501
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Inflammation, Aging, and Cardiovascular Disease: JACC Review Topic of the Week. J Am Coll Cardiol 2022; 79:837-847. [PMID: 35210039 PMCID: PMC8881676 DOI: 10.1016/j.jacc.2021.12.017] [Citation(s) in RCA: 147] [Impact Index Per Article: 73.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/08/2021] [Indexed: 01/19/2023]
Abstract
Aging and inflammation both contribute pivotally to cardiovascular (CV) and cerebrovascular disease, the leading causes of death and disability worldwide. The concept of inflamm-aging recognizes that low-grade inflammatory pathways observed in the elderly contribute to CV risk. Understanding the mechanisms that link inflammation and aging could reveal new therapeutic targets and offer options to cope with the growing aging population worldwide. This review reports recent scientific advances in the pathways through which inflamm-aging mediates age-dependent decline in CV function and disease onset and considers critically the translational potential of such concepts into everyday clinical practice.
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502
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Dronkers J, Meems LMG, van Veldhuisen DJ, Meyer S, Kieneker LM, Gansevoort RT, Bakker SJL, Rienstra M, de Boer RA, Suthahar N. Sex differences in associations of comorbidities with incident cardiovascular disease: focus on absolute risk. EUROPEAN HEART JOURNAL OPEN 2022; 2:oeac017. [PMID: 35919118 PMCID: PMC9242082 DOI: 10.1093/ehjopen/oeac017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/07/2022] [Indexed: 11/12/2022]
Abstract
Aim To examine sex differences in associations of obesity, type-2 diabetes, hypertension, and atrial fibrillation (AF) with incident cardiovascular disease (CVD), focusing on absolute risk measures. Methods and results We included a total of 7994 individuals (mean age 49.1 years; 51.2% women) without prior CVD from the PREVEND (Prevention of Renal and Vascular End-stage Disease) cohort with a median follow-up of 12.5 years. Using Poisson regression, we calculated the increase in absolute as well as relative CVD risk associated with a comorbidity using incidence rate differences (IRD = IRcomorbidity−IRno-comorbidity) and incidence rate ratios (IRR = IRcomorbidity/IRno-comorbidity), respectively. Sex differences were presented as women-to-men differences (WMD = IRDwomen−IRDmen) and women-to-men ratios (WMR = IRRwomen/IRRmen). Absolute CVD risk was lower in women than in men (IRwomen: 6.73 vs. IRmen: 14.58 per 1000 person-years). While increase in absolute CVD risk associated with prevalent hypertension was lower in women than in men [WMD: −6.12, 95% confidence interval: (−9.84 to −2.40), P = 0.001], increase in absolute CVD risk associated with prevalent obesity [WMD: −4.25 (−9.11 to 0.61), P = 0.087], type-2 diabetes [WMD: −1.04 (−14.36 to 12.29), P = 0.879] and AF [WMD: 18.39 (−39.65 to 76.43), P = 0.535] did not significantly differ between the sexes. Using relative risk measures, prevalent hypertension [WMR: 1.49%, 95% confidence interval: (1.12–1.99), P = 0.006], type-2 diabetes [WMR: 1.73 (1.09–2.73), P = 0.019], and AF [WMR: 2.53 (1.12–5.70), P = 0.025] were all associated with higher CVD risk in women than in men. Conclusion Increase in absolute risk of developing CVD is higher in hypertensive men than in hypertensive women, but no substantial sex-related differences were observed among individuals with obesity, type-2 diabetes and AF. On a relative risk scale, comorbidities, in general, confer a higher CVD risk in women than in men.
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Affiliation(s)
- Just Dronkers
- Department of Cardiology, University of Groningen, University Medical Center Groningen, AB43, Hanzeplein 1, Groningen 9713 GZ, the Netherlands
| | - Laura M G Meems
- Department of Cardiology, University of Groningen, University Medical Center Groningen, AB43, Hanzeplein 1, Groningen 9713 GZ, the Netherlands
| | - Dirk J van Veldhuisen
- Department of Cardiology, University of Groningen, University Medical Center Groningen, AB43, Hanzeplein 1, Groningen 9713 GZ, the Netherlands
| | - Sven Meyer
- Department of Cardiology, University of Groningen, University Medical Center Groningen, AB43, Hanzeplein 1, Groningen 9713 GZ, the Netherlands.,Heart Center Oldenburg, Department of Cardiology, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Lyanne M Kieneker
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ron T Gansevoort
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Michiel Rienstra
- Department of Cardiology, University of Groningen, University Medical Center Groningen, AB43, Hanzeplein 1, Groningen 9713 GZ, the Netherlands
| | - Rudolf A de Boer
- Department of Cardiology, University of Groningen, University Medical Center Groningen, AB43, Hanzeplein 1, Groningen 9713 GZ, the Netherlands
| | - Navin Suthahar
- Department of Cardiology, University of Groningen, University Medical Center Groningen, AB43, Hanzeplein 1, Groningen 9713 GZ, the Netherlands
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503
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Gender differences in secondary prevention of coronary heart disease: Far from closing the gap. Int J Cardiol 2022; 355:52-53. [DOI: 10.1016/j.ijcard.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/07/2022] [Indexed: 11/18/2022]
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504
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Dev R, Raparelli V, Pilote L, Azizi Z, Kublickiene K, Kautzky-Willer A, Herrero MT, Norris CM. Cardiovascular health through a sex and gender lens in six South Asian countries: Findings from the WHO STEPS surveillance. J Glob Health 2022; 12:04020. [PMID: 35265330 PMCID: PMC8876159 DOI: 10.7189/jogh.12.04020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Sex and gender-based differences in cardiovascular health (CVH) has been explored in the context of high-income countries. However, these relationships have not been examined in low- and middle-income countries. The main aim of this study was to examine how sex and gender-related factors are associated with cardiovascular risk factors of people in South Asian countries. Methods We conducted a retrospective analysis of the World Health Organization’s “STEPwise approach to surveillance of risk factors for non-communicable disease” or “STEPS” from six South Asian countries, surveys conducted between 2014-2019. The main outcomes were CVH as measured by a composite measure of STEPS-HEART health index (smoking, physical activity, fruit and vegetable consumption, overweight/obesity, diabetes and hypertension), values ranging from 0 (worst) to 6 (best or ideal) and self-reported occurrence of cardiovascular disease (ie, heart attack and stroke). Multivariate linear and logistic regression models were performed. Multiple imputation with chained equations was performed. Results The final analytic sample consisted of 33 106 participants (57.5% females). The mean STEPS-HEART index score in the South Asian population was 3.43 [SD: 0.92]. Female sex (β: 0.05, 95% confidence interval (CI) = 0.01-0.08, P < 0.05) was significantly associated with better CVH compared to males. Being married (βmale = -0.30, 95% CI = -0.37, -0.23 vs βfemale = -0.23, 95% CI = -0.29, -0.17; P < 0.001) and having a household size ≥5 (βmale = -0.15, 95% CI = -0.24, -0.06 vs βfemale = -0.11, 95% CI = -0.16, -0.04; P < 0.01) were associated with poorer CVH, more so in males. Being married was also associated with high risk of CVD (ORmale = 2.54, 95% CI = 1.68-3.86, P < 0.001 vs ORfemale = 1.19, 95% CI = 0.84-1.68, P = 0.31), significant in males. Conclusions Among the South Asian population, being female may be advantageous in having an ideal CVH. However, gender-related factors such as marital status and large household size were associated with poorer CVH and greater risk of CVD, regardless of sex.
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Affiliation(s)
- Rubee Dev
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Valeria Raparelli
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Louise Pilote
- Research Institute of McGill University Health Centre, Division of Clinical Epidemiology McGill University, Montreal, Quebec, Canada
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Zahra Azizi
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Karolina Kublickiene
- Department of Clinical Science, Intervention & Technology (CLINTEC), Section for Renal Medicine, Karolinska Institute and Karolinska University hospital, Stockholm, Sweden
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, and Gender Institute, Iapura, Gars am Kamp, Austria
| | - Maria Trinidad Herrero
- Clinical & Experimental Neuroscience (NiCE-IMIB-IUIE), School of Medicine. University of Murcia, Murcia, Spain
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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505
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Lucà F, Abrignani MG, Parrini I, Di Fusco SA, Giubilato S, Rao CM, Piccioni L, Cipolletta L, Passaretti B, Giallauria F, Leone A, Francese GM, Riccio C, Gelsomino S, Colivicchi F, Gulizia MM. Update on Management of Cardiovascular Diseases in Women. J Clin Med 2022; 11:1176. [PMID: 35268267 PMCID: PMC8911459 DOI: 10.3390/jcm11051176] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 02/08/2023] Open
Abstract
Cardiovascular diseases (CVD) have a lower prevalence in women than men; although, a higher mortality rate and a poorer prognosis are more common in women. However, there is a misperception of CVD female risk since women have commonly been considered more protected so that the real threat is vastly underestimated. Consequently, female patients are more likely to be treated less aggressively, and a lower rate of diagnostic and interventional procedures is performed in women than in men. In addition, there are substantial sex differences in CVD, so different strategies are needed. This review aims to evaluate the main gender-specific approaches in CVD.
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Affiliation(s)
- Fabiana Lucà
- Cardiology Department, Big Metropolitan Hospital, 89129 Reggio Calabria, Italy;
| | | | - Iris Parrini
- Cardiology Department, Ospedale Mauriziano Umberto I Hospital, 10128 Turin, Italy;
| | - Stefania Angela Di Fusco
- Clinical and Rehabilitation Cardiology Department, San Filippo Neri Hospital, ASL Roma 1, 00100 Roma, Italy; (S.A.D.F.); (F.C.)
| | - Simona Giubilato
- Division of Cardiology, Cannizzaro Hospital, 95121 Catania, Italy;
| | | | - Laura Piccioni
- Italy Cardiology Department, “G. Mazzini” Hospital, 64100 Teramo, Italy;
| | - Laura Cipolletta
- Division of Cardiology, Department of Cardiovascular Sciences, University of Ancona, 60126 Ancona, Italy;
| | - Bruno Passaretti
- Rehabilitation Cardiology Department, Humanitas Gavazzeni, 24125 Bergamo, Italy;
| | - Francesco Giallauria
- Department of Translational Medical Sciences, Federico II University of Naples, 80138 Naples, Italy;
| | - Angelo Leone
- Cardiology Division, Annunziata Hospital Cosenza, 87100 Cosenza, Italy;
| | | | - Carmine Riccio
- Division of Clinical Cardiology, ‘Sant’Anna e San Sebastiano’ Hospital, 81100 Caserta, Italy;
| | - Sandro Gelsomino
- Cardio Thoracic Department, Maastricht University, 6202 AZ Maastricht, The Netherlands;
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Department, San Filippo Neri Hospital, ASL Roma 1, 00100 Roma, Italy; (S.A.D.F.); (F.C.)
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506
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Maukel L, Weidner G, Beyersmann J, Spaderna H. Sex Differences in Recovery and Device Replacement After Left Ventricular Assist Device Implantation as Destination Therapy. J Am Heart Assoc 2022; 11:e023294. [PMID: 35191318 PMCID: PMC9075087 DOI: 10.1161/jaha.121.023294] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background The relevance of sex and preimplant factors for clinical outcomes among patients with left ventricular assist devices intended for destination therapy is unclear. Methods and Results INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) data (2006-2017) from 6771 men and 1690 women with left ventricular assist devices as destination therapy were analyzed to evaluate the contribution of preimplant clinical, demographic, and clinically judged psychosocial characteristics to time until death, heart transplant, device explant due to recovery, or complication-related device replacement. Associations of sex with time until each competing outcome were evaluated using cumulative incidence functions and event-specific Cox proportional hazards models. Women were younger, more likely to have nonischemic diagnoses, and reported less substance abuse but were more likely to be unmarried, not working for an income, overweight, and depressed than men. After 2 years, women had higher probabilities for recovery (3.7% versus 1.6%, P<0.001) and device replacement (12.1% versus 10%, P=0.019) than men but not for death and transplant (P>0.12). The sex differences remained after controlling for covariates (adjusted hazard ratio [HRadj] recovery, 1.85; 95% CI, 1.30-2.70; P<0.001; HRadj device replacement, 1.22; 95% CI, 1.04-1.33; P=0.015). Female-specific diagnoses (eg, postpartum heart failure) contributed to women's enhanced rate of recovery. Demographic and psychosocial factors were unrelated to women's increased event rates. Conclusions In destination therapy, women have higher rates of device replacement and recovery than men. The latter was partly explained by female-specific diagnoses. Standardized assessments of psychosocial characteristics are needed to elucidate their association with sex differences in outcomes.
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Affiliation(s)
| | - Gerdi Weidner
- Biology, San Francisco State UniversitySan FranciscoCA
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507
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Liu L, Zhang X, Peng L, Ma N, Yang T, Nie C, Zhang L, Xu Z, Yang J, Tang X, Zheng L, Zhang T, Hong F. Hyperuricemia is Related to the Risk of Cardiovascular Diseases in Ethnic Chinese Elderly Women. Glob Heart 2022; 17:12. [PMID: 35342699 PMCID: PMC8877644 DOI: 10.5334/gh.1102] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/20/2022] [Indexed: 11/20/2022] Open
Abstract
Background The association between hyperuricemia (HUA) and cardiovascular diseases (CVDs) is not fully elucidated. Objective To assess the relationship according to factors of sex and age in the Chinese ethnic groups. Methods We performed a population-based cross-sectional study in a multi-ethnic population from southwestern China. HUA patients were identified by serum uric acid ≥7 mg/dL in men and 6 mg/dL in women. The outcome was composite prevalent CVDs, including coronary heart disease (CHD), stroke, and arrhythmia. Multivariate logistic regression analysis, estimating odds ratio (ORs) and 95% confidence intervals (CIs), were applied to evaluate the HUA-CVDs relationship. Results We included 16,618 people (37.48% Dong, 30.00% Miao, and 32.52% Bouyei) aged 30-79 years without a reduced estimated glomerular filtration rate <60 mL/min/1.73 m2. CVDs developed in 250 Dong, 196 Miao, and 205 Bouyei adults. Among women, HUA was positively associated with the risk of stroke in Dong ethnicity and CVDs in Bouyei ethnicity (ORs (95% CIs) 2.02 (1.07-3.81) and 1.66 (1.06-2.59)) compared with non-HUA. In the age-specific analysis, HUA was related to the risk of CVDs (OR 2.32, 95% CI 1.00-5.38) and CHD (5.37, 1.61-17.89) among Miao people aged < median age, CVDs (1.52, 1.11-2.08) and stroke (1.67, 1.02-2.72) among Dong adults aged ≥ median age, and CVDs (1.67, 1.16-2.40) and CHD (1.77, 1.13-2.77) among Bouyei ethnicity aged ≥ median age. After stratification by sex and the median age, for women aged > 50 years, a 55% (1.55, 1.00-2.39) and 65% (1.65, 1.02-2.66) increased risk for CVDs was observed in Dong and Bouyei ethnicities. Conclusions HUA may be related to an increased risk of CVDs among women in the Dong and Bouyei ethnic groups in China, especially women aged > 50 years.
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Affiliation(s)
- Leilei Liu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Xiao Zhang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
- Center for Diseases Control and Prevention of Yunyan District, Guiyang 550004, China
| | - Lian Peng
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Nana Ma
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Tingting Yang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Chan Nie
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Linyuan Zhang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Zixuan Xu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Jun Yang
- Guiyang Center for Diseases Control and Prevention, Guiyang 550003, China
| | - Xuejie Tang
- The Higher Education Mega Center Hospital, Guizhou Medical University, Guiyang 550025, China
| | - Liubo Zheng
- Guizhou Provincial People’s Hospital, Guiyang 550002, China
| | - Tao Zhang
- Guiyang Public Health Clinical Center, Guiyang 550004, China
| | - Feng Hong
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
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508
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Wu P, Sharma GV, Mehta LS, Chew-Graham CA, Lundberg GP, Nerenberg KA, Graham MM, Chappell LC, Kadam UT, Jordan KP, Mamas MA. In-Hospital Complications in Pregnancies Conceived by Assisted Reproductive Technology. J Am Heart Assoc 2022; 11:e022658. [PMID: 35191320 PMCID: PMC9075081 DOI: 10.1161/jaha.121.022658] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Assisted reproductive technology (ART) has emerged as a common treatment option for infertility, a problem that affects an estimated 48 million couples worldwide. Advancing maternal age with increasing prepregnancy cardiovascular risk factors, such as chronic hypertension, obesity, and diabetes, has raised concerns about pregnancy complications associated with ART. However, in-hospital complications following pregnancies conceived by ART are poorly described. Methods and Results To assess the patient characteristics, obstetric outcomes, vascular complications and temporal trends of pregnancies conceived by ART, we analyzed hospital deliveries conceived with or without ART between January 1, 2008, and December 31, 2016, from the United States National Inpatient Sample database. We included 106 248 deliveries conceived with ART and 34 167 246 deliveries conceived without ART. Women who conceived with ART were older (35 versus 28 years; P<0.0001) and had more comorbidities. ART-conceived pregnancies were independently associated with vascular complications (acute kidney injury: adjusted odds ratio [aOR], 2.52; 95% CI 1.99-3.19; and arrhythmia: aOR, 1.65; 95% CI, 1.46-1.86), and adverse obstetric outcomes (placental abruption: aOR, 1.57; 95% CI, 1.41-1.74; cesarean delivery: aOR, 1.38; 95% CI, 1.33-1.43; and preterm birth: aOR, 1.26; 95% CI, 1.20-1.32), including in subgroups without cardiovascular disease risk factors or without multifetal pregnancies. Higher hospital charges ($18 705 versus $11 983; P<0.0001) were incurred compared with women who conceived without ART. Conclusions Pregnancies conceived by ART have higher risks of adverse obstetric outcomes and vascular complications compared with spontaneous conception. Clinicians should have detailed discussions on the associated complications of ART in women during prepregnancy counseling.
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Affiliation(s)
- Pensée Wu
- Keele Cardiovascular Research Group School of Medicine Keele University Staffordshire United Kingdom.,Academic Unit of Obstetrics and Gynaecology University Hospital of North Midlands Stoke-on-Trent United Kingdom.,Department of Obstetrics and Gynecology National Cheng Kung University Hospital, College of MedicineNational Cheng Kung University Tainan Taiwan
| | - Garima V Sharma
- Division of Cardiology Department of Medicine Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins University School of Medicine Baltimore MD
| | - Laxmi S Mehta
- Division of Cardiology Department of Medicine The Ohio State University Columbus OH
| | - Carolyn A Chew-Graham
- School of Medicine Keele University Staffordshire United Kingdom.,National Institute for Health ResearchApplied Research CollaborationWest Midlands, Keele University Staffordshire United Kingdom
| | - Gina P Lundberg
- Division of Cardiology MedStar Heart and Vascular InstituteMedStar Washington Hospital CenterGeorgetown University Washington DC.,Division of Cardiology Emory University School of Medicine Atlanta GA
| | - Kara A Nerenberg
- Departments of Medicine, Obstetrics and Gynecology and Community Health Sciences University of Calgary Calgary Alberta Canada
| | - Michelle M Graham
- Division of Cardiology University of Alberta and Mazankowski Alberta Heart Institute Edmonton Alberta Canada
| | - Lucy C Chappell
- School of Life Course Sciences King's College London London United Kingdom
| | - Umesh T Kadam
- Diabetes Research Centre University of Leicester Leicester United Kingdom
| | - Kelvin P Jordan
- School of Medicine Keele University Staffordshire United Kingdom
| | - Mamas A Mamas
- Keele Cardiovascular Research Group School of Medicine Keele University Staffordshire United Kingdom.,The Heart Centre University Hospital of North Midlands Stoke-on-Trent United Kingdom
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509
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Bikdeli B, Khairani CD, Barns BM, Rosovsky RP, Jimenez D, Monreal M, Sylvester KW, Middeldorp S, Bates SM, Krumholz HM, Goldhaber SZ, Hunt BJ, Piazza G. Women's representation in venous thromboembolism randomized trials and registries: The illustrative example of direct oral anticoagulants for acute treatment. Contemp Clin Trials 2022; 115:106714. [PMID: 35202841 DOI: 10.1016/j.cct.2022.106714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/14/2022] [Accepted: 02/18/2022] [Indexed: 12/22/2022]
Affiliation(s)
- Behnood Bikdeli
- Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Thrombosis Research Group, Brigham and Women's Hospital, Boston, MA, USA; Center for Outcomes Research and Evaluation (CORE), Yale School of Medicine, New Haven, CT, USA; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA.
| | - Candrika D Khairani
- Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Thrombosis Research Group, Brigham and Women's Hospital, Boston, MA, USA
| | - Briana M Barns
- Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Thrombosis Research Group, Brigham and Women's Hospital, Boston, MA, USA
| | - Rachel P Rosovsky
- Division of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David Jimenez
- Respiratory Department, Hospital Ramón y Cajal and Medicine Department, Universidad de Alcalá (Instituto de Ramón y Cajal de Investigación Sanitaria), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Universitari Germans Trials i Pujol, Universidad Católica San Antonio de Murcia, Barcelona, Spain
| | - Katelyn W Sylvester
- Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA, USA
| | - Saskia Middeldorp
- Department of Internal Medicine &, Radboud Institute of Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Shannon M Bates
- Division of Hematology and Thromboembolism, Department of Medicine, McMaster University, Hamilton, ON, Canada; Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation (CORE), Yale School of Medicine, New Haven, CT, USA; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA; Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT, USA
| | - Samuel Z Goldhaber
- Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Thrombosis Research Group, Brigham and Women's Hospital, Boston, MA, USA
| | - Beverley J Hunt
- Haemostasis and Thrombosis Centre, St Thomas' Hospital, Westminster Bridge Road, London, United Kingdom
| | - Gregory Piazza
- Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Thrombosis Research Group, Brigham and Women's Hospital, Boston, MA, USA
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510
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Abstract
Peripheral artery disease (PAD) is a prevalent condition that confers substantial morbidity and mortality and remains underdiagnosed as well as undertreated in the overall population. Although PAD prevalence is similar or higher in women compared with men, associations of traditional and nontraditional risk factors with PAD and clinical manifestations of PAD differ by sex and may contribute to delayed or lack of diagnosis in women. Such sex-based differences in the manifestation of PAD may arise from sexual dimorphism in the vascular substrate in health as well as sex variation in the responses to vascular stressors. Despite the availability of proven therapies for improving symptoms and reducing risk of ischemic cardiovascular and limb events among patients with diagnosed PAD, important sex differences in treatment and outcomes have been observed. We provide an overview of current knowledge regarding sex differences in the epidemiology, pathophysiology, clinical presentation, and management of PAD.
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Affiliation(s)
- Maria Pabon
- Division of Cardiovascular Medicine, Brigham and Women's Hospital (M.P.)
| | - Susan Cheng
- Department of Cardiology, Cedars-Sinai Medical Center (S.C.)
| | - S Elissa Altin
- Division of Cardiology, Yale University School of Medicine (S.E.A.)
| | - Sanjum S Sethi
- Columbia Interventional Cardiovascular Care, Division of Cardiology, Columbia University Irving Medical Center (S.S.S.)
| | - Michael D Nelson
- Department of Kinesiology, University of Texas at Arlington (M.D.N.)
| | - Kerrie L Moreau
- Division of Geriatrics, University of Colorado School of Medicine, and Eastern Colorado Geriatric Research Education and Clinical Center (K.L.M.)
| | | | - Connie N Hess
- Division of Cardiology, University of Colorado School of Medicine (C.N.H.)
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511
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Zeitler EP, Poole JE, Albert CM, Al-Khatib SM, Ali-Ahmed F, Birgersdotter-Green U, Cha YM, Chung MK, Curtis AB, Hurwitz JL, Lampert R, Sandhu RK, Shaik F, Sullivan E, Tamirisa KP, Santos Volgman A, Wright JM, Russo AM. Arrhythmias in Female Patients: Incidence, Presentation and Management. Circ Res 2022; 130:474-495. [PMID: 35175839 DOI: 10.1161/circresaha.121.319893] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There is a growing appreciation for differences in epidemiology, treatment, and outcomes of cardiovascular conditions by sex. Historically, cardiovascular clinical trials have under-represented females, but findings have nonetheless been applied to clinical care in a sex-agnostic manner. Thus, much of the collective knowledge about sex-specific cardiovascular outcomes result from post hoc and secondary analyses. In some cases, these investigations have revealed important sex-based differences with implications for optimizing care for female patients with arrhythmias. This review explores the available evidence related to cardiac arrhythmia care among females, with emphasis on areas in which important sex differences are known or suggested. Considerations related to improving female enrollment in clinical trials as a way to establish more robust clinical evidence for the treatment of females are discussed. Areas of remaining evidence gaps are provided, and recommendations for areas of future research and specific action items are suggested. The overarching goal is to improve appreciation for sex-based differences in cardiac arrhythmia care as 1 component of a comprehensive plan to optimize arrhythmia care for all patients.
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Affiliation(s)
- Emily P Zeitler
- The Geisel School of Medicine at Dartmouth, Hanover, NH (E.P.Z.).,Division of Cardiology, Dartmouth-Hitchcock Medical Center, The Dartmouth Institute, Lebanon, NH (E.P.Z.)
| | - Jeanne E Poole
- University of Washington Medical Center, Seattle (J.E.P.)
| | - Christine M Albert
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Hospital, Los Angeles, CA (C.M.A., R.K.S.)
| | - Sana M Al-Khatib
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (S.M.A.-K.)
| | | | | | - Yong-Mei Cha
- Mayo Clinic, St Mary's Campus, Rochester, MN (F.A.-A., Y.-M.C.)
| | | | - Anne B Curtis
- Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo General Medical Center, NY (A.B.C.)
| | | | - Rachel Lampert
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (R.L.)
| | - Roopinder K Sandhu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Hospital, Los Angeles, CA (C.M.A., R.K.S.)
| | - Fatima Shaik
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ (F.S., A.M.R.)
| | | | | | | | - Jennifer M Wright
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (J.M.W.)
| | - Andrea M Russo
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ (F.S., A.M.R.)
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512
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Adedinsewo DA, Pollak AW, Phillips SD, Smith TL, Svatikova A, Hayes SN, Mulvagh SL, Norris C, Roger VL, Noseworthy PA, Yao X, Carter RE. Cardiovascular Disease Screening in Women: Leveraging Artificial Intelligence and Digital Tools. Circ Res 2022; 130:673-690. [PMID: 35175849 PMCID: PMC8889564 DOI: 10.1161/circresaha.121.319876] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardiovascular disease remains the leading cause of death in women. Given accumulating evidence on sex- and gender-based differences in cardiovascular disease development and outcomes, the need for more effective approaches to screening for risk factors and phenotypes in women is ever urgent. Public health surveillance and health care delivery systems now continuously generate massive amounts of data that could be leveraged to enable both screening of cardiovascular risk and implementation of tailored preventive interventions across a woman's life span. However, health care providers, clinical guidelines committees, and health policy experts are not yet sufficiently equipped to optimize the collection of data on women, use or interpret these data, or develop approaches to targeting interventions. Therefore, we provide a broad overview of the key opportunities for cardiovascular screening in women while highlighting the potential applications of artificial intelligence along with digital technologies and tools.
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Affiliation(s)
- Demilade A. Adedinsewo
- Department of Cardiovascular Medicine (D.A.A., A.W.P., S.D.P.), Mayo Clinic, Jacksonville, FL
| | - Amy W. Pollak
- Department of Cardiovascular Medicine (D.A.A., A.W.P., S.D.P.), Mayo Clinic, Jacksonville, FL
| | - Sabrina D. Phillips
- Department of Cardiovascular Medicine (D.A.A., A.W.P., S.D.P.), Mayo Clinic, Jacksonville, FL
| | - Taryn L. Smith
- Division of General Internal Medicine (T.L.S.), Mayo Clinic, Jacksonville, FL
| | - Anna Svatikova
- Department of Cardiovascular Diseases (A.S.), Mayo Clinic, Phoenix, AZ
| | - Sharonne N. Hayes
- Department of Cardiovascular Medicine (S.N.H., S.L.M., V.L.R., P.A.N.), Mayo Clinic, Rochester, MN
| | - Sharon L. Mulvagh
- Department of Cardiovascular Medicine (S.N.H., S.L.M., V.L.R., P.A.N.), Mayo Clinic, Rochester, MN
- Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada (S.L.M.)
| | - Colleen Norris
- Cardiovascular Health and Stroke Strategic Clinical Network, Edmonton, Canada (C.N.)
| | - Veronique L. Roger
- Department of Cardiovascular Medicine (S.N.H., S.L.M., V.L.R., P.A.N.), Mayo Clinic, Rochester, MN
- Department of Quantitative Health Sciences (V.L.R.), Mayo Clinic, Rochester, MN
- Epidemiology and Community Health Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (V.L.R.)
| | - Peter A. Noseworthy
- Department of Cardiovascular Medicine (S.N.H., S.L.M., V.L.R., P.A.N.), Mayo Clinic, Rochester, MN
| | - Xiaoxi Yao
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery (X.Y.), Mayo Clinic, Rochester, MN
| | - Rickey E. Carter
- Department of Quantitative Health Sciences (R.E.C.), Mayo Clinic, Jacksonville, FL
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513
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Oliveira GMMD, Wenger NK. Considerações Especiais na Prevenção de Doenças Cardiovasculares nas Mulheres. Arq Bras Cardiol 2022; 118:374-377. [PMID: 35262568 PMCID: PMC8856687 DOI: 10.36660/abc.20220028] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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514
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Aßmus B, Angermann CE. Geschlechtsspezifische Unterschiede bei Herzinsuffizienz: Pathophysiologie,
Risikofaktoren und Bildgebung. AKTUELLE KARDIOLOGIE 2022. [DOI: 10.1055/a-1692-1023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungHerzinsuffizienz betrifft etwa 4 Millionen Menschen in Deutschland, stellt die häufigste
Ursache für Hospitalisierungen dar und trägt wesentlich zur Morbidität und Letalität einer
älter werdenden Gesellschaft bei. Bei der Herzinsuffizienz gibt es ausgeprägte
geschlechtsspezifische Unterschiede, sowohl bezüglich Epidemiologie, Pathophysiologie und
Risikofaktoren als auch in der bildgebenden Diagnostik. Daher ist die Kenntnis der
Unterschiede zwischen Männern und Frauen mit Herzinsuffizienz in Hinblick auf die
genannten Faktoren essenziell sowohl für das Erkennen der Erkrankung als auch für
Interpretation der Diagnostik. Mit dem aktuellen Artikel wollen wir einen kurzen Überblick
zu geschlechtsspezifischen Unterschieden der Herzinsuffizienz-Entwicklung geben und zum
Weiterlesen inspirieren.
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Affiliation(s)
- Birgit Aßmus
- Med. Klinik I Kardiologie, Justus Liebig Universität Gießen
Fachbereich Medizin, Gießen, Deutschland
| | - Christiane E. Angermann
- Deutsches Zentrum für Herzinsuffizienz der Universität und des
Universitätsklinikums Würzburg, Würzburg, Deutschland
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515
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Angermann CE, Aßmus B. Geschlechtsunterschiede bei Herzinsuffizienz – Behandlung und
Prognose. AKTUELLE KARDIOLOGIE 2022. [DOI: 10.1055/a-1692-1070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungWeltweit sind bei Frauen kardiovaskuläre Erkrankungen die Haupttodesursache. Bei
Ätiologie, Epidemiologie, Pathophysiologie, Symptomatik und Komorbiditäten der
Herzinsuffizienz (HI) sowie bei Wirkungen und Nebenwirkungen von Therapiemaßnahmen und der
Prognose gibt es relevante Geschlechtsunterschiede. Trotzdem sind in klinischen Studien
Frauen als Teilnehmerinnen bzw. in der Studienleitung unterrepräsentiert. Sekundäre
Analysen aus Therapiestudien legen Geschlechtsunterschiede bei Wirksamkeit,
Nebenwirkungsprofil und optimaler Dosierung von Medikamenten und beim Nutzen von
Device-Therapien nahe. Prospektive Studiendesigns mit dem Ziel, Geschlechtsunterschiede zu
herauszuarbeiten, gibt es kaum, und Leitlinienempfehlungen sind meist geschlechtsneutral.
Dieser Übersichtsartikel beschreibt Unterschiede bei Behandlungseffekten, Verfügbarkeit
von Therapien und Krankheitsprognose, beleuchtet Wissenslücken und zeigt, wo
Handlungsbedarf besteht, um die Situation von Frauen mit HI zu verbessern.
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Affiliation(s)
- Christiane E. Angermann
- Deutsches Zentrum für Herzinsuffizienz, Universität und Universitätsklinikum
Würzburg, Würzburg, Deutschland
| | - Birgit Aßmus
- Kardiologie-Angiologie, Universitätsklinikum Gießen und Marburg, Gießen,
Deutschland
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516
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Abe M, Arima H, Yoshida Y, Fukami A, Sakima A, Metoki H, Tada K, Mito A, Morimoto S, Shibata H, Mukoyama M. Optimal blood pressure target to prevent severe hypertension in pregnancy: A systematic review and meta-analysis. Hypertens Res 2022; 45:887-899. [PMID: 35136186 DOI: 10.1038/s41440-022-00853-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/25/2021] [Accepted: 12/31/2021] [Indexed: 12/25/2022]
Abstract
Severe hypertension in pregnancy is a hypertensive crisis that requires urgent and intensive care due to its high maternal and fetal mortality. However, there is still a conflict of opinion on the recommendations of antihypertensive therapy. This study aimed to identify the optimal blood pressure (BP) levels to prevent severe hypertension in pregnant women with nonsevere hypertension. Ovid MEDLINE and the Cochrane Library were searched, and only randomized controlled trials (RCTs) were included if they compared the effects of antihypertensive drugs and placebo/no treatment or more intensive and less intensive BP-lowering treatments in nonsevere hypertensive pregnant patients. A random effects model meta-analysis was performed to estimate the pooled risk ratio (RR) for the outcomes. Forty RCTs with 6355 patients were included in the study. BP-lowering treatment significantly prevented severe hypertension (RR, 0.46; 95% CI, 0.37-0.56), preeclampsia (RR, 0.82; 95% CI, 0.69-0.98), severe preeclampsia (RR, 0.38; 95% CI, 0.17-0.84), placental abruption (RR, 0.52; 95% CI, 0.32-0.86), and preterm birth (< 37 weeks; RR, 0.81; 95% CI, 0.71-0.93), while the risk of small for gestational age infants was increased (RR, 1.25; 95% CI, 1.02-1.54). An achieved systolic blood pressure (SBP) of < 130 mmHg reduced the risk of severe hypertension to nearly one-third compared with an SBP of ≥ 140 mmHg, with a significant interaction of the BP levels achieved with BP-lowering therapy. There was no significant interaction between the subtypes of hypertensive disorders of pregnancy and BP-lowering treatment, except for placental abruption. BP-lowering treatment aimed at an SBP < 130 mmHg and accompanied by the careful monitoring of fetal growth might be recommended to prevent severe hypertension.
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Affiliation(s)
- Makiko Abe
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
| | - Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Oita, Japan
| | - Ako Fukami
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Atsushi Sakima
- Health Administration Center, University of the Ryukyus, Okinawa, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Kazuhiro Tada
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Asako Mito
- Division of Maternal Medicine, Center for Maternal-Fetal-Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Satoshi Morimoto
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masashi Mukoyama
- Department of Nephrology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
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517
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Détriché G, Guédon A, Mohamedi N, Sellami O, Cheng C, Galloula A, Goudot G, Khider L, Mortelette H, Sitruk J, Gendron N, Sapoval M, Julia P, Smadja DM, Mirault T, Messas E. Women Specific Characteristics and 1-Year Outcome Among Patients Hospitalized for Peripheral Artery Disease: A Monocentric Cohort Analysis in a Tertiary Center. Front Cardiovasc Med 2022; 9:824466. [PMID: 35198617 PMCID: PMC8858944 DOI: 10.3389/fcvm.2022.824466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/17/2022] [Indexed: 12/24/2022] Open
Abstract
Although women have lower age-standardized cardiovascular disease incidence, prevalence, and death-related rates than men, there are also reports indicating that women with cardiovascular disease receive less care, fewer investigations, and have poorer outcomes after a coronary event. The aims of this study were to compare the characteristics of men and women hospitalized for peripheral artery disease (PAD), their cardiovascular and limb outcomes, and their 1-year mortality. The study is a prospective registry collecting data about all consecutive patients hospitalized for PAD within the vascular department of the tertiary center Georges-Pompidou European Hospital (Paris, France). Patients were required to have one of three inclusion criteria: previous revascularization of the lower limb or any lower limb artery occlusion due to an atherosclerotic vascular disease or hemodynamic evidence of PAD. Exclusion criteria were patients with lower extremity arterial occlusion due to another cause. All patients were followed-up for at least 12 months after the initial hospitalization. Among the 235 patients included, there were 61 women (26%), older than men with a median age of 75.6 and 68.3 years, respectively. Main cardiovascular risk factors and comorbidities were similar for men and women except more former or current smokers [145 (83.4%) vs. 33 (54.1%)] and more history of coronary heart disease [42 (24.1%) vs. 7 (11.5%)] in men. Most patients [138 (58.8%)] had critical limb ischemia and 97 (41.3%) had claudication, with no difference for sex. After discharge, 218 patients received an antithrombotic therapy (93.2%), 195 a lipid-lowering drug (83.3%), 185 an angiotensin converting enzyme inhibitor or angiotensin-receptor blocker (78.9%), similarly between sex. At 1-year, overall mortality, major adverse cardiovascular events, major adverse limb events did not differ with 23 (13.2%), 11 (6.3%) and 32 (18.4%) in men, and 8 (13.1%), 3 (4.9%), 15 (24.6%) in women, respectively, despite the difference in age. Overall mortality, cardiovascular outcomes, limb revascularization or amputation did not differ between men and women, 1-year after hospitalization for PAD although the latter were older, less smoker and had less coronary artery disease. Due to the small size of this cohort, larger studies and future research are needed to better understand sex-specific mechanisms in the pathophysiology and natural history of PAD.
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Affiliation(s)
- Grégoire Détriché
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
- *Correspondence: Grégoire Détriché
| | - Alexis Guédon
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Nassim Mohamedi
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Olfa Sellami
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Charles Cheng
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Alexandre Galloula
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Guillaume Goudot
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Paris Research Cardiovascular Center (PARCC), INSERM U970, Paris, France
| | - Lina Khider
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
| | - Hélène Mortelette
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Jonas Sitruk
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Nicolas Gendron
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
- Hematology Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Marc Sapoval
- Université de Paris, Paris Research Cardiovascular Center (PARCC), INSERM U970, Paris, France
- Interventional Radiology Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Universit de Paris (APHP-CUP), Paris, France
| | - Pierre Julia
- Université de Paris, Paris Research Cardiovascular Center (PARCC), INSERM U970, Paris, France
- Vascular Surgery Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - David M. Smadja
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
- Hematology Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
| | - Tristan Mirault
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Paris Research Cardiovascular Center (PARCC), INSERM U970, Paris, France
| | - Emmanuel Messas
- Vascular Medicine Department, Hôpital Europeen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris (APHP-CUP), Paris, France
- Université de Paris, Paris Research Cardiovascular Center (PARCC), INSERM U970, Paris, France
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518
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Dai H, Zhang X, Zhang W, Wang Z, Qiu M. Editorial: The Role of Sex Dimorphism in Disease Susceptibility and Immune Response. Front Nutr 2022; 9:849563. [PMID: 35198592 PMCID: PMC8860246 DOI: 10.3389/fnut.2022.849563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hongji Dai
- Key Laboratory of Molecular Cancer Epidemiology of Tianjin, Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- *Correspondence: Hongji Dai
| | - Xi Zhang
- Clinical Research Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Zheng Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Miaozhen Qiu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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519
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Lander BS, Layton AM, Garofano RP, Schwartz A, Engel DJ, Bello NA. Average Exercise Capacity in Men and Women >75 Years of Age Undergoing a Bruce Protocol Exercise Stress Test. Am J Cardiol 2022; 164:21-26. [PMID: 34844736 PMCID: PMC8727541 DOI: 10.1016/j.amjcard.2021.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 02/03/2023]
Abstract
Exercise stress testing is routinely performed to evaluate suspected coronary artery disease in older adults. However, the available data to predict and compare relative exercise capacity in the general population were developed using predominantly younger, healthy cohorts with few or no women. This study aimed to describe the exercise capacity of patients older than 75 years who underwent a clinically indicated Bruce protocol exercise stress test. This was a retrospective, cross-sectional study of 2,041 consecutive patients older than 75 years who performed a Bruce protocol exercise stress echocardiogram that was terminated because of maximal effort without ischemia at Columbia University Medical Center between April 10, 2009, and July 30, 2020. The analytic sample included 2,041 exercise stress tests in 786 women (median [interquartile range] age 79 [77 to 81] years) and 1,255 men (median [interquartile range] age 79 [77 to 82] years). Cardiovascular risk factors and clinical coronary disease were common and more prevalent in men than women. The median exercise time for men aged 76 to 80 years was 7:22 (minutes:seconds) and for women was 6:00 and significantly decreased in both genders as age increased (p <0.001). The mean (SD) METs achieved for women and men were 6.5 (1.6) and 7.7 (1.7), respectively. Most women (85%) and men (95%) completed the first stage, whereas only 32% of women and 64% of men completed the second stage. It was uncommon for women (3%) or men (15%) to complete the third stage. Fewer than 1% of patients completed the fourth stage, and none completed the fifth stage. At all ages, women had a lower exercise capacity than men. These data allow physicians to compare the exercise capacity of older patients who underwent a Bruce protocol exercise stress test more accurately to a representative sample of similarly aged adults.
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Affiliation(s)
- Bradley S. Lander
- Department of Medicine, Seymour, Paul and Gloria Milstein Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Aimee M. Layton
- Cardiopulmonary Exercise Laboratory, Department of Pediatrics, Division of Pediatric Cardiology, Columbia University, New York, NY, USA
| | - Robert P. Garofano
- Cardiopulmonary Exercise Laboratory, Department of Pediatrics, Division of Pediatric Cardiology, Columbia University, New York, NY, USA
| | - Allan Schwartz
- Department of Medicine, Seymour, Paul and Gloria Milstein Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA
| | - David J. Engel
- Department of Medicine, Seymour, Paul and Gloria Milstein Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Natalie A. Bello
- Department of Medicine, Seymour, Paul and Gloria Milstein Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA.,Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
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520
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Du Y, Xia S, Zhang J, Zhang L, Liu J. Plasma folate deficiency increases the risk for abnormal blood pressure in Chinese women of childbearing age. Nutr Res 2022; 98:9-17. [DOI: 10.1016/j.nutres.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
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521
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Burgess SN. Understudied, Under-Recognized, Underdiagnosed, and Undertreated: Sex-Based Disparities in Cardiovascular Medicine. Circ Cardiovasc Interv 2022; 15:e011714. [PMID: 35067073 DOI: 10.1161/circinterventions.121.011714] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Sonya N Burgess
- Department of Cardiology, Nepean Hospital, Sydney.,University of Sydney, NSW, Australia
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522
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Zhu Y, Guo P, Zou Z, Li X, Cao M, Ma J, Jing J. Status of Cardiovascular Health in Chinese Children and Adolescents. JACC: ASIA 2022; 2:87-100. [PMID: 36340258 PMCID: PMC9627810 DOI: 10.1016/j.jacasi.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/15/2021] [Accepted: 09/19/2021] [Indexed: 01/14/2023]
Abstract
Background The American Heart Association defined “ideal cardiovascular health (CVH)” in pediatric populations to promote primordial prevention in cardiovascular diseases. Little is known about CVH and associated sociodemographic factors among Chinese children and adolescents. Objectives This study aimed to evaluate CVH and the associations with sociodemographic characteristics in Chinese children and adolescents. Methods This cross-sectional study analyzed baseline data of 15,583 participants aged 7 to 17 years from a Chinese national intervention program against obesity (2013-2014). CVH status was estimated according to 4 health behaviors (nonsmoking, body mass index, physical activity, and diet) and 3 health factors (total cholesterol, blood pressure, and fasting plasma glucose), using revised American Heart Association criteria. Multinomial logistic regression was used to assess the association between sociodemographic characteristics and the number of ideal CVH metrics. Results The prevalence of ideal CVH status was 1.7% (males: 1.9%; females: 1.6%) in the study population. The prevalence of ideal CVH behaviors and ideal health factors was 3.1% (males 3.3%; females: 3.0%) and 53.6% (males: 52.4%; females: 54.9%), respectively. Ideal fasting plasma glucose was the most prevalent component (males: 94.4%; females: 97.4%), whereas ideal physical activity (males: 34.6%; females: 23.9%) and diet (males: 28.3%; females: 30.1%) were the least prevalent. Female sex, younger age, undeveloped economy, residence in the southern region, and no family history of cardiovascular diseases were associated with more ideal CVH metrics. Conclusions Ideal CVH status in Chinese children and adolescents is alarmingly rare. Physical activity and diet are key to promotion of CVH. Effective interventions are needed to promote CVH and reduce health disparities in early life.
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523
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Thompson KJ. Inclusivity starts with language. Lancet 2022; 399:434. [PMID: 35093225 DOI: 10.1016/s0140-6736(21)02495-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/10/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Kelly Jane Thompson
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia.
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524
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Focus on today's evidence while keeping an eye on the future: lessons derived from hypertension in women. J Hum Hypertens 2022; 36:882-886. [PMID: 35082377 DOI: 10.1038/s41371-021-00652-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/13/2021] [Accepted: 12/21/2021] [Indexed: 12/17/2022]
Abstract
While evidence-based medicine has contributed enormously to the uniformity and rationale of patient care, it is necessary that we anticipate changes in order to implement their rapid translation to practice. The purpose of this review is to expose three issues regarding cardiovascular health in women, including milestones to reflect the pace at which these are incorporated into public policies. Two of these matters, as changes in the thresholds of normal blood pressure in gestation and in nonpregnant women, need further evidence and deserve to be retrospectively analyzed in high-quality databases. The third subject derives from the association of remote cardiovascular complications of hypertensive pregnancies, an example of the unnecessary delay of more than two decades to install a wide prevention strategy when the health system is not on the watch.
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525
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Gender and Social Inequalities in Awareness of Coronary Artery Disease in European Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031388. [PMID: 35162415 PMCID: PMC8835179 DOI: 10.3390/ijerph19031388] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 12/13/2022]
Abstract
Coronary artery disease (CAD) is the single leading cause of death in Europe and the most common form of cardiovascular disease. Little is known about awareness in the European population. A cross-sectional telephone survey of 2609 individuals from six European countries was conducted to gather information on perceptions of CAD, risk factors, preventive measures, knowledge of heart attack symptoms and ability to seek emergency medical care. Level of awareness was compared according to gender, age, socioeconomic status (SES) and educational level. Women were approximately five times less likely than men to consider heart disease as a main health issue or leading cause of death (OR = 0.224, 95% CI: 0.178–0.280, OR = 0.196, 95% CI: 0.171–0.226). Additionally, women were significantly less likely to have ever had a cardiovascular screening test (OR = 0.515, 95% CI: 0.459–0.578). Only 16.3% of men and 15.3% of women were able to spontaneously identify the main symptoms of a heart attack. Almost half of the sample failed to state that they would call emergency services in case of a cardiac event. Significant differences according to age, SES and education were found for many indicators amongst both men and women. Development of a European strategy targeting improved awareness of CAD and reduced gender and social inequalities within the European population is warranted.
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526
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Jackson J, Alkhalil M, Ratcovich H, Wilkinson C, Mehran R, Kunadian V. Evidence base for the management of women with non-ST elevation acute coronary syndrome. BRITISH HEART JOURNAL 2022; 108:1682-1689. [DOI: 10.1136/heartjnl-2021-320533] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/30/2021] [Indexed: 12/23/2022]
Abstract
According to the Global Burden of Disease study, in 2019, there were an estimated 275.2 million cases of cardiovascular disease (CVD) in women worldwide. Although there was a decrease in the global age-standardised prevalence of CVD in women between 1990 and 2010 (–5.8%), there has been a slight increase (1.0%) since 2010. There were an estimated 6.10 million deaths from CVD in women in 1990, rising to 8.94 million in 2019. Hospital admissions of young women with acute myocardial infarction (AMI) steadily increased from 27% in 1995–1999 to 32% in 2010–2014. Women with AMI compared with men are less likely to receive guideline-indicated pharmacological (aspirin 93.4% vs 94.7%, P2Y12 inhibitors 79.3% vs 86.1% and statins 73.7% vs 77.5%) and revascularisation treatments (angiography (adjusted OR (aOR) 0.71), percutaneous coronary intervention (aOR 0.73)). Women represent <39% of clinical cardiovascular trial participants between 2010 and 2017. Major factors of under-representation in studies included concerns about the burden of participation on health and time. Women were more likely than men to document caring responsibilities as reasons for not participating in a clinical trial. Current clinical practice guidelines recommending risk stratification to guide the appropriateness of an invasive strategy in the context of acute coronary syndrome (ACS) may not be applicable to women given lack of studies specifically evaluating women using contemporary treatment strategies. In our review, we identify significant limitations in the evidence base for the best care of women with ACS, emphasising the need for well-designed clinical trials specifically recruiting women.
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527
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Coronary Artery Disease and Cancer: Treatment and Prognosis Regarding Gender Differences. Cancers (Basel) 2022; 14:cancers14020434. [PMID: 35053596 PMCID: PMC8774086 DOI: 10.3390/cancers14020434] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/04/2022] [Accepted: 01/12/2022] [Indexed: 12/27/2022] Open
Abstract
Simple Summary Cardiovascular disease and cancer are the leading causes of hospitalization and mortality in high-income countries. Studies of myocardial infarction show a disadvantage for the female sex in terms of survival and development of heart failure after myocardial infarction. The extent to which this also applies to the co-occurrence of coronary heart disease and cancer was investigated and analyzed here in large registry studies. Particular attention has been paid to the four most common cancers and hematologic diseases associated with coronary artery disease requiring treatment. Abstract Cardiovascular disease and cancer remain the leading causes of hospitalization and mortality in high-income countries. Survival after myocardial infarction has improved but there is still a difference in clinical outcome, mortality, and developing heart failure to the disadvantage of women with myocardial infarction. Most major cardiology trials and registries have excluded patients with cancer. As a result, there is only very limited information on the effects of coronary artery disease in cancer patients. In particular, the outcomes in women with cancer and coronary artery disease and its management remain empiric. We reviewed studies of over 27 million patients with coronary artery disease and cancer. Our review focused on the most important types of cancer (breast, colon, lung, prostate) and hematological malignancies with particular attention to sex-specific differences in treatment and prognosis.
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528
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Gulati M, Hendry C, Parapid B, Mulvagh SL. Why We Need Specialised Centres for Women's Hearts: Changing the Face of Cardiovascular Care for Women. Eur Cardiol 2022; 16:e52. [PMID: 35024054 PMCID: PMC8728884 DOI: 10.15420/ecr.2021.49] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/19/2021] [Indexed: 11/05/2022] Open
Abstract
Although cardiovascular disease (CVD) is the leading cause of mortality in women globally, cardiovascular care for women remains suboptimal, with poorer outcomes than for men. During the past two decades, there has been an incremental increase in research and publications on CVD in women, addressing sex-specific risk factors, symptoms, pathophysiology, treatment, prevention and identification of inequities in care. Nonetheless, once women have manifested CVD, they continue to have increasingly worse outcomes than men. An approach to addressing these global disparities has been the worldwide establishment of specialised centres providing cardiovascular care for women. These women’s heart centres (WHCs) allow a comprehensive approach to the cardiovascular care of women across the lifespan. The purpose of this article is to define the need for and role of these specialised centres by outlining sex-specific gaps in CVD care, and to provide guidance on components within WHCs that may be considered when establishing such programmes.
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Affiliation(s)
- Martha Gulati
- Division of Cardiology, University of Arizona Phoenix, AZ, US
| | - Cara Hendry
- Manchester Heart Institute, Manchester University Hospital NHS Trust Manchester, UK
| | | | - Sharon L Mulvagh
- Division of Cardiology, Department of Medicine, Dalhousie University Halifax, Nova Scotia, Canada.,Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN, US
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529
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Bühler A, Willmund GD. Adherence and Psychosocial Well-Being During Pandemic-Associated Pre-deployment Quarantine. Front Public Health 2022; 9:802180. [PMID: 35004600 PMCID: PMC8727777 DOI: 10.3389/fpubh.2021.802180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: With the purpose of preventing SARS-Cov-2 traveling with the troops, pre-deployment and post-deployment quarantine are mandatory for the German military. This study investigates which factors could be addressed in order to facilitate adherence and mental health during isolation. Method: Six hundred three soldiers completed questionnaires at the beginning and at the end of pre-deployment quarantine: Mini-SCL (BSI), Perceived Social Support (FSozU-K22), Unit Cohesion, Military Quarantine Adherence Questionnaire (MQAQ), and quarantine-associated factors including informedness about Covid-19, perceived individual risk, benefit of quarantine, clarity of quarantine protocol, need of intimacy, social norms, stigma, practicality of the quarantine, financial disadvantages, boredom, and health promoting leadership. Results: Using stepwise regression analyses, up to 57% of the quarantine adherence was explained by social norms, boredom, perceived benefit/effectiveness of the quarantine, clear communication of the quarantine protocol and perceived risk of an infection, with social norms explaining 43%. In respect to mental health (Mini-SCL) at the beginning of quarantine, only 15% is explained by being in a partnership, (un)fulfilled need for bonding/intimacy, perceived unit cohesion, and perceived social support. Up to 20 % of the variance in mental health at the end of quarantine is explained by accumulated days of isolation before pre-deployment quarantine, age, clear communication of the quarantine protocol, perceived social support, fulfilled need for bonding/intimacy and perceived stigma. Mental health and quarantine adherence did correlate significantly, but to a slight extent. No differences between the beginning and the end of pre-deployment quarantine were found for the overall group in respect to mental health, quarantine adherence, perceived social support and perceived unit cohesion, while their trajectories differed for different subgroups including age, gender, rank, and accumulated days of quarantine: With increasing accumulated days of isolation prior to pre-deployment quarantine, mental health declined over the course of quarantine, though to a small degree. Conclusion: Findings suggest that addressing the norms of fellow soldiers and dependents alike could contribute to quarantine adherence in pre-deployment quarantine. Ongoing research should examine long-term effects on mental health, including these of accumulated days of quarantine, also taking into account post-deployment quarantine.
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Affiliation(s)
- Antje Bühler
- German Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
| | - Gerd-Dieter Willmund
- German Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
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530
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Sadegh-Zadeh SA, Bahrami M, Najafi A, Asgari-Ahi M, Campion R, Hajiyavand AM. Evaluation of COVID-19 pandemic on components of social and mental health using machine learning, analysing United States data in 2020. Front Psychiatry 2022; 13:933439. [PMID: 36003977 PMCID: PMC9393328 DOI: 10.3389/fpsyt.2022.933439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/12/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND COVID-19 was named a global pandemic by the World Health Organization in March 2020. Governments across the world issued various restrictions such as staying at home. These restrictions significantly influenced mental health worldwide. This study aims to document the prevalence of mental health problems and their relationship with the quality and quantity of social relationships affected by the pandemic during the United States national lockdown. METHODS Sample data was employed from the COVID-19 Impact Survey on April 20-26, 2020, May 4-10, 2020, and May 30-June 8, 2020 from United States Dataset. A total number of 8790, 8975, and 7506 adults participated in this study for April, May and June, respectively. Participants' mental health evaluations were compared clinically by looking at the quantity and quality of their social ties before and during the pandemic using machine learning techniques. To predict relationships between COVID-19 mental health and demographic and social factors, we employed random forest, support vector machine, Naive Bayes, and logistic regression. RESULTS The result for each contributing feature has been analyzed separately in detail. On the other hand, the influence of each feature was studied to evaluate the impact of COVID-19 on mental health. The overall result of our research indicates that people who had previously been diagnosed with any type of mental illness were most affected by the new constraints during the pandemic. These people were among the most vulnerable due to the imposed changes in lifestyle. CONCLUSION This study estimates the occurrence of mental illness among adults with and without a history of mental disease during the COVID-19 preventative limitations. With the persistence of quarantine limitations, the prevalence of psychiatric issues grew. In the third survey, which was done under quarantine or house restrictions, mental health problems and acute stress reactions were substantially greater than in the prior two surveys. The findings of the study reveal that more focused messaging and support are needed for those with a history of mental illness throughout the implementation of restrictions.
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Affiliation(s)
| | - Mahboobe Bahrami
- Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirreza Najafi
- Department of Information Technology Engineering, Tarbiat Modares University, Tehran, Iran
| | - Meisam Asgari-Ahi
- Department of Information Technology Management, University of Tehran, Tehran, Iran
| | - Russell Campion
- Department of Computing, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Amir M Hajiyavand
- Department of Mechanical Engineering, School of Engineering, University of Birmingham, Birmingham, United Kingdom
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531
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Mamas MA, Van Spall HG. Why is it important for male cardiologists to enroll more women in cardiovascular trials? AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 13:100090. [PMID: 38560079 PMCID: PMC10978214 DOI: 10.1016/j.ahjo.2022.100090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/31/2021] [Accepted: 01/01/2022] [Indexed: 04/04/2024]
Affiliation(s)
- Mamas A. Mamas
- Keele Cardiovascular Research Group, School of Medicine, Keele University, UK
| | - Harriette G.C. Van Spall
- Department of Medicine, McMaster University, Hamilton, Canada
- Population Health Research Institute, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
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532
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Kesavadev J, Abraham G, Chandni R, Chawla P, Nambiar A, Deshpande N, Joshi S, Jothydev S, Krishnan G, Das AK. Type 2 Diabetes in Women: Differences and Difficulties. Curr Diabetes Rev 2022; 18:e081221198651. [PMID: 34879808 DOI: 10.2174/1573399818666211208110759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Lifestyle modification, along with medication, has improved the quality of life of patients with type 2 diabetes (T2D), but the treatment of diabetes in women still lacks a gender-centric approach. METHODS Expert opinions to improve diabetes management in women were collated from the open discussion forum organized by the sixth Jothydev's Professional Education Forum Diabetes Convention, which included global diabetes care experts and the general public. The review is also based on the studies published in electronic databases such as PubMed and Google Scholar that discussed the problems and challenges faced by the Indian diabetes care sector in treating women with diabetes. RESULTS The complex interplay of biological, socioeconomic, psychosocial, and physiological factors in women with type 2 diabetes has not been well addressed to date. Biological factors such as neurohumoral pathways, sex hormones, genetic predisposition as well as gender-based environmental and behavioural differences must be considered for modern personalized diabetes treatment. Most importantly, pregnant women with diabetes deserve special attention. This vulnerable phase has a marked impact on the future health of both the mother and the offspring. CONCLUSION The review provides an overview of the challenges and issues that exist in the clinical management of diabetes and its complications among women in India. Women-centric clinical approaches should be encouraged for the effective management of diabetes in Indian women.
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Affiliation(s)
- Jothydev Kesavadev
- Department of Diabetology, Jothydev's Diabetes Research Centre, Trivandrum, Kerala, India
| | - Georgi Abraham
- Madras Medical Mission Hospital, Chennai, Tamil Nadu, India
| | - R Chandni
- Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala, India
| | - Purvi Chawla
- Lina Diabetes Care & Mumbai Diabetes Research Centre, Bhartia Arogya Nidhi Hospital, Mumbai, Maharashtra, India
| | - Anita Nambiar
- Gopal Clinic & Diabetic Care Centre, Tripunithura, Kerala, India
| | - Neeta Deshpande
- Belgaum Diabetes Centre, Children's Diabetes Centre and Weight Watch Centre, Belgaum, India
- Department of Medicine, MM Dental College, Belgaum, India
- 8USM-KLE International Medical Program, Belgaum, Karnataka, India
| | - Shilpa Joshi
- 8USM-KLE International Medical Program, Belgaum, Karnataka, India
| | - Sunitha Jothydev
- Department of Diabetology, Jothydev's Diabetes Research Centre, Trivandrum, Kerala, India
| | - Gopika Krishnan
- Department of Diabetology, Jothydev's Diabetes Research Centre, Trivandrum, Kerala, India
| | - Ashok Kumar Das
- Mumbai Diet and Health Centre, Mumbai, Maharashtra, India
- Pondicherry Institute of Medical Sciences, Pondicherry, Tamil Nadu, India
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533
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An opportunity to improve secondary prevention with icosapent ethyl in patients who have undergone coronary artery bypass graft surgery. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2021; 41:170-172. [PMID: 34974987 DOI: 10.1016/j.carrev.2021.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Icosapent ethyl reduces cardiovascular events in high-risk patients with hypertriglyceridaemia on statin therapy. However, it is not widely available and the potential application following coronary artery bypass graft (CABG) surgery is not well-established. We aimed to determine the real-world percentage of CABG surgery patients who may be eligible for the therapy. METHODS A retrospective analysis was performed between February 2015 and August 2020 in an Australian hospital. Patients were included if a lipid profile was performed at least three weeks following CABG surgery. Data was extracted from electronic medical records. Eligibility for icosapent ethyl was defined according to inclusion criteria from the REDUCE-IT trial. RESULTS Of 484 patients with follow-up lipid profiles, 21 (4.3%) were not eligible for icosapent ethyl based on age and 39 (8.1%) were not prescribed statin therapy or were prescribed a fibrate. After applying triglyceride and low-density lipoprotein cholesterol level criteria, 124 (25.6%) patients were potentially eligible for icosapent ethyl therapy. Of those eligible, high-intensity statin therapy were prescribed in 108 (87.1%). DISCUSSION A substantial percentage of CABG surgery patients may be eligible for icosapent ethyl and could potentially benefit from its cardiovascular protection. Further research should evaluate the additional cardiovascular benefits of icosapent ethyl in this very high-risk group of patients who are already treated with high-intensity statins.
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534
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Gomes CS, Gonçalves RPF, Silva AGD, Sá ACMGND, Alves FTA, Ribeiro ALP, Malta DC. Factors associated with cardiovascular disease in the Brazilian adult population: National Health Survey, 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210013. [PMID: 34910067 DOI: 10.1590/1980-549720210013.supl.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/13/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to estimate the prevalence and investigate the sociodemographic, health, and lifestyle factors associated with the self-reported diagnosis of Cardiovascular Disease (CVD) in the adult Brazilian population. METHODS Data from the National Health Survey (PNS 2019) were analyzed. The presence of CVD was self-reported through the question: "Has any doctor ever given you a diagnosis of heart disease?". Sociodemographic factors, health conditions, and lifestyle were evaluated. For data analysis, Poisson Regression with robust variance was used. RESULTS 5.3% (95%CI 5.04-5.57) of Brazilian adults reported CVD, of which, 29.08% (95%CI 27.04-31.21) underwent coronary artery bypass surgery or angioplasty and 8.26% (95%CI 7.09-9.6) reported severe limitation in usual activities due to CVD. The factors associated with CVD were advanced age; being male; white race/color; complete middle school and incomplete high school education; have health insurance; self-assessing health as regular or bad/very bad; self-reported hypertension, high cholesterol, and diabetes; being a former smoker; consuming fruits and vegetables as recommended; not consuming alcohol in excess; and not practicing leisure-time physical activity. CONCLUSIONS CVD is associated with sociodemographic, health, and lifestyle factors. It is important to support public policies, programs, and goals for the reduction of cardiovascular diseases in Brazil, especially in the most vulnerable groups.
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Affiliation(s)
- Crizian Saar Gomes
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Renata Patrícia Fonseca Gonçalves
- Postgraduate Program in Health Education, Department of Nursing, Universidade Federal dos Vales do Jequitinhonha e Mucuri - Diamantina (MG), Brazil
| | - Alanna Gomes da Silva
- Postgraduate Program in Nursing, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | | | | | - Antonio Luiz Pinho Ribeiro
- Hospital das Clínicas, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Deborah Carvalho Malta
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.,Postgraduate Program in Nursing, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.,Maternal and Child Department, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
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535
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Marill MC. Getting To The Heart Of America's Maternal Mortality Crisis. Health Aff (Millwood) 2021; 40:1824-1829. [PMID: 34871087 DOI: 10.1377/hlthaff.2021.01702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A Missouri cardio-obstetrics program and a national registry target the leading cause of maternal death.
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Affiliation(s)
- Michele Cohen Marill
- This article is part of a series on transforming health systems published with support from The Robert Wood Johnson Foundation. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt, and build upon this work, for commercial use, provided the original work is properly cited. See https://creativecommons.org/licenses/by/4.0/. Michele Cohen Marill is a freelance reporter based in Atlanta, Georgia. The patient referred to as Megan requested the use of only her first name to protect her privacy
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536
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Crescioli C. The Role of Estrogens and Vitamin D in Cardiomyocyte Protection: A Female Perspective. Biomolecules 2021; 11:1815. [PMID: 34944459 PMCID: PMC8699224 DOI: 10.3390/biom11121815] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 12/20/2022] Open
Abstract
Women experience a dramatical raise in cardiovascular events after menopause. The decline in estrogens is pointed to as the major responsible trigger for the increased risk of cardiovascular disease (CVD). Indeed, the menopausal transition associates with heart macro-remodeling, which results from a fine-tuned cell micro-remodeling. The remodeling of cardiomyocytes is a biomolecular response to several physiologic and pathologic stimuli, allowing healthy adaptation in normal conditions or maladaptation in an unfavorable environment, ending in organ architecture disarray. Estrogens largely impinge on cardiomyocyte remodeling, but they cannot fully explain the sex-dimorphism of CVD risk. Albeit cell remodeling and adaptation are under multifactorial regulation, vitamin D emerges to exert significant protective effects, controlling some intracellular paths, often shared with estrogen signaling. In post-menopause, the unfavorable association of hypoestrogenism-D hypovitaminosis may converge towards maladaptive remodeling and contribute to increased CVD risk. The aim of this review is to overview the role of estrogens and vitamin D in female cardiac health, speculating on their potential synergistic effect in cardiomyocyte remodeling, an issue that is not yet fully explored. Further learning the crosstalk between these two steroids in the biomolecular orchestration of cardiac cell fate during adaptation may help the translational approach to future cardioprotective strategies for women health.
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Affiliation(s)
- Clara Crescioli
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
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537
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Kemp KA, Norris CM, Steele B, Fairie P, Santana MJ. Sex Differences in the Care Experiences of Patients Hospitalized Due to Ischemic Heart Disease in Alberta, Canada. CJC Open 2021; 3:S36-S43. [PMID: 34993432 PMCID: PMC8712602 DOI: 10.1016/j.cjco.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/24/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Women with heart disease experience disparities in the diagnosis, treatment, and management of their condition. However, it is unknown whether these sex differences exist with respect to in-hospital patient experience. We examined the comprehensive experience of patients hospitalized due to ischemic heart disease (IHD) across Alberta, Canada, according to sex. METHODS Patients completed a modified version of the Canadian Patient Experiences Survey-Inpatient Care (CPES-IC) within 6 weeks of discharge. We examined 37 questions, including 33 regarding specific care processes and 4 global rating scales. Survey responses were reported as raw "top-box" percentages, that is, the most-positive answer choice to each question. Odds and corresponding 95% confidence intervals of women reporting a top-box response were then calculated for each question, while controlling for demographic and clinical factors. RESULTS From April 2014 to March 2020, a total of 5795 surveys (1612 women, 4183 men) were completed. Taking the survey margin of error into account, women had lower top-box percentages on 26 of 37 questions. Similar results were obtained for the adjusted odds of reporting a top-box response. Women did not have a higher percentage of top-box responses on any of the questions studied. CONCLUSIONS This study is a Canadian first, which stratified the experiences of hospitalized patients living with ischemic heart disease according to sex. Our results highlighted important sex differences. Future research to understand the mechanisms associated with these observed sex differences in patient-reported experiences is warranted.
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Affiliation(s)
- Kyle A. Kemp
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Patient Engagement Platform, Alberta Strategy for Patient-Oriented Research (SPOR), Calgary, Alberta, Canada
| | - Colleen M. Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Cardiovascular Health and Stroke Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - Brian Steele
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Paul Fairie
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Patient Engagement Platform, Alberta Strategy for Patient-Oriented Research (SPOR), Calgary, Alberta, Canada
| | - Maria J. Santana
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Patient Engagement Platform, Alberta Strategy for Patient-Oriented Research (SPOR), Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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538
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Davis LL. Improving Outcomes for Women With Heart Disease: Implications for Nurse Practitioners. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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539
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Omaña-Guzmán LI, Ortiz-Hernández L, Ancira-Moreno M, Morales-Hernández V, O’Neill MS, Vadillo-Ortega F. Association of pre-pregnancy body mass index and rate of weight gain during pregnancy with maternal indicators of cardiometabolic risk. Nutr Diabetes 2021; 11:36. [PMID: 34824195 PMCID: PMC8616911 DOI: 10.1038/s41387-021-00178-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/17/2021] [Accepted: 10/29/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND/OBJECTIVE Changes in metabolism and extensive hemodynamic adjustments occur during normal pregnancy. The presence of maternal obesity imposes an overload to these physiological adaptations that may result in increased risk for the development of cardiometabolic complications during and after pregnancy. The aim of this study is to describe total cholesterol (TC), triglycerides (TG), glucose, and arterial blood pressure (BP) trajectories and to analyze the association of these cardiometabolic risk indicators during pregnancy with pre-pregnancy body mass index (pBMI) and monthly gestational weight gain (MGWG). SUBJECTS/METHODS A prospective cohort study of pregnant women was conducted in Mexico City. Monthly samples of blood were taken during clinical follow-up and biochemical and blood pressure were measured during each visit. Adjusted linear mixed-effect regression models were fit to describe the trajectories of these biomarkers during pregnancy and to analyze the association with pBMI and MGWG. RESULTS Seven hundred and twenty women were included of which 16.6% had pre-gestational obesity, 33.2% had pre-gestational overweight, 45.8% had normal pBMI and 4.4% had pre-gestational underweight. Women with pre-gestational obesity had higher lipids concentrations in the beginning of pregnancy (TC: [Formula: see text] = 33.08, p = 0.010; TG: [Formula: see text] = 31.29, p = <0.001) but the concentrations increased less than in women with normal pBMI (TC: [Formula: see text] = -14.18, p = 0.001; TG: [Formula: see text] = -5.42, p < 0.001). By the end of pregnancy, women with pre-gestational obesity had lower concentrations of lipids than women with normal pBMI. By contrast, women with pre-gestational obesity had higher glucose concentrations and higher BP levels than women with normal pBMI over pregnancy. CONCLUSIONS pBMI is differentially associated with longitudinal trajectories of maternal biochemical markers of cardiometabolic risk. MGWG did not significantly affect the biochemical indicators or BP trajectories. Our results suggest that pBMI is more relevant to predicting adverse cardiometabolic markers trajectories during pregnancy than MGWG.
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Affiliation(s)
- Luz Isabel Omaña-Guzmán
- grid.7220.70000 0001 2157 0393Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico ,grid.452651.10000 0004 0627 7633Unidad de Vinculación Científica de la Facultad de Medicina UNAM, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Luis Ortiz-Hernández
- grid.7220.70000 0001 2157 0393Departamento de Atención a la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Mónica Ancira-Moreno
- grid.441047.20000 0001 2156 4794Departamento de Salud, Universidad Iberoamericana, Mexico City, Mexico
| | - Vanesa Morales-Hernández
- grid.419218.70000 0004 1773 5302Biología de la Reproducción, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Marie S. O’Neill
- grid.214458.e0000000086837370Epidemiology and Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI USA
| | - Felipe Vadillo-Ortega
- grid.452651.10000 0004 0627 7633Unidad de Vinculación Científica de la Facultad de Medicina UNAM, Instituto Nacional de Medicina Genómica, Mexico City, Mexico ,grid.214458.e0000000086837370Epidemiology and Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI USA
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540
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Sayyad N, Maji R, Omolo CA, Ganai AM, Ibrahim UH, Pathan TK, Devnarain N, Karpoormath R, Dhawan S, Obakachi VA, Merugu SR, Kayamba F, Mahlalela M, Govender T, Tzakos AG, Singh S. Development of niosomes for encapsulating captopril-quercetin prodrug to combat hypertension. Int J Pharm 2021; 609:121191. [PMID: 34670120 DOI: 10.1016/j.ijpharm.2021.121191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 12/18/2022]
Abstract
Novel and effective anti-hypertensive agents are required to manage hypertension; therefore, we synthesised a novel antihypertensive drug from captopril and quercetin (cap-que) and explored its antihypertensive potential in a niosomal formulation via molecular hybridisation. The cap-que hybrid was synthesised, and its structure was characterised via NMR, FTIR, and HRMS. Niosomes were then loaded with cap-que using the thin-film hydration method. The particle size, polydispersity index, surface charge and drug entrapment efficiency (EE%) of the formulation were 418.8 ± 4.21 nm, 0.393 ± 0.063, 16.25 ± 0.21 mV, and 87.74 ± 2.82%, respectively. The drug release profile showed a sustained release of the active compound (43 ± 0.09%) from the niosomal formulation, compared to the parent drug (80.7 ± 4.68%), over 24 h. The cell viability study confirmed the biosafety of the formulation. The in vivo study in a rat model showed enhanced antihypertensive activity of the hybrid molecule and niosomal formulation which reduced systolic and diastolic pressure when compared to the individual, bare drugs. The findings of this study concluded that the antihypertensive potential of captopril can be enhanced by its hybridisation with quercetin, followed by niosomal nano drug delivery.
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Affiliation(s)
- Nisar Sayyad
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa
| | - Ruma Maji
- Department of Pharmaceutics, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu Natal, (Westville Campus), Private Bag X54001, Durban, South Africa
| | - Calvin A Omolo
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa; United States International University-Africa, School of Pharmacy and Health Sciences, Department of Pharmaceutics, P.O. Box 14634-00800, Nairobi, Kenya
| | - Ab Majeed Ganai
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa
| | - Usri H Ibrahim
- Department of Pharmaceutics, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu Natal, (Westville Campus), Private Bag X54001, Durban, South Africa
| | - Tabasum Khan Pathan
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa
| | - Nikita Devnarain
- Department of Pharmaceutics, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu Natal, (Westville Campus), Private Bag X54001, Durban, South Africa
| | - Rajshekhar Karpoormath
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa.
| | - Sanjeev Dhawan
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa
| | - Vincent A Obakachi
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa
| | - Srinivas Reddy Merugu
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa
| | - Francis Kayamba
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa
| | - Mavela Mahlalela
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa
| | - Thirumala Govender
- Department of Pharmaceutics, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu Natal, (Westville Campus), Private Bag X54001, Durban, South Africa
| | - Andreas G Tzakos
- Section of Organic Chemistry and Biochemistry, Department of Chemistry, University of Ioannina, Ioannina 45110, Greece
| | - Sima Singh
- Department of Pharmaceutical Chemistry, Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa
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541
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Kimenai DM, Shah ASV, Mills NL. A sex-specific prediction model is not enough to achieve equality for women in preventative cardiovascular medicine. Eur Heart J 2021; 43:239-240. [PMID: 34791170 PMCID: PMC8790764 DOI: 10.1093/eurheartj/ehab759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Dorien M Kimenai
- BHF Centre for Cardiovascular Science, University of Edinburgh, Chancellors Building, 49 Little France Crescent, Edinburgh EH16 4SA, UK
| | - Anoop S V Shah
- Department of Non-Communicable Disease, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Nicholas L Mills
- BHF Centre for Cardiovascular Science, University of Edinburgh, Chancellors Building, 49 Little France Crescent, Edinburgh EH16 4SA, UK.,Usher Institute, University of Edinburgh, NINE, 9 Little France Road, Edinburgh BioQuarter, Edinburgh EH16 4UX, UK
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542
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Kringeland E, Tell GS, Midtbø H, Igland J, Haugsgjerd TR, Gerdts E. Response to 'Letter to the Editor' by Rognstad et al. Eur J Prev Cardiol 2021; 29:e172. [PMID: 34751770 DOI: 10.1093/eurjpc/zwab188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ester Kringeland
- Department of Clinical Science, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009 Bergen, Norway
| | - Helga Midtbø
- Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009 Bergen, Norway
| | - Teresa R Haugsgjerd
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009 Bergen, Norway
| | - Eva Gerdts
- Department of Clinical Science, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway
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543
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Cook S, Matthews S, Murray S, Bueser T, Wynne R, Clayton T, Sanders J. Wonder women: wondering where the women in cardiovascular trials are? Eur J Cardiovasc Nurs 2021; 20:629-630. [PMID: 34431995 DOI: 10.1093/eurjcn/zvab074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 08/16/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Samantha Cook
- St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Stacey Matthews
- Heart Foundation, Level 2 850 Collins Street, Docklands, VIC 3008, Australia
| | - Sarah Murray
- Lay Representative Group, Society of Cardiothoracic Society of Great Britain and Ireland, 35-43 Lincoln's Inn Fields, London WC2A 3PE, UK
| | - Teofila Bueser
- St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Rochelle Wynne
- Western Sydney Nursing & Midwifery Research Centre, Research & Education Network WSLHD and Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Tim Clayton
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Julie Sanders
- St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK.,William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
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544
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Mihailidou AS, Gulati M. Impact of hypertensive disorders of pregnancy: lessons from CONCEPTION. Eur Heart J 2021; 43:3362-3364. [PMID: 34661641 DOI: 10.1093/eurheartj/ehab666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Anastasia S Mihailidou
- Department of Cardiology and Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia.,Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
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545
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Aljadeeah S, Nagel E, Wirtz VJ. Outpatient cardiovascular diseases and diabetes medicines dispensing in the population with government health insurance in Syria between 2018 and 2019: a retrospective analysis. BMC Health Serv Res 2021; 21:1088. [PMID: 34645430 PMCID: PMC8515648 DOI: 10.1186/s12913-021-07124-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/27/2021] [Indexed: 12/03/2022] Open
Abstract
Background Low- and middle-income countries bear the highest burden of non-communicable diseases (NCDs) mortality and morbidity. Syria has undergone an epidemiological transition from infectious diseases to NCDs in the past decades. Despite the high prevalence of cardiovascular diseases (CVDs) and diabetes in Syria, little is known about medicines utilization or prescriptions for these diseases. The aims of this study are to present the patterns and rates of dispensing medicines used for CVDs and diabetes among patients with government health insurance in Syria and examine age, sex, and regional variation in the dispensing of these medicines. Methods Outpatient data from June 2018 to May 2019 on dispensed medicines for 81,314 adults with government health insurance were obtained. The dispensing rate was expressed as the number of defined daily doses (DDDs) per 1000 beneficiaries per day (DID). The DID is a measurement that is used in drug utilization research to control for differences or changes in population size between or within countries. The number of DIDs was adjusted according to beneficiaries’ sex, age, and governorate. Results Beneficiaries received 302.09 DIDs of CVDs medicines and 35.66 DIDs of diabetes medicines, including 0.96 DID of insulin (2.99% of the total of diabetes medicines). CVDs and diabetes medicine dispensing rates were low during the study period and included very low rates of insulin dispensing compared to the dispensing rates of these medicines in other countries in East Mediterranean Region or in Europe. We found lower dispensing rates of CVDs medicines among female beneficiaries (249.59 DIDs) than male beneficiaries (388.80 DIDs). Similarly, the dispensing rates of diabetes medicines among female beneficiaries (29.42 DIDs) were lower than those among male beneficiaries (45.98 DIDs). In addition, there were lower rates of CVDs and diabetes medicines and very low to no dispensing of insulin in some governorates that were partly controlled by the Syrian government compared to other governorates that were completely or mostly controlled by the Syrian government. Conclusions Additional efforts are needed to raise awareness about the prevention and management of CVDs and diabetes especially among females in Syria and consider cultural issues that might influence access to healthcare services. There is a crucial need to address the political and geographical challenges caused by the conflict which have limited access to CVDs and diabetes medicines in some regions in Syria. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07124-6.
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Affiliation(s)
- Saleh Aljadeeah
- University of Bayreuth, Institute of Medical Management and Health Sciences, Prieserstr. 2, 95440, Bayreuth, Germany.
| | - Eckhard Nagel
- University of Bayreuth, Institute of Medical Management and Health Sciences, Prieserstr. 2, 95440, Bayreuth, Germany
| | - Veronika J Wirtz
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd floor, Boston, MA, 02118, USA
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546
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Schamroth Pravda N, Karny-Rahkovich O, Shiyovich A, Schamroth Pravda M, Rapeport N, Vaknin-Assa H, Eisen A, Kornowski R, Porter A. Coronary Artery Disease in Women: A Comprehensive Appraisal. J Clin Med 2021; 10:jcm10204664. [PMID: 34682787 PMCID: PMC8541551 DOI: 10.3390/jcm10204664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/02/2021] [Accepted: 10/09/2021] [Indexed: 01/16/2023] Open
Abstract
Coronary artery disease (CAD) is a significant cause of illness and death amongst women. The pathophysiology, manifestations, and outcomes of CVD and CAD differ between sexes. These sex differences remain under-recognized. The aim of this review is to highlight and raise awareness of the burden and unique aspects of CAD in women. It details the unique pathophysiology of CAD in women, cardiovascular risk factors in women (both traditional and sex-specific), the clinical presentation of CAD in women, and the range of disease in obstructive and non-obstructive CAD in women.
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Affiliation(s)
- Nili Schamroth Pravda
- Department of Cardiology, Rabin Medical Center, Petach Tikva 49100, Israel; (O.K.-R.); (A.S.); (H.V.-A.); (A.E.); (R.K.); (A.P.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
- Correspondence: ; Tel.: +972-544476243
| | - Orith Karny-Rahkovich
- Department of Cardiology, Rabin Medical Center, Petach Tikva 49100, Israel; (O.K.-R.); (A.S.); (H.V.-A.); (A.E.); (R.K.); (A.P.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | - Arthur Shiyovich
- Department of Cardiology, Rabin Medical Center, Petach Tikva 49100, Israel; (O.K.-R.); (A.S.); (H.V.-A.); (A.E.); (R.K.); (A.P.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | | | | | - Hana Vaknin-Assa
- Department of Cardiology, Rabin Medical Center, Petach Tikva 49100, Israel; (O.K.-R.); (A.S.); (H.V.-A.); (A.E.); (R.K.); (A.P.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | - Alon Eisen
- Department of Cardiology, Rabin Medical Center, Petach Tikva 49100, Israel; (O.K.-R.); (A.S.); (H.V.-A.); (A.E.); (R.K.); (A.P.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | - Ran Kornowski
- Department of Cardiology, Rabin Medical Center, Petach Tikva 49100, Israel; (O.K.-R.); (A.S.); (H.V.-A.); (A.E.); (R.K.); (A.P.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | - Avital Porter
- Department of Cardiology, Rabin Medical Center, Petach Tikva 49100, Israel; (O.K.-R.); (A.S.); (H.V.-A.); (A.E.); (R.K.); (A.P.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
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547
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Zhang J, Jin Y, Jia P, Li N, Zheng ZJ. Global Gender Disparities in Premature Death from Cardiovascular Disease, and Their Associations with Country Capacity for Noncommunicable Disease Prevention and Control. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910389. [PMID: 34639689 PMCID: PMC8507619 DOI: 10.3390/ijerph181910389] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/27/2022]
Abstract
This study aimed to describe the prevalence of gender disparity in cardiovascular disease and explore its association with a country’s capacity for controlling noncommunicable diseases. Study data were extracted from the Global Health Estimates, and the Noncommunicable Disease Country Capacity Survey. Age-standardized premature death rates from cardiovascular disease, defined as any death occurring from ages 30 to 70 years, were calculated. Univariate and multivariate general linear regression models were fitted to estimate the correlations between gender disparity and country capacity for noncommunicable disease control. Globally, the premature death rate from cardiovascular diseases was 35.6% higher among men than women in 2000, and the figure hardly changed from 2000 to 2016. The highest gender differences were observed in Europe and high-income countries. The existence of dedicated and multisectoral noncommunicable disease governance bodies and the availability of cardiovascular disease stratification in primary healthcare facilities were positively correlated with gender differences. Conclusively, gender disparities in premature death rates from cardiovascular diseases differed with economic conditions and across geographic regions, with higher relative differences observed in more developed countries. The effects of existing control measures may have plateaued in men but are ongoing among women, especially in more developed countries, widening the gender disparity.
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Affiliation(s)
- Ji Zhang
- Department of Global Health, School of Public Health, Peking University, Beijing 100191, China; (J.Z.); (Y.J.); (N.L.)
- Institute for Global Health and Development, Peking University, Beijing 100871, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing 100191, China; (J.Z.); (Y.J.); (N.L.)
- Institute for Global Health and Development, Peking University, Beijing 100871, China
| | - Peng Jia
- School of Resources and Environmental Science, Wuhan University, Wuhan 430072, China;
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan University, Wuhan 430072, China
| | - Na Li
- Department of Global Health, School of Public Health, Peking University, Beijing 100191, China; (J.Z.); (Y.J.); (N.L.)
- Institute for Global Health and Development, Peking University, Beijing 100871, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing 100191, China; (J.Z.); (Y.J.); (N.L.)
- Institute for Global Health and Development, Peking University, Beijing 100871, China
- Correspondence:
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548
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Zhan Q. Welcome to your new journal: Medical Review. MEDICAL REVIEW (BERLIN, GERMANY) 2021; 1:2. [PMID: 37724078 PMCID: PMC10388774 DOI: 10.1515/mr-2021-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Affiliation(s)
- Qimin Zhan
- Peking University Health Science Centre, Xueyuan Road #38, Beijing, 100083, China
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549
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Riaz S, Jaffar K, Perveen M, Riaz A, Nazir S, Iqbal J. Computational study of therapeutic potential of phosphorene as a nano-carrier for drug delivery of nebivolol for the prohibition of cardiovascular diseases: a DFT study. J Mol Model 2021; 27:306. [PMID: 34590181 DOI: 10.1007/s00894-021-04907-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/08/2021] [Indexed: 02/07/2023]
Abstract
Density functional theory (DFT) calculations were utilized to assess the drug delivery efficiency of phosphorene carrier for nebivolol drug to treat cardiovascular diseases. The optimized structures, excited state, and electronic properties of nebivolol, phosphorene, and nebivolol-phosphorene (nebivolol-PH) complex were considered to determine the drug delivery ability of phosphorene at the target site. The increased dipole moment (6.08 D) results in the higher solubility of the complex in polar solvents (water). Weak interactive forces between nebivolol and phosphorene were demonstrated by the non-covalent interaction (NCI) plot that facilitated the offloading of nebivolol at the targeted area. The analysis of frontier molecular orbitals (FMOs) revealed that during excitation, the charge was transferred from nebivolol as a higher occupied molecular orbital (HOMO) to phosphorene as a lower unoccupied molecular orbital (LUMO). Thus, the charge-transfer process was further studied by charge decomposition analysis (CDA). The calculated results at the excited state for the nebivolol-PH complex exhibited that the maximum wavelength (λmax) was red-shifted by 6 nm in the gas phase. The electron-hole theory and photoinduced electron transfer (PET) processes were carried out for the exploration of different excited states of the complex. Additionally, phosphorene with + 1 and - 1 charge states indicated the minor structural changes and provide the stable nebivolol-PH complex. This theoretical study also investigated that phosphorene can be exploited as an effective carrier for the delivery of a therapeutic agent as nebivolol to treat cardiovascular diseases. This work will also encourage the researchers to investigate the other 2D nanoparticles as a nano-drug delivery system (NDDS).
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Affiliation(s)
- Saima Riaz
- Department of Chemistry, University of Agriculture, Faisalabad, 38000, Pakistan
| | - Kinza Jaffar
- Department of Chemistry, University of Agriculture, Faisalabad, 38000, Pakistan
| | - Mehvish Perveen
- Department of Chemistry, University of Agriculture, Faisalabad, 38000, Pakistan
| | | | - Sidra Nazir
- Faisalabad Institute of Cardiology, Faisalabad, Pakistan
| | - Javed Iqbal
- Department of Chemistry, University of Agriculture, Faisalabad, 38000, Pakistan.
- Punjab Bio-Energy Institute, University of Agriculture, Faisalabad, 38000, Pakistan.
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Peters SAE, Kluin J. Why do women do worse after coronary artery bypass grafting? Eur Heart J 2021; 43:29-31. [PMID: 34524421 DOI: 10.1093/eurheartj/ehab617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,The George Institute for Global Health, Imperial College London, London, UK.,The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Jolanda Kluin
- Department of Cardiothoracic Surgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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