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Safdar M, Ullah M, Hamayun S, Wahab A, Khan SU, Abdikakhorovich SA, Haq ZU, Mehreen A, Naeem M, Mustopa AZ, Hasan N. Microbiome miracles and their pioneering advances and future frontiers in cardiovascular disease. Curr Probl Cardiol 2024; 49:102686. [PMID: 38830479 DOI: 10.1016/j.cpcardiol.2024.102686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 06/05/2024]
Abstract
Cardiovascular diseases (CVDs) represent a significant global health challenge, underscoring the need for innovative approaches to prevention and treatment. Recent years have seen a surge in interest in unraveling the complex relationship between the gut microbiome and cardiovascular health. This article delves into current research on the composition, diversity, and impact of the gut microbiome on CVD development. Recent advancements have elucidated the profound influence of the gut microbiome on disease progression, particularly through key mediators like Trimethylamine-N-oxide (TMAO) and other microbial metabolites. Understanding these mechanisms reveals promising therapeutic targets, including interventions aimed at modulating the gut microbiome's interaction with the immune system and its contribution to endothelial dysfunction. Harnessing this understanding, personalized medicine strategies tailored to individuals' gut microbiome profiles offer innovative avenues for reducing cardiovascular risk. As research in this field continues to evolve, there is vast potential for transformative advancements in cardiovascular medicine, paving the way for precision prevention and treatment strategies to address this global health challenge.
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Affiliation(s)
- Mishal Safdar
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Punjab, Pakistan
| | - Muneeb Ullah
- College of Pharmacy, Pusan National University, Busandaehak-ro 63 beon-gil 2, Geumjeong-gu, Busan 46241, Republic of Korea; Department of Pharmacy, Kohat University of Science and Technology, Kohat, 26000, Khyber Pakhtunkhwa, Pakistan
| | - Shah Hamayun
- Department of Cardiology, Pakistan Institute of Medical Sciences (PIMS), Islamabad, 04485 Punjab, Pakistan
| | - Abdul Wahab
- Department of Pharmacy, Kohat University of Science and Technology, Kohat, 26000, Khyber Pakhtunkhwa, Pakistan
| | - Shahid Ullah Khan
- Department of Biochemistry, Women Medical and Dental College, Khyber Medical University, Abbottabad, 22080, Khyber Pakhtunkhwa, Pakistan
| | | | - Zia Ul Haq
- Department of Public Health, Institute of Public Health Sciences, Khyber Medical University, Peshawar 25120, Pakistan
| | - Aqsa Mehreen
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Punjab, Pakistan
| | - Muhammad Naeem
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Punjab, Pakistan
| | - Apon Zaenal Mustopa
- Research Center for Genetic Engineering, National Research, and Innovation Agency (BRIN), Bogor 16911, Indonesia
| | - Nurhasni Hasan
- Faculty of Pharmacy, Universitas Hasanuddin, Jl. Perintis Kemerdekaan Km 10, Makassar 90245, Republic of Indonesia.
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Arena R, Laddu D, Pronk NP, Woodard C. The geographic distribution of unhealthy living characteristics according to the American Nations model: Cultural factors warranting attention. Prog Cardiovasc Dis 2023; 79:100-106. [PMID: 37419166 DOI: 10.1016/j.pcad.2023.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Affiliation(s)
- Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America.
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Nicolaas P Pronk
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America; HealthPartners Institute, Minneapolis, MN, United States of America; Department of Health Policy and Management, University of Minnesota, Minneapolis, MN, United States of America
| | - Colin Woodard
- Nationhood Lab, Pell Center for International Relations and Public Policy, Salve Regina University, Newport, RI, United States of America
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Arena R, Pronk NP, Laddu D, Faghy MA, Bond S, Lavie CJ. COVID-19, Unhealthy lifestyle behaviors and chronic disease in the United States: Mapping the social injustice overlay. Prog Cardiovasc Dis 2023; 76:112-117. [PMID: 36925212 PMCID: PMC10012225 DOI: 10.1016/j.pcad.2023.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Affiliation(s)
- Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Nicolaas P Pronk
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; HealthPartners Institute, Minneapolis, MN, USA; Department of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Mark A Faghy
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Biomedical Research Theme, School of Human Sciences, University of Derby, Derby, UK
| | - Samantha Bond
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Biomedical Health Information Sciences, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Carl J Lavie
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA, USA
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Arena R, Lavie CJ, Faghy MA. What Comes First, the Behavior or the Condition? In the COVID-19 Era, It May Go Both Ways. Curr Probl Cardiol 2022; 47:100963. [PMID: 34391763 PMCID: PMC8358102 DOI: 10.1016/j.cpcardiol.2021.100963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 08/08/2021] [Indexed: 01/12/2023]
Abstract
Which came first, the chicken or the egg? This causality dilemma was first proposed by the Greek biographer Plutarch in the 1st century CE. While the cause-effect relationship between lifestyle behaviors and chronic disease is not always a certainty, and genetic predisposition can independently lead to premature chronic disease, the likelihood of developing one or more chronic conditions is significantly higher in those who: (1) lead sedentary lifestyles; (2) consume unhealthy diets; (3) smoke; or (4) have excess body mass. Recently, the Royal College of General Practitioners issued an apology for the title of an online event that suggested the coronavirus disease 2019 (COVID-19) is a lifestyle disease. We feel that this was the correct course of action as leading an unhealthy lifestyle is certainly not the cause for an individual contracting COVID-19 (ie, effect). However, a body of evidence has demonstrated that unhealthy lifestyle behaviors and characteristics as well as being diagnosed with one or more chronic diseases does significantly increase the risk for a complicated medical course in individuals infected with COVID-19. Moreover, the cause-effect relationship between lifestyle behaviors and characteristics and COVID-19 may eventually prove to go both ways, as the pandemic may lead to a higher prevalence of unhealthy lifestyle behaviors and characteristics over the long term that eventually leads to a higher prevalence of chronic disease. As such, health living medicine must be widely practiced and prescribed to all individuals globally.
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Affiliation(s)
- Ross Arena
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL.
| | - Carl J Lavie
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA
| | - Mark A Faghy
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL; Human Sciences Research Centre, University of Derby, Derby, United Kingdom
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Bond S, Arena R, Berra K, Popovic D, Smirmaul BPC, Ortega FB. Introducing the HL-PIVOT Network. J Cardiopulm Rehabil Prev 2020; 40:356-358. [DOI: 10.1097/hcr.0000000000000555] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Arena R. Moving more and sitting less - Now more than ever, an important message for the prevention and treatment of chronic disease and pandemics. Prog Cardiovasc Dis 2020:S0033-0620(20)30175-4. [PMID: 33098845 PMCID: PMC7577219 DOI: 10.1016/j.pcad.2020.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Ross Arena
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
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Arena R, Lavie CJ. Moving more and sitting less - Now more than ever-an important message for the prevention and treatment of chronic disease and pandemics. Prog Cardiovasc Dis 2020; 64:1-2. [PMID: 33065144 PMCID: PMC7554455 DOI: 10.1016/j.pcad.2020.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Ross Arena
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Carl J Lavie
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA, USA
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8
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Affiliation(s)
- Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Carl J Lavie
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA, USA
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Effect of Strength Training on Lipid and Inflammatory Outcomes: Systematic Review With Meta-Analysis and Meta-Regression. J Phys Act Health 2019; 16:477-491. [PMID: 31023184 DOI: 10.1123/jpah.2018-0317] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: The aim of this study was to perform a systematic review with meta-analysis and meta-regressions evaluating the effects of isolated strength training (ST), compared with a control group, on total cholesterol (TC), triglycerides (TG), low-density (LDL), high-density lipoprotein (HDL), C-reactive protein (CRP), and adiponectin of adults. Methods: Embase, PubMed, Cochrane, and Scopus data sources were searched up to May 2017. Clinical trials that compared ST with a control group of adults older than 18 years, which evaluated blood TC, TG, LDL, HDL, CRP, or adiponectin as an outcome were included. Random effect was used and the effect size (ES) was calculated by using the standardized mean difference with a 95% confidence interval. Results: ST promotes a reduction in TC (ES: -0.399; P < .001), TG (ES: -0.204; P = .002), LDL (ES: -0.451; P < .001), and CRP (ES: -0.542; P = .01) levels. In addition, ST is associated to an increase in HDL (ES: 0.363; P < .001) and adiponectin concentrations (ES: 1.105; P = .01). Conclusion: ST promotes decreases in TC, TG, LDL, and CRP levels and increases HDL and adiponectin concentrations. Thus, progressive ST could be a potential therapeutic option for improving abnormalities in lipid and inflammatory outcomes in adults.
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Determining Cardiorespiratory Fitness With Precision: Compendium of Findings From the FRIEND Registry. Prog Cardiovasc Dis 2019; 62:76-82. [DOI: 10.1016/j.pcad.2018.10.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 10/23/2018] [Indexed: 02/07/2023]
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Standley RA, Vega RB. Furthering Precision Medicine Genomics With Healthy Living Medicine. Prog Cardiovasc Dis 2019; 62:60-67. [DOI: 10.1016/j.pcad.2018.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 12/28/2018] [Indexed: 12/23/2022]
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Merging precision and healthy living medicine: Individualizing the path to a healthier lifestyle. Prog Cardiovasc Dis 2018; 62:1-2. [PMID: 30586563 DOI: 10.1016/j.pcad.2018.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Arena R, Ozemek C. Getting patients with cardiovascular disease to move more: cardiac rehabilitation and beyond. Expert Rev Cardiovasc Ther 2018; 17:79-81. [PMID: 30509114 DOI: 10.1080/14779072.2019.1556097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ross Arena
- a Department of Physical Therapy , College of Applied Health Sciences, University of Illinois at Chicago , Chicago , IL , USA
| | - Cemal Ozemek
- a Department of Physical Therapy , College of Applied Health Sciences, University of Illinois at Chicago , Chicago , IL , USA
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Arena R, Ozemek C, Laddu D, Campbell T, Rouleau CR, Standley R, Bond S, Abril EP, Hills AP, Lavie CJ. Applying Precision Medicine to Healthy Living for the Prevention and Treatment of Cardiovascular Disease. Curr Probl Cardiol 2018; 43:448-483. [DOI: 10.1016/j.cpcardiol.2018.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Ozemek C, Phillips SA, Fernhall B, Williams MA, Stamos TD, Bond S, Claeys H, Laddu DR, Arena R. Enhancing Participation in Cardiac Rehabilitation: A Question of Proximity and Integration of Outpatient Services. Curr Probl Cardiol 2018; 43:424-435. [DOI: 10.1016/j.cpcardiol.2018.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Strieter L, Laddu DR, Sainsbury J, Arena R. The Importance of School-based Healthy Living Initiatives: Introducing the Health and Wellness Academy Concept. Prog Cardiovasc Dis 2018; 62:68-73. [PMID: 30236752 DOI: 10.1016/j.pcad.2018.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 08/19/2018] [Indexed: 11/26/2022]
Abstract
Over the last 15 years, the number of school and community based health-intervention programs in the United States has grown. Many of these programs aim to prevent non-communicable chronic disease diagnoses (e.g., obesity, cardiovascular disease and type-2 diabetes). The Department of Physical Therapy in the College of Applied Health Sciences (CAHS) at the University of Illinois at Chicago (UIC) created a school-based wellness program (SBWP) that focuses on nutrition and physical activity, providing tailored experiences that motivate adolescents to make healthier lifestyle choices. The SBWP began as a camp for children in the surrounding neighborhoods and implemented healthy living practices utilizing students from Departments in the CAHS. From this camp, the Health and Wellness Academy (HWA) evolved. This paper provides a review of school-based initiatives and introduces the UIC HWA, an innovative and reproducible approach that can bring positive environmental change by improving health outcomes for children and their families.
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Affiliation(s)
- Lindsey Strieter
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
| | - Deepika R Laddu
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Jenna Sainsbury
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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Prueba de esfuerzo cardiopulmonar en pacientes con insuficiencia cardiaca y fracción de eyección conservada: colmando las lagunas sobre el pronóstico. Rev Esp Cardiol (Engl Ed) 2018. [DOI: 10.1016/j.recesp.2017.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lavie CJ, Archer E, Nauman J. Arrival and survival of the fittest. Am Heart J 2018; 196:153-155. [PMID: 29421007 DOI: 10.1016/j.ahj.2017.08.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 08/28/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA.
| | | | - Javaid Nauman
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates; K. G. Jebsen Center for Exercise in Medicine at the Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway and St. Olav's University Hospital, Trondheim, Norway
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Fabbri M, Yost K, Finney Rutten LJ, Manemann SM, Boyd CM, Jensen D, Weston SA, Jiang R, Roger VL. Health Literacy and Outcomes in Patients With Heart Failure: A Prospective Community Study. Mayo Clin Proc 2018; 93:9-15. [PMID: 29217337 PMCID: PMC5756510 DOI: 10.1016/j.mayocp.2017.09.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/06/2017] [Accepted: 09/25/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine the impact of health literacy on hospitalizations and death in a population of patients with heart failure (HF). PATIENTS AND METHODS Residents from the 11-county region in southeast Minnesota with a first-ever International Classification of Diseases, Ninth Revision code 428 or Tenth Revision code 150 (n=5121) from January 1, 2013, through December 31, 2015, were identified and prospectively surveyed to measure health literacy using established screening questions. A total of 2647 patients returned the survey (response rate, 52%); 2487 patients with complete health literacy data were retained for analysis. Health literacy, measured as a composite score on three 5-point scales, was categorized as adequate (≥8) or low (<8). Cox proportional hazards regression and Andersen-Gill models were used to examine the association of health literacy with mortality and hospitalization. RESULTS Of 2487 patients (mean age, 73.5 years; 53.6% male [n=1333]), 10.5% (n= 261) had low health literacy. After mean ± SD follow-up of 15.5±7.2 months, 250 deaths and 1584 hospitalizations occurred. Low health literacy was associated with increased mortality and hospitalizations. After adjusting for age, sex, comorbidity, education, and marital status, the hazard ratios for death and hospitalizations in patients with low health literacy were 1.91 (95% CI, 1.38-2.65; P<.001) and 1.30 (95% CI, 1.02-1.66; P=.03), respectively, compared with patients with adequate health literacy. CONCLUSION Low health literacy is associated with increased risks of hospitalization and death in patients with HF. The clinical evaluation of health literacy could help design interventions individualized for patients with low health literacy.
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Affiliation(s)
- Matteo Fabbri
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Kathleen Yost
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | - Cynthia M Boyd
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD
| | - Daniel Jensen
- Olmsted County Public Health Services, Rochester, MN
| | - Susan A Weston
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Ruoxiang Jiang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Véronique L Roger
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
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Stone JA, Arena R, Aggarwal S. Failing at Heart Failure Therapies: Are Health Behaviours to Blame? Can J Cardiol 2017; 33:1462-1464. [DOI: 10.1016/j.cjca.2017.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 08/25/2017] [Accepted: 08/25/2017] [Indexed: 11/26/2022] Open
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Gorelick PB, Furie KL, Iadecola C, Smith EE, Waddy SP, Lloyd-Jones DM, Bae HJ, Bauman MA, Dichgans M, Duncan PW, Girgus M, Howard VJ, Lazar RM, Seshadri S, Testai FD, van Gaal S, Yaffe K, Wasiak H, Zerna C. Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association. Stroke 2017; 48:e284-e303. [PMID: 28883125 PMCID: PMC5654545 DOI: 10.1161/str.0000000000000148] [Citation(s) in RCA: 239] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Cognitive function is an important component of aging and predicts quality of life, functional independence, and risk of institutionalization. Advances in our understanding of the role of cardiovascular risks have shown them to be closely associated with cognitive impairment and dementia. Because many cardiovascular risks are modifiable, it may be possible to maintain brain health and to prevent dementia in later life. The purpose of this American Heart Association (AHA)/American Stroke Association presidential advisory is to provide an initial definition of optimal brain health in adults and guidance on how to maintain brain health. We identify metrics to define optimal brain health in adults based on inclusion of factors that could be measured, monitored, and modified. From these practical considerations, we identified 7 metrics to define optimal brain health in adults that originated from AHA's Life's Simple 7: 4 ideal health behaviors (nonsmoking, physical activity at goal levels, healthy diet consistent with current guideline levels, and body mass index <25 kg/m2) and 3 ideal health factors (untreated blood pressure <120/<80 mm Hg, untreated total cholesterol <200 mg/dL, and fasting blood glucose <100 mg/dL). In addition, in relation to maintenance of cognitive health, we recommend following previously published guidance from the AHA/American Stroke Association, Institute of Medicine, and Alzheimer's Association that incorporates control of cardiovascular risks and suggest social engagement and other related strategies. We define optimal brain health but recognize that the truly ideal circumstance may be uncommon because there is a continuum of brain health as demonstrated by AHA's Life's Simple 7. Therefore, there is opportunity to improve brain health through primordial prevention and other interventions. Furthermore, although cardiovascular risks align well with brain health, we acknowledge that other factors differing from those related to cardiovascular health may drive cognitive health. Defining optimal brain health in adults and its maintenance is consistent with the AHA's Strategic Impact Goal to improve cardiovascular health of all Americans by 20% and to reduce deaths resulting from cardiovascular disease and stroke by 20% by the year 2020. This work in defining optimal brain health in adults serves to provide the AHA/American Stroke Association with a foundation for a new strategic direction going forward in cardiovascular health promotion and disease prevention.
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Affiliation(s)
- Philip B Gorelick
- Also a member of Maintenance of Brain Health writing group section. Also a member of Optimal Brain Health writing group section. Lead of Maintenance of Brain Health writing group section. Lead of Public Health Impact of Cognitive Impairment, Dementia, Stroke, and Cardiovascular and Stroke Risks writing group section. Senior reviewer
| | - Karen L Furie
- Also a member of Maintenance of Brain Health writing group section. Also a member of Optimal Brain Health writing group section. Lead of Maintenance of Brain Health writing group section. Lead of Public Health Impact of Cognitive Impairment, Dementia, Stroke, and Cardiovascular and Stroke Risks writing group section. Senior reviewer
| | - Costantino Iadecola
- Also a member of Maintenance of Brain Health writing group section. Also a member of Optimal Brain Health writing group section. Lead of Maintenance of Brain Health writing group section. Lead of Public Health Impact of Cognitive Impairment, Dementia, Stroke, and Cardiovascular and Stroke Risks writing group section. Senior reviewer
| | - Eric E Smith
- Also a member of Maintenance of Brain Health writing group section. Also a member of Optimal Brain Health writing group section. Lead of Maintenance of Brain Health writing group section. Lead of Public Health Impact of Cognitive Impairment, Dementia, Stroke, and Cardiovascular and Stroke Risks writing group section. Senior reviewer
| | - Salina P Waddy
- Also a member of Maintenance of Brain Health writing group section. Also a member of Optimal Brain Health writing group section. Lead of Maintenance of Brain Health writing group section. Lead of Public Health Impact of Cognitive Impairment, Dementia, Stroke, and Cardiovascular and Stroke Risks writing group section. Senior reviewer
| | - Donald M Lloyd-Jones
- Also a member of Maintenance of Brain Health writing group section. Also a member of Optimal Brain Health writing group section. Lead of Maintenance of Brain Health writing group section. Lead of Public Health Impact of Cognitive Impairment, Dementia, Stroke, and Cardiovascular and Stroke Risks writing group section. Senior reviewer
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Ozemek C, Arena R. Cardiopulmonary Exercise Testing in Patients With Heart Failure and a Preserved Ejection Fraction: Filling the Prognostic Knowledge Gap. ACTA ACUST UNITED AC 2017; 71:237-239. [PMID: 28919241 DOI: 10.1016/j.rec.2017.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 08/01/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Cemal Ozemek
- Department of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States.
| | - Ross Arena
- Department of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
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Lavie CJ, Bennett A, Arena R. Enhancing Cardiac Rehabilitation in Women. J Womens Health (Larchmt) 2017; 26:817-819. [PMID: 28613967 DOI: 10.1089/jwh.2017.6476] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Carl J Lavie
- 1 Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute , Ochsner Clinical School-The University of Queensland School of Medicine , New Orleans, Louisiana
| | - Amanda Bennett
- 1 Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute , Ochsner Clinical School-The University of Queensland School of Medicine , New Orleans, Louisiana
| | - Ross Arena
- 2 Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago , Chicago, Illinois
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Abstract
Noncommunicable and chronic disease are interchangeable terms. According to the World Health Organization, "they are of long duration and generally slow progression. The 4 main types of chronic diseases are cardiovascular diseases (ie, heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes." We have known about the benefits of physical activity (PA) for thousands of years. Perhaps our approach, from public health messaging to the individual clinical encounter, as to how PA and exercise are discussed and prescribed can be improved upon, with the ultimate goal of increasing the likelihood that an individual moves more; ultimately moving more should be the goal. In fact, there is an incongruence between the evidence for the benefits of physical movement and how we message and integrate PA and exercise guidance into health care, if it is discussed at all. Specifically, evidence clearly indicates any migration away from the sedentary phenotype toward a movement phenotype is highly beneficial. As we necessarily move to a proactive, preventive healthcare model, we must reconceptualize how we evaluate and treat conditions that pose the greatest threat, namely chronic disease; there is a robust body of evidence supporting the premise of movement as medicine. The purpose of this perspective paper is to propose an alternate model for promoting, assessing, discussing, and prescribing physical movement.
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