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Fazlalizadeh H, Khan MS, Fox ER, Douglas PS, Adams D, Blaha MJ, Daubert MA, Dunn G, van den Heuvel E, Kelsey MD, Martin RP, Thomas JD, Thomas Y, Judd SE, Vasan RS, Budoff MJ, Bloomfield GS. Closing the Last Mile Gap in Access to Multimodality Imaging in Rural Settings: Design of the Imaging Core of the Risk Underlying Rural Areas Longitudinal Study. Circ Cardiovasc Imaging 2024; 17:e015496. [PMID: 38377236 PMCID: PMC10883604 DOI: 10.1161/circimaging.123.015496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Achieving optimal cardiovascular health in rural populations can be challenging for several reasons including decreased access to care with limited availability of imaging modalities, specialist physicians, and other important health care team members. Therefore, innovative solutions are needed to optimize health care and address cardiovascular health disparities in rural areas. Mobile examination units can bring imaging technology to underserved or remote communities with limited access to health care services. Mobile examination units can be equipped with a wide array of assessment tools and multiple imaging modalities such as computed tomography scanning and echocardiography. The detailed structural assessment of cardiovascular and lung pathology, as well as the detection of extracardiac pathology afforded by computed tomography imaging combined with the functional and hemodynamic assessments acquired by echocardiography, yield deep phenotyping of heart and lung disease for populations historically underrepresented in epidemiological studies. Moreover, by bringing the mobile examination unit to local communities, innovative approaches are now possible including engagement with local professionals to perform these imaging assessments, thereby augmenting local expertise and experience. However, several challenges exist before mobile examination unit-based examinations can be effectively integrated into the rural health care setting including standardizing acquisition protocols, maintaining consistent image quality, and addressing ethical and privacy considerations. Herein, we discuss the potential importance of cardiac multimodality imaging to improve cardiovascular health in rural regions, outline the emerging experience in this field, highlight important current challenges, and offer solutions based on our experience in the RURAL (Risk Underlying Rural Areas Longitudinal) cohort study.
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Affiliation(s)
- Hooman Fazlalizadeh
- Lundquist Institute, Harbor-University of California Los Angeles Medical Center, Torrance (H.F., M.J.B.)
| | - Muhammad Shahzeb Khan
- Division of Cardiology, Department of Medicine (M.S.K., P.S.D., M.A.D., M.D.K., G.S.B.), Duke University, Durham, NC
| | - Ervin R Fox
- Division of Cardiology, Department of Medicine University of Mississippi Medical Center, Jackson, MS (E.R.F.)
| | - Pamela S Douglas
- Division of Cardiology, Department of Medicine (M.S.K., P.S.D., M.A.D., M.D.K., G.S.B.), Duke University, Durham, NC
- Duke Clinical Research Institute (P.S.D., M.A.D., G.D., M.D.K., G.S.B.), Duke University, Durham, NC
| | - David Adams
- Caption Health, Inc, San Francisco, CA (D.A., R.P.M., Y.T.)
| | - Michael J Blaha
- Lundquist Institute, Harbor-University of California Los Angeles Medical Center, Torrance (H.F., M.J.B.)
| | - Melissa A Daubert
- Division of Cardiology, Department of Medicine (M.S.K., P.S.D., M.A.D., M.D.K., G.S.B.), Duke University, Durham, NC
- Duke Clinical Research Institute (P.S.D., M.A.D., G.D., M.D.K., G.S.B.), Duke University, Durham, NC
| | - Gary Dunn
- Duke Clinical Research Institute (P.S.D., M.A.D., G.D., M.D.K., G.S.B.), Duke University, Durham, NC
| | - Edwin van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, The Netherlands (E.v.d.H.)
| | - Michelle D Kelsey
- Division of Cardiology, Department of Medicine (M.S.K., P.S.D., M.A.D., M.D.K., G.S.B.), Duke University, Durham, NC
- Duke Clinical Research Institute (P.S.D., M.A.D., G.D., M.D.K., G.S.B.), Duke University, Durham, NC
| | | | - James D Thomas
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (J.D.T.)
- Center for Artificial Intelligence, Northwestern Medicine Bluhm Cardiovascular Institute, Chicago, IL (J.D.T.)
| | - Yngvil Thomas
- Caption Health, Inc, San Francisco, CA (D.A., R.P.M., Y.T.)
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham (S.E.J.)
| | - Ramachandran S Vasan
- University of Texas Health Sciences Center, University of Texas School of Public Health, San Antonio (R.S.V.)
| | - Matthew J Budoff
- Division of Cardiology, John Hopkins University School of Medicine, Baltimore, MD (M.J.B.)
| | - Gerald S Bloomfield
- Division of Cardiology, Department of Medicine (M.S.K., P.S.D., M.A.D., M.D.K., G.S.B.), Duke University, Durham, NC
- Duke Clinical Research Institute (P.S.D., M.A.D., G.D., M.D.K., G.S.B.), Duke University, Durham, NC
- Duke Global Health Institute (G.S.B.), Duke University, Durham, NC
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Zeinali-Nezhad N, Najafipour H, Shadkam M, Pourhamidi R. Prevalence and trend of multiple coronary artery disease risk factors and their 5-year incidence rate among adult population of Kerman: results from KERCADR study. BMC Public Health 2024; 24:25. [PMID: 38166891 PMCID: PMC10763330 DOI: 10.1186/s12889-023-17504-8] [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: 08/14/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Coronary artery diseases (CADs) are the most important non‑communicable diseases (NCDs), which cause the highest number of deaths around the world. Hypertension (HTN), dyslipidemia (DL), diabetes mellitus (DM), obesity (OB), low physical activity (LPA), smoking, opium consumption (OC) and anxiety are the most important CAD risk factors, which are more dangerously present in combination in some patients. METHODS A total of 5835 people aged 15 to 75 years were enrolled in the phase 1 (2012) and followed up to the phase 2 (2017) of the population-based Kerman coronary artery diseases risk factors study (KERCADRS). The prevalence and pattern of different combinations of CAD risk factors (double to quintuple) and their 5-year incidence rates were assessed. RESULTS The prevalence of single CAD risk factors (RFs) in phase 2 was 50.2% (DL), 47.1% (LPA), 28.1% (abdominal obesity), 21.2% (OB), 16.5% (HTN), 9.2% (smoking), 9.1% (OC), and 8.4% (DM). The most frequent combination of risk factors was LPA plus DL (23.9%), metabolic syndrome (19.6%), and DL plus OB (17.8%). The 5-year incidence rates of multiple comorbidities (in persons per 100 person-years) was DL plus LPA (2.80%), HTN plus DL (1.53%), and abdominal obesity (AOB) plus DL (1.47%). The most participants (84.4%) suffered from at least one RF, while 54.9% had at least two and 29.9% had at least three RFs. CONCLUSION The results showed that a large portion of the study population suffers from multiple CAD RFs. The findings underscore the importance of identifying multiple CAD risk factors to reduce the overall burden of these NCDs.
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Affiliation(s)
- Nazanin Zeinali-Nezhad
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Najafipour
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
- Department of Physiology and Cardiovascular Research Center, Afzalipour Medical Faculty, Kerman University of Medical Sciences, Kerman, Iran.
| | - Mitra Shadkam
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Rashed Pourhamidi
- Non Communicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran
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Wang X, Xin R, Shan D, Dou G, Zhang W, Jing J, He B, Chen Y, Yang J. Incremental Value of Noncontrast Chest Computed Tomography-derived Parameters in Predicting Subclinical Carotid Atherosclerosis: From the PERSUADE Study. J Thorac Imaging 2023; 38:113-119. [PMID: 35576552 PMCID: PMC9936967 DOI: 10.1097/rti.0000000000000655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate the incremental value of noncontrast chest computed tomography (CT)-derived parameters, such as coronary artery calcium score (CACS) and epicardial adipose tissue volume (EATv), in predicting subclinical carotid atherosclerosis above traditional risk factors in community-based asymptomatic populations of northern China. MATERIALS AND METHODS A total of 2195 community-based asymptomatic individuals were enrolled from Jidong Oilfield in accordance with the PERSUADE study. CACS and EATv were measured on noncontrast chest CT. Demographics and ideal cardiovascular health score (ICHS) were collected through questionnaires. We recalculated the ideal cardiovascular health risk score (ICHRS) (ICHRS=14-ICHS) and standardized the parameters as log-CACS and body mass index adjusted EATv (i-EATv). Subclinical carotid atherosclerosis was assessed by Doppler sonography and defined as any prevalence of average carotid intima-media thickness ≥1.00 mm, appearance of carotid plaque, and carotid arterial stenosis in the areas of extracranial carotid arteries on both sides. RESULTS A total of 451 (20.55%) individuals presented subclinical carotid atherosclerosis. CACS and EATv were significantly greater in the subclinical group, while ICHS was lower. In multivariate logistic regression, ICHRS (odds ratio [OR]=1.143, 95% confidence interval [CI]: 1.080-1.210, P <0.001), log-CACS (OR=1.701, 95% CI: 1.480-1.955, P <0.001), and i-EATv (OR=1.254, 95% CI: 1.173-1.341, P <0.001) were found to be independent risk predictors for subclinical carotid atherosclerosis. In receiver-operating characteristic curve analysis, when combined with male sex and age level, the area under the curve of the ICHRS basic model increased from 0.627 (95% CI: 0.599-0.654) to 0.757 (95% CI: 0.732-0.781) ( P <0.0001). Further adding log-CACS and i-EATv, the area under the curve demonstrated a statistically significant improvement (0.788 [95% CI: 0.765-0.812] vs. 0.757 [95% CI: 0.732-0.781], P <0.0001). CONCLUSION Noncontrast chest CT-derived parameters, including CACS and EATv, could provide significant incremental improvement for predicting subclinical carotid atherosclerosis beyond the conventional risk assessment model based on ICHRS.
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Affiliation(s)
- Xi Wang
- Medical School of Chinese PLA
- Department of Cardiology, the Sixth Medical Centre
| | - Ran Xin
- Department of Cardiology, the Sixth Medical Centre
- School of Medicine, Nankai University, Tianjin, P.R. China
| | - Dongkai Shan
- Department of Cardiology, the Sixth Medical Centre
| | - Guanhua Dou
- Department of Cardiology, the Second Medical Centre
| | - Wei Zhang
- Department of Cardiology, the First Medical Centre, Chinese PLA General Hospital, Beijing
| | - Jing Jing
- Department of Cardiology, the First Medical Centre, Chinese PLA General Hospital, Beijing
| | - Bai He
- Department of Cardiology, the First Medical Centre, Chinese PLA General Hospital, Beijing
| | - Yundai Chen
- Department of Cardiology, the Sixth Medical Centre
| | - Junjie Yang
- Department of Cardiology, the Sixth Medical Centre
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Ndlovu H, Lawal IO, Popoola GO, Brits B, Mokoala KMG, Maserumule LC, Hlongwa KN, Mahapane J, Davis C, Sathekge MM. [ 68Ga]Ga-NODAGAZOL uptake in atherosclerotic plaques correlates with the cardiovascular risk profile of patients. Ann Nucl Med 2022; 36:684-692. [PMID: 35612698 DOI: 10.1007/s12149-022-01752-6] [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: 01/26/2022] [Accepted: 05/06/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES This study aimed to determine the correlation of [68Ga]Ga-NODAGAZOL uptake in atherosclerotic plaques and the cardiovascular risk profile of patients imaged with positron emission tomography (PET), wherein quantification of uptake was determined by atherosclerotic plaque maximum target-to-background ratio (TBRmax). We also correlated uptake with a history of cardiovascular events. METHODS We included patients who underwent PET/CT imaging post-injection of [68Ga] Ga-NODAGAZOL. We documented the number of atherosclerotic plaques found in the major arteries on CT and the cardiovascular risks in each patient. We quantified the intensity of tracer uptake in atherosclerotic plaque in the major arteries using the maximum standardized uptake value (SUVmax). The SUVmax of the most tracer-avid plaque was documented as representative of the individual arterial bed. We determined background vascular tracer activity using the mean standardized uptake value (SUVmean) obtained from the lumen of the superior vena cava. The maximum target-to-background ratio (TBRmax) was calculated as a ratio of the SUVmax to the SUVmean. The TBRmax was correlated to the number of atherogenic risk factors and history of cardiovascular events. RESULTS Thirty-four patients (M: F 31:3; mean age ± SD: 63 ± 10.01 years) with ≥ 2 cardiovascular risk factors were included. Statistically significant correlation between TBRmax and the number of cardiovascular risk factors was noted in the right carotid (r = 0.50; p < 0.05); left carotid (r = 0. 649; p < 0.05); ascending aorta (r = 0.375; p < 0.05); aortic arch (r = 0.483; p < 0.05); thoracic aorta (r = 0.644; p < 0.05); left femoral (r = 0.552; p < 0.05) and right femoral arteries (r = 0.533; p < 0.05). TBRmax also demonstrated a positive correlation to history of cardiovascular event in the right carotid (U = 26.00; p < 0.05); left carotid (U = 11.00; p < 0.05); ascending aorta (U = 49.00; p < 0.05); aortic arch (U = 37.00; p < 0.05); thoracic aorta (U = 16.00; p < 0.05); left common iliac (U = 49.500; p < 0.05), right common iliac (U = 43.00; p < 0.05), left femoral (U = 40.500; p < 0.05) and right femoral (U = 37.500; p < 0.05). CONCLUSION In this cohort of patients, a positive correlation was noted between atherosclerotic plaque uptake of [68Ga]Ga-NODAGAZOL and the number of atherogenic risk factors which translates to the risk of atherosclerosis and cardiovascular risk factors.
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Affiliation(s)
- Honest Ndlovu
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa.,Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
| | - Ismaheel O Lawal
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa.,Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
| | - Gbenga O Popoola
- Saxon Court Lincolnshire Partnership NHS Foundation Trust (LPFT), Lincoln, Lincolnshire, UK
| | - Bradley Brits
- Department of Cardiology, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Kgomotso M G Mokoala
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Letjie C Maserumule
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Khanyisile N Hlongwa
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Johncy Mahapane
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Cindy Davis
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Mike M Sathekge
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa. .,Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa.
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Wang Y, Luo M, Mao X, Shi X, Liu X. Targeted Delivery of Salusin-α Into Rabbit Carotid Arterial Endothelium Using SonoVue. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:365-376. [PMID: 33818784 PMCID: PMC9291317 DOI: 10.1002/jum.15714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES A new method based on the adhesion of SonoVue to plasmids was assessed to achieve targeted gene delivery into the vascular endothelium. METHODS pEGFP-Salusin-α and pcDNA3.1-Salusin-α plasmids were transfected into the arterial endothelium of different rabbit groups. Western blotting was performed to analyze the expression of EGFP and salusin-α in the common carotid arteries of rabbits from different groups, and ELISA was performed to detect plasma salusin-α levels in rabbits from each group; simultaneously, blood parameters of different groups of rabbits were measured. RESULTS Green fluorescence was observed in the right common carotid artery of rabbits transfected with pEGFP-Salusin-α, but not in the endothelial cells of not-transfected control rabbits. The expression of salusin-α in the transfected animals was higher than that in the control not-transfected animals (P < .05). In rabbits transfected with pcDNA3.1-Salusin-α plasmid, salusin-α expression was higher than in the not-transfected control animals (P < .05). However, there was no significant difference in plasma salusin-α levels between transfected animals and controls (P > .05). Blood parameters were also measured in both groups. CONCLUSIONS Our data confirm the establishment of a new method using SonoVue for targeted gene delivery into the arterial endothelium. Our study outcomes propose a new method of intervention in atherosclerosis and a new tool for targeted gene delivery.
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Affiliation(s)
- Yuxue Wang
- Department of Laboratory MedicineHubei University of Chinese MedicineWuhanChina
| | - Min Luo
- Department of Laboratory MedicineHubei University of Chinese MedicineWuhanChina
| | - Xiaolu Mao
- Central Laboratory, The Central Hospital of Wuhan, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Xiaoyan Shi
- Central Laboratory, The Central Hospital of Wuhan, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Xiang Liu
- Department of Laboratory MedicineHubei University of Chinese MedicineWuhanChina
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Fang H, Qi X, Zhou S, Yang S, Hang C, Tian Y, Wang C. High-Efficient Vacuum Ultraviolet-Ozone Assist-Deposited Polydopamine for Poly(lactic- co-glycolic acid)-Coated Pure Zn toward Biodegradable Cardiovascular Stent Applications. ACS APPLIED MATERIALS & INTERFACES 2022; 14:3536-3550. [PMID: 34941257 DOI: 10.1021/acsami.1c21567] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Zinc is a prospective metal for biodegradable cardiovascular stent applications, but the excessively released Zn2+ during degradation remains a huge challenge in biocompatibility. Considerable efforts have been made to develop a high-efficient surface modification method, while maintaining adhesion strength, mechanical support, and vascular compatibility. Biomimetic polydopamine (PDA) can adhere to Zn tightly, subsequently achieving robust chemical bonds with poly(lactic-co-glycolic acid) (PLGA) coating. However, the deposition of PDA on Zn depends on the controlled conditions such as a sensitive pH and a long period of time. Herein, we introduce vacuum ultraviolet-ozone (VUV/O3) assist-deposition technology to accelerate the polymerization of PDA on pure Zn, which shortens the process to 40 min at a moderate pH of 8.5 and improves the deposition rate by 1-2 orders of magnitude under sufficient active oxygen species (ROS). Additionally, PLGA/PDA coating enhances the corrosion resistance, and their effective protection maintains the mechanical properties after long-term corrosion. Moreover, the controlled Zn2+ release contributes to the superior in vitro biocompatibility, which inhibits the hemolysis rate and smooth muscle cell (SMC) proliferation. The enhanced endothelial cell (EC) proliferation is promising to promote the re-endothelialization, avoiding in-stent restenosis and neointimal hyperplasia. Such modified Zn might be a viable candidate for the treatment of cardiovascular diseases.
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Affiliation(s)
- Hui Fang
- State Key Laboratory of Advanced Welding and Joining, Harbin Institute of Technology, Harbin 150001, China
| | - Xiaoyun Qi
- State Key Laboratory of Advanced Welding and Joining, Harbin Institute of Technology, Harbin 150001, China
| | - Shicheng Zhou
- State Key Laboratory of Advanced Welding and Joining, Harbin Institute of Technology, Harbin 150001, China
| | - Shuhan Yang
- State Key Laboratory of Advanced Welding and Joining, Harbin Institute of Technology, Harbin 150001, China
| | - Chunjin Hang
- State Key Laboratory of Advanced Welding and Joining, Harbin Institute of Technology, Harbin 150001, China
| | - Yanhong Tian
- State Key Laboratory of Advanced Welding and Joining, Harbin Institute of Technology, Harbin 150001, China
| | - Chenxi Wang
- State Key Laboratory of Advanced Welding and Joining, Harbin Institute of Technology, Harbin 150001, China
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Sidebottom AC, Miedema MD, Benson G, Vacquier M, VanWormer JJ, Sillah A, Lindberg R, Boucher JL, Bradley SM. The impact of a population-based prevention program on cardiovascular events: Findings from the heart of new Ulm project. Am Heart J 2021; 239:38-51. [PMID: 33957104 DOI: 10.1016/j.ahj.2021.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 04/24/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) and its associated risk factors are the principal drivers of mortality and healthcare costs in the United States with rural residents experiencing higher CVD death rates than their urban counterparts. METHODS The purpose of this study was to examine incidence of major CVD events over 9 years of implementation of the Heart of New Ulm (HONU) Project, a rural population-based CVD prevention initiative. HONU interventions were delivered at individual, organizational, and community levels addressing clinical risk factors, lifestyle behaviors and environmental changes. The sample included 4,056 residents of New Ulm matched with 4,056 residents from a different community served by the same health system. The primary outcome was a composite of major CVD events (myocardial infarction, ischemic stroke, percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and CVD-related death). Secondary outcomes were the individual CVD events and procedures. RESULTS The proportion of residents in New Ulm with a major CVD event (7.79%) was not significantly different than the comparison community (8.43%, P = .290). However, the total number of events did differ by community with fewer events in New Ulm than the comparison community (447 vs 530, P = .005), with 48 fewer strokes (84 vs 132, P = .001) and 42 fewer PCI procedures (147 vs 189, P = 0.019) in New Ulm. Incidence of ischemic stroke was lower in the New Ulm community (1.85 vs 2.61, P = .020) than in the comparison community. Other specific CVD events did not have significantly different incidence or frequencies between the 2 communities. CONCLUSION In HONU, the proportion of residents experiencing a CVD event was not significantly lower than a match comparison community. However, there was a significant reduction in the total number of CVD events in New Ulm, driven primarily by lower stroke, PCI, and CABG events in the intervention community.
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Mamudu HM, Jones A, Paul TK, Osedeme F, Stewart D, Alamian A, Wang L, Orimaye S, Bledsoe J, Poole A, Blackwell G, Budoff M. The co-existence of diabetes and subclinical atherosclerosis in rural central Appalachia: Do residential characteristics matter? J Diabetes Complications 2021; 35:107851. [PMID: 33468398 DOI: 10.1016/j.jdiacomp.2021.107851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/02/2021] [Indexed: 10/22/2022]
Abstract
UNLABELLED Aim Disparities exist in cardiovascular diseases (CVD) and diabetes in the United States (U.S.) with Central Appalachia having disproportionate burden. This study examined prevalence and correlates of CVD risk-factors among patients with diabetes/subclinical atherosclerosis in Central Appalachia. METHODS During 2012-2016, 3000 patients from Central Appalachia were screened for subclinical atherosclerosis, using coronary artery calcium (CAC) scores; 419 participants had diabetes. Patients were categorized into four groups, with emphasis on those having subclinical atherosclerosis, CAC score ≥ 1. Descriptive statistics and multilevel multinomial logistic regression were conducted to identify CVD risk and spatial factors associated with co-existence of diabetes and subclinical atherosclerosis. RESULTS Among participants, prevalence of CVD risk-factors ranged from 11.7% for current smokers to 69.2% for those with CVD family history. Average BMI was 29.8. Compared to patients with diabetes only, age [RR = 1.07; p ≤ 0.0001], being male [RR = 5.33; p ≤ 0.0001], having hypertension [RR = 2.37; p ≤ 0.05] and being a former smoker were associated with increased likelihood of having diabetes/subclinical atherosclerosis. At the zip-code level, unemployment rate [RR = 1.37; p ≤ 0.05] was significantly associated with having diabetes/subclinical atherosclerosis. CONCLUSION Consistent with clinical guidelines, study results suggest the need to integrate CAC screening into primary care diabetes programs while addressing spatial issues that predispose patients to have diabetes/subclinical atherosclerosis.
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Affiliation(s)
- Hadii M Mamudu
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.
| | - Antwan Jones
- Department of Sociology and Department of Epidemiology & Biostatistics, The George Washington University, Washington, DC 20052, USA
| | - Timir K Paul
- John H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614, USA
| | - Fenose Osedeme
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - David Stewart
- Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA
| | - Arsham Alamian
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Liang Wang
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Sylvester Orimaye
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - James Bledsoe
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Amy Poole
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | | | - Mathew Budoff
- Los Angeles Biomedical Research Institute, University of California in Los Angeles, Los Angeles, California 90502, USA
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Zhang YM, Meng LB, Yu SJ, Ma DX. Identification of potential crucial genes in monocytes for atherosclerosis using bioinformatics analysis. J Int Med Res 2021; 48:300060520909277. [PMID: 32314637 PMCID: PMC7175059 DOI: 10.1177/0300060520909277] [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] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective To use bioinformatics tools to screen for gene biomarkers from monocytes, which play an important role in the pathogenesis of atherosclerosis. Methods Two expression profiling datasets (GSE27034 and GSE10195) were obtained from the Gene Expression Omnibus dataset and the differentially expressed genes (DEGs) between atherosclerotic human peripheral blood mononuclear cells (PBMC) samples and control subjects were screened using GEO2R. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses were conducted for the DEGs. STRING and MCODE plug-in of Cytoscape were used for constructing a protein–protein interaction network and analysing hub genes. Results The two datasets had 237 DEGs in common between non-atherosclerotic- and atherosclerotic PBMC samples. Functional annotation demonstrated that these DEGs were mainly enriched in protein binding, positive regulation of transcription from RNA polymerase II promoter, nucleus and viral carcinogenesis. Five hub genes, FBXL4, UBOX5, KBTBD6, FZR1 and FBXO2, were identified. Conclusion This present bioinformatics analysis identified that the FBXL4, UBOX5, KBTBD6 and FBXO21 genes might play vital roles in the pathogenesis of atherosclerosis. These four genes might represent new biomarkers for the diagnosis and treatment of atherosclerosis.
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Affiliation(s)
- Yuan-Meng Zhang
- Department of Internal Medicine, The Third Medical Centre of Chinese PLA General Hospital, The Training Site for Postgraduate of Jinzhou Medical University, Beijing, China
| | - Ling-Bing Meng
- Department of Neurology, Beijing Hospital, National Centre of Gerontology, Beijing, China
| | - Si-Jun Yu
- Department of Cardiology, The Third Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Dong-Xing Ma
- Department of Cardiology, The Third Medical Centre of Chinese PLA General Hospital, Beijing, China
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10
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Alsaud W, Tabbaa MJ, Kasabri VN, Suyagh MF, Abu Alsamen MA, Haddad HM, ALshweki AO. Prevalence of Cardiovascular Diseases Risk Factors among Jordanians. J Saudi Heart Assoc 2020; 32:324-333. [PMID: 33154938 PMCID: PMC7640553 DOI: 10.37616/2212-5043.1074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/25/2020] [Accepted: 05/30/2020] [Indexed: 12/13/2022] Open
Abstract
Background and aims One of the most common causes of death worldwide is cardiovascular diseases (CVDs). This study evaluated the prevalence of CVDs risk factors (RFs) and their constellation electively among the Jordanian population and, assessing the most prevalent RF interplay with the rest of CVDs RFs as well as the impact of age and gender dimorphism on the frequencies of coexistence of multiple CVDs risk factors (RFs) among the Jordanian population. Methods and results In this observational multicenter study, a total of 1449 subjects were enrolled. The mean age (±SD) was 44.35 ± 14.46 years; 796 (54.9%) of them were females and 801 (55.28%) of the whole study pool had no family history of premature CVDs. Only 5.9% of the population did not have any of these RFs. The prevalence of CVDs MRFs within-affected subjects was as follows: there were 1081 (74.6%) subjects with overall dyslipidemia, 471 (32.51%) with obesity, 456 (31.47%) were smokers, and at the first diagnostic encounter 541 (37.47%) were with elevated blood pressure and, 310 (21.51%) were with elevated random blood sugar. The coexistence of ≥ two, ≥ three and, ≥ four RFs was observed in 75.7%, 44.4%, and 21.4% of the subjects, respectively. The constellation of multiple RFs was more frequent in men than that in women, where the presence of ≥ two RFs for men was at 86.18% vs. 67.09% for women. Similarly, the appearance of multiple RFs increases with age, starting from the existence of ≥ three, and four RFs respectively. Most notably the clustering of ≥ five RFs in the age group of 45–59 years showed the greatest frequency vs. any other age group. Conclusions CVDs risk factors (RFs) and clusters of them are extremely prevalent in the Jordanian population. Overall dyslipidemia is the most prevalent MRF and the most favors clustering with other CVDs RFs. Combined two RFs had the highest proportional frequency between all six RFs clusters. The constellation of at least two, three, and four CVDs RFs presented at almost three-fourth, half, and around one-fourth; respectively, Middle-aged males presented significantly higher rates of ≥ five RFs occurrences than females.
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Affiliation(s)
- Wesam Alsaud
- Scientific Office, Jordanian Pharmaceutical Company, Amman, Jordan
| | | | | | | | | | | | - Anas O ALshweki
- Scientific Office, Jordanian Pharmaceutical Company, Amman, Jordan
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GÖZÜM S, TUZCU A, MUSLU L, AYDEMİR K, ILGAZ A, DAĞISTAN AKGÖZ A, DEMİR AVCI Y. Kırsal alanda yaşayan erişkin bireylerde bazı bulaşıcı olmayan hastalıklar için risk sıklığı. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.632153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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12
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Xie M, Tang Q, Nie J, Zhang C, Zhou X, Yu S, Sun J, Cheng X, Dong N, Hu Y, Chen L. BMAL1-Downregulation Aggravates Porphyromonas Gingivalis-Induced Atherosclerosis by Encouraging Oxidative Stress. Circ Res 2020; 126:e15-e29. [PMID: 32078488 DOI: 10.1161/circresaha.119.315502] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
RATIONALE Atherosclerotic cardiovascular diseases are the leading cause of mortality worldwide. Atherosclerotic cardiovascular diseases are considered as chronic inflammation processes. In addition to risk factors associated with the cardiovascular system itself, pathogenic bacteria such as the periodontitis-associated Porphyromonas gingivalis (P gingivalis) are also closely correlated with the development of atherosclerosis, but the underlying mechanisms are still elusive. OBJECTIVE To elucidate the mechanisms of P gingivalis-accelerated atherosclerosis and explore novel therapeutic strategies of atherosclerotic cardiovascular diseases. METHODS AND RESULTS Bmal1-/- (brain and muscle Arnt-like protein 1) mice, ApoE-/- mice, Bmal1-/-ApoE-/- mice, conditional endothelial cell Bmal1 knockout mice (Bmal1fl/fl; Tek-Cre mice), and the corresponding jet-legged mouse model were used. Pgingivalis accelerates atherosclerosis progression by triggering arterial oxidative stress and inflammatory responses in ApoE-/- mice, accompanied by the perturbed circadian clock. Circadian clock disruption boosts P gingivalis-induced atherosclerosis progression. The mechanistic dissection shows that P gingivalis infection activates the TLRs-NF-κB signaling axis, which subsequently recruits DNMT-1 to methylate the BMAL1 promoter and thus suppresses BMAL1 transcription. The downregulation of BMAL1 releases CLOCK, which phosphorylates p65 and further enhances NF-κB signaling, elevating oxidative stress and inflammatory response in human aortic endothelial cells. Besides, the mouse model exhibits that joint administration of metronidazole and melatonin serves as an effective strategy for treating atherosclerotic cardiovascular diseases. CONCLUSIONS P gingivalis accelerates atherosclerosis via the NF-κB-BMAL1-NF-κB signaling loop. Melatonin and metronidazole are promising auxiliary medications toward atherosclerotic cardiovascular diseases.
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Affiliation(s)
- Mengru Xie
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Qingming Tang
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Jiaming Nie
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Chao Zhang
- Department of Cardiovascular Surgery (C.Z., N.D.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Zhou
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Shaoling Yu
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Jiwei Sun
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Xiang Cheng
- Department of Cardiology (X.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nianguo Dong
- Department of Cardiovascular Surgery (C.Z., N.D.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Hu
- Institute of Hematology (Y.H.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lili Chen
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
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Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation 2020; 141:e139-e596. [PMID: 31992061 DOI: 10.1161/cir.0000000000000757] [Citation(s) in RCA: 4904] [Impact Index Per Article: 1226.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals. RESULTS Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Sidebottom AC, Benson G, Vacquier M, Pereira R, Hayes J, Boersma P, Boucher JL, Lindberg R, Pribyl B, VanWormer JJ. Population-Level Reach of Cardiovascular Disease Prevention Interventions in a Rural Community: Findings from the Heart of New Ulm Project. Popul Health Manag 2020; 24:86-100. [PMID: 31971871 PMCID: PMC7875136 DOI: 10.1089/pop.2019.0196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study examines participation by residents of a rural community in programs implemented as part of The Heart of New Ulm (HONU) Project, a population-based cardiovascular disease (CVD) prevention initiative. The study compares participation rates for the various interventions to assess which were the most engaging in the priority community and identifies factors that differentiate participants vs. nonparticipants. Participation data were merged with electronic health record (EHR) data representing the larger community population to enable an analysis of participation in the context of the entire community. HONU individual-level interventions engaged 44% of adult residents in the community. Participation ranked as follows: (1) heart health screenings (37% of adult residents), (2) a year-long community weight loss intervention (12% of adult residents), (3) community health challenges (10% of adult residents), and (4) a phone coaching program for invited high CVD-risk residents (enrolled 6% of adult residents). Interventions that yielded the highest engagement were those that had significant staffing and recruited participants over several months, often with many opportunities to participate or register. Compared to nonparticipants, HONU participants were significantly older and a higher proportion were female, married, overweight or obese, and had high cholesterol. Participants also had a lower prevalence of smoking and diabetes than nonparticipants. Findings indicate community-based CVD prevention initiatives can be successful in engaging a high proportion of adult community members. Partnering with local health care systems can allow for use of EHR data to identify eligible participants and evaluate reach and engagement of the priority population.
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Affiliation(s)
| | - Gretchen Benson
- Population Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Marc Vacquier
- Care Delivery Research, Allina Health, Minneapolis, Minnesota, USA
| | - Raquel Pereira
- Population Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Joy Hayes
- Population Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Peter Boersma
- Population Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | | | - Rebecca Lindberg
- Population Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | | | - Jeffrey J VanWormer
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
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15
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Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O'Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019; 139:e56-e528. [PMID: 30700139 DOI: 10.1161/cir.0000000000000659] [Citation(s) in RCA: 5387] [Impact Index Per Article: 1077.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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16
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Qin Z, Song Y, Jin Y. Green Worship: The Effects of Devotional and Behavioral Factors on Adopting Electronic Incense Products in Religious Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193618. [PMID: 31561617 PMCID: PMC6801997 DOI: 10.3390/ijerph16193618] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/18/2019] [Accepted: 09/22/2019] [Indexed: 01/24/2023]
Abstract
The Buddhist tradition of incense burning has been practiced in many Asian countries. Prior studies have indicated that frequent exposure to incense smoke is linked to carcinogen-related health issues. However, widespread acceptance of health-friendly electronic incense and rituals remains limited. Based on theories of religious perceptions and health behavior, the present study aims to identify the factors which influence the acceptance of electronic incense burning in religious practices. A between-subjects (105 Buddhist participants) experiment was designed to compare the effects of different incense burners on religiosity, worship intention, perceived self-efficacy, health-promotion intention, and its underlying mechanism. Our results imply that Buddhists tend to show similar religiosity and worship intention in three different scenarios, namely, the usage of a traditional incense burner, an electronic incense burner, and an electronic burner attached with a doctrine reminder. Buddhists also tend to have a higher perceived self-efficacy and higher health-promotion intention when exposed to electronic incense scenarios (either with or without the attached doctrine reminder). The perceived self-efficacy was found to mediate the effect of the incense burning on health-promotion intention. Important implications for public policies are also discussed.
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Affiliation(s)
- Zhenzhen Qin
- School of Journalism and Communication, Anhui Normal University, Wuhu 241002, China.
| | - Yao Song
- School of Design, The Hong Kong Polytechnic University, Hung Hom, Hong Kong 00852, China.
| | - Yang Jin
- General Affairs Department, Anhui College of Traditional Chinese Medicine, Wuhu 241002, China.
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Li HJ, Groden C, Hoenig MP, Ray EC, Ferreira CR, Gahl W, Novacic D. Case report: extreme coronary calcifications and hypomagnesemia in a patient with a 17q12 deletion involving HNF1B. BMC Nephrol 2019; 20:353. [PMID: 31500578 PMCID: PMC6734489 DOI: 10.1186/s12882-019-1533-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 08/23/2019] [Indexed: 01/30/2023] Open
Abstract
Background 17q12 deletion syndrome encompasses a broad constellation of clinical phenotypes, including renal magnesium wasting, maturity-onset diabetes of the young (MODY), renal cysts, genitourinary malformations, and neuropsychiatric illness. Manifestations outside of the renal, endocrine, and nervous systems have not been well described. Case presentation We report a 62-year-old male referred to the Undiagnosed Diseases Program (UDP) at the National Institutes of Health (NIH) who presented with persistent hypermagnesiuric hypomagnesemia and was found to have a 17q12 deletion. The patient exhibited several known manifestations of the syndrome, including severe hypomagnesemia, renal cysts, diabetes and cognitive deficits. Coronary CT revealed extensive coronary calcifications, with a coronary artery calcification score of 12,427. Vascular calcifications have not been previously reported in this condition. We describe several physiologic mechanisms and a review of literature to support the expansion of the 17q12 deletion syndrome to include vascular calcification. Conclusion Extensive coronary and vascular calcifications may be an extension of the 17q12 deletion phenotype, particularly if hypomagnesemia and hyperparathyroidism are prevalent. In patients with 17q12 deletions involving HNF1B, hyperparathyroidism and hypomagnesemia may contribute to significant cardiovascular risk.
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Affiliation(s)
- Howard J Li
- Harvard Medical School, Boston, MA, 02115, USA.,National Institute of Mental Health, NIH, Bethesda, MD, 20892, USA
| | - Catherine Groden
- Undiagnosed Diseases Program, Office of the Clinical Director and National Human Genome Research Institute, NIH, Bethesda, MD, 20892, USA
| | - Melanie P Hoenig
- Harvard Medical School, Boston, MA, 02115, USA.,Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Evan C Ray
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Carlos R Ferreira
- Medical Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, MD, USA
| | - Willam Gahl
- Undiagnosed Diseases Program, Office of the Clinical Director and National Human Genome Research Institute, NIH, Bethesda, MD, 20892, USA.,Medical Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, MD, USA
| | - Danica Novacic
- Undiagnosed Diseases Program, Office of the Clinical Director and National Human Genome Research Institute, NIH, Bethesda, MD, 20892, USA.
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Abbott LS, Slate EH, Lemacks JL. Influencing cardiovascular health habits in the rural, deep south: results of a cluster randomized trial. HEALTH EDUCATION RESEARCH 2019; 34:200-208. [PMID: 30601979 PMCID: PMC6736056 DOI: 10.1093/her/cyy052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 12/06/2018] [Indexed: 06/09/2023]
Abstract
Cardiovascular disease (CVD) is a major cause of death among people living in the United States. Populations, especially minorities, living in the rural South are disproportionately affected by CVD and have greater CVD risk, morbidity and mortality. Culturally relevant cardiovascular health programs implemented in rural community settings can potentially reduce CVD risk and facilitate health behavior modification. The purpose of this study was to examine the effects of a cardiovascular health promotion intervention on the health habits of a group of rural African American adults. The study had a cluster randomized controlled trial design involving 12 rural churches that served as statistical clusters. From the churches (n = 6) randomized to the intervention group, 115 participants were enrolled, received the 6-week health program and completed pretest-posttest measures. The 114 participants from the control group churches (n = 6) did not receive the health program and completed the same pretest-posttest measures. The linear mixed model was used to compare group differences from pretest to posttest. The educational health intervention positively influenced select dietary and confidence factors that may contribute toward CVD risk reduction.
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Affiliation(s)
- Laurie S Abbott
- College of Nursing, Florida State University, 98 Varsity Way, Tallahassee, FL, USA
| | - Elizabeth H Slate
- Department of Statistics, Florida State University, 117 N. Woodward Ave., Tallahassee, FL, USA
| | - Jennifer L Lemacks
- Department of Nutrition and Food Systems, University of Southern Mississippi, 118 College Drive, Hattiesburg, MS, USA
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Sahebi R, Hassanian SM, Ghayour‐Mobarhan M, Farrokhi E, Rezayi M, Samadi S, Bahramian S, Ferns GA, Avan A. Scavenger receptor Class B type I as a potential risk stratification biomarker and therapeutic target in cardiovascular disease. J Cell Physiol 2019; 234:16925-16932. [DOI: 10.1002/jcp.28393] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Reza Sahebi
- Department of Modern Sciences and Technologies, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
- Department of Molecular Medicine, School of Advanced Technologies Shahrekord University of Medical Sciences Shahrekord Iran
| | - Seyed Mahdi Hassanian
- Metabolic Syndrome Research Center Mashhad University of Medical Sciences Mashhad Iran
| | - Majid Ghayour‐Mobarhan
- Department of Modern Sciences and Technologies, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
- Metabolic Syndrome Research Center Mashhad University of Medical Sciences Mashhad Iran
| | - Effat Farrokhi
- Department of Molecular Medicine, School of Advanced Technologies Shahrekord University of Medical Sciences Shahrekord Iran
| | - Majid Rezayi
- Metabolic Syndrome Research Center Mashhad University of Medical Sciences Mashhad Iran
| | - Sara Samadi
- Department of Modern Sciences and Technologies, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
| | - Shabbou Bahramian
- Stem Cell Research Center Golestan University of Medical Sciences Gorgan Iran
| | - Gordon A. Ferns
- Division of Medical Education Brighton & Sussex Medical School, Falmer Brighton Sussex
| | - Amir Avan
- Metabolic Syndrome Research Center Mashhad University of Medical Sciences Mashhad Iran
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Cluster Analysis of Obesity Disease Based on Comorbidities Extracted from Clinical Notes. J Med Syst 2019; 43:52. [DOI: 10.1007/s10916-019-1172-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 01/16/2019] [Indexed: 12/20/2022]
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21
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Mamudu HM, Alamian A, Paul T, Subedi P, Wang L, Jones A, Alamin AE, Stewart D, Blackwell G, Budoff M. Diabetes, subclinical atherosclerosis and multiple cardiovascular risk factors in hard-to-reach asymptomatic patients. Diab Vasc Dis Res 2018; 15:519-527. [PMID: 30113211 DOI: 10.1177/1479164118791654] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AIM To examine the association of cardiovascular disease risk factors with and their cumulative effect on coronary artery calcium in hard-to-reach asymptomatic patients with diabetes. METHODS A total of 2563 community-dwelling asymptomatic subjects from Central Appalachia participated in coronary artery calcium screening at a heart centre. Binary variable was used to indicate that coronary artery calcium was either present or absent. Independent variables consisted of demographic and modifiable risk factors and medical conditions. Descriptive statistics and multinomial logistic regression analyses were conducted. RESULTS In total, 55.8% and 13.7% of study participants had subclinical atherosclerosis (coronary artery calcium ⩾1) and diabetes, respectively. The presence of coronary artery calcium was higher in subjects with diabetes (68.5%) than those without (53.8%). Compared to subjects without diabetes with coronary artery calcium = 0, obesity, hypertension, hypercholesterolaemia and smoking increased the odds of the presence of coronary artery calcium (coronary artery calcium score ⩾1) regardless of diabetes status; however, with larger odds ratios in subjects with diabetes. Compared to subjects without diabetes with coronary artery calcium score = 0, having 3, 4 and ⩾5 risk factors increased the odds of presence of coronary artery calcium in subjects with diabetes by 14.06 (confidence interval = 3.26-62.69), 32.30 (confidence interval = 7.41-140.82) and 47.12 (confidence interval = 10.35-214.66) times, respectively. CONCLUSION There is a need for awareness about subclinical atherosclerosis in patients with diabetes and more research about coronary artery calcium in subpopulations of patients.
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Affiliation(s)
- Hadii M Mamudu
- 1 Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Arsham Alamian
- 2 East Tennessee State University, Johnson City, TN, USA
| | - Timir Paul
- 2 East Tennessee State University, Johnson City, TN, USA
| | - Pooja Subedi
- 2 East Tennessee State University, Johnson City, TN, USA
| | - Liang Wang
- 2 East Tennessee State University, Johnson City, TN, USA
| | - Antwan Jones
- 3 The George Washington University, Washington, DC, USA
| | - Ali E Alamin
- 2 East Tennessee State University, Johnson City, TN, USA
| | - David Stewart
- 2 East Tennessee State University, Johnson City, TN, USA
| | - Gerald Blackwell
- 4 Wellmont Health System (now part of Ballad Health), Kingsport, TN, USA
| | - Matthew Budoff
- 5 University of California, Los Angeles, Los Angeles, CA, USA
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22
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Mamudu HM, Subedi P, Paul T, Alamin AE, Alamian A, Wang L, Stewart D, Jones A, Harirforoosh S, Blackwell G, Budoff M. The associated risk factors for coronary artery calcium in asymptomatic individuals with and without diabetes in rural Central Appalachia. J Diabetes Complications 2018; 32:900-905. [PMID: 30082173 DOI: 10.1016/j.jdiacomp.2018.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 07/13/2018] [Accepted: 07/14/2018] [Indexed: 11/29/2022]
Abstract
AIM To examine the risk factor of coronary artery calcium (CAC) in individuals with diabetes and those without diabetes in Central Appalachia. METHODS Study population included 2479 asymptomatic participants who underwent CAC screening between August 2012 and November 2016. CAC score was classified into four categories [0 (no plaque), 1-99 (mild plaque), 100-399 (moderate plaque), and ≥400 (severe plaque)]. Multinomial logistic regression analyses were conducted to test the association between CAC and cardiovascular disease (CVD) risk factors among participants with diabetes, age and gender matched controls, and randomly selected controls. RESULTS 13.6% of total participants had diabetes. Around 69%, 59.8%, and 57.7% of the participants with diabetes, matched controls, and randomly selected controls had CAC score ≥1, respectively. Participants with diabetes had higher prevalence of all CVD risk factors than controls. Among participants with diabetes, hypertension and physical inactivity increased the odds of CAC = 100-399, while among those without diabetes, hypertension and hypercholesteremia increased the odds of having CAC = 1-99 and CAC ≥ 400. CONCLUSION Half of study participants had subclinical atherosclerosis (i.e., CAC), and individuals with diabetes had higher CAC scores. This study suggests that individuals with diabetes in Central Appalachia might benefit from screening for CAC.
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Affiliation(s)
- Hadii M Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.
| | - Pooja Subedi
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA; Department of Epidemiology, College of Public Health and Health Professions College of Medicine, University of Florida, Gainesville, FL 32610, USA.
| | - Timir Paul
- Division of Cardiology, James. H. Quillen College of Medicine, East Tennessee State University, 329 N State of Franklin Rd, Johnson City, TN 37604, USA.
| | - Ali E Alamin
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.
| | - Arsham Alamian
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.
| | - Liang Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.
| | - David Stewart
- Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA.
| | - Antwan Jones
- Department of Sociology, George Washington University, Washington, DC 20052, USA.
| | - Sam Harirforoosh
- Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA.
| | | | - Matthew Budoff
- Los Angeles Biomedical Research Institute, 1124 W Carson Street, Torrance, CA 90502, USA.
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23
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Yang Z, Yang Y, Zhang L, Xiong K, Li X, Zhang F, Wang J, Zhao X, Huang N. Mussel-inspired catalytic selenocystamine-dopamine coatings for long-term generation of therapeutic gas on cardiovascular stents. Biomaterials 2018; 178:1-10. [PMID: 29902532 DOI: 10.1016/j.biomaterials.2018.06.008] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 05/31/2018] [Accepted: 06/06/2018] [Indexed: 11/17/2022]
Abstract
The development of a nitric oxide (NO)-generating surface with long-term, stable and controllable NO release improves the therapeutic efficacy of cardiovascular stents. In this work, we developed a "one-pot" method inspired by mussel adhesive proteins for copolymerization of selenocystamine (SeCA) and dopamine (Dopa) to form a NO-generating coating on a 316 L stainless steel (SS) stent. This "one-pot" method is environmentally friendly and easy to popularize, with many advantages including simple manufacturing procedure, high stability and no involvement of organic solvents. Such SeCA/Dopa coatings also enabled us to develop a catalytic surface for local NO-generation by reaction of endogenously existing S-nitrothiol species from fresh blood. We found that the developed SeCA/Dopa coatings could release NO in a controllable and stable manner for more than 60 days. Additionally, the released NO significantly inhibited smooth muscle cell (SMC) proliferation and migration, as well as platelet activation and aggregation through the up-regulation of cyclic guanosine monophosphate synthesis. Moreover, such NO generation enhanced the adhesion, proliferation and migration of endothelial cells (ECs), and achieved rapid in vivo re-endothelialization, effectively reducing in-stent restenosis and neointimal hyperplasia. We envision that the SeCA/Dopa-coated 316 L SS stent could be a promising platform for treatment of cardiovascular diseases.
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Affiliation(s)
- Zhilu Yang
- Key Lab. of Advanced Technology for Materials of Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, 610031, China.
| | - Ying Yang
- Key Lab. of Advanced Technology for Materials of Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Li Zhang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Kaiqin Xiong
- Key Lab. of Advanced Technology for Materials of Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Xiangyang Li
- Key Lab. of Advanced Technology for Materials of Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Feng Zhang
- Key Lab. of Advanced Technology for Materials of Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Jin Wang
- Key Lab. of Advanced Technology for Materials of Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Xin Zhao
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Nan Huang
- Key Lab. of Advanced Technology for Materials of Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, 610031, China.
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24
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Glenn BA, Crespi CM, Rodriguez HP, Nonzee NJ, Phillips SM, Sheinfeld Gorin SN, Johnson SB, Fernandez ME, Estabrooks P, Kessler R, Roby DH, Heurtin-Roberts S, Rohweder CL, Ory MG, Krist AH. Behavioral and mental health risk factor profiles among diverse primary care patients. Prev Med 2018; 111:21-27. [PMID: 29277413 PMCID: PMC5930037 DOI: 10.1016/j.ypmed.2017.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/02/2017] [Accepted: 12/13/2017] [Indexed: 10/18/2022]
Abstract
Behavioral and mental health risk factors are prevalent among primary care patients and contribute substantially to premature morbidity and mortality and increased health care utilization and costs. Although prior studies have found most adults screen positive for multiple risk factors, limited research has attempted to identify factors that most commonly co-occur, which may guide future interventions. The purpose of this study was to identify subgroups of primary care patients with co-occurring risk factors and to examine sociodemographic characteristics associated with these subgroups. We assessed 12 behavioral health risk factors in a sample of adults (n=1628) receiving care from nine primary care practices across six U.S. states in 2013. Using latent class analysis, we identified four distinct patient subgroups: a 'Mental Health Risk' class (prevalence=14%; low physical activity, high stress, depressive symptoms, anxiety, and sleepiness), a 'Substance Use Risk' class (29%; highest tobacco, drug, alcohol use), a 'Dietary Risk' class (29%; high BMI, poor diet), and a 'Lower Risk' class (27%). Compared to the Lower Risk class, patients in the Mental Health Risk class were younger and less likely to be Latino/Hispanic, married, college educated, or employed. Patients in the Substance Use class tended to be younger, male, African American, unmarried, and less educated. African Americans were over 7 times more likely to be in the Dietary Risk versus Lower Risk class (OR 7.7, 95% CI 4.0-14.8). Given the heavy burden of behavioral health issues in primary care, efficiently addressing co-occurring risk factors in this setting is critical.
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Affiliation(s)
- Beth A Glenn
- Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA 90095, USA.
| | - Catherine M Crespi
- Center for Cancer Prevention and Control Research, Department of Biostatistics, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA 90095, USA
| | - Hector P Rodriguez
- Division of Health Policy and Management, University of California, Berkeley School of Public Health, 50 University Hall, Berkeley, CA 94720, USA
| | - Narissa J Nonzee
- Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA 90095, USA
| | - Siobhan M Phillips
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Chicago, IL 60611, USA
| | - Sherri N Sheinfeld Gorin
- New York Physicians against Cancer (NYPAC), Herbert Irving Comprehensive Cancer Center, New York, NY 10032, USA; Division of Cancer Control and Population Sciences (Leidos Biomedical Research, Inc.), National Cancer Institute, 6130 Executive Plaza, Bethesda, MD 20892, USA
| | - Sallie Beth Johnson
- Department of Health Sciences Administration, Jefferson College of Health Sciences at Carilion Clinic, 101 Elm Avenue, Roanoke, VA 24016, USA; Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA
| | - Maria E Fernandez
- University of Texas Health Science Center at Houston, School of Public Health, 7000 Fannin Street, Houston, TX 77030, USA
| | - Paul Estabrooks
- Department of Health Promotion, University of Nebraska Medical Center, 986075 Nebraska Medical Center, Omaha, NE 68198, USA
| | - Rodger Kessler
- Doctor of Behavorial Health Program, College of Health Solutions, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004, USA
| | - Dylan H Roby
- Department of Health Services Administration, University of Maryland School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA
| | - Suzanne Heurtin-Roberts
- Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Boulevard, Rockville, MD 20852, USA
| | - Catherine L Rohweder
- UNC Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, NC 27599, USA
| | - Marcia G Ory
- Center for Population Health and Aging, Texas A&M Health Sciences Center, College Station, TX 77843, USA
| | - Alex H Krist
- Department of Family Medicine and Population Health, Virginia Commonwealth University, PO Box 980251, Richmond, VA 23298, USA
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25
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Uzhova I, Mateo-Gallego R, Moreno-Franco B, Molina-Montes E, Leon-Latre M, Casasnovas Lenguas JA, Civeira F, Peñalvo JL. The additive effect of adherence to multiple healthy lifestyles on subclinical atherosclerosis: Insights from the AWHS. J Clin Lipidol 2018; 12:615-625. [DOI: 10.1016/j.jacl.2018.03.081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/30/2018] [Accepted: 03/16/2018] [Indexed: 11/25/2022]
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26
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Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 2018; 137:e67-e492. [PMID: 29386200 DOI: 10.1161/cir.0000000000000558] [Citation(s) in RCA: 4545] [Impact Index Per Article: 757.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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27
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Mamudu HM, Jones A, Paul T, Subedi P, Wang L, Alamian A, Alamin AE, Blackwell G, Budoff M. Geographic and Individual Correlates of Subclinical Atherosclerosis in an Asymptomatic Rural Appalachian Population. Am J Med Sci 2018; 355:140-148. [DOI: 10.1016/j.amjms.2017.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/26/2017] [Accepted: 08/18/2017] [Indexed: 01/13/2023]
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28
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Effect of multimorbidity on quality of life in adult with cardiovascular disease: a cross-sectional study. Health Qual Life Outcomes 2017; 15:240. [PMID: 29221456 PMCID: PMC5723093 DOI: 10.1186/s12955-017-0820-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 12/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of present study was to describe the effect of multimorbidity on Health-Related Quality of Life (HRQoL) in patients with coronary artery disease (CAD). METHODS A cross-sectional study with a simple sampling method of 296 patients undergoing coronary artery bypass surgery in a referral hospital of the northern part of Iran was conducted between April, 2015 and September, 2016. Multimorbidity was defined as the presence of at least two chronic diseases based on self-reporting and medical records. HRQoL was measured using the 36-item short form (SF-36) health status survey. We used analysis of variance (ANOVA) to assess the effect of multimorbidity on mental and physical component of HRQoL. RESULTS Approximately, 69% of CAD patients had at least one other disease like diabetes or hypertension. Patients without multimorbidity compared with patients with multimorbidity were significantly older (p = 0.012) and more educated (p = 0.002). Both physical and mental component score of HRQoL was better in patients without any morbidity (48.82 vs. 43.93 with 95%CI of mean difference: 3.37-6.42 and 54.85 vs. 50.44 with 95% CI of mean difference: 1.68-7.15, respectively). Both physical and mental component score was significantly lower in female and lower educated patients (physical mean score 43.07 vs. 46.54 with P = .001 and 42.53 vs. 46.82 with P < .001 and mental mean score 49.98 vs. 52.65 with P = .055 and 49.80 vs. 52.75 with P = .022 for sex and education, respectively). Also, two-way ANOVA showed that regards to morbidity, physical component score was grater in patients with lower education level than higher education level (P < .001). CONCLUSION The findings of this study suggest that women, lower education level and overweight reported lower quality of life. HRQoL is affected by multimorbidity among CAD patients specially in less educated.
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29
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Hammoudeh AJ, Alhaddad IA, Khader Y, Tabbalat R, Al-Mousa E, Saleh A, Jarrah M, Nammas A, Izraiq M. Cardiovascular risk factors in Middle Eastern patients undergoing percutaneous coronary intervention: Results from the first Jordanian percutaneous coronary intervention study. J Saudi Heart Assoc 2017; 29:195-202. [PMID: 28652673 PMCID: PMC5475346 DOI: 10.1016/j.jsha.2016.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/17/2016] [Accepted: 10/09/2016] [Indexed: 12/01/2022] Open
Abstract
Background and aims: Cardiovascular disease (CVD) is the leading cause of death in the Middle East. We sought to study the prevalence and coexistence of 6 cardiovascular risk factors (RFs) among patients who underwent percutaneous coronary intervention (PCI), and to evaluate the impact of age and gender on the presence of multiple RFs. METHODS AND RESULTS In this prospective, multicenter study, 2426 consecutive patients were enrolled. Mean age was 59.0 ± 10.1 years and 500 (20.6%) were women. Acute coronary syndrome and stable coronary disease were the indications for PCI in 77.1% and 22.9%, respectively. Hypertension was present in 62.3%, diabetes in 53.8%, hypercholesterolemia in 48.8%, smoking in 43.5%, family history of premature CVD 39.4% and obesity in 28.8%. Only 3.8% did not have any of these RFs. Presence of ⩾3 and ⩾4 RFS was observed in 57.4% and 29.5% of patients, respectively. Presence of ⩾3 RFs was more common in women than men (69.0% vs. 54.5%, p < 0.0001), and among patients 41-65 years of age than older or younger patients (60.1% vs. 52.0% vs. 48.3%, respectively, p = 0.017). Conclusions: Cardiovascular RFs are highly prevalent in this PCI Middle Eastern population undergoing PCI. More than half and more than one-fourth of the patients had at least 3 or 4 RFs; respectively. More women than men and more middle aged patients than older or younger patients had significantly higher rates of presence of multiple RFs.
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Affiliation(s)
| | | | - Yousef Khader
- School of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Ramzi Tabbalat
- Cardiology Department, Khalidi Medical Center, Amman, Jordan
| | - Eyas Al-Mousa
- Cardiology Department, Istishari Hospital, Amman, Jordan
| | - Akram Saleh
- Cardiology Section, Internal Medicine Department, Jordan University Hospital, Amman, Jordan
| | - Mohamad Jarrah
- Cardiology Section, Internal Medicine Department, King Abdullah University Hospital, Irbid, Jordan
| | - Assem Nammas
- Cardiology Department, Ibn Haitham Hospital, Amman, Jordan
| | - Mahmoud Izraiq
- Cardiology Department, Specialty Hospital, Amman, Jordan
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30
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Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017; 135:e146-e603. [PMID: 28122885 PMCID: PMC5408160 DOI: 10.1161/cir.0000000000000485] [Citation(s) in RCA: 6120] [Impact Index Per Article: 874.3] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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