and CVD markers in normal weight, overweight and obese volunteers. The 143 participants were followed up at baseline and after six and twelfth months of moderate regular exercise, 2 times a week, for 12 months. The volunteers were distributed into 3 groups: Normal Weight Group (NWG,), Overweight Group (OVG) and Obese Group (OBG). We evaluated blood pressure, resting heart rate, anthropometric parameters, body composition, fitness capacity (VO2max and isometric back strength), cardiovascular markers (CRP, total cholesterol, LDL-c, HDL-c, homocysteine) and adipokine levels (leptin, adiponectin, resistin, IL-6 and TNF-alpha). There were no significant changes in anthropometric parameters and body composition in any of the groups following 6 and 12 months of exercise training. Leptin, IL-6 levels and systolic blood pressure were significantly elevated in OBG before the training. Regular exercise decreased HDL-c, leptin, adiponectin and resistin levels and diastolic blood pressure in OVG. In OBG, exercise diminished HDL-c, homocysteine, leptin, resistin, IL-6, adiponectin. Moderate exercise had no effect on the body composition; however, exercise did promote beneficial effects on the low-grade inflammatory state and CVD clinical markers in overweight and obese individuals. PMID:26474157

  1. Physical Activity and Public Health in Older Adults: Recommendation from the American College of Sports Medicine and the American Heart Association

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective: To issue a recommendation on the types and amounts of physical activity needed to improve and maintain health in older adults. Participants: A panel of scientists with expertise in public health, behavioral science, epidemiology, exercise science, medicine, and gerontology. Evidence: The ...

  2. Growing-Related Changes in Arterial Properties of Healthy Children, Adolescents, and Young Adults Nonexposed to Cardiovascular Risk Factors: Analysis of Gender-Related Differences.

    PubMed

    Curcio, S; García-Espinosa, V; Arana, M; Farro, I; Chiesa, P; Giachetto, G; Zócalo, Y; Bia, D

    2016-01-01

    The aims of our work were to determine normal aging rates for structural and functional arterial parameters in healthy children, adolescents, and young adults and to identify gender-related differences in these aging rates. Methods. 161 subjects (mean: 15 years (range: 4-28 years), 69 females) were studied. Subjects included had no congenital or chronic diseases, nor had they been previously exposed to traditional cardiovascular risk factors. Arterial parameters assessed were (1) central blood pressure (BP) and aortic pulse wave analysis, (2) arterial local (pressure-strain elastic modulus) and regional (pulse wave velocity, PWV) stiffness, and (3) arterial diameters and carotid intima-media thickness (CIMT). Simple linear regression models (age as the independent variable) were obtained for all the parameters and the resulting rates of change were compared between genders. Results. No gender-related differences were found in mean values of arterial structural and functional parameters in prepubertal ages (4-8 years), but they started to appear at ~15 years. Boys showed a greater rate of change for central systolic BP, central pulse pressure, CIMT, and carotid-femoral PWV. Conclusion. Gender-related differences in arterial characteristics of adults can be explained on the basis of different growing-related patterns between boys and girls, with no existing differences in prepubertal ages.

  3. Growing-Related Changes in Arterial Properties of Healthy Children, Adolescents, and Young Adults Nonexposed to Cardiovascular Risk Factors: Analysis of Gender-Related Differences

    PubMed Central

    Curcio, S.; García-Espinosa, V.; Arana, M.; Farro, I.; Chiesa, P.; Giachetto, G.; Zócalo, Y.; Bia, D.

    2016-01-01

    The aims of our work were to determine normal aging rates for structural and functional arterial parameters in healthy children, adolescents, and young adults and to identify gender-related differences in these aging rates. Methods. 161 subjects (mean: 15 years (range: 4–28 years), 69 females) were studied. Subjects included had no congenital or chronic diseases, nor had they been previously exposed to traditional cardiovascular risk factors. Arterial parameters assessed were (1) central blood pressure (BP) and aortic pulse wave analysis, (2) arterial local (pressure-strain elastic modulus) and regional (pulse wave velocity, PWV) stiffness, and (3) arterial diameters and carotid intima-media thickness (CIMT). Simple linear regression models (age as the independent variable) were obtained for all the parameters and the resulting rates of change were compared between genders. Results. No gender-related differences were found in mean values of arterial structural and functional parameters in prepubertal ages (4–8 years), but they started to appear at ~15 years. Boys showed a greater rate of change for central systolic BP, central pulse pressure, CIMT, and carotid-femoral PWV. Conclusion. Gender-related differences in arterial characteristics of adults can be explained on the basis of different growing-related patterns between boys and girls, with no existing differences in prepubertal ages. PMID:26989504

  4. Use of Aspirin for Prevention of Recurrent Atherosclerotic Cardiovascular Disease Among Adults — 20 States and the District of Columbia, 2013.

    PubMed

    Fang, Jing; George, Mary G; Hong, Yuling; Loustalot, Fleetwood

    2015-07-17

    The effectiveness of regular aspirin therapy in reducing risk (secondary prevention) for myocardial infarction, ischemic stroke, and fatal coronary events among persons with preexisting atherosclerotic cardiovascular disease (ASCVD) is well established and recommended in current guidelines. Reported use of aspirin or other antiplatelet agents for secondary ASCVD prevention has varied widely across settings and data collection methods, from 54% of outpatient visits for those with ischemic vascular disease to 98% at the time of discharge for acute coronary syndrome. To estimate the prevalence of aspirin use for secondary ASCVD prevention among community-dwelling adults, CDC analyzed 2013 Behavioral Risk Factor Surveillance System (BRFSS) data from 20 states and the District of Columbia. Overall, 70.8% of adult respondents with existing ASCVD reported using aspirin regularly (every day or every other day). Within this group, 93.6% reported using aspirin for heart attack prevention, 79.6% for stroke prevention and 76.2% for both heart attack and stroke prevention. Differences in use were found by age, sex, race/ethnicity, and ASCVD risk status, and state. Most of the state differences were not statistically significant; however, these estimates can be used to promote the use of aspirin as a low-cost and highly effective intervention.

  5. Introduction: Cardiovascular physics

    NASA Astrophysics Data System (ADS)

    Wessel, Niels; Kurths, Jürgen; Ditto, William; Bauernschmitt, Robert

    2007-03-01

    The number of patients suffering from cardiovascular diseases increases unproportionally high with the increase of the human population and aging, leading to very high expenses in the public health system. Therefore, the challenge of cardiovascular physics is to develop high-sophisticated methods which are able to, on the one hand, supplement and replace expensive medical devices and, on the other hand, improve the medical diagnostics with decreasing the patient's risk. Cardiovascular physics-which interconnects medicine, physics, biology, engineering, and mathematics-is based on interdisciplinary collaboration of specialists from the above scientific fields and attempts to gain deeper insights into pathophysiology and treatment options. This paper summarizes advances in cardiovascular physics with emphasis on a workshop held in Bad Honnef, Germany, in May 2005. The meeting attracted an interdisciplinary audience and led to a number of papers covering the main research fields of cardiovascular physics, including data analysis, modeling, and medical application. The variety of problems addressed by this issue underlines the complexity of the cardiovascular system. It could be demonstrated in this Focus Issue, that data analyses and modeling methods from cardiovascular physics have the ability to lead to significant improvements in different medical fields. Consequently, this Focus Issue of Chaos is a status report that may invite all interested readers to join the community and find competent discussion and cooperation partners.

  6. A comprehensive fracture prevention strategy in older adults: the European Union Geriatric Medicine Society (EUGMS) statement.

    PubMed

    Blain, H; Masud, T; Dargent-Molina, P; Martin, F C; Rosendahl, E; van der Velde, N; Bousquet, J; Benetos, A; Cooper, C; Kanis, J A; Reginster, J Y; Rizzoli, R; Cortet, B; Barbagallo, M; Dreinhöfer, K E; Vellas, B; Maggi, S; Strandberg, T

    2016-08-01

    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society, in collaboration with the International Association of Gerontology and Geriatrics for the European Region, the European Union of Medical Specialists, and the International Osteoporosis Foundation-European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people. PMID:27299902

  7. A COMPREHENSIVE FRACTURE PREVENTION STRATEGY IN OLDER ADULTS: THE EUROPEAN UNION GERIATRIC MEDICINE SOCIETY (EUGMS) STATEMENT

    PubMed Central

    BLAIN, H.; MASUD, T.; DARGENT-MOLINA, P.; MARTIN, F.C.; ROSENDAHL, E.; VAN DER VELDE, N.; BOUSQUET, J.; BENETOS, A.; COOPER, C.; KANIS, J.A.; REGINSTER, J.Y.; RIZZOLI, R.; CORTET, B.; BARBAGALLO, M.; DREINHÖFER, K.E.; VELLAS, B.; MAGGI, S.; STRANDBERG, T.

    2016-01-01

    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people. PMID:27273355

  8. Cardiovascular disease is the main cause of long-term excess mortality after ischemic stroke in young adults.

    PubMed

    Rutten-Jacobs, Loes C A; Arntz, Renate M; Maaijwee, Noortje A M; Schoonderwaldt, Hennie C; Dorresteijn, Lucille D; van Dijk, Ewoud J; de Leeuw, Frank-Erik

    2015-03-01

    Adults with stroke at a young age (18-50 years) remain at an increased risk of death for decades. It is unclear what cause underlies this long-term excess mortality and whether this is sex and time specific. Therefore, we investigated sex-specific temporal changes in cause of death after transient ischemic attack or ischemic stroke in young adults aged 18 to 50 years. We included all 845 consecutive 30-day survivors, of a first-ever transient ischemic attack (n=261) or ischemic stroke (n=584), admitted to our hospital between 1980 and 2010. Survival status was assessed at April 1, 2013. Observed cause-specific mortality was compared with expected mortality, derived from mortality rates in the general population with similar age, sex, and calendar-year characteristics. During a median follow-up of 9.2 years, 146 patients (17.3%) died, such that 29 years of life was lost by each individual. For all causes of death, observed mortality exceeded expected mortality. The absolute excess risk of death was for 74% attributable to a vascular cause (absolute excess risk, 2.8 per 1000 person-years [95% confidence interval, 1.8-4.1] for stroke and absolute excess risk, 4.3 per 1000 person-years [95% confidence interval, 2.9-5.9] for other vascular causes). The absolute excess risk was highest between 10 and 15 years after stroke and this peak was most pronounced in men and mainly attributable to vascular death. Long-term excess death after stroke in young adults is mainly attributable to a vascular cause and most pronounced in men. Attempts to reduce the risk of vascular disease after stroke in young adults should extend beyond the acute phase into the long term.

  9. Oxidative Stress in Cardiovascular Disease

    PubMed Central

    Csányi, Gábor; Miller, Francis J.

    2014-01-01

    In the special issue “Oxidative Stress in Cardiovascular Disease” authors were invited to submit papers that investigate key questions in the field of cardiovascular free radical biology. The original research articles included in this issue provide important information regarding novel aspects of reactive oxygen species (ROS)-mediated signaling, which have important implications in physiological and pathophysiological cardiovascular processes. The issue also included a number of review articles that highlight areas of intense research in the fields of free radical biology and cardiovascular medicine. PMID:24722571

  10. Serum Uric Acid and Prehypertension Among Adults Free of Cardiovascular Diseases and Diabetes: Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    PubMed

    Lotufo, Paulo A; Baena, Cristina P; Santos, Itamar S; Bensenor, Isabela M

    2016-02-01

    The association between serum uric acid (SUA) and prehypertension was evaluated in a racially admixed sample of civil servants aged 35 to 74 years, enrolled (2008-2010) in the Brazilian Longitudinal Study of Health (ELSA-Brasil). Of the 15 105 patients who enrolled in the study, we analyzed 3412 after excluding those who reported previous cardiovascular diseases, diabetes, or hypertension; were heavy drinkers; or had a body mass index (BMI) ≥ 35 kg/m(2). Among the men, logistic regression, adjusted for age, race, income, birth weight, salt intake, insulin resistance, BMI, and renal function revealed odds ratios (ORs) and 95% confidence intervals (CIs) of prehypertension from the bottom quartile (referent) to the top quartile of SUA levels as follows: 0.84 (95% CI, 0.61-1.38), 0.97 (0.71-1.34) and 1.44 (1.04-2.0; P for trend .01). Analyzing for 1-standard deviation of change in SUA, the ORs were 1.19 (1.06-1.32). This association persisted in the subgroup analysis consisting of patients who were white, overweight, with a high salt intake but with normal renal function, and without metabolic syndrome. No association was found among women. In conclusion, SUA levels were associated with prehypertension among men.

  11. Serum Uric Acid and Prehypertension Among Adults Free of Cardiovascular Diseases and Diabetes: Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    PubMed

    Lotufo, Paulo A; Baena, Cristina P; Santos, Itamar S; Bensenor, Isabela M

    2016-02-01

    The association between serum uric acid (SUA) and prehypertension was evaluated in a racially admixed sample of civil servants aged 35 to 74 years, enrolled (2008-2010) in the Brazilian Longitudinal Study of Health (ELSA-Brasil). Of the 15 105 patients who enrolled in the study, we analyzed 3412 after excluding those who reported previous cardiovascular diseases, diabetes, or hypertension; were heavy drinkers; or had a body mass index (BMI) ≥ 35 kg/m(2). Among the men, logistic regression, adjusted for age, race, income, birth weight, salt intake, insulin resistance, BMI, and renal function revealed odds ratios (ORs) and 95% confidence intervals (CIs) of prehypertension from the bottom quartile (referent) to the top quartile of SUA levels as follows: 0.84 (95% CI, 0.61-1.38), 0.97 (0.71-1.34) and 1.44 (1.04-2.0; P for trend .01). Analyzing for 1-standard deviation of change in SUA, the ORs were 1.19 (1.06-1.32). This association persisted in the subgroup analysis consisting of patients who were white, overweight, with a high salt intake but with normal renal function, and without metabolic syndrome. No association was found among women. In conclusion, SUA levels were associated with prehypertension among men. PMID:25972396

  12. Effect of Flavonoids on Oxidative Stress and Inflammation in Adults at Risk of Cardiovascular Disease: A Systematic Review.

    PubMed

    Suen, Jenni; Thomas, Jolene; Kranz, Amelia; Vun, Simon; Miller, Michelle

    2016-01-01

    Oxidative stress (OS) and inflammatory processes initiate the first stage of cardiovascular disease (CVD). Flavonoid consumption has been related to significantly improved flow-mediated dilation and blood pressure. Antioxidant and anti-inflammatory mechanisms are thought to be involved. The effect of flavonoids on markers of oxidative stress and inflammation, in at risk individuals is yet to be reviewed. Systematic literature searches were conducted in MEDLINE, Cochrane Library, CINAHL and SCOPUS databases. Randomised controlled trials in a Western country providing a food-based flavonoid intervention to participants with one or two modifiable risk factors for CVD measuring a marker of OS and/or inflammation, were included. Reference lists were hand-searched. The Cochrane Collaboration Risk of Bias Tool was used to assess study quality. The search strategy retrieved 1248 articles. Nineteen articles meeting the inclusion criteria were reviewed. Eight studies were considered at low risk of bias. Cocoa flavonoids provided to Type 2 diabetics and olive oil flavonoids to mildly-hypertensive women reduced OS and inflammation. Other food sources had weaker effects. No consistent effect on OS and inflammation across patients with varied CVD risk factors was observed. Study heterogeneity posed a challenge for inter-study comparisons. Rigorously designed studies will assist in determining the effectiveness of flavonoid interventions for reducing OS and inflammation in patients at risk of CVD. PMID:27649255

  13. Association of oral health and cardiovascular disease risk factors "results from a community based study on 5900 adult subjects".

    PubMed

    Najafipour, Hamid; Malek Mohammadi, Tayebeh; Rahim, Foad; Haghdoost, Ali Akbar; Shadkam, Mitra; Afshari, Mahdi

    2013-01-01

    Objectives. This study aimed to determine the association between some oral health status as a risk factor for cardiac diseases and other cardiovascular disease (CVD) risk factors in a sample of Iranian population in 2011. Methods. The study recruited 5900 inhabitants who aged 15-75 years old of Kerman city through a population based cluster sampling. Having collected informed consent, participants were interviewed for CVD risk factors. Some oral health indicators such as DMFT, Gingival Inflammation index, and Community Periodontal Index were assessed. The association between oral health indices and CVD risk factors was tested using multivariate regression models. Results. The mean age of participants was 33.5 years, and 45.1% were male. Moderate gingival inflammation was observed in 67.6% of participants. Presence of sub- or supragingival calculus was more common (90%) in participants. Older age (RR from 2.7 to 3.88), cigarette smoking (RR = 1.49), and high blood glucose (RR = 1.41) showed an increased risk for oral diseases after adjustment for different covariates including established CVD risk factors. Conclusion. The study results showed an increase in periodontal diseases in the presence of some CVD risk factors. Therefore there may be a bilateral but independent association for both conditions and common risk factor approach preventive program is highly recommended.

  14. Cardiovascular risk profiles of adults with type-2 diabetes treated at urban hospitals in Riyadh, Saudi Arabia.

    PubMed

    Al Slail, Fatima Y; Abid, Omer; Assiri, Abdullah M; Memish, Ziad A; Ali, Mohammed K

    2016-03-01

    Diabetes mellitus substantially increases cardiovascular disease (CVD) risk. Among Saudi Arabian citizens with diabetes, little is known about the prevalence and control of other CVD risk factors. We extracted data from medical records of a random selection of 422 patients seen between 2008 and 2012 at two diabetic clinics in Riyadh, Saudi Arabia. We calculated the proportion of patients who had additional CVD risk factors: obesity (body mass index ⩾ 30 kg/m(2)), hypertension (BP ⩾ 140/90 mmHg), elevated cholesterol fractions, and multiple risk factors). Further, we calculated the proportion of patients meeting the American Diabetes Association's recommended care targets for each risk factor. Of 422 patients (mean age, 52 years), half were women, 56% were obese, 45% had hypertension, and 77% had elevated LDL concentrations. In addition to diabetes, 70% had two or more CVD risk factors. Although 9% met both target HbA1c and BP values, only 3.5% had optimum HbA1c, BP, and lipid values. In Saudi Arabia's best diabetes clinics, most patients have poor control of their disease. This huge disease burden and related care gaps have important health and financial implications for the country.

  15. Effect of Flavonoids on Oxidative Stress and Inflammation in Adults at Risk of Cardiovascular Disease: A Systematic Review

    PubMed Central

    Suen, Jenni; Thomas, Jolene; Kranz, Amelia; Vun, Simon; Miller, Michelle

    2016-01-01

    Oxidative stress (OS) and inflammatory processes initiate the first stage of cardiovascular disease (CVD). Flavonoid consumption has been related to significantly improved flow-mediated dilation and blood pressure. Antioxidant and anti-inflammatory mechanisms are thought to be involved. The effect of flavonoids on markers of oxidative stress and inflammation, in at risk individuals is yet to be reviewed. Systematic literature searches were conducted in MEDLINE, Cochrane Library, CINAHL and SCOPUS databases. Randomised controlled trials in a Western country providing a food-based flavonoid intervention to participants with one or two modifiable risk factors for CVD measuring a marker of OS and/or inflammation, were included. Reference lists were hand-searched. The Cochrane Collaboration Risk of Bias Tool was used to assess study quality. The search strategy retrieved 1248 articles. Nineteen articles meeting the inclusion criteria were reviewed. Eight studies were considered at low risk of bias. Cocoa flavonoids provided to Type 2 diabetics and olive oil flavonoids to mildly-hypertensive women reduced OS and inflammation. Other food sources had weaker effects. No consistent effect on OS and inflammation across patients with varied CVD risk factors was observed. Study heterogeneity posed a challenge for inter-study comparisons. Rigorously designed studies will assist in determining the effectiveness of flavonoid interventions for reducing OS and inflammation in patients at risk of CVD. PMID:27649255

  16. [Dietary fats and cardiovascular health].

    PubMed

    Fernández, Lourdes Carrillo; Serra, Jaime Dalmau; Álvarez, Jesús Román Martínez; Alberich, Rosa Solà; Jiménez, Francisco Pérez

    2011-03-01

    Although dietary fat and its role in cardiovascular prevention has been one of the most extensively studied nutritional topics, it continues to be an ever-expanding research area. Particularly thanks to studies on Mediterranean diet, we now know that fat quality is more relevant than the amount of fat we eat in the diet. Thus, saturated and trans fats have been found to increase the risk of atherogenic disease. This is why it is recommended to substitute complex carbohydrates or unsaturated fat for unsaturated and trans fats with the aim of reducing saturated and trans fat intake to <10% and <1%, respectively, of the total calorie intake. Recent population studies, particularly that conducted in Kuopio, Finland, and those on Mediterranean diet, stress the important role of monounsaturated and polyunsaturated fats as key nutrients in preventing cardiovascular disease in modern societies. Furthermore, a special type of polyunsaturated fatty acids, i.e. those of the omega-3 (n-3) series, is increasingly becoming essential nutrients for a healthy diet, especially in the case of children. Therefore, there is a rationale for four the Scientific Societies that are strongly committed to disseminate the benefits of a healthy diet in preventing cardiovascular disease, and to prepare a joint statement with the purpose of spreading improved knowledge on the importance of changing to a healthy diet with a well-balanced fat intake for industrialized populations. Accordingly, a multidisciplinary panel of experts from the following institutions has developed the present joint statement targeted at both adults and children of different ages: Spanish Society of Arteriosclerosis, Spanish Society of Family and Community Medicine, Spanish Association of Paediatrics, Spanish Society of Gastroenterology, Hepatology and Paediatric Nutrition and Dietetics, and Spanish Society for Food Sciences.

  17. Fish oil and olive oil supplements attenuate the adverse cardiovascular effects of concentrated ambient air pollution particles exposure in healthy middle-aged adult human volunteers

    EPA Science Inventory

    Exposure to ambient levels of air pollution increases cardiovascular morbidity and mortality. Advanced age is among the factors associated with susceptibility to the adverse effects of air pollution. Dietary fatty acid supplementation has been shown to decrease cardiovascular ris...

  18. Complementary and alternative medicine for IBS in adults: mind-body interventions.

    PubMed

    Kearney, David J; Brown-Chang, Janelle

    2008-11-01

    Standard treatment for IBS focuses on the management or alleviation of the predominant gastrointestinal presenting symptoms, such as diarrhea or constipation, often using pharmacological therapy. For many patients, this approach is unsatisfactory, and patients frequently seek the advice of complementary and alternative medicine (CAM) practitioners in order to explore other treatment options. CAM practices include a broad range of modalities, and mind-body interventions hold particular promise as treatment modalities for IBS because psychological factors could have an important role in IBS symptomatology and quality of life. Psychological stressors are postulated to result in gastrointestinal symptoms through alteration of intestinal function mediated by the autonomic nervous system, hypothalamic-pituitary-adrenal axis and immune system. Hypnotherapy has the strongest supportive evidence as a beneficial mind-body intervention for IBS. Clinical studies of hypnotherapy have uniformly shown improvement of gastrointestinal symptoms, anxiety, depression and quality of life in patients with IBS. Mindfulness meditation remains unstudied for IBS, but is theoretically attractive as a stress-reduction technique. There is a suggestion that relaxation therapy or multimodal therapy (a combination of relaxation therapy, education and psychotherapy) is beneficial for IBS. The most generally accepted psychological mind-body intervention is cognitive behavioral therapy, and clinical trials support the beneficial effects of cognitive behavioral therapy in patients with IBS.

  19. Usability of a novel digital medicine system in adults with schizophrenia treated with sensor-embedded tablets of aripiprazole

    PubMed Central

    Peters-Strickland, Timothy; Pestreich, Linda; Hatch, Ainslie; Rohatagi, Shashank; Baker, Ross A; Docherty, John P; Markovtsova, Lada; Raja, Praveen; Weiden, Peter J; Walling, David P

    2016-01-01

    Objective Digital medicine system (DMS) is a novel drug–device combination that objectively measures and reports medication ingestion. The DMS consists of medication embedded with an ingestible sensor (digital medicine), a wearable sensor, and software applications. This study evaluated usability of the DMS in adults with schizophrenia rated by both patients and their health care providers (HCPs) during 8-week treatment with prescribed doses of digital aripiprazole. Methods Six US sites enrolled outpatients into this Phase IIa, open-label study (NCT02219009). The study comprised a screening phase, a training phase (three weekly site visits), and a 5-week independent phase. Patients and HCPs independently rated usability of and satisfaction with the DMS. Results Sixty-seven patients were enrolled, and 49 (73.1%) patients completed the study. The mean age (SD) of the patients was 46.6 years (9.7 years); the majority of them were male (74.6%), black (76.1%), and rated mildly ill on the Clinical Global Impression – Severity scale (70.1%). By the end of week 8 or early termination, 82.1% (55/67) of patients had replaced the wearable sensor independently or with minimal assistance, based on HCP rating. The patients used the wearable sensor for a mean (SD) of 70.7% (24.7%) and a median of 77.8% of their time in the trial. The patients contacted a call center most frequently at week 1. At the last visit, 78% (47/60) of patients were somewhat satisfied/satisfied/extremely satisfied with the DMS. Conclusion A high proportion of patients with schizophrenia were able to use the DMS and reported satisfaction with the DMS. These data support the potential utility of the DMS in clinical practice. PMID:27785036

  20. Health consequences of same and opposite-sex unions: partnership, parenthood, and cardiovascular risk among young adults.

    PubMed

    Frech, Adrianne; Lynch, Jamie L; Barr, Peter

    2016-02-01

    We use the National Longitudinal Survey of Adolescent to Adult Health to examine union and parenthood differences across same and opposite-sex couples in systolic and diastolic blood pressure (SBP and DBP), C-reactive protein (CRP), and abdominal adiposity (waist circumference) among partnered (dating, cohabiting, married) young adults ages 25-33. Relative to women dating men, women cohabiting with women reported lower DBP and were less likely to have high CRP. Mothers reported lower SBP and DBP than non-mothers, but were more likely to have high waist circumference if they lived with a biological or step-child. Among men, nonresidential fathers reported higher DBP than nonfathers, and married men were more likely to have high waist circumference than men dating an opposite-sex partner. Same-sex cohabitation was neither a risk factor nor a health resource for men. Although the sample sizes for same-sex couples are quite small compared with those for opposite-sex couples, this study provides initial insight that occupying a sexual minority status while partnered is associated with some health benefits and few or no health risks relative to those who are dating an opposite sex partner.

  1. Leukocyte Subtype Counts and Its Association with Vascular Structure and Function in Adults with Intermediate Cardiovascular Risk. MARK Study

    PubMed Central

    Gomez-Sanchez, Leticia; García-Ortiz, Luis; Recio-Rodríguez, José I.; Patino-Alonso, Maria C.; Agudo-Conde, Cristina; Rigo, Fernando; Ramos, Rafel; Martí, Ruth; Gomez-Marcos, Manuel A.

    2015-01-01

    Objectives We investigated the relationship between leukocyte subtype counts and vascular structure and function based on carotid intima-media thickness, pulse wave velocity, central augmentation index and cardio-ankle vascular index by gender in intermediate cardiovascular risk patients. Methods This study analyzed 500 subjects who were included in the MARK study, aged 35 to 74 years (mean: 60.3±8.4), 45.6% women. Measurement: Brachial ankle Pulse Wave Velocity (ba-PWV) estimate by equation, Cardio-AnkleVascular Index (CAVI) using the VaSera device and Carotid ultrasound was used to measure carotid Intima Media Thickness (IMT). The Mobil-O-Graph was used to measure the Central Augmentation Index (CAIx). Results Total leukocyte, neutrophil and monocyte counts were positively correlated with IMT (p < 0.01) in men. Monocyte count was positively correlated with CAIx in women (p < 0.01). In a multiple linear regression analysis, the IMT mean maintained a positive association with the neutrophil count (β = 1.500, p = 0.007) in men. CAIx maintained a positive association with the monocyte count (β = 2.445, p = 0.022) in women. Conclusion The results of this study suggest that the relationship between subtype circulating leukocyte counts and vascular structure and function, although small, may be different by gender. In men, the neutrophil count was positively correlated with IMT and in women, the monocyte count with CAIx, in a large sample of intermediate-risk patients. These association were maintained after adjusting for age and other confounders. Trial Registration ClinicalTrials.gov NCT01428934 PMID:25885665

  2. Internet Use for Searching Information on Medicines and Disease: A Community Pharmacy–Based Survey Among Adult Pharmacy Customers

    PubMed Central

    2016-01-01

    Background The Internet is increasingly used as a source of health-related information, and a vast majority of Internet users are performing health-related searches in the United States and Europe, with wide differences among countries. Health information searching behavior on the Internet is affected by multiple factors, including demographics, socioeconomic factors, education, employment, attitudes toward the Internet, and health conditions, and their knowledge may help to promote a safer use of the Internet. Limited information however exists so far about Internet use to search for medical information in Italy. Objective The objective of this study was to investigate the use of the Internet for searching for information on medicines and disease in adult subjects in Northern Italy. Methods Survey in randomly selected community pharmacies, using a self-administered questionnaire, with open and multiple choices questions, was conducted. Results A total of 1008 participants were enrolled (59.5% women; median age: 43 years; range: 14-88 years). Previous use of the Internet to search for information about medicines or dietary supplements was reported by 26.0% of respondents, more commonly by women (30.00% vs 20.10% men, P<.001), unmarried subjects (32.9% vs 17.4% widowed subjects, P=.022), and employed people (29.1% vs 10.4% retired people, P=.002). Use was highest in the age range of 26 to 35 (40.0% users vs 19.6% and 12.3% in the age range ≤25 and ≥56, respectively, P<.001) and increased with years of education (from 5.3% with 5 years, up to 41.0% with a university degree, P<.001). Previous use of the Internet to search for information about disease was reported by 59.1% of respondents, more commonly by women (64.5% vs 51.0% males, P<.001), unmarried subjects (64.2% vs 58.5% married or divorced subjects and 30.4% widowed subjects, P=.012), unemployed people (66.7% vs 64.0% workers and 29.9% retired people, P<.001). Use was highest in the age range of 26 to 35

  3. Body Mass Index, Waist-circumference and Cardiovascular Disease Risk Factors in Iranian Adults: Isfahan Healthy Heart Program

    PubMed Central

    Nazem, Masoud; Sarrafzadegan, Nizal; Nouri, Fatemeh; Sajjadi, Firouzeh; Maghroun, Maryam; Alikhasi, Hassan

    2013-01-01

    Considering the main effect of obesity on chronic non-communicable diseases, this study was performed to assess the association between body mass index (BMI), waist-circumference (WC), cardiometabolic risk factors and to corroborate whether either or both BMI and WC are independently associated with the risk factors in a sample of Iranian adults. This cross-sectional study was performed on data from baseline survey of Isfahan Healthy Heart Program (IHHP). The study was done on 12,514 randomly-selected adults in Isfahan, Najafabad and Arak counties in 2000-2001. Ages of the subjects were recorded. Fasting blood glucose (FBG), 2-hour post-load glucose (2hpp), serum lipids, systolic and diastolic blood pressure (SBP and DBP), BMI, WC, smoking status, and total daily physical activity were determined. Increase in BMI and WC had a significant positive relation with the mean of FBG, 2hpp, SBP, DBP, serum lipids, except for HDL-C (p<0.001 for all). After adjustment for age, smoking, physical activity, socioeconomic status (SES), and BMI, the highest odds ratio (OR) (95% CI) for diabetes mellitus (DM) according to WC was 3.13 (1.93-5.08) and 1.99 (1.15-3.44) in women and men respectively. Moreover, the highest ORs based on BMI with adjustment for age, smoking, physical activity, SES, and WC were for dyslipidaemia (DLP) [1.97 (1.58-2.45) in women and 2.96 (2.41-3.63) in men]. The use of BMI or WC alone in the models caused to enhance all ORs. When both BMI and WC were entered in the model, the ORs for all risk factors, in men, according to BMI, were more compared to WC. However, in women, ORs for DM and hypertension (HTN) in WC quartiles were more than in BMI quartiles. BMI is the better predictor of DM, HTN, and DLP in men compared to WC. Conversely, in women, WC is a superior predictor than BMI, particularly for DM and HTN. Furthermore, the measurement of both WC and BMI in Iranian adults may be a better predictor of traditional risk factors of CVDs compared to BMI or WC

  4. Higher diet quality is associated with decreased risk of all-cause, cardiovascular disease, and cancer mortality among older adults.

    PubMed

    Reedy, Jill; Krebs-Smith, Susan M; Miller, Paige E; Liese, Angela D; Kahle, Lisa L; Park, Yikyung; Subar, Amy F

    2014-06-01

    Increased attention in dietary research and guidance has been focused on dietary patterns, rather than on single nutrients or food groups, because dietary components are consumed in combination and correlated with one another. However, the collective body of research on the topic has been hampered by the lack of consistency in methods used. We examined the relationships between 4 indices--the Healthy Eating Index-2010 (HEI-2010), the Alternative Healthy Eating Index-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH)--and all-cause, cardiovascular disease (CVD), and cancer mortality in the NIH-AARP Diet and Health Study (n = 492,823). Data from a 124-item food-frequency questionnaire were used to calculate scores; adjusted HRs and 95% CIs were estimated. We documented 86,419 deaths, including 23,502 CVD- and 29,415 cancer-specific deaths, during 15 y of follow-up. Higher index scores were associated with a 12-28% decreased risk of all-cause, CVD, and cancer mortality. Specifically, comparing the highest with the lowest quintile scores, adjusted HRs for all-cause mortality for men were as follows: HEI-2010 HR: 0.78 (95% CI: 0.76, 0.80), AHEI-2010 HR: 0.76 (95% CI: 0.74, 0.78), aMED HR: 0.77 (95% CI: 0.75, 0.79), and DASH HR: 0.83 (95% CI: 0.80, 0.85); for women, these were HEI-2010 HR: 0.77 (95% CI: 0.74, 0.80), AHEI-2010 HR: 0.76 (95% CI: 0.74, 0.79), aMED HR: 0.76 (95% CI: 0.73, 0.79), and DASH HR: 0.78 (95% CI: 0.75, 0.81). Similarly, high adherence on each index was protective for CVD and cancer mortality examined separately. These findings indicate that multiple scores reflect core tenets of a healthy diet that may lower the risk of mortality outcomes, including federal guidance as operationalized in the HEI-2010, Harvard's Healthy Eating Plate as captured in the AHEI-2010, a Mediterranean diet as adapted in an Americanized aMED, and the DASH Eating Plan as included in the DASH score.

  5. An exploratory study of the combined effects of orally administered methylphenidate and delta-9-tetrahydrocannabinol (THC) on cardiovascular function, subjective effects, and performance in healthy adults

    PubMed Central

    Kollins, Scott H.; Schoenfelder, Erin N.; English, Joseph S.; Holdaway, Alex; Van Voorhees, Elizabeth; O’Brien, Benjamin R.; Dew, Rachel; Chrisman, Allan K.

    2014-01-01

    Methylphenidate (MPH) is commonly prescribed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD), and is often used illicitly by young adults. Illicit users often coadminister MPH with marijuana. Little is known about physiologic and subjective effects of these substances used in combination. In this double-blind, cross-over experiment, sixteen healthy adult subjects free from psychiatric illness (including ADHD) and reporting modest levels of marijuana use participated in 6 experimental sessions wherein all combinations of placebo or 10 mg oral doses of delta-9-tetrahydocannibinol (THC); and 0 mg, 10 mg and 40 mg of MPH were administered. Sessions were separated by at least 48 hours. Vital signs, subjective effects, and performance measure were collected. THC and MPH showed additive effects on heart rate and rate pressure product (e.g., peak heart rate for 10 mg THC + 0 mg, 10 mg, and 40 mg MPH = 89.1, 95.9, 102.0 beats/min, respectively). Main effects of THC and MPH were also observed on a range of subjective measures of drug effects, and significant THC dose × MPH dose interactions were found on measures of “Feel Drug,” “Good Effects,” and “Take Drug Again.” THC increased commission errors on a continuous performance test (CPT) and MPH reduced reaction time variability on this measure. Effects of THC, MPH, and their combination were variable on a measure of working memory (n-back task), though in general, MPH decreased reaction times and THC mitigated these effects. These results suggest that the combination of low to moderate doses of MPH and THC produces unique effects on cardiovascular function, subjective effects and performance measures. PMID:25175495

  6. An exploratory study of the combined effects of orally administered methylphenidate and delta-9-tetrahydrocannabinol (THC) on cardiovascular function, subjective effects, and performance in healthy adults.

    PubMed

    Kollins, Scott H; Schoenfelder, Erin N; English, Joseph S; Holdaway, Alex; Van Voorhees, Elizabeth; O'Brien, Benjamin R; Dew, Rachel; Chrisman, Allan K

    2015-01-01

    Methylphenidate (MPH) is commonly prescribed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD), and is often used illicitly by young adults. Illicit users often coadminister MPH with marijuana. Little is known about physiologic and subjective effects of these substances used in combination. In this double-blind, cross-over experiment, sixteen healthy adult subjects free from psychiatric illness (including ADHD) and reporting modest levels of marijuana use participated in 6 experimental sessions wherein all combinations of placebo or 10mg oral doses of delta-9-tetrahydocannibinol (THC); and 0mg, 10mg and 40 mg of MPH were administered. Sessions were separated by at least 48 hours. Vital signs, subjective effects, and performance measure were collected. THC and MPH showed additive effects on heart rate and rate pressure product (e.g., peak heart rate for 10mg THC+0mg, 10mg, and 40 mg MPH=89.1, 95.9, 102.0 beats/min, respectively). Main effects of THC and MPH were also observed on a range of subjective measures of drug effects, and significant THC dose × MPH dose interactions were found on measures of "Feel Drug," "Good Effects," and "Take Drug Again." THC increased commission errors on a continuous performance test (CPT) and MPH reduced reaction time variability on this measure. Effects of THC, MPH, and their combination were variable on a measure of working memory (n-back task), though in general, MPH decreased reaction times and THC mitigated these effects. These results suggest that the combination of low to moderate doses of MPH and THC produces unique effects on cardiovascular function, subjective effects and performance measures.

  7. Sex difference in the prevalence of metabolic syndrome and cardiovascular-related risk factors in urban adults from 33 communities of China: The CHPSNE study.

    PubMed

    Song, Qing-Bin; Zhao, Yang; Liu, Yu-Qin; Zhang, Jian; Xin, Shi-Jie; Dong, Guang-Hui

    2015-05-01

    Little is known about the epidemiology of metabolic syndrome in urban areas of China. To estimate the prevalence of MetS and identify its cardiovascular-related factors in men and women, a representative sample of 15,477 urban adults aged 18-74 years in Northeast China was selected from 2009 to 2010. The diagnosis of metabolic syndrome was based on criteria set by the National Cholesterol Education Program/Adult Treatment Panel. The overall prevalence of metabolic syndrome was 27.4% (men 27.9% and women 26.8%). Multivariable logistic regression analysis revealed that a higher education level and a higher family income were associated with a higher prevalence of metabolic syndrome in men, but associated with lower prevalence of metabolic syndrome among women. Higher physical activity was associated with a decreased prevalence of metabolic syndrome in men (adjusted odds ratios (aORs) = 0.88, 95% confidence interval (CI): 0.79-0.99), but associated with an increased prevalence of metabolic syndrome in women (aOR = 1.14, 95% CI: 1.00-1.29). Compared with rice as the major staple food, cooked wheaten foods were associated with lower adjusted odds for metabolic syndrome both in men (aOR = 0.72, 95% CI: 0.58-0.90) and in women (aOR = 0.72, 95% CI: 0.56-0.92). In conclusion, metabolic syndrome is highly prevalent in urban areas of China, and there is heterogeneity by sex in the relationships between risk factors and metabolic syndrome prevalence.

  8. An exploratory study of the combined effects of orally administered methylphenidate and delta-9-tetrahydrocannabinol (THC) on cardiovascular function, subjective effects, and performance in healthy adults.

    PubMed

    Kollins, Scott H; Schoenfelder, Erin N; English, Joseph S; Holdaway, Alex; Van Voorhees, Elizabeth; O'Brien, Benjamin R; Dew, Rachel; Chrisman, Allan K

    2015-01-01

    Methylphenidate (MPH) is commonly prescribed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD), and is often used illicitly by young adults. Illicit users often coadminister MPH with marijuana. Little is known about physiologic and subjective effects of these substances used in combination. In this double-blind, cross-over experiment, sixteen healthy adult subjects free from psychiatric illness (including ADHD) and reporting modest levels of marijuana use participated in 6 experimental sessions wherein all combinations of placebo or 10mg oral doses of delta-9-tetrahydocannibinol (THC); and 0mg, 10mg and 40 mg of MPH were administered. Sessions were separated by at least 48 hours. Vital signs, subjective effects, and performance measure were collected. THC and MPH showed additive effects on heart rate and rate pressure product (e.g., peak heart rate for 10mg THC+0mg, 10mg, and 40 mg MPH=89.1, 95.9, 102.0 beats/min, respectively). Main effects of THC and MPH were also observed on a range of subjective measures of drug effects, and significant THC dose × MPH dose interactions were found on measures of "Feel Drug," "Good Effects," and "Take Drug Again." THC increased commission errors on a continuous performance test (CPT) and MPH reduced reaction time variability on this measure. Effects of THC, MPH, and their combination were variable on a measure of working memory (n-back task), though in general, MPH decreased reaction times and THC mitigated these effects. These results suggest that the combination of low to moderate doses of MPH and THC produces unique effects on cardiovascular function, subjective effects and performance measures. PMID:25175495

  9. Comparative Cost-Effectiveness of Conservative or Intensive Blood Pressure Treatment Guidelines in Adults Aged 35-74 Years: The Cardiovascular Disease Policy Model.

    PubMed

    Moise, Nathalie; Huang, Chen; Rodgers, Anthony; Kohli-Lynch, Ciaran N; Tzong, Keane Y; Coxson, Pamela G; Bibbins-Domingo, Kirsten; Goldman, Lee; Moran, Andrew E

    2016-07-01

    The population health effect and cost-effectiveness of implementing intensive blood pressure goals in high-cardiovascular disease (CVD) risk adults have not been described. Using the CVD Policy Model, CVD events, treatment costs, quality-adjusted life years, and drug and monitoring costs were simulated over 2016 to 2026 for hypertensive patients aged 35 to 74 years. We projected the effectiveness and costs of hypertension treatment according to the 2003 Joint National Committee (JNC)-7 or 2014 JNC8 guidelines, and then for adults aged ≥50 years, we assessed the cost-effectiveness of adding an intensive goal of systolic blood pressure <120 mm Hg for patients with CVD, chronic kidney disease, or 10-year CVD risk ≥15%. Incremental cost-effectiveness ratios <$50 000 per quality-adjusted life years gained were considered cost-effective. JNC7 strategies treat more patients and are more costly to implement compared with JNC8 strategies. Adding intensive systolic blood pressure goals for high-risk patients prevents an estimated 43 000 and 35 000 annual CVD events incremental to JNC8 and JNC7, respectively. Intensive strategies save costs in men and are cost-effective in women compared with JNC8 alone. At a willingness-to-pay threshold of $50 000 per quality-adjusted life years gained, JNC8+intensive had the highest probability of cost-effectiveness in women (82%) and JNC7+intensive the highest probability of cost-effectiveness in men (100%). Assuming higher drug and monitoring costs, adding intensive goals for high-risk patients remained consistently cost-effective in men, but not always in women. Among patients aged 35 to 74 years, adding intensive blood pressure goals for high-risk groups to current national hypertension treatment guidelines prevents additional CVD deaths while saving costs provided that medication costs are controlled.

  10. Healthy Lifestyle through Young Adulthood and Presence of Low Cardiovascular Disease Risk Profile in Middle Age: The Coronary Artery Risk Development in (Young) Adults (CARDIA) Study

    PubMed Central

    Liu, Kiang; Daviglus, Martha L.; Loria, Catherine M.; Colangelo, Laura A.; Spring, Bonnie; Moller, Arlen C.; Lloyd-Jones, Donald M.

    2012-01-01

    Background A low cardiovascular disease (CVD) risk profile (untreated cholesterol < 200 mg/dl, untreated blood pressure < 120/<80 mmHg, never smoking, and no history of diabetes and myocardial infarction) in middle age is associated with markedly better health outcomes in older age, but few middle aged adults have this low risk profile. We examined whether adopting a healthy lifestyle throughout young adulthood is associated with presence of the low CVD risk profile in middle age. Methods and Results The CARDIA study sample consisted of 3,154 black and white participants aged 18 to 30 years at Year 0 (Y0, 1985-86) who attended the Year 0, 7 and 20 (Y0, Y7 and Y20) examinations. Healthy lifestyle factors (HLFs) defined at Y0, Y7 and Y20 included: 1) Average BMI < 25 kg/m2; 2) No or moderate alcohol intake; 3) higher healthy diet score; 4) higher physical activity score; and 5) Never smoking. Mean age (25 years) and percentage of women (56%) were comparable across groups defined by number of HLFs. The age-, sex- and race-adjusted prevalences of low CVD risk profile at Y20 were 3.0%, 14.6%, 29.5%, 39.2% and 60.7% for people with 0 or 1, 2, 3, 4, and 5 HLFs, respectively (p-trend <0.0001). Similar graded relationships were observed for each sex-race group (all p-trend<0.0001). Conclusions Maintaining a healthy lifestyle throughout young adulthood is strongly associated with low CVD risk profile in middle age. Public health and individual efforts are needed to improve adoption and maintenance of healthy lifestyles in young adults. PMID:22291127

  11. Complementary and Alternative Medicine Use in the US Adult Low Back Pain Population.

    PubMed

    Ghildayal, Neha; Johnson, Pamela Jo; Evans, Roni L; Kreitzer, Mary Jo

    2016-01-01

    背景:许多有腰背痛 (Low Back Pain, LBP) 的人都发现常规药物治疗不足以管理其腰背痛,并越来越多地转向补充和替代医学 (Complementary and Alternative Medicine, CAM) 来疼痛缓解。需要全面描绘 CAM 在 LBP 人群中的使用情况,包括所有最常用的方式。研究目标:通过限制性与非限制性 LBP 考察在美国 LBP 人群中使用 CAM 的普遍性和感知利益,同时评估去年在 LBP 人群中使用 CAM 的几率。方法:数据来自于 2012 年国家健康访谈调查,替代健康补充。我们考察了美国成人 LBP 患者的全国代表性样本(N=9665,未加权)。使用多次逻辑回归估计去年使用 CAM的几率。结果:总体而言,41.2% 的 LBP 人群去年使用了 CAM,其中在限制性 LBP 患者中报告的使用率较高。LBP人群中使用最多的疗法包括草药补充剂、整脊疗法和按摩。多数 LBP人群使用了专用于治疗背痛的 CAM,在使用 CAM 治疗背痛者中,58.1% 感觉受益匪浅。结论:结果表明,CAM 正成为 LBP病患护理越来越重要的组成部分。进一步了解 CAM 在 LBP 人群中的使用方式将帮助卫生保健专业人员作出更加知情的护理决定,并指导研究者发展未来的背痛相关 CAM 研究。.

  12. Association of Socioeconomic Position and Demographic Characteristics with Cardiovascular Disease Risk Factors and Healthcare Access among Adults Living in Pohnpei, Federated States of Micronesia.

    PubMed

    Hosey, G M; Samo, M; Gregg, E W; Barker, L; Padden, D; Bibb, S G

    2014-01-01

    Background. The burden of cardiovascular disease (CVD) is increasing in low-to-middle income countries. We examined how socioeconomic and demographic characteristics may be associated with CVD risk factors and healthcare access in such countries. Methods. We extracted data from the World Health Organization's STEPwise approach to surveillance 2002 cross-sectional dataset from Pohnpei, Federated States of Micronesia (FSM). We used these data to estimate associations for socioeconomic position (education, income, and employment) and demographics (age, sex, and urban/rural) with CVD risk factors and with healthcare access, among a sample of 1638 adults (25-64 years). Results. In general, we found significantly higher proportions of daily tobacco use among men than women and respondents reporting primary-level education (<9 years) than among those with postsecondary education (>12 years). Results also revealed significant positive associations between paid employment and waist circumference and systolic blood pressure. Healthcare access did not differ significantly by socioeconomic position. Women reported significantly higher mean waist circumference than men. Conclusion. Our results suggest that socioeconomic position and demographic characteristics impact CVD risk factors and healthcare access in FSM. This understanding may help decision-makers tailor population-level policies and programs. The 2002 Pohnpei data provides a baseline; subsequent population health surveillance data might define trends.

  13. Behavioral, normative and control beliefs underlying low-fat dietary and regular physical activity behaviors for adults diagnosed with type 2 diabetes and/or cardiovascular disease.

    PubMed

    White, Katherine M; Terry, Deborah J; Troup, Carolyn; Rempel, Lynn A

    2007-08-01

    Promoting healthy lifestyle behaviors is an important aspect of interventions designed to improve the management of chronic diseases such as Type 2 diabetes and cardiovascular disease. The present study used Ajzen's (1991) theory of planned behavior as a framework to examine beliefs amongst adults diagnosed with these conditions who do and do not engage in low-fat dietary and regular physical activity behaviors. Participants (N = 192) completed a questionnaire assessing their behavioral, normative and control beliefs in relation to regular, moderate physical activity and eating foods low in saturated fats. Measures of self-reported behavior were also examined. The findings revealed that, in general, it is the underlying behavioral beliefs that are important determinants for both physical activity and low-fat food consumption with some evidence to suggest that pressure from significant others is an important consideration for low-fat food consumption. Laziness, as a barrier to engaging in physical activity, also emerged as an important factor. To encourage a healthy lifestyle amongst this population, interventions should address the perceived costs associated with behavioral performance and encourage people to maintain healthy behaviors in light of these costs.

  14. Behavioral, normative and control beliefs underlying low-fat dietary and regular physical activity behaviors for adults diagnosed with type 2 diabetes and/or cardiovascular disease.

    PubMed

    White, Katherine M; Terry, Deborah J; Troup, Carolyn; Rempel, Lynn A

    2007-08-01

    Promoting healthy lifestyle behaviors is an important aspect of interventions designed to improve the management of chronic diseases such as Type 2 diabetes and cardiovascular disease. The present study used Ajzen's (1991) theory of planned behavior as a framework to examine beliefs amongst adults diagnosed with these conditions who do and do not engage in low-fat dietary and regular physical activity behaviors. Participants (N = 192) completed a questionnaire assessing their behavioral, normative and control beliefs in relation to regular, moderate physical activity and eating foods low in saturated fats. Measures of self-reported behavior were also examined. The findings revealed that, in general, it is the underlying behavioral beliefs that are important determinants for both physical activity and low-fat food consumption with some evidence to suggest that pressure from significant others is an important consideration for low-fat food consumption. Laziness, as a barrier to engaging in physical activity, also emerged as an important factor. To encourage a healthy lifestyle amongst this population, interventions should address the perceived costs associated with behavioral performance and encourage people to maintain healthy behaviors in light of these costs. PMID:17620212

  15. Association of Socioeconomic Position and Demographic Characteristics with Cardiovascular Disease Risk Factors and Healthcare Access among Adults Living in Pohnpei, Federated States of Micronesia

    PubMed Central

    Hosey, G. M.; Samo, M.; Gregg, E. W.; Barker, L.; Padden, D.; Bibb, S. G.

    2014-01-01

    Background. The burden of cardiovascular disease (CVD) is increasing in low-to-middle income countries. We examined how socioeconomic and demographic characteristics may be associated with CVD risk factors and healthcare access in such countries. Methods. We extracted data from the World Health Organization's STEPwise approach to surveillance 2002 cross-sectional dataset from Pohnpei, Federated States of Micronesia (FSM). We used these data to estimate associations for socioeconomic position (education, income, and employment) and demographics (age, sex, and urban/rural) with CVD risk factors and with healthcare access, among a sample of 1638 adults (25–64 years). Results. In general, we found significantly higher proportions of daily tobacco use among men than women and respondents reporting primary-level education (<9 years) than among those with postsecondary education (>12 years). Results also revealed significant positive associations between paid employment and waist circumference and systolic blood pressure. Healthcare access did not differ significantly by socioeconomic position. Women reported significantly higher mean waist circumference than men. Conclusion. Our results suggest that socioeconomic position and demographic characteristics impact CVD risk factors and healthcare access in FSM. This understanding may help decision-makers tailor population-level policies and programs. The 2002 Pohnpei data provides a baseline; subsequent population health surveillance data might define trends. PMID:26464859

  16. Society of Anesthesia and Sleep Medicine Guidelines on Preoperative Screening and Assessment of Adult Patients With Obstructive Sleep Apnea

    PubMed Central

    Memtsoudis, Stavros G.; Ramachandran, Satya Krishna; Nagappa, Mahesh; Opperer, Mathias; Cozowicz, Crispiana; Patrawala, Sara; Lam, David; Kumar, Anjana; Joshi, Girish P.; Fleetham, John; Ayas, Najib; Collop, Nancy; Doufas, Anthony G.; Eikermann, Matthias; Englesakis, Marina; Gali, Bhargavi; Gay, Peter; Hernandez, Adrian V.; Kaw, Roop; Kezirian, Eric J.; Malhotra, Atul; Mokhlesi, Babak; Parthasarathy, Sairam; Stierer, Tracey; Wappler, Frank; Hillman, David R.; Auckley, Dennis

    2016-01-01

    The purpose of the Society of Anesthesia and Sleep Medicine guideline on preoperative screening and assessment of adult patients with obstructive sleep apnea (OSA) is to present recommendations based on the available clinical evidence on the topic where possible. As very few well-performed randomized studies in this field of perioperative care are available, most of the recommendations were developed by experts in the field through consensus processes involving utilization of evidence grading to indicate the level of evidence upon which recommendations were based. This guideline may not be appropriate for all clinical situations and all patients. The decision whether to follow these recommendations must be made by a responsible physician on an individual basis. Protocols should be developed by individual institutions taking into account the patients’ conditions, extent of interventions and available resources. This practice guideline is not intended to define standards of care or represent absolute requirements for patient care. The adherence to these guidelines cannot in any way guarantee successful outcomes and is rather meant to help individuals and institutions formulate plans to better deal with the challenges posed by perioperative patients with OSA. These recommendations reflect the current state of knowledge and its interpretation by a group of experts in the field at the time of publication. While these guidelines will be periodically updated, new information that becomes available between updates should be taken into account. Deviations in practice from guidelines may be justifiable and such deviations should not be interpreted as a basis for claims of negligence. PMID:27442772

  17. Society of Anesthesia and Sleep Medicine Guidelines on Preoperative Screening and Assessment of Adult Patients With Obstructive Sleep Apnea.

    PubMed

    Chung, Frances; Memtsoudis, Stavros G; Ramachandran, Satya Krishna; Nagappa, Mahesh; Opperer, Mathias; Cozowicz, Crispiana; Patrawala, Sara; Lam, David; Kumar, Anjana; Joshi, Girish P; Fleetham, John; Ayas, Najib; Collop, Nancy; Doufas, Anthony G; Eikermann, Matthias; Englesakis, Marina; Gali, Bhargavi; Gay, Peter; Hernandez, Adrian V; Kaw, Roop; Kezirian, Eric J; Malhotra, Atul; Mokhlesi, Babak; Parthasarathy, Sairam; Stierer, Tracey; Wappler, Frank; Hillman, David R; Auckley, Dennis

    2016-08-01

    The purpose of the Society of Anesthesia and Sleep Medicine guideline on preoperative screening and assessment of adult patients with obstructive sleep apnea (OSA) is to present recommendations based on the available clinical evidence on the topic where possible. As very few well-performed randomized studies in this field of perioperative care are available, most of the recommendations were developed by experts in the field through consensus processes involving utilization of evidence grading to indicate the level of evidence upon which recommendations were based. This guideline may not be appropriate for all clinical situations and all patients. The decision whether to follow these recommendations must be made by a responsible physician on an individual basis. Protocols should be developed by individual institutions taking into account the patients' conditions, extent of interventions and available resources. This practice guideline is not intended to define standards of care or represent absolute requirements for patient care. The adherence to these guidelines cannot in any way guarantee successful outcomes and is rather meant to help individuals and institutions formulate plans to better deal with the challenges posed by perioperative patients with OSA. These recommendations reflect the current state of knowledge and its interpretation by a group of experts in the field at the time of publication. While these guidelines will be periodically updated, new information that becomes available between updates should be taken into account. Deviations in practice from guidelines may be justifiable and such deviations should not be interpreted as a basis for claims of negligence. PMID:27442772

  18. [Sleep rhythm and cardiovascular diseases].

    PubMed

    Maemura, Koji

    2012-07-01

    Sleep disturbance is a common problem in general adult population. Recent evidence suggests the link between the occurrence of cardiovascular events and several sleep disturbances including sleep apnea syndrome, insomnia and periodic limb movements during sleep. Sleep duration may affect the cardiovascular outcome. Shift work also may increase the risk of ischemic heart disease. Normalization of sleep rhythm has a potential to be a therapeutic target of ischemic heart diseases, although further study is required to evaluate the preventive effect on cardiovascular events. Here we describe the current understandings regarding the roles of sleep disorders during the pathogenesis of cardiovascular events. PMID:22844804

  19. [Promoting development of new traditional Chinese medicine by combination disease-syndrome and multi-objective optimization research in prevention and treatment of cardiovascular disease].

    PubMed

    Wang, Jie; Guo, Li-li

    2015-09-01

    Differences in theories, application forms and evaluation standards about curative effect between traditional Chinese medicine and modern medicine lead to not only question safty and effectiveness but also hinder development and internationalization of traditional Chinese medicine. Combination of common problems in traditional Chinese new drug registration with experiences in research on traditional Chinese new drugs of prevention and treatment of coronary heart disease elucidate application value about theory of disease-syndrome combination and multi-objective optimization in several ways such as the indications positioning, preparation process optimization, preclinical efficacy evaluating and clinical assessmenting of efficacy and analysis development prospect.

  20. [Promoting development of new traditional Chinese medicine by combination disease-syndrome and multi-objective optimization research in prevention and treatment of cardiovascular disease].

    PubMed

    Wang, Jie; Guo, Li-li

    2015-09-01

    Differences in theories, application forms and evaluation standards about curative effect between traditional Chinese medicine and modern medicine lead to not only question safty and effectiveness but also hinder development and internationalization of traditional Chinese medicine. Combination of common problems in traditional Chinese new drug registration with experiences in research on traditional Chinese new drugs of prevention and treatment of coronary heart disease elucidate application value about theory of disease-syndrome combination and multi-objective optimization in several ways such as the indications positioning, preparation process optimization, preclinical efficacy evaluating and clinical assessmenting of efficacy and analysis development prospect. PMID:26978980

  1. The European Medicines Agency review of eltrombopag (Revolade) for the treatment of adult chronic immune (idiopathic) thrombocytopenic purpura: summary of the scientific assessment of the Committee for Medicinal Products for Human Use.

    PubMed

    Nieto, Maria; Calvo, Gonzalo; Hudson, Ian; Feldschreiber, Peter; Brown, David; Lee, Ching Cheng; Lay, Geoffrey; Valeri, Anna; Abadie, Eric; Thomas, Angela; Pignatti, Francesco

    2011-09-01

    On 11(th) March 2010, the European Commission issued a marketing authorization valid throughout the European Union for Revolade for the treatment of adult chronic immune (idiopathic) thrombocytopenic purpura. Revolade is an orphan medicinal product indicated for splenectomized patients with immune (idiopathic) thrombocytopenic purpura who are refractory to other treatments (e.g. corticosteroids, immunoglobulins) and as second-line treatment for non-splenectomized patients where surgery is contraindicated. The active substance of Revolade is eltrombopag (ATC code B02BX05). Eltrombopag increases platelet production through activation of the thrombopoietin receptor. The recommended oral dose is 50 mg once daily to achieve and maintain a platelet count of the 50×10(9)/L or more necessary to reduce or prevent the risk of bleeding. The benefit of Revolade is a durable response in maintaining platelet levels. The most common side effects include headache, nausea, hepatobiliary toxicity, diarrhea, fatigue, paresthesia, constipation, rash, pruritus, cataract, arthralgia and myalgia. The decision to grant the marketing authorization was based on the favorable recommendation of the Committee for Medicinal Products for Human Use of the European Medicines Agency. The objective of this paper is to describe the data submitted to the European Medicines Agency and to summarize the scientific review of the application. The detailed scientific assessment report and product information, including the summary of product characteristics, are available on the European Medicines Agency website (www.ema.europa.eu). PMID:21712542

  2. Cardiovascular Disease Consequences of CKD.

    PubMed

    Go, Alan S

    2016-07-01

    Chronic kidney disease, defined as reduced glomerular filtration rate (estimated using serum creatinine- and/or serum cystatin C-based equations) or excess urinary protein excretion, affects approximately 13% of adult Americans and is linked to a variety of clinical complications. Although persons with end-stage renal disease requiring chronic dialysis therapy experience a substantially high cardiovascular burden, whether mild-to-moderate chronic kidney disease is an independent risk factor for fatal and nonfatal cardiovascular events has been more controversial. This review evaluates the current evidence about the clinical and subclinical cardiovascular consequences associated with chronic kidney disease of varying levels of severity. In addition, it discusses the predictors of adverse cardiovascular outcomes while also focusing on recent insights into the relationships between chronic kidney disease and cardiovascular disease from the Chronic Renal Insufficiency Cohort study, a large current prospective cohort study of adults from across the spectrum of chronic kidney disease. PMID:27475660

  3. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

    PubMed Central

    Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

    2015-01-01

    The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. SLEEP 2015;38(8):1161–1183. PMID:26194576

  4. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

    PubMed Central

    Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

    2015-01-01

    The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. J Clin Sleep Med 2015;11(8):931–952. PMID:26235159

  5. Dietary patterns and cardiovascular risk factors in adolescents and young adults: the Northern Ireland Young Hearts Project.

    PubMed

    McCourt, Hannah J; Draffin, Claire R; Woodside, Jayne V; Cardwell, Chris R; Young, Ian S; Hunter, Steven J; Murray, Liam J; Boreham, Colin A; Gallagher, Alison M; Neville, Charlotte E; McKinley, Michelle C

    2014-11-28

    Dietary pattern (DP) analysis allows examination of the combined effects of nutrients and foods on the markers of CVD. Very few studies have examined these relationships during adolescence or young adulthood. Traditional CVD risk biomarkers were analysed in 12-15-year-olds (n 487; Young Hearts (YH)1) and again in the same individuals at 20-25 years of age (n 487; YH3). Based on 7 d diet histories, in the present study, DP analysis was performed using a posteriori principal component analysis for the YH3 cohort and the a priori Mediterranean Diet Score (MDS) was calculated for both YH1 and YH3 cohorts. In the a posteriori DP analysis, YH3 participants adhering most closely to the 'healthy' DP were found to have lower pulse wave velocity (PWV) and homocysteine concentrations, the 'sweet tooth' DP were found to have increased LDL concentrations, and decreased HDL concentrations, [corrected] the 'drinker/social' DP were found to have lower LDL and homocysteine concentrations, but exhibited a trend towards a higher TAG concentration, and finally the 'Western' DP were found to have elevated homocysteine and HDL concentrations. In the a priori dietary score analysis, YH3 participants adhering most closely to the Mediterranean diet were found to exhibit a trend towards a lower PWV. MDS did not track between YH1 and YH3, and nor was there a longitudinal relationship between the change in the MDS and the change in CVD risk biomarkers. In conclusion, cross-sectional analysis revealed that some associations between DP and CVD risk biomarkers were already evident in the young adult population, namely the association between the healthy DP (and the MDS) and PWV; however, no longitudinal associations were observed between these relatively short time periods. PMID:25234582

  6. Dietary patterns and cardiovascular risk factors in adolescents and young adults: the Northern Ireland Young Hearts Project.

    PubMed

    McCourt, Hannah J; Draffin, Claire R; Woodside, Jayne V; Cardwell, Chris R; Young, Ian S; Hunter, Steven J; Murray, Liam J; Boreham, Colin A; Gallagher, Alison M; Neville, Charlotte E; McKinley, Michelle C

    2014-11-28

    Dietary pattern (DP) analysis allows examination of the combined effects of nutrients and foods on the markers of CVD. Very few studies have examined these relationships during adolescence or young adulthood. Traditional CVD risk biomarkers were analysed in 12-15-year-olds (n 487; Young Hearts (YH)1) and again in the same individuals at 20-25 years of age (n 487; YH3). Based on 7 d diet histories, in the present study, DP analysis was performed using a posteriori principal component analysis for the YH3 cohort and the a priori Mediterranean Diet Score (MDS) was calculated for both YH1 and YH3 cohorts. In the a posteriori DP analysis, YH3 participants adhering most closely to the 'healthy' DP were found to have lower pulse wave velocity (PWV) and homocysteine concentrations, the 'sweet tooth' DP were found to have increased LDL concentrations, and decreased HDL concentrations, [corrected] the 'drinker/social' DP were found to have lower LDL and homocysteine concentrations, but exhibited a trend towards a higher TAG concentration, and finally the 'Western' DP were found to have elevated homocysteine and HDL concentrations. In the a priori dietary score analysis, YH3 participants adhering most closely to the Mediterranean diet were found to exhibit a trend towards a lower PWV. MDS did not track between YH1 and YH3, and nor was there a longitudinal relationship between the change in the MDS and the change in CVD risk biomarkers. In conclusion, cross-sectional analysis revealed that some associations between DP and CVD risk biomarkers were already evident in the young adult population, namely the association between the healthy DP (and the MDS) and PWV; however, no longitudinal associations were observed between these relatively short time periods.

  7. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion.

    PubMed

    Watson, Nathaniel F; Badr, M Safwan; Belenky, Gregory; Bliwise, Donald L; Buxton, Orfeu M; Buysse, Daniel; Dinges, David F; Gangwisch, James; Grandner, Michael A; Kushida, Clete; Malhotra, Raman K; Martin, Jennifer L; Patel, Sanjay R; Quan, Stuart F; Tasali, Esra

    2015-08-01

    The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.

  8. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion.

    PubMed

    Watson, Nathaniel F; Badr, M Safwan; Belenky, Gregory; Bliwise, Donald L; Buxton, Orfeu M; Buysse, Daniel; Dinges, David F; Gangwisch, James; Grandner, Michael A; Kushida, Clete; Malhotra, Raman K; Martin, Jennifer L; Patel, Sanjay R; Quan, Stuart F; Tasali, Esra

    2015-08-15

    The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.

  9. Association of Fetuin-A With Incident Fractures in Community-Dwelling Older Adults: The Cardiovascular Health Study.

    PubMed

    Fink, Howard A; Bůžková, Petra; Garimella, Pranav S; Mukamal, Kenneth J; Cauley, Jane A; Kizer, Jorge R; Barzilay, Joshua I; Jalal, Diana I; Ix, Joachim H

    2015-08-01

    Fetuin-A, a serum protein that regulates calcium mineralization, has been associated with bone mineral density (BMD) in several cross-sectional human studies, suggesting a possible beneficial effect on clinically important measures of bone health. Fetuin-A and incidence of subsequent fracture was assessed in 4714 men and women ≥65 years of age. Proportional hazards models were used to estimate risk of incident hip (hospital discharge ICD-9 codes) and composite fracture (hip, pelvis, humerus, or proximal forearm; hospital discharge ICD-9 codes and Medicare claims data). A total of 576 participants had an incident hip fracture (median follow-up 11.2 years) and 768 had an incident composite fracture (median follow-up 6.9 years). In unadjusted analyses, there was no association between fetuin-A (per SD increase) and risk of hip fracture (hazard ratio [HR], 0.96; 95% CI, 0.88 to 1.05) or composite fracture (HR, 0.99; 95% CI, 0.92 to 1.06). Results were not significantly changed after adjustment for potential confounding variables. Analyses modeling fetuin-A in quartiles or within a subset with available BMD measures also showed no statistically significant association with risk of hip or composite fracture. Though fetuin-A was positively associated with areal BMD in partially adjusted models (total hip: β, 0.013 g/cm(2) ; 95% CI, 0.005 to 0.021; femoral neck: β, 0.011 g/cm(2) ; 95% CI, 0.004 to 0.018; and lumbar spine: β, 0.007 g/cm(2) ; 95% CI, 0.001 to 0.028), these associations were no longer significant after further adjustment for BMI and in final multivariate models. In this large sample of community-dwelling older adults, a small positive association between fetuin-A and areal BMD appeared attributable to confounding variables and we found no evidence of an association between fetuin-A and risk of clinical fracture. PMID:25656814

  10. Cardiovascular Deconditioning

    NASA Technical Reports Server (NTRS)

    Charles, John B.; Fritsch-Yelle, Janice M.; Whitson, Peggy A.; Wood, Margie L.; Brown, Troy E.; Fortner, G. William

    1999-01-01

    Spaceflight causes adaptive changes in cardiovascular function that may deleteriously affect crew health and safety. Over the last three decades, symptoms of cardiovascular changes have ranged from postflight orthostatic tachycardia and decreased exercise capacity to serious cardiac rhythm disturbances during extravehicular activities (EVA). The most documented symptom of cardiovascular dysfunction, postflight orthostatic intolerance, has affected a significant percentage of U.S. Space Shuttle astronauts. Problems of cardiovascular dysfunction associated with spaceflight are a concern to NASA. This has been particularly true during Shuttle flights where the primary concern is the crew's physical health, including the pilot's ability to land the Orbiter, and the crew's ability to quickly egress and move to safety should a dangerous condition arise. The study of astronauts during Shuttle activities is inherently more difficult than most human research. Consequently, sample sizes have been small and results have lacked consistency. Before the Extended Duration Orbiter Medical Project (EDOMP), there was a lack of normative data on changes in cardiovascular parameters during and after spaceflight. The EDOMP for the first time allowed studies on a large enough number of subjects to overcome some of these problems. There were three primary goals of the Cardiovascular EDOMP studies. The first was to establish, through descriptive studies, a normative data base of cardiovascular changes attributable to spaceflight. The second goal was to determine mechanisms of cardiovascular changes resulting from spaceflight (particularly orthostatic hypotension and cardiac rhythm disturbances). The third was to evaluate possible countermeasures. The Cardiovascular EDOMP studies involved parallel descriptive, mechanistic, and countermeasure evaluations.

  11. A dose-response study of consuming high-fructose corn syrup–sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults123456

    PubMed Central

    Medici, Valentina; Bremer, Andrew A; Lee, Vivien; Lam, Hazel D; Nunez, Marinelle V; Chen, Guoxia X; Keim, Nancy L; Havel, Peter J

    2015-01-01

    Background: National Health and Nutrition Examination Survey data show an increased risk of cardiovascular disease (CVD) mortality with an increased intake of added sugar. Objective: We determined the dose-response effects of consuming beverages sweetened with high-fructose corn syrup (HFCS) at zero, low, medium, and high proportions of energy requirements (Ereq) on circulating lipid/lipoprotein risk factors for CVD and uric acid in adults [age: 18–40 y; body mass index (in kg/m2): 18–35]. Design: We conducted a parallel-arm, nonrandomized, double-blinded intervention study in which adults participated in 3.5 inpatient days of baseline testing at the University of California Davis Clinical and Translational Science Center’s Clinical Research Center. Participants then consumed beverages sweetened with HFCS at 0% (aspartame sweetened, n = 23), 10% (n = 18), 17.5% (n = 16), or 25% (n = 28) of Ereq during 13 outpatient days and during 3.5 inpatient days of intervention testing at the research center. We conducted 24-h serial blood collections during the baseline and intervention testing periods. Results: Consuming beverages containing 10%, 17.5%, or 25% Ereq from HFCS produced significant linear dose-response increases of lipid/lipoprotein risk factors for CVD and uric acid: postprandial triglyceride (0%: 0 ± 4; 10%: 22 ± 8; 17.5%: 25 ± 5: 25%: 37 ± 5 mg/dL, mean of Δ ± SE, P < 0.0001 effect of HFCS-dose), fasting LDL cholesterol (0%: −1.0 ± 3.1; 10%: 7.4 ± 3.2; 17.5%: 8.2 ± 3.1; 25%: 15.9 ± 3.1 mg/dL, P < 0.0001), and 24-h mean uric acid concentrations (0%: −0.13 ± 0.07; 10%: 0.15 ± 0.06; 17.5%: 0.30 ± 0.07; 25%: 0.59 ± 0.09 mg/dL, P < 0.0001). Compared with beverages containing 0% HFCS, all 3 doses of HFCS-containing beverages increased concentrations of postprandial triglyceride, and the 2 higher doses increased fasting and/or postprandial concentrations of non–HDL cholesterol, LDL cholesterol, apolipoprotein B, apolipoprotein CIII, and

  12. Relations of Digital Vascular Function, Cardiovascular Risk Factors, and Arterial Stiffness: The Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil) Cohort Study

    PubMed Central

    Brant, Luisa C. C.; Hamburg, Naomi M.; Barreto, Sandhi M.; Benjamin, Emelia J.; Ribeiro, Antonio L. P.

    2014-01-01

    Background Vascular dysfunction is an early expression of atherosclerosis and predicts cardiovascular (CV) events. Peripheral arterial tonometry (PAT) evaluates basal pulse amplitude (BPA), endothelial function (PAT ratio), and wave reflection (PAT‐AIx) in the digital microvessels. In Brazilian adults, we investigated the correlations of PAT responses to CV risk factors and to carotid‐femoral pulse wave velocity (PWV), a measure of arterial stiffness. Methods and Results In a cross‐sectional study, 1535 participants of the ELSA‐Brasil cohort underwent PAT testing (52±9 years; 44% women). In multivariable analyses, more‐impaired BPA and PAT ratios were associated with male sex, higher body mass index (BMI), and total cholesterol/high‐density lipoprotein. Higher age and triglycerides were related to higher BPA, whereas lower systolic blood pressure, hypertension (HTN) treatment, and prevalent CV disease (CVD) were associated with lower PAT ratio. PAT‐AIx correlated positively with female sex, advancing age, systolic and diastolic blood pressures, and smoking and inversely to heart rate, height, BMI, and prevalent CVD. Black race was associated with lower BPA, higher PAT ratio, and PAT‐AIx. Microvessel vasodilator function was not associated with PWV. Higher PAT‐AIx was modestly correlated to higher PWV and PAT ratio and inversely correlated to BPA. Conclusion Metabolic risk factors are related to impaired microvessel vasodilator function in Brazil. However, in contrast to studies from the United States, black race was not associated with an impaired microvessel vasodilator response, implying that vascular function may vary by race across populations. PAT‐AIx relates to HTN, may be a valid measure of wave reflection, and provides distinct information from arterial stiffness. PMID:25510401

  13. Overview of the 80(th) Annual Scientific Meeting of the Japanese Circulation Society - The Past, Present and Future of Cardiovascular Medicine in Japan - - The 5(th) Anniversary of the Great East Japan Earthquake.

    PubMed

    Takahashi, Jun; Satoh, Kimio; Fukuda, Koji; Sugimura, Koichiro; Matsumoto, Yasuharu; Nakano, Makoto; Tsuburaya, Ryuji; Aoki, Tatsuo; Hao, Kiyotaka; Nishimiya, Kensuke; Ito, Kenta; Sakata, Yasuhiko; Shimokawa, Hiroaki

    2016-07-25

    The 80(th)Annual Scientific Meeting of the Japanese Circulation Society was held in Sendai, Japan, on March 18-20, 2016, which coincided with the 5(th)anniversary of the Great East Japan Earthquake that hit the Tohoku area on March 11, 2011. Thus, the main themes for this meeting were "The Past, Present and Future of Cardiovascular Medicine in Japan" and "The 5(th)Anniversary of the Great East Japan Earthquake". Despite the provincial location, approximately 15,000 people attended during the 3-day meeting, and there were in-depth discussions in each of the various sessions on these themes. Especially, to our great pleasure, the Japanese Royals, Emperor Akihito and Empress Michiko, kindly visited the panel exhibition of the Great East Japan Earthquake and spoke words of appreciation to us. The meeting successfully completed and we sincerely appreciate the great cooperation and support from all affiliates. (Circ J 2016; 80: 1689-1694).

  14. Overview of the 80(th) Annual Scientific Meeting of the Japanese Circulation Society - The Past, Present and Future of Cardiovascular Medicine in Japan - - The 5(th) Anniversary of the Great East Japan Earthquake.

    PubMed

    Takahashi, Jun; Satoh, Kimio; Fukuda, Koji; Sugimura, Koichiro; Matsumoto, Yasuharu; Nakano, Makoto; Tsuburaya, Ryuji; Aoki, Tatsuo; Hao, Kiyotaka; Nishimiya, Kensuke; Ito, Kenta; Sakata, Yasuhiko; Shimokawa, Hiroaki

    2016-07-25

    The 80(th)Annual Scientific Meeting of the Japanese Circulation Society was held in Sendai, Japan, on March 18-20, 2016, which coincided with the 5(th)anniversary of the Great East Japan Earthquake that hit the Tohoku area on March 11, 2011. Thus, the main themes for this meeting were "The Past, Present and Future of Cardiovascular Medicine in Japan" and "The 5(th)Anniversary of the Great East Japan Earthquake". Despite the provincial location, approximately 15,000 people attended during the 3-day meeting, and there were in-depth discussions in each of the various sessions on these themes. Especially, to our great pleasure, the Japanese Royals, Emperor Akihito and Empress Michiko, kindly visited the panel exhibition of the Great East Japan Earthquake and spoke words of appreciation to us. The meeting successfully completed and we sincerely appreciate the great cooperation and support from all affiliates. (Circ J 2016; 80: 1689-1694). PMID:27385500

  15. Effect of a Web-Based Behavior Change Program on Weight Loss and Cardiovascular Risk Factors in Overweight and Obese Adults at High Risk of Developing Cardiovascular Disease: Randomized Controlled Trial

    PubMed Central

    Watson, Sinead; Woodside, Jayne V; Ware, Lisa J; Hunter, Steven J; McGrath, Alanna; Cardwell, Christopher R; Appleton, Katherine M; Young, Ian S

    2015-01-01

    Background Web-based programs are a potential medium for supporting weight loss because of their accessibility and wide reach. Research is warranted to determine the shorter- and longer-term effects of these programs in relation to weight loss and other health outcomes. Objective The aim was to evaluate the effects of a Web-based component of a weight loss service (Imperative Health) in an overweight/obese population at risk of cardiovascular disease (CVD) using a randomized controlled design and a true control group. Methods A total of 65 overweight/obese adults at high risk of CVD were randomly allocated to 1 of 2 groups. Group 1 (n=32) was provided with the Web-based program, which supported positive dietary and physical activity changes and assisted in managing weight. Group 2 continued with their usual self-care (n=33). Assessments were conducted face-to-face. The primary outcome was between-group change in weight at 3 months. Secondary outcomes included between-group change in anthropometric measurements, blood pressure, lipid measurements, physical activity, and energy intake at 3, 6, and 12 months. Interviews were conducted to explore participants’ views of the Web-based program. Results Retention rates for the intervention and control groups at 3 months were 78% (25/32) vs 97% (32/33), at 6 months were 66% (21/32) vs 94% (31/33), and at 12 months were 53% (17/32) vs 88% (29/33). Intention-to-treat analysis, using baseline observation carried forward imputation method, revealed that the intervention group lost more weight relative to the control group at 3 months (mean –3.41, 95% CI –4.70 to –2.13 kg vs mean –0.52, 95% CI –1.55 to 0.52 kg, P<.001), at 6 months (mean –3.47, 95% CI –4.95 to –1.98 kg vs mean –0.81, 95% CI –2.23 to 0.61 kg, P=.02), but not at 12 months (mean –2.38, 95% CI –3.48 to –0.97 kg vs mean –1.80, 95% CI –3.15 to –0.44 kg, P=.77). More intervention group participants lost ≥5% of their baseline body

  16. Sex- and gender-specific research priorities for the emergency management of heart failure and acute arrhythmia: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

    PubMed

    McGregor, Alyson J; Frank Peacock, W; Marie Chang, Anna; Safdar, Basmah; Diercks, Deborah

    2014-12-01

    The emergency department (ED) is the point of first contact for patients with acute heart failure and arrhythmias, with 1 million annual ED visits in the United States. Although the total numbers of men and women living with heart failure are similar, female patients are underrepresented in clinical studies, with current knowledge predominantly based on data from male patients. This has led to an underappreciation of the sex-specific differences in clinical characteristics and pathophysiology-based management of heart failure. Similar disparities have been found in management of acute arrhythmias, especially atrial arrhythmias that lead to an increased risk of stroke in women. Additionally, peripartum and postpartum cardiomyopathy represent a diagnostic and treatment dilemma. This article is the result of a breakout session in the cardiovascular and resuscitation work group of the 2014 Academic Emergency Medicine consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." A nominal group technique was used to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Consensus was achieved through three rounds of nomination followed by the meeting on May 13, 2014, and resulted in seven priority themes that are essential to the common complex clinical syndrome of heart failure for both men and women and include the areas of pathophysiology; presentation and symptomatology; and diagnostic strategies using biomarkers, treatment, and mortality, with special consideration to arrhythmia management and pregnancy.

  17. Childhood obesity and cardiovascular dysfunction.

    PubMed

    Cote, Anita T; Harris, Kevin C; Panagiotopoulos, Constadina; Sandor, George G S; Devlin, Angela M

    2013-10-01

    Obesity-related cardiovascular disease in children is becoming more prevalent in conjunction with the rise in childhood obesity. Children with obesity are predisposed to an increased risk of cardiovascular morbidity and mortality in adulthood. Importantly, research in children with obesity over the last decade has demonstrated that children may exhibit early signs of cardiovascular dysfunction as a result of their excess adiposity, often independent of other obesity-related comorbidities such as dyslipidemia and insulin resistance. The clinical evidence is accumulating to suggest that the cardiovascular damage, once observed only in adults, is also occurring in obese children. The objective of this review is to provide a synopsis of the current research on cardiovascular abnormalities in children with obesity and highlight the importance and need for early detection and prevention programs to mitigate this potentially serious health problem.

  18. Nanomedicine: Addressing Cardiovascular Disease and Cardiovascular Tissue Regeneration

    PubMed Central

    Botchwey, Edward A.

    2016-01-01

    Cardiovascular disease is becoming an increasingly significant problem. In attempts to overcome many of the traditional hurdles of cardiovascular disease treatment, therapeutic approaches have been gradually moving beyond an exclusive focus on orally delivered drugs towards the development of nanoscale applications. These technologies exploit molecular scale events to improve drug and gene delivery applications, enhance preventative medicine and diagnostic strategies, and create biomimicking substrates for vascular tissue engineering. As nanoscale treatments enter the arena of clinical medicine, new ways of thinking about and routes for applying nanomedicine to cardiovascular health issues are emerging. With focuses on drug delivery, gene therapy, and biomimetics, this article will provide a comprehensive review of various nanomedicine applications for combating atherosclerosis and for improving upon current vascular tissue engineering designs.

  19. Nanomedicine: Addressing Cardiovascular Disease and Cardiovascular Tissue Regeneration

    PubMed Central

    Botchwey, Edward A.

    2016-01-01

    Cardiovascular disease is becoming an increasingly significant problem. In attempts to overcome many of the traditional hurdles of cardiovascular disease treatment, therapeutic approaches have been gradually moving beyond an exclusive focus on orally delivered drugs towards the development of nanoscale applications. These technologies exploit molecular scale events to improve drug and gene delivery applications, enhance preventative medicine and diagnostic strategies, and create biomimicking substrates for vascular tissue engineering. As nanoscale treatments enter the arena of clinical medicine, new ways of thinking about and routes for applying nanomedicine to cardiovascular health issues are emerging. With focuses on drug delivery, gene therapy, and biomimetics, this article will provide a comprehensive review of various nanomedicine applications for combating atherosclerosis and for improving upon current vascular tissue engineering designs. PMID:27630537

  20. Development of a food-exchange model to replace saturated fat with MUFAs and n-6 PUFAs in adults at moderate cardiovascular risk.

    PubMed

    Weech, Michelle; Vafeiadou, Katerina; Hasaj, Marinela; Todd, Susan; Yaqoob, Parveen; Jackson, Kim G; Lovegrove, Julie A

    2014-06-01

    The recommendation to reduce saturated fatty acid (SFA) consumption to ≤10% of total energy (%TE) is a key public health target aimed at lowering cardiovascular disease (CVD) risk. Replacement of SFA with unsaturated fats may provide greater benefit than replacement with carbohydrates, yet the optimal type of fat is unclear. The aim of the DIVAS (Dietary Intervention and Vascular Function) study was to develop a flexible food-exchange model to investigate the effects of substituting SFAs with monounsaturated fatty acids (MUFAs) or n-6 (ω-6) polyunsaturated fatty acids (PUFAs) on CVD risk factors. In this parallel study, UK adults aged 21-60 y with moderate CVD risk (50% greater than the population mean) were identified using a risk assessment tool (n = 195; 56% females). Three 16-wk isoenergetic diets of specific fatty acid (FA) composition (%TE SFA:%TE MUFA:%TE n-6 PUFA) were designed using spreads, oils, dairy products, and snacks as follows: 1) SFA-rich diet (17:11:4; n = 65); 2) MUFA-rich diet (9:19:4; n = 64); and 3) n-6 PUFA-rich diet (9:13:10; n = 66). Each diet provided 36%TE total fat. Dietary targets were broadly met for all intervention groups, reaching 17.6 ± 0.4%TE SFA, 18.5 ± 0.3%TE MUFA, and 10.4 ± 0.3%TE n-6 PUFA in the respective diets, with significant overall diet effects for the changes in SFAs, MUFAs, and n-6 PUFAs between groups (P < 0.001). There were no differences in the changes of total fat, protein, carbohydrate, and alcohol intake or anthropometric measures between groups. Plasma phospholipid FA composition showed changes from baseline in the proportions of total SFAs, MUFAs, and n-6 PUFAs for each diet group, with the changes in SFAs and MUFAs differing between the groups (P < 0.001). In conclusion, successful implementation of the food-exchange model broadly achieved the dietary target intakes for the exchange of SFAs with MUFAs or n-6 PUFAs with minimal disruption to the overall diet in a free-living population. This trial was

  1. Association between Dietary Patterns and Cardiovascular Risk Factors among Middle-Aged and Elderly Adults in Taiwan: A Population-Based Study from 2003 to 2012

    PubMed Central

    Muga, Miriam Adoyo; Owili, Patrick Opiyo; Hsu, Chien-Yeh; Rau, Hsiao-Hsien; Chao, Jane C-J

    2016-01-01

    Background Cardiovascular disease (CVD) is one of the leading causes of mortality and loss of disability-adjusted life years in developed countries. This study derived a dietary pattern using an a priori method and additionally derived dietary patterns using a posteriori methods, and assessed the relationship with CVD risk factors in Taiwanese middle-aged and elderly adults. Methods Cross-sectional analyses of 62,965 subjects aged 40 years and above from the Mei Jau (MJ) database collected between 2003 and 2012 in Taiwan. Diet was assessed using a 22 item semi-quantitative food frequency questionnaire. Using this information, three dietary patterns were generated. The a priori diet was labeled the Taiwanese dietary pattern and was derived using hypothesized effect of 22 food groups, while two a posteriori dietary patterns, “vegi-fruits” and “meat-processed”, were derived using principal component analysis. The association between dietary patterns and a range of CVD risk factors (i.e. blood lipids, blood glucose and C-reactive protein) was evaluated using linear regression. Results The results showed that high intake (Q5, quintile 5) of Taiwanese diet was negatively associated with CVD risk factors at (p < 0.001, model 3), but not with triacylglycerol. In addition, high intake of vegi-fruit dietary pattern (Q5) was negatively associated with CVD risk factors (p < 0.001), but not with high-density lipoprotein, while high consumption of meat-processed dietary pattern (Q5) was positively associated with CVD risk factors (p < 0.001), but negatively related with triacylglycerol in Q3 level and no association with C-reactive protein. Conclusion A negative association was observed between Taiwanese or vegi-fruit dietary patterns and CVD risk factors, while a positive association was found between meat-processed dietary pattern and CVD risk factors. The findings suggested that a diet rich in vegetables and fruits has a beneficial effect in the management of CVD risk

  2. Hyperuricemia, Cardiovascular Disease, and Hypertension

    PubMed Central

    Kuwabara, Masanari

    2016-01-01

    In recent years, there has been an increase in the prevalence of hyperuricemia, and the latter has attracted attention as an adult lifestyle-associated disease, together with hypertension, diabetes, and dyslipidemia. Although hyperuricemia is known to be an independent risk factor for hypertension, whether it is an independent risk factor for cardiovascular disease remains controversial. Recently, some small-scale interventional studies on antihyperuricemic medications showed that the latter improved angina symptoms and prevented cardiovascular disease. Here, we will mainly explain the cause of hyperuricemia and the associations between hyperuricemia, hypertension, and cardiovascular disease based on the latest published evidence. PMID:27195245

  3. Multiple Chronic Conditions and Use of Complementary and Alternative Medicine Among US Adults: Results From the 2012 National Health Interview Survey

    PubMed Central

    Shi, Zaixing; Greenlee, Heather

    2016-01-01

    Introduction More than 25% of American adults report having 2 or more chronic conditions. People with chronic conditions often use complementary and alternative medicine (CAM) for self-care and disease management, despite a limited evidence base. Methods Data from the 2012 National Health Interview Survey (NHIS) (n = 33,557) were analyzed to assess associations between presence of multiple chronic conditions (n = 13) and CAM use, using multivariable relative risk and linear regressions weighted for complex NHIS sampling. CAM use was defined as self-reported use of one or more of 16 therapies in the previous 12 months. Results Chronic conditions were common. US adults reported one (22.3%) or 2 or more (33.8%) conditions. Many used at least one form of CAM. Multivitamins, multiminerals, or both (52.7%); vitamins (34.8%); and minerals (28.4%) were the most common. Compared with adults with no conditions, adults with 2 or more conditions were more likely to use multivitamins or multiminerals or both, vitamins, minerals, nonvitamins or herbs, mind–body therapies, chiropractic or osteopathic manipulation, massage, movement therapies, special diets, acupuncture, naturopathy, or some combination of these therapies (P <.003). Conclusion People with multiple chronic conditions have a high prevalence of CAM use. Longitudinal studies are needed to understand the association between CAM use and chronic disease prevention and treatment. PMID:27149072

  4. Two-modality γ detection of blood volume by camera imaging and nonimaging stethoscope for kinetic studies of cardiovascular control in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Eclancher, Bernard; Chambron, Jacques; Dumitresco, Barbu; Karman, Miklos; Pszota, Agnes; Simon, Atilla; Didon-Poncelet, Anna; Demangeat, Jean

    2002-04-01

    The quantification of rapid hemodynamic reactions to wide and slow breathing movements has been performed, by two modalities (gamma) -left ventriculography of 99mTc-labeled blood volume, in anterior oblique incidence on standing and even exercising healthy volunteers and cardiac patients. A highly sensitive stethoscope delivered whole (gamma) -counts acquired at 30 msec intervals in a square field of view including the left ventricle, in a one dimensional low resolution imaging mode for beat to beat analysis. A planar 2D (gamma) -camera imaging of the same cardiac area was then performed without cardiac gating for alternate acquisitions during deep inspiration and deep expiration, completed by a 3D MRI assessment of the stethoscope detection field. Young healthy volunteers displayed wide variations of diastolic times and stroke volumes, as a result of enhanced baroreflex control, together with +/- 16% variations of the stethoscope's background blood volume counts. Any of the components of these responses were shifted, abolished or even inverted as a result of either obesity, hypertension, aging or cardiac pathologies. The assessment of breathing control of the cardiovascular system by the beat to beat (gamma) -ventriculography combined with nuclear 2D and 3D MRI imaging is a kinetic method allowing the detection of functional anomalies in still ambulatory patients.

  5. A dose-response of consuming high fructose corn syrup-sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    National Health and Nutrition Examination Survey data show increased risk of cardiovascular disease (CVD) mortality with increased intake of added sugar across quintiles. Objective: To determine the dose response effects of consuming beverages sweetened with high fructose corn syrup (HFCS) at zero, ...

  6. Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: Synopsis of the 2013 ACC/AHA cholesterol guideline

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Atherosclerotic cardiovascular disease (ASCVD) is the leading U.S. cause of death, lost quality of life and medical costs. Nearly one in three Americans die from heart disease and stroke. Most ASCVD is preventable through a healthy lifestyle and effective treatment of cholesterol and blood pressure...

  7. Correlation of anthropometric indices with common cardiovascular risk factors in an urban adult population of Iran: data from Zanjan Healthy Heart Study.

    PubMed

    Mellati, Ali Awsat; Mousavinasab, Seyed Nouraddin; Sokhanvar, Sepide; Kazemi, Seyed Ali Naghi; Esmailli, Mohammad Hossain; Dinmohamadi, Hossain

    2009-01-01

    The purpose of this study was to determine the anthropometric index that best predicts common cardiovascular risk factors. A total of 2768 individuals (1310 men and 1458 women) aged 21-75 years with full relevant data from the Zanjan Healthy Heart Study (a prospective study in Zanjan and Abhar, two main cities of Zanjan Province, Iran) were recruited. Common cardiovascular risk factors (TG, TC, HDL-c, LDL-c, fast blood sugar, blood pressure), anthropometric indices (BMI, WC, WHR, WHtR) were measured using standard process, and their correlated classification was evaluated by partial correlation and Receiver Operator Characteristic (ROC) curve analysis. Area under curve (AUC) of WHtR was the largest for most (6 of 7) of the common cardiovascular risk factors in both men and women; followed by WC (4 of the 7 including ties) in men, while AUCs of three anthropometric indices (WC, BMI, WHR) were the same with the largest for 1 of 7 risk factors in women. These results show that the high prevalence of lipid profiles, as cardiovascular risk factors, need special attention, intervention and appropriate treatment. Consistence with other reports, WHtR is a better discriminator of cardiovascular risk factors compared with the other three indices (BMI, WC, and WHR). We determined its optimal cut-off point of 0.5 for both genders. However, due to differences in reported cut-off values across different ethnic groups, future research and longitudinal data is needed before reaching an internationally accepted simple and appropriate measure that could be effectively used in the clinical and epidemiological fields.

  8. Cardiovascular disease in Adult Life after Childhood Cancer in Scandinavia: A population-based cohort study of 32,308 one-year survivors.

    PubMed

    Gudmundsdottir, Thorgerdur; Winther, Jeanette F; de Fine Licht, Sofie; Bonnesen, Trine G; Asdahl, Peter H; Tryggvadottir, Laufey; Anderson, Harald; Wesenberg, Finn; Malila, Nea; Hasle, Henrik; Olsen, Jørgen H

    2015-09-01

    The lifetime risk for cardiovascular disease in a large cohort of childhood cancer survivors has not been fully assessed. In a retrospective population-based cohort study predicated on comprehensive national health registers, we identified a cohort of 32,308 one-year survivors of cancer diagnosed before the age of 20 in the five Nordic countries between the start of cancer registration in the 1940s and 1950s to 2008; 211,489 population comparison subjects were selected from national population registers. Study subjects were linked to national hospital registers, and the observed numbers of first hospital admission for cardiovascular disease among survivors were compared with the expected numbers derived from the population comparison cohort. Cardiovascular disease was diagnosed in 2,632 childhood cancer survivors (8.1%), yielding a standardized hospitalization rate ratio (RR) of 2.1 (95% CI 2.0-2.2) and an overall absolute excess risk (AER) of 324 per 100,000 person-years. At the end of follow-up 12% of the survivors were ≥ 50 years of age and 4.5% ≥ 60 years of age. Risk estimates were significantly increased throughout life, with an AER of ∼500-600 per 100,000 person-years at age ≥ 40. The highest relative risks were seen for heart failure (RR, 5.2; 95% CI 4.5-5.9), valvular dysfunction (4.6; 3.8-5.5) and cerebrovascular diseases (3.7; 3.4-4.1). Survivors of hepatic tumor, Hodgkin lymphoma and leukemia had the highest overall risks for cardiovascular disease, although each main type of childhood cancer had increased risk with different risk profiles. Nordic childhood cancer survivors are at markedly increased risk for cardiovascular disorders throughout life. These findings indicate the need for preventive interventions and continuous follow-up for this rapidly growing population.

  9. Society for Adolescent Health and Medicine

    MedlinePlus

    ... Media Use by Adolescents Mental Health Sexual & Reproductive Health Sports Medicine Substance Use Transition to Adult Care Related ... Puberty/Normal Development Eating Disorders and Nutrition LGBT Health Media Use by ... Medicine Substance Abuse Transition to Adult Care Clinical ...

  10. Cardiovascular Glossary

    MedlinePlus

    ... who have not responded to other antiarrhythmic medicines. Aneurysm - A sac-like protrusion from a blood vessel ... the brain resulting from a ruptured blood vessel, aneurysm, or head injury. Cerebral thrombosis - Formation of a ...

  11. Fetal cardiovascular physiology.

    PubMed

    Rychik, J

    2004-01-01

    The cardiovascular system of the fetus is physiologically different than the adult, mature system. Unique characteristics of the myocardium and specific channels of blood flow differentitate the physiology of the fetus from the newborn. Conditions of increased preload and afterload in the fetus, such as sacrococcygeal teratoma and twin-twin transfusion syndrome, result in unique and complex pathophysiological states. Echocardiography has improved our understanding of human fetal cadiovasvular physiology in the normal and diseased states, and has expanded our capability to more effectively treat these disease processes.

  12. Risks for end-stage renal disease, cardiovascular events, and death in Hispanic versus non-Hispanic white adults with chronic kidney disease.

    PubMed

    Peralta, Carmen A; Shlipak, Michael G; Fan, Dongjie; Ordoñez, Juan; Lash, James P; Chertow, Glenn M; Go, Alan S

    2006-10-01

    Rates of ESRD are rising faster in Hispanic than non-Hispanic white individuals, but reasons for this are unclear. Whether rates of cardiovascular events and mortality differ among Hispanic and non-Hispanic white patients with chronic kidney disease (CKD) also is not well understood. Therefore, this study examined the associations between Hispanic ethnicity and risks for ESRD, cardiovascular events, and death in patients with CKD. A total of 39,550 patients with stages 3 to 4 CKD from Kaiser Permanente of Northern California were included. Hispanic ethnicity was obtained from self-report supplemented by surname matching. GFR was estimated from the abbreviated Modification of Diet in Renal Disease equation, and clinical outcomes, patient characteristics, and longitudinal medication use were ascertained from health plan databases and state mortality files. After adjustment for sociodemographic characteristics, Hispanic ethnicity was associated with an increased risk for ESRD (hazard ratio [HR] 1.93; 95% confidence interval [CI] 1.72 to 2.17) when compared with non-Hispanic white patients, which was attenuated after controlling for diabetes and insulin use (HR 1.50; 95% CI 1.33 to 1.69). After further adjustment for potential confounders, Hispanic ethnicity remained independently associated with an increased risk for ESRD (HR 1.33; 95% CI 1.17 to 1.52) as well as a lower risk for cardiovascular events (HR 0.82; 95% CI 0.76 to 0.88) and death (HR 0.72; 95% CI 0.66 to 0.79). Among a large cohort of patients with CKD, Hispanic ethnicity was associated with lower rates of death and cardiovascular events and a higher rate of progression to ESRD. The higher prevalence of diabetes among Hispanic patients only partially explained the increased risk for ESRD. Further studies are required to elucidate the cause(s) of ethnic disparities in CKD-associated outcomes.

  13. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care for Older Adults Clinical Trial is to develop and evaluate the clinical effectiveness and feasibility of a patient-centered, collaborative care model with family medicine physicians and doctors of chiropractic for the treatment of low back pain in older adults. Methods/design This pragmatic, pilot randomized controlled trial will enroll 120 participants, age 65 years or older with subacute or chronic low back pain lasting at least one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain and disability. Secondary outcomes include general and functional health status, symptom bothersomeness, expectations for treatment effectiveness and improvement, fear avoidance behaviors, depression, anxiety, satisfaction, medication use and health care utilization. Treatment safety and adverse events also are monitored. Participant-rated outcome measures are collected via self-reported questionnaires and computer-assisted telephone interviews at baseline, and at 4, 8, 12, 24, 36 and 52 weeks post-randomization. Provider-rated expectations for treatment effectiveness and participant improvement also are evaluated. Process outcomes are assessed through qualitative interviews with study participants and research clinicians, chart audits of progress notes and content

  14. Cardiovascular system

    MedlinePlus

    ... the network of arteries, veins, and capillaries that transport blood throughout the body. The average adult male has between 5 to 6 liters of blood or blood volume, while the average adult female has between 4 to 5 liters. The blood carries oxygen and essential nutrients to all of the living ...

  15. [Transition of adolescents with the exstrophy-epispadias complex to adult medicine: influence of long-term outcome results on management].

    PubMed

    Ebert, A-K; Reutter, H; Neissner, C; Rösch, W

    2012-11-01

    Today, young individuals with rare congenital anomalies as the Exstrophy-Epispadias-Complex (EEC) are mostly monitored interdisciplinary with a high standard of care and enthusiasm during childhood. However, when growing up through adolescence to adulthood adequate care-givers are not available at the moment in adult medicine in Germany and a concrete transition process has yet not been established. Over the past years, we put much effort in systematic evaluation of long-term outcome after reconstruction of the EEC in the newborn period to further improve outcome results. Beside predictive parameters for continence and long-term bladder function, genital function and fertility, as well as postoperative pelvic floor morphology and gynecological outcome, orthopedic results and psychosexual and psychosocial development in EEC were of major interest. As a consequence we currently develop a German-wide follow-up concept in EEC patients regarding age- and gender specific outcome issues. Long-term observations of the EEC outcome however, underline the unrestricted importance of careful long-term follow-up of all EEC patients, as well as the necessity of close cooperation of pediatric urologist, pediatric surgeons, urologists, orthopedic surgeons, gynecologists, andrologists, psychologists and urotherapists from early childhood and the need of knowledge transfer and hopefully a successful transition of the EEC individuals to general medicine.

  16. Societal views on NICE, cancer drugs fund and value-based pricing criteria for prioritising medicines: a cross-sectional survey of 4118 adults in Great Britain.

    PubMed

    Linley, Warren G; Hughes, Dyfrig A

    2013-08-01

    The criteria used by the National Institute for Health and Clinical Excellence (NICE) for accepting higher incremental cost-effectiveness ratios for some medicines over others, and the recent introduction of the Cancer Drugs Fund (CDF) in England, are assumed to reflect societal preferences for National Health Service resource allocation. Robust empirical evidence to this effect is lacking. To explore societal preferences for these and other criteria, including those proposed for rewarding new medicines under the future value-based pricing (VBP) system, we conducted a choice-based experiment in 4118 UK adults via web-based surveys. Preferences were determined by asking respondents to allocate fixed funds between different patient and disease types reflecting nine specific prioritisation criteria. Respondents supported the criteria proposed under the VBP system (for severe diseases, address unmet needs, are innovative--provided they offered substantial health benefits, and have wider societal benefits) but did not support the end-of-life premium or the prioritisation of children or disadvantaged populations as specified by NICE, nor the special funding status for treatments of rare diseases, nor the CDF. Policies introduced on the basis of perceived--and not actual--societal values may lead to inappropriate resource allocation decisions with the potential for significant population health and economic consequences.

  17. Heterogeneous responses of personalised high intensity interval training on type 2 diabetes mellitus and cardiovascular disease risk in young healthy adults.

    PubMed

    Higgins, Timothy P; Baker, Matthew D; Evans, Shelley-Ann; Adams, Rachel A; Cobbold, Christian

    2015-01-01

    Hypertension, decreased glucose tolerance, adverse lipid profiles and low physical activity levels are associated with increased type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) risk. High intensity interval training (HIIT), a low volume, reduced time, high intensity programme, may be a useful alternative to current government guidelines which specify a minimum of 150 minutes of physical activity per week. We describe a personalised programme of high intensity exercise which provides significant improvements in CVD risk markers. Healthy volunteers undertook 6 weeks of HIIT. T2DM and CVD risk predictors including glucose tolerance, VO2max, blood pressure (BP), and lipids were measured before and after HIIT. HIIT training was associated with beneficial changes in a range of predictors of blood flow and cardiovascular risk. There was a heterogeneous response to HIIT, with some subjects responding with favourable changes and others being non-responders to HIIT. In responders, HIIT was associated with a statistically significant (p = 0.023) increase in VO2max, from 45.4 (38.4,52.5) to 56.9 (51.2,65.7) (median (interquartile range)(ml/min/kg)). In responders HIIT resulted in a decrease in systolic BP from 127 (126,129) to 116 (106,122) (mmHg) with p = 0.026 and a decrease is diastolic blood pressure from 72 (69,74) to 57 (56,66) with p = 0.026. There was also some evidence of a beneficial change in blood lipid and glucose concentrations with HIIT. In conclusion, personalised HIIT has potential as an intervention to improve blood flow and cardiovascular health.

  18. Design of a Randomized Controlled Trial of a Web-Based Intervention to Reduce Cardiovascular Disease Risk Factors Among Remote Reservation–Dwelling American Indian Adults with Type 2 Diabetes

    PubMed Central

    Chubak, Jessica; O’Connell, Joan; Ramos, Maria C.; Jensen, Julie; Jobe, Jared B.

    2012-01-01

    We describe a randomized controlled trial, the Lakota Oyate Wicozani Pi Kte (LOWPK) trial, which was designed to determine whether a Web-based diabetes and nutritional intervention can improve risk factors related to cardiovascular disease (CVD) among a group of remote reservation–dwelling adult American Indian men and women with type 2 diabetes who are at high risk for CVD. Enrollment on a rolling basis of 180 planned participants began during 2009; an average 18-month follow-up was completed by June 2011. The primary outcome variable is change in glycosylated hemoglobin level after an average 18-month follow-up period. Secondary outcome variables include changes in low-density lipoprotein cholesterol, systolic blood pressure, body mass index, and smoking status, as well as an evaluation of intervention cost-effectiveness. If effective, the LOWPK trial may serve as a guide for future chronic disease intervention trials in remote, technologically challenged settings. PMID:23001642

  19. The prevalence and determinants of the use of complementary and alternative medicine in adult Turkish cancer patients.

    PubMed

    Tas, Faruk; Ustuner, Zeki; Can, Gulbeyaz; Eralp, Yesim; Camlica, Hakan; Basaran, Mert; Karagol, Hakan; Sakar, Burak; Disci, Rian; Topuz, Erkan

    2005-01-01

    A study was undertaken to analyze the extent of using complementary alternative medicine (CAM) and to compare sociodemographic and medical characteristics of users and non-users of CAM in Turkish oncology patients. A total of 615 patients with cancer who attended ambulatory patient care units answered the questionnaires. Medical information was reviewed from chart data. Some 291 patients (47.3%) had used at least one type of CAM since the time of initial diagnosis. CAMs almost always consisted of herbal agents (95%). Nettle (Urticae herba) used in conjunction with (88%) or without (56%) various herbal agents were the most popular and prominent CAMs used by patients. Univariate and multivariate comparisons of users and non-users of CAM were performed. In multivariate analysis, female sex (p=0.0006), high income (p=0.0008), advanced stage at diagnosis (p=0.02), and usage of multiple chemotherapy applications (p=0.03) were determined as independent factors for CAM use.

  20. Effect of noise stress on cardiovascular system in adult male albino rat: implication of stress hormones, endothelial dysfunction and oxidative stress.

    PubMed

    Said, Mona A; El-Gohary, Ola A

    2016-07-01

    Noise pollution has been realized as an environmental stressor associated with modern life style that affects our health without being consciously aware of it. The present study investigated the effect of acute, chronic intermittent and chronic continuous exposure to noise of intensity 80-100 dB on heart rate and mean systemic arterial blood pressure in rats and the possible underlying mechanisms. Noise stress causes significant increase in heart rate, mean systemic arterial blood pressure as well as significant increase in plasma levels of corticosterone, adrenaline, noradrenaline, endothelin-1, nitric oxide and malondialdehyde with significant decrease in superoxide dismutase and these values are significantly more worse in chronic continuous exposure to noise than acute or chronic intermittent exposure. These findings suggest that noise stress has many adverse effects on cardiovascular system via increasing plasma levels of stress hormones, oxidative stress and endothelial dysfunction. These findings have major implication in the management of adverse cardiovascular reactions of people subjected to daily noise stress. PMID:27174896

  1. Effect of noise stress on cardiovascular system in adult male albino rat: implication of stress hormones, endothelial dysfunction and oxidative stress.

    PubMed

    Said, Mona A; El-Gohary, Ola A

    2016-07-01

    Noise pollution has been realized as an environmental stressor associated with modern life style that affects our health without being consciously aware of it. The present study investigated the effect of acute, chronic intermittent and chronic continuous exposure to noise of intensity 80-100 dB on heart rate and mean systemic arterial blood pressure in rats and the possible underlying mechanisms. Noise stress causes significant increase in heart rate, mean systemic arterial blood pressure as well as significant increase in plasma levels of corticosterone, adrenaline, noradrenaline, endothelin-1, nitric oxide and malondialdehyde with significant decrease in superoxide dismutase and these values are significantly more worse in chronic continuous exposure to noise than acute or chronic intermittent exposure. These findings suggest that noise stress has many adverse effects on cardiovascular system via increasing plasma levels of stress hormones, oxidative stress and endothelial dysfunction. These findings have major implication in the management of adverse cardiovascular reactions of people subjected to daily noise stress.

  2. Modeling the effects of indoor passive smoking at home, work, or other households on adult cardiovascular and mental health: the Scottish Health Survey, 2008-2011.

    PubMed

    Shiue, Ivy

    2014-03-01

    Passive smoking has contributed increased risks of cardiovascular disease, mental health, and mortality, but the cumulative effects from work or other households were less studied. Therefore, it was aimed to model the effects of indoor passive smoking from own home, work, and other households in a country-wide, population-based setting. Data in the Scottish Health Survey between 2008 and 2011 after the law banning smoking in public places were analyzed. Information including demographics, lifestyle factors, and self-reported cardiovascular disease and mental health was obtained by household interview. Analyses included chi-square test and survey-weighted logistic regression modeling. After full adjustment, it was observed that being exposed to indoor passive smoking, in particular in more than two places of exposure, was significantly associated with risks of stroke, angina, heart attack, abnormal heart rhythms, and GHQ ≥ 12. The significance remained for angina, GHQ ≥ 12 and probably heart attack in never smokers. The cumulative risks also impacted on sleep problems, self-recognition, making decisions, self-confidence, under strain constantly, depressed, happiness and self-worth. The significance remained for sleep problems, self-confidence, under strain constantly, depressed, and happiness in never smokers. Elimination of indoor passive smoking from different sources should still be a focus in future public health programs. PMID:24633145

  3. Modeling the Effects of Indoor Passive Smoking at Home, Work, or Other Households on Adult Cardiovascular and Mental Health: The Scottish Health Survey, 2008–2011

    PubMed Central

    Shiue, Ivy

    2014-01-01

    Passive smoking has contributed increased risks of cardiovascular disease, mental health, and mortality, but the cumulative effects from work or other households were less studied. Therefore, it was aimed to model the effects of indoor passive smoking from own home, work, and other households in a country-wide, population-based setting. Data in the Scottish Health Survey between 2008 and 2011 after the law banning smoking in public places were analyzed. Information including demographics, lifestyle factors, and self-reported cardiovascular disease and mental health was obtained by household interview. Analyses included chi-square test and survey-weighted logistic regression modeling. After full adjustment, it was observed that being exposed to indoor passive smoking, in particular in more than two places of exposure, was significantly associated with risks of stroke, angina, heart attack, abnormal heart rhythms, and GHQ ≥ 12. The significance remained for angina, GHQ ≥ 12 and probably heart attack in never smokers. The cumulative risks also impacted on sleep problems, self-recognition, making decisions, self-confidence, under strain constantly, depressed, happiness and self-worth. The significance remained for sleep problems, self-confidence, under strain constantly, depressed, and happiness in never smokers. Elimination of indoor passive smoking from different sources should still be a focus in future public health programs. PMID:24633145

  4. The European Medicines Agency review of ipilimumab (Yervoy) for the treatment of advanced (unresectable or metastatic) melanoma in adults who have received prior therapy: summary of the scientific assessment of the Committee for Medicinal Products for Human Use.

    PubMed

    Hanaizi, Zahra; van Zwieten-Boot, Barbara; Calvo, Gonzalo; Lopez, Arantxa Sancho; van Dartel, Maaike; Camarero, Jorge; Abadie, Eric; Pignatti, Francesco

    2012-01-01

    On 13 July 2011 the European Commission issued a marketing authorisation valid throughout the European Union (EU) for ipilimumab for the treatment of advanced (unresectable or metastatic) melanoma in adults who have received prior therapy. Ipilimumab is a monoclonal antibody that specifically blocks the inhibitory signal of cytotoxic T lymphocyte antigen 4 (CTLA-4), resulting in T cell activation, proliferation and lymphocyte infiltration into tumours, leading to tumour cell death. The recommended induction regimen of ipilimumab is 3mg/kg administered intravenously over a 90 min period every 3 weeks for a total of four doses. In a phase 3 trial in patients with advanced melanoma, median overall survival for ipilimumab was 10 months versus 6 months for gp100, an experimental melanoma vaccine (Hazard ratio (HR) 0.66; 95% confidence interval (CI): 0.51, 0.87; p = 0.0026). Ipilimumab was most commonly associated with adverse reactions resulting from increased or excessive immune activity. Most of these, including severe reactions, resolved following initiation of appropriate medical therapy or withdrawal of ipilimumab. The most common side-effects (affecting more than 10% of patients) were diarrhoea, rash, pruritus, fatigue, nausea, vomiting, decreased appetite and abdominal pain. The objective of this paper is to summarise the scientific review of the application leading to approval in the EU. The detailed scientific assessment report and product information, including the summary of product characteristics (SmPC), are available on the European Medicines Agency (EMA) website (www.ema.europa.eu).

  5. Editorial: cardiovascular drug therapy in paediatric age: from metabolomics to clinical practice.

    PubMed

    Bassareo, Pier Paolo; Fanos, Vassilios

    2014-01-01

    In adult patients, cardiovascular drugs are widely administered in the treatment of numerous diseases. The indications and doses are strictly codified by international Guidelines, which are periodically updated by the American and European Societies of Cardiology. In paediatric patients, however, the situation is substantially different. The lack of large interventional studies on the use of these compounds has led to a greater uncertainty, with a less extensive administration and more limited indications. Furthermore, some important differences in therapeutic approach for the same diseases are present between the U.S. and Europe. The purpose of this Special Issue is to review the pharmacological treatment of certain heart diseases, such as heart failure, and arterial blood pressure, which can result in both adult and pediatric patients [1, 2]. Differences and similarities have been highlighted. Regarding the differences in medical treatment for the same disease in the U.S. and Europe, it has been emphasized that the regulation of drugs is largely determined not only by scientific considerations, but also by other concerns - legal, cultural - which vary in different parts of the world. Such discrepancies are found even in the informational documents provided by pharmaceutical companies (different in USA and Europe for the same drug) and drug agencies (different between FDA and equivalent agencies in Europe). In this issue of Current Medicinal Chemistry, a specific paper is dedicated to the pharmacological treatment of the patency of ductus arteriosus in neonates, which is still a controversial issue. In fact, notwithstanding ibuprofen appears to be lesser dangerous for newborns than indomethacin, with a similar efficacy in closing the ductus; in a number of countries the latter is still administered to all preterm subjects as a prophylactic tool [3]. An unusual case report is the interesting starting point to perform an extensive literature review about the new

  6. Editorial: cardiovascular drug therapy in paediatric age: from metabolomics to clinical practice.

    PubMed

    Bassareo, Pier Paolo; Fanos, Vassilios

    2014-01-01

    In adult patients, cardiovascular drugs are widely administered in the treatment of numerous diseases. The indications and doses are strictly codified by international Guidelines, which are periodically updated by the American and European Societies of Cardiology. In paediatric patients, however, the situation is substantially different. The lack of large interventional studies on the use of these compounds has led to a greater uncertainty, with a less extensive administration and more limited indications. Furthermore, some important differences in therapeutic approach for the same diseases are present between the U.S. and Europe. The purpose of this Special Issue is to review the pharmacological treatment of certain heart diseases, such as heart failure, and arterial blood pressure, which can result in both adult and pediatric patients [1, 2]. Differences and similarities have been highlighted. Regarding the differences in medical treatment for the same disease in the U.S. and Europe, it has been emphasized that the regulation of drugs is largely determined not only by scientific considerations, but also by other concerns - legal, cultural - which vary in different parts of the world. Such discrepancies are found even in the informational documents provided by pharmaceutical companies (different in USA and Europe for the same drug) and drug agencies (different between FDA and equivalent agencies in Europe). In this issue of Current Medicinal Chemistry, a specific paper is dedicated to the pharmacological treatment of the patency of ductus arteriosus in neonates, which is still a controversial issue. In fact, notwithstanding ibuprofen appears to be lesser dangerous for newborns than indomethacin, with a similar efficacy in closing the ductus; in a number of countries the latter is still administered to all preterm subjects as a prophylactic tool [3]. An unusual case report is the interesting starting point to perform an extensive literature review about the new

  7. Candy consumption was not associated with body weight measures, risk factors for cardiovascular disease, or metabolic syndrome in US adults: NHANES 1999-2004

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is limited research examining the relationship of candy consumption by adults on diet and health. The purpose of this study was to determine total, chocolate, or sugar candy consumption and their effect on energy, saturated fatty acid and added sugar intake, weight, risk factors for cardiovasc...

  8. Obesity Is Associated with Race/Sex Disparities in Diabetes and Hypertension Prevalence, But Not Cardiovascular Disease, Among HIV-Infected Adults

    PubMed Central

    Westfall, Andrew O.; Overton, E. Turner; Mugavero, Michael J.; Burkholder, Greer A.; Kim, David; Chamot, Eric; Raper, James L.; Crane, Heidi M.; Saag, Michael S.; Willig, James H.

    2015-01-01

    Abstract Race/sex differences are observed in cardiometabolic disease (CMD) risk and prevalence in the context of treated, chronic HIV infection, and these differences could be exacerbated by disparities in obesity prevalence. We sought to determine the effect of obesity on these disparities among people living with HIV. Prevalence of CMD (dyslipidemia, cardiovascular disorders, hypertension, diabetes, chronic kidney disease) was determined for patients seen at the University of Alabama at Birmingham HIV clinic between 7/2010 and 6/2011. Staged logistic regression was used to examine the impact of race/sex on comorbidities adjusting for key confounders including/excluding obesity (body mass index ≥30 kg/m2). Of 1,800 participants, 77% were male, 54% were black, and 25% were obese. Obesity prevalence differed by race/sex: black women 49%, black men 24%, white women 24%, white men 15% (p<0.01). Compared to white men, other groups had reduced odds for dyslipidemia and cardiovascular disorders (p<0.01). Black men had increased odds for hypertension and chronic kidney disease, while black women had a nearly 2-fold increased odds for diabetes and hypertension (all at p<0.01). The associations of black women with diabetes and hypertension were attenuated when obesity was included in the models. Other group differences remained significant. Disparities in obesity prevalence do not explain race/sex differences in all CMD among people with HIV. Obesity accounted for associations with diabetes/hypertension for black women, who may benefit from weight reduction to decrease disease risk. Further investigations into the etiology and treatment of CMD in people living with HIV should consider unique race/sex treatment issues. PMID:26114374

  9. Obesity is associated with race/sex disparities in diabetes and hypertension prevalence, but not cardiovascular disease, among HIV-infected adults.

    PubMed

    Willig, Amanda L; Westfall, Andrew O; Overton, E Turner; Mugavero, Michael J; Burkholder, Greer A; Kim, David; Chamot, Eric; Raper, James L; Crane, Heidi M; Saag, Michael S; Willig, James H

    2015-09-01

    Race/sex differences are observed in cardiometabolic disease (CMD) risk and prevalence in the context of treated, chronic HIV infection, and these differences could be exacerbated by disparities in obesity prevalence. We sought to determine the effect of obesity on these disparities among people living with HIV. Prevalence of CMD (dyslipidemia, cardiovascular disorders, hypertension, diabetes, chronic kidney disease) was determined for patients seen at the University of Alabama at Birmingham HIV clinic between 7/2010 and 6/2011. Staged logistic regression was used to examine the impact of race/sex on comorbidities adjusting for key confounders including/excluding obesity (body mass index ≥30 kg/m(2)). Of 1,800 participants, 77% were male, 54% were black, and 25% were obese. Obesity prevalence differed by race/sex: black women 49%, black men 24%, white women 24%, white men 15% (p<0.01). Compared to white men, other groups had reduced odds for dyslipidemia and cardiovascular disorders (p<0.01). Black men had increased odds for hypertension and chronic kidney disease, while black women had a nearly 2-fold increased odds for diabetes and hypertension (all at p<0.01). The associations of black women with diabetes and hypertension were attenuated when obesity was included in the models. Other group differences remained significant. Disparities in obesity prevalence do not explain race/sex differences in all CMD among people with HIV. Obesity accounted for associations with diabetes/hypertension for black women, who may benefit from weight reduction to decrease disease risk. Further investigations into the etiology and treatment of CMD in people living with HIV should consider unique race/sex treatment issues.

  10. Pharmacokinetic Profiles of Active Components After Oral Administration of a Kampo Medicine, Shakuyakukanzoto, to Healthy Adult Japanese Volunteers.

    PubMed

    Sadakane, Chiharu; Watanabe, Junko; Fukutake, Miwako; Nisimura, Hiroaki; Maemura, Kazuya; Kase, Yoshio; Kono, Toru

    2015-11-01

    Shakuyakukanzoto (SKT), a traditional Japanese (Kampo) medicine, has been used by patients with muscle cramps and abdominal pains. In this trial, we analyzed plasma concentrations of active components after SKT was administered as a single oral dose of 2.5 or 5.0 g/day per person. The study was a randomized, open-label, two-arm, two-period, crossover trial conducted in healthy Japanese volunteers. Albiflorin (ALB), paeoniflorin (PAE), glycycoumarin (GCM), isoliquiritigenin (ILG), glycyrrhetic acid (GA), and glycyrrhetic acid-3-O-monoglucuronide were targeted, and the plasma concentration of each component was measured using a liquid chromatography-tandem mass spectrometry method. The pharmacokinetic parameters were calculated, and the linearity was assessed. All targeted components were detected in the plasma after oral administration of SKT. ALB, PAE, GCM, and ILG were detected at an early stage. The linearity was observed for the maximum plasma concentration of GCM, ILG, and GA and for the area under the plasma concentration-time curve of GA. In this trial, we demonstrated for the first time in humans that these components were absorbed into the blood after oral administration of SKT. The results of this pharmacokinetic trial in humans are also important and useful for understanding the mechanism of action of SKT, verifying the active components predicted in basic research, and conducting pharmacokinetics and safety studies in the future. PMID:26211516

  11. Nuclear Medicine

    MedlinePlus

    ... Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive tracers? ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

  12. Cardiovascular group

    NASA Technical Reports Server (NTRS)

    Blomqvist, Gunnar

    1989-01-01

    As a starting point, the group defined a primary goal of maintaining in flight a level of systemic oxygen transport capacity comparable to each individual's preflight upright baseline. The goal of maintaining capacity at preflight levels would seem to be a reasonable objective for several different reasons, including the maintenance of good health in general and the preservation of sufficient cardiovascular reserve capacity to meet operational demands. It is also important not to introduce confounding variables in whatever other physiological studies are being performed. A change in the level of fitness is likely to be a significant confounding variable in the study of many organ systems. The principal component of the in-flight cardiovascular exercise program should be large-muscle activity such as treadmill exercise. It is desirable that at least one session per week be monitored to assure maintenance of proper functional levels and to provide guidance for any adjustments of the exercise prescription. Appropriate measurements include evaluation of the heart-rate/workload or the heart-rate/oxygen-uptake relationship. Respiratory gas analysis is helpful by providing better opportunities to document relative workload levels from analysis of the interrelationships among VO2, VCO2, and ventilation. The committee felt that there is no clear evidence that any particular in-flight exercise regimen is protective against orthostatic hypotension during the early readaptation phase. Some group members suggested that maintenance of the lower body muscle mass and muscle tone may be helpful. There is also evidence that late in-flight interventions to reexpand blood volume to preflight levels are helpful in preventing or minimizing postflight orthostatic hypotension.

  13. Cardiovascular Disease

    PubMed Central

    Grace, Sherry L; Fry, Rick; Cheung, Angela; Stewart, Donna E

    2004-01-01

    Health Issue Cardiovascular disease (CVD) is the leading cause of death in Canadian women and men. In general, women present with a wider range of symptoms, are more likely to delay seeking medial care and are less likely to be investigated and treated with evidence-based medications, angioplasty or coronary artery bypass graft than men. Key Findings In 1998, 78,964 Canadians died from CVD, almost half (39,197) were women. Acute myocardial infarction, which increases significantly after menopause, was the leading cause of death among women. Cardiovascular disease accounted for 21% of all hospital admissions for Canadian women over age 50 in 1999. Admissions to hospital for ischemic heart disease were more frequent for men, but the mean length of hospital stay was longer for women. Mean blood pressure increases with age in both men and women. After age 65, however, high blood pressure is more common among Canadian women. More than one-third of postmenopausal Canadian women have hypertension. Diabetes increases the mortality and morbidity associated with CVD in women more than it does in men. Depression also contributes to the incidence and recovery from CVD, particularly for women who experience twice the rate of depression as men. Data Gaps and Recommendations CVD needs to be recognized as a woman's health issue given Canadian mortality projections (particularly heart failure). Health professionals should be trained to screen, track, and address CVD risk factors among women, including hypertension, elevated lipid levels, smoking, physical inactivity, depression, diabetes and low socio-economic status. PMID:15345078

  14. Prevalence and Correlates of Vitamin D Deficiency and Insufficiency in Luxembourg Adults: Evidence from the Observation of Cardiovascular Risk Factors (ORISCAV-LUX) Study.

    PubMed

    Alkerwi, Ala'a; Sauvageot, Nicolas; Gilson, Georges; Stranges, Saverio

    2015-08-01

    Evidence on vitamin D status and related risk factors in Luxembourg adults is lacking. This study aimed to determine the prevalence of vitamin D deficiency and insufficiency and related risk factors among healthy adults in Luxembourg. Based on clinicians' observations, it was hypothesized that vitamin D deficiency and insufficiency might be common in our population, constituting a significant public health concern. A nationally representative random sample of 1432 adults was enrolled in the ORISCAV-LUX study, 2007-2008. The participants were divided into four categories according to their serum concentrations of 25-hydroxyvitamin D [25(OH)D]. Descriptive, univariate and multivariate statistical analyses used weighted methods to account for the stratified sampling scheme. Only 17.1% of the population had a "desirable" serum 25(OH)D level ≥75 nmol/L, whereas 27.1% had "inadequate" [serum 25(OH)D level 50-74 nmol/L], 40.4% had "insufficient" [serum 25(OH)D level 25-49 nmol/L], and 15.5% had "deficient" [serum 25(OH)D level <25 nmol/L)]. The prevalence of vitamin D deficiency was greater among current smokers, obese subjects, those having reduced HDL-cholesterol level and fair/poor self-perception of health, compared to their counterparts. The prevalence of vitamin D insufficiency was additionally higher among nondrinkers of alcohol, Portuguese and subjects from non-European countries. The final multivariate logistic regression analyses revealed that smoking status and obesity were independent correlates of vitamin D deficiency and insufficiency, respectively. Inadequate vitamin D status is highly prevalent among adults in