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Nain P, Stabellini N, Makram OM, Rast J, Yerraguntla S, Gopu G, Bhave A, Seth L, Patel V, Jiang S, Malik S, Shetewi A, Montero AJ, Cullen J, Agarwal N, Wang X, Ky B, Baldassarre LA, Weintraub NL, Harris RA, Guha A. Adverse social determinants of health elevate uncontrolled hypertension risk: a cardio-oncology prospective cohort study. JNCI Cancer Spectr 2024; 8:pkae064. [PMID: 39115393 PMCID: PMC11368120 DOI: 10.1093/jncics/pkae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/14/2024] [Accepted: 06/25/2024] [Indexed: 09/03/2024] Open
Abstract
The role of social determinants of health (SDOH) in controlling hypertension (HTN) in cancer patients is unknown. We hypothesize that high SDOH scores correlate with uncontrolled HTN in hypertensive cancer patients. In our prospective study, patients completed the Protocol for Responding to & Assessing Patients' Assets, Risks & Experiences questionnaire. After integrating home and clinic blood pressure readings, uncontrolled HTN was defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg. Using Cox regression, we analyzed the impact of SDOH on HTN control, adjusting for relevant factors. The study involved 318 participants (median age 66.4, median follow-up 166 days, SDOH score 6.5 ± 3.2), with stress, educational insecurity, and social isolation as prevalent adverse SDOH. High SDOH scores led to 77% increased risk of uncontrolled HTN (adjusted hazards ratio = 1.77; 95% confidence interval = 1.10 to 2.83, P = .018). Urban residents with high SDOH scores were at an even greater risk. Identifying SDOH and mitigating underlying factors may help control HTN, the most typical disease process treated in all cardio-oncology clinics.
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Affiliation(s)
- Priyanshu Nain
- Department of Medicine, Division of Cardiology, and Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Nickolas Stabellini
- Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Division of Hematology and Oncology, Department of Medicine, University Hospitals/Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Omar M Makram
- Department of Medicine, Division of Cardiology, and Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Johnathan Rast
- Department of Internal Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | | | - Gaurav Gopu
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Aditya Bhave
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Lakshya Seth
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Vraj Patel
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Stephanie Jiang
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Sarah Malik
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Ahmed Shetewi
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Alberto J Montero
- Division of Hematology and Oncology, Department of Medicine, University Hospitals/Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jennifer Cullen
- Cancer Population Sciences, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Neeraj Agarwal
- Division of Medical Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Xiaoling Wang
- Georgia Prevention Institute, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Bonnie Ky
- Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lauren A Baldassarre
- Section of Cardiovascular Medicine, Department of Medicine and Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Neal L Weintraub
- Department of Medicine, Division of Cardiology, and Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Ryan A Harris
- Georgia Prevention Institute, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Avirup Guha
- Department of Medicine, Division of Cardiology, and Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA
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Graybeal AJ, Compton AT, Swafford SH, Brandner CF, Thorsen T, Renna ME, Stavres J. Measurements of Abdominal Obesity are Associated with Metabolic Syndrome Severity Independent of Hypertensive Phenotype in White but not Black Young Adults. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02051-8. [PMID: 38902464 DOI: 10.1007/s40615-024-02051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/30/2024] [Accepted: 06/07/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE This study sought to determine if metabolic syndrome severity (MetSindex) was differentially associated with abdominal obesity based on waist circumference (WC) site and the presentation of hypertensive phenotypes in a group of young White and Black adults. METHODS A total of 139 young adult (22.5 ± 3.3 years) non-Hispanic White (n = 73) and non-Hispanic Black (n = 66) males and females (M 53, 86 F) completed this cross-sectional evaluation. Participants had their WC measured at three distinct locations along the abdomen which were used to calculate waist-to-hip and waist-to-height ratios. Systolic (SBP) and diastolic blood pressure (DBP) were collected and used to calculate mean arterial pressure (MAP). In addition to traditional metabolic syndrome (MetS) risk factors, BP values were individually used to produce three separate MetSindex scores representing three specific hypertensive phenotypes (MetSSBP, MetSDBP, MetSMAP), and each of these were evaluated against each abdominal obesity estimate. RESULTS MetSDBP and MetSSBP were significantly higher than all other indices for females (all p ≤ 0.002) and males (all p < 0.001), respectively. MetSDBP was significantly higher than MetSMAP for White females (p = 0.039), and MetSSBP was significantly higher than MetSDBP and MetSMAP (both p < 0.001) for Black males. Standalone and joint estimates of abdominal obesity were uniquely associated with MetSindex across hypertensive phenotypes for White, but not Black males and females. CONCLUSIONS Specific hypertensive phenotypes may differentially determine MetSindex, but these estimates are not associated with abdominal obesity in young Black adults regardless of measurement location. Healthcare professionals should address this disparity by providing more comprehensive MetS screening procedures for young Black adults. CLINICAL TRIALS REGISTRATION NCT05885672.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA.
| | - Abby T Compton
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Sydney H Swafford
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Caleb F Brandner
- Department of Kinesiology and Health, Iowa State University, Ames, IA, 50011, USA
| | - Tanner Thorsen
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Megan E Renna
- School of Psychology, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Jon Stavres
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
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Wippold GM, Abshire DA, Wilson DK, Woods T, Zarrett N, Griffith DM. Shop Talk: A Qualitative Study to Understand Peer Health-related Communication Among Black Men at the Barbershop. Ann Behav Med 2024; 58:498-505. [PMID: 38815252 PMCID: PMC11185087 DOI: 10.1093/abm/kaae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND While successful health promotion efforts among Black men have been implemented at barbershops, the focus has largely been on outcomes as opposed to the processes by which outcomes are produced. An understanding of processes can be leveraged in the design and implementation of future efforts to improve the health of Black men. PURPOSE The objectives of the present study were to: (i) understand peer-derived sources of health-related support at the barbershop and (ii) understand the role of the barbershop in promoting health among Black men. METHODS Seven focus groups were conducted at barbershops used predominately by Black men. Each focus group lasted between 45 and 60 min. Using a thematic approach, each focus group was independently coded by two coders using a codebook derived from an inductive and deductive approach. The results were confirmed with members of the community advisory board. RESULTS Three themes emerged: (i) dynamic and candid exchange of health-related support at the barbershop; (ii) tailored forms of health-related and judgment-free communication that provide encouragement and increase motivation; and (iii) characteristics of a supportive environment at the barbershop that facilitate health-related communication. CONCLUSIONS The findings of the present study offer a potential pathway for public health efforts seeking to improve health among Black men. Those interested in designing and implementing these efforts can create tailored programs for Black men by recognizing and leveraging the unique dynamics of health-related conversations at the barbershop.
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Affiliation(s)
- Guillermo M Wippold
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Demetrius A Abshire
- College of Nursing, University of South Carolina, Columbia, South Carolina, USA
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Terry Woods
- Healthy Mind, Body, and Family Foundation, Sumter, South Carolina, USA
- Main Attraction Barbershop, Sumter, South Carolina, USA
| | - Nicole Zarrett
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Derek M Griffith
- Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC, USA
- Center for Men’s Health Equity, Georgetown University, Washington, DC, USA
- Racial Justice Institute, Georgetown University, Washington, DC, USA
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Salman A, Larik MO, Amir MA, Majeed Y, Urooj M, Tariq MA, Azam F, Shiraz MI, Fiaz MM, Waheed MA, Nadeem H, Zahra R, Fazalullah DM, Mattumpuram J. Trends in Rheumatic Heart Disease-Related Mortality in the United States from 1999 to 2020. Curr Probl Cardiol 2024; 49:102148. [PMID: 37863458 DOI: 10.1016/j.cpcardiol.2023.102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/14/2023] [Indexed: 10/22/2023]
Abstract
There is a lack of mortality data on rheumatic heart disease (RHD) in the United States (US). In light of this, a retrospective analysis was conducted to investigate the temporal, sex-based, racial, and regional trends in RHD-related mortality in the US, ranging from 1999 to 2020. The Center for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER) dataset was analyzed, where crude and age-adjusted mortality rates (AAMR) were identified, along with annual percentage changes (APCs) determined by Joinpoint regression. Through the period of 1999 to 2020, there were 141,137 RHD-related deaths reported, with a marginal decline from 4.05/100,000 in 1999 to 3.12/100,000 in 2020. However, the recent rise in AAMR from 2017 to 2020 has created a source of concern (APC: 6.62 [95% CI, 3.19-8.72]). Similar trends were observed in the Black or African American race from 2017 to 2020 (APC: 10.58 [95% CI, 6.29-17.80]). Moreover, the highest percentage change from 2018 to 2020 was observed in residents of large metropolitan areas (APC: 7.6 [95% CI, 2.8-10.5]). A prominent disparity was observed among states, with values ranging from 1.74/100,000 in Louisiana to 5.27/100,000 in Vermont. States within the top 90th percentile of RHD-related deaths included Alaska, Minnesota, Washington, Wyoming, and Vermont. In conclusion, it is imperative to delve deeper into the evidently rising trends of RHD-related mortality and outline the possible sources of social determinants within US healthcare in order to provide equal and quality medical care throughout the nation.
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Affiliation(s)
- Ali Salman
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
| | - Muhammad Omar Larik
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Ali Amir
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Yasir Majeed
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Maryam Urooj
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Ali Tariq
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Fatima Azam
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Maria Muhammad Fiaz
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Maryam Amjad Waheed
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hafsa Nadeem
- Department of Medicine, Hamdard College of Medicine and Dentistry, Karachi, Pakistan
| | - Roshnee Zahra
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Jishanth Mattumpuram
- Division of Cardiology, Department of Medicine, University of Louisville School of Medicine, Louisville, KY
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Bogoian HR, Barber SJ, Carter SE, Mingo C, Rosano C, Dotson VM. Association of white matter hyperintensities and clinical vascular burden with depressive symptoms in Black older adults. Int J Geriatr Psychiatry 2024; 39:e6052. [PMID: 38165121 PMCID: PMC10947565 DOI: 10.1002/gps.6052] [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] [Received: 05/17/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES Black older adults have a higher vascular burden compared to non-Hispanic White (NHW) older adults, which may put them at risk for a form of depression known as vascular depression (VaDep). The literature examining VaDep in Black older adults is sparse. The current study addressed this important gap by examining whether vascular burden was associated with depressive symptoms in Black older adults. METHODS Participants included 113 Black older adults from the Healthy Brain Project, a substudy of the Health, Aging, and Body Composition Study. In multiple regression analyses, clinical vascular burden (sum of vascular conditions) and white matter hyperintensity (WMH) volume predicted depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale, controlling for demographic variables. Follow-up analyses compared the associations in the Black subsample and in 179 NHW older adults. RESULTS Higher total WMH volume, but not clinically-defined vascular burden, predicted higher concurrent depressive symptoms and higher average depressive symptoms over 4 years. Similar associations were found between uncinate fasciculus (UF) WMHs and concurrent depressive symptoms and between superior longitudinal fasciculus WMHs and average depressive symptoms. The association between depressive symptoms and UF WMH was stronger in Black compared to NHW individuals. CONCLUSION This research is consistent with the VaDep hypothesis and extends it to Black older adults, a group that has historically been underrepresented in the literature. Results highlight WMH in the UF as particularly relevant to depressive symptoms in Black older adults and suggest this group may be particularly vulnerable to the negative effects of WMH.
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Affiliation(s)
- Hannah R. Bogoian
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Sarah J. Barber
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
- Gerontology Institute, Georgia State University, Atlanta, Georgia, USA
| | - Sierra E. Carter
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Chivon Mingo
- Gerontology Institute, Georgia State University, Atlanta, Georgia, USA
| | - Caterina Rosano
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Vonetta M. Dotson
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
- Gerontology Institute, Georgia State University, Atlanta, Georgia, USA
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Hamadeh IS, Patel JN, Jacobs R, Zeng H, He J, Hu B, Moyo TK, Soni A, Park S, Copelan E, Avalos B, Hamilton A, Steuerwald N, Ghosh N. Genetic Predictors of Ibrutinib-related Cardiovascular Side Effects in Patients with Chronic Lymphocytic Leukemia. Clin Cancer Res 2023; 29:4941-4948. [PMID: 37738027 DOI: 10.1158/1078-0432.ccr-23-0421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/25/2023] [Accepted: 09/20/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Patients with chronic lymphocytic leukemia (CLL) treated with ibrutinib are at risk of developing cardiovascular side effects (CVSE). The molecular determinants of CVSEs have not been fully elucidated. We interrogated genetic polymorphisms in the Bruton tyrosine kinase (BTK) signaling pathway for their association with ibrutinib-related CVSEs. EXPERIMENTAL DESIGN We conducted a retrospective/prospective observational pharmacogenetic study of 50 patients with newly diagnosed or relapsed CLL who received ibrutinib at a starting daily dose of 420 mg for at least 6 months. CVSEs, primarily atrial fibrillation and hypertension, occurred in 10 patients (20%), of whom 4 discontinued therapy. DNA was isolated from buccal swabs of all 50 patients and genotyped for 40 SNPs in GATA4, SGK1, KCNQ1, KCNA4, NPPA, and SCN5A using a customized next-generation sequencing panel. Univariate and multivariate logistic regression analysis were performed to determine genetic and clinical factors associated with the incidence of ibrutinib-related CVSEs. RESULTS GATA4 rs804280 AA (P = 0.043), KCNQ1 rs163182 GG (P = 0.036), and KCNQ1 rs2237895 AA (P = 0.023) genotypes were univariately associated with ibrutinib-related CVSEs. On the basis of multivariate analysis, a high genetic risk score, defined as the presence of at least two of these genotypes, was associated with 11.5-fold increased odds of CVSEs (P = 0.019; 95% confidence interval, 1.79-119.73). CONCLUSIONS Our findings suggest possible genetic determinants of ibrutinib-related CVSEs in CLL. If replicated in a larger study, pretreatment pharmacogenetic testing for GATA4 and KCNQ1 polymorphisms may be a useful clinical tool for personalizing treatment selection for CLL and/or instituting early risk mitigation strategies.
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Affiliation(s)
- Issam S Hamadeh
- Department of Cancer Pharmacology and Pharmacogenomics, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Jai N Patel
- Department of Cancer Pharmacology and Pharmacogenomics, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Ryan Jacobs
- Department of Hematologic Malignancies and Blood Disorders, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Hang Zeng
- Department of Cancer Biostatistics, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Jiaxian He
- Department of Cancer Biostatistics, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Bei Hu
- Department of Hematologic Malignancies and Blood Disorders, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Tamara Kay Moyo
- Department of Hematologic Malignancies and Blood Disorders, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Amy Soni
- Department of Hematologic Malignancies and Blood Disorders, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Steven Park
- Department of Hematologic Malignancies and Blood Disorders, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Ed Copelan
- Department of Hematologic Malignancies and Blood Disorders, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Belinda Avalos
- Department of Hematologic Malignancies and Blood Disorders, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Alicia Hamilton
- Molecular Biology and Genomics Core Facility, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Nury Steuerwald
- Molecular Biology and Genomics Core Facility, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
| | - Nilanjan Ghosh
- Department of Hematologic Malignancies and Blood Disorders, Atrium Health Levine Cancer Institute, Charlotte, North Carolina
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Allouch F, Mills KT, Laurent J, Alvarado F, Gustat J, He H, He J, Ferdinand KC. Perceived Religious Influence on Health Is Associated with Beneficial Health Behaviors in Members of Predominantly Black Churches. Ethn Dis 2023; DECIPHeR:81-88. [PMID: 38846731 PMCID: PMC11099522 DOI: 10.18865/ed.decipher.81] [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] [Indexed: 06/09/2024] Open
Abstract
Background Cardiovascular disease is the leading cause of death in the United States, and Black populations are disproportionately affected. Black populations also have high rates of religiosity, which may be an important health motivator, but mechanisms are unclear. Objective We examined the relationship between perceived religious influence on health and cardiovascular health behaviors, risk factors, and confidence participating in medical care in Black church congregants. Methods We surveyed 302 members of 13 churches with predominantly Black congregations in New Orleans, Louisiana. Participants reported if religious beliefs had an influence on their health and if they avoided harmful behaviors because of religion. Fruit and vegetable intake, physical activity, smoking status, confidence asking questions to health care providers, understanding treatment plans and self-reported hypertension, hypercholesterolemia, and diabetes were assessed. Logistic regression was used adjusting for age, sex, and education. Results Survey respondents were 77% female with a median age of 66 years, and 72%, 56%, and 37% reported hypertension, hypercholesterolemia, and diabetes, respectively. Perceived religious influence on health was positively associated with fruit and vegetable intake, physical activity, and confidence asking questions to health care providers. Avoiding harmful behaviors because of religion was positively associated with physical activity. There was no association between perceived religious influence on health and smoking, hypertension, hypercholesterolemia, or diabetes. Conclusion Perceived religious influence on health was associated with beneficial cardiovascular health behaviors and confidence participating in medical care. These findings can inform the design and delivery of interventions to reduce cardiovascular disease among Black religious communities.
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Affiliation(s)
- Farah Allouch
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Katherine T. Mills
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Sciences Institute, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Jodie Laurent
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Flor Alvarado
- Department of Medicine, School of Medicine, Tulane University, New Orleans, LA
| | - Jeanette Gustat
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Sciences Institute, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Hua He
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Sciences Institute, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Jiang He
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Sciences Institute, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Department of Medicine, School of Medicine, Tulane University, New Orleans, LA
| | - Keith C. Ferdinand
- Translational Sciences Institute, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Department of Medicine, School of Medicine, Tulane University, New Orleans, LA
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Butler FM, Utt J, Mathew RO, Casiano CA, Montgomery S, Wiafe SA, Lampe JW, Fraser GE. Plasma metabolomics profiles in Black and White participants of the Adventist Health Study-2 cohort. BMC Med 2023; 21:408. [PMID: 37904137 PMCID: PMC10617178 DOI: 10.1186/s12916-023-03101-4] [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] [Received: 03/24/2023] [Accepted: 10/03/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Black Americans suffer disparities in risk for cardiometabolic and other chronic diseases. Findings from the Adventist Health Study-2 (AHS-2) cohort have shown associations of plant-based dietary patterns and healthy lifestyle factors with prevention of such diseases. Hence, it is likely that racial differences in metabolic profiles correlating with disparities in chronic diseases are explained largely by diet and lifestyle, besides social determinants of health. METHODS Untargeted plasma metabolomics screening was performed on plasma samples from 350 participants of the AHS-2, including 171 Black and 179 White participants, using ultrahigh-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) and a global platform of 892 metabolites. Differences in metabolites or biochemical subclasses by race were analyzed using linear regression, considering various models adjusted for known confounders, dietary and/or other lifestyle behaviors, social vulnerability, and psychosocial stress. The Storey permutation approach was used to adjust for false discovery at FDR < 0.05. RESULTS Linear regression revealed differential abundance of over 40% of individual metabolites or biochemical subclasses when comparing Black with White participants after adjustment for false discovery (FDR < 0.05), with the vast majority showing lower abundance in Blacks. Associations were not appreciably altered with adjustment for dietary patterns and socioeconomic or psychosocial stress. Metabolite subclasses showing consistently lower abundance in Black participants included various lipids, such as lysophospholipids, phosphatidylethanolamines, monoacylglycerols, diacylglycerols, and long-chain monounsaturated fatty acids, among other subclasses or lipid categories. Among all biochemical subclasses, creatine metabolism exclusively showed higher abundance in Black participants, although among metabolites within this subclass, only creatine showed differential abundance after adjustment for glomerular filtration rate. Notable metabolites in higher abundance in Black participants included methyl and propyl paraben sulfates, piperine metabolites, and a considerable proportion of acetylated amino acids, including many previously found associated with glomerular filtration rate. CONCLUSIONS Differences in metabolic profiles were evident when comparing Black and White participants of the AHS-2 cohort. These differences are likely attributed in part to dietary behaviors not adequately explained by dietary pattern covariates, besides other environmental or genetic factors. Alterations in these metabolites and associated subclasses may have implications for the prevention of chronic diseases in Black Americans.
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Affiliation(s)
- Fayth M Butler
- Adventist Health Study, Loma Linda University, Loma Linda, CA, USA.
- Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, 24951 Circle Drive, NH2031, Loma Linda, CA, 92350, USA.
- Department of Preventive Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, USA.
- Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA.
- Department of Basic Science, Loma Linda University School of Medicine, Loma Linda, CA, USA.
| | - Jason Utt
- Adventist Health Study, Loma Linda University, Loma Linda, CA, USA
| | - Roy O Mathew
- Division of Nephrology, Department of Medicine, Loma Linda VA Health Care System, Loma Linda, CA, USA
- Department of Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Carlos A Casiano
- Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
- Department of Basic Science, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Suzanne Montgomery
- Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
- School of Behavioral Health, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Seth A Wiafe
- Center for Leadership in Health Systems, School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Johanna W Lampe
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Gary E Fraser
- Adventist Health Study, Loma Linda University, Loma Linda, CA, USA
- Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, 24951 Circle Drive, NH2031, Loma Linda, CA, 92350, USA
- Department of Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, USA
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Crabbe DL, Richardson BT, Hausman A, Gardiner H. COVID-19: An opportunity to engage African Americans and women in research on cardiovascular disease. J Natl Med Assoc 2023; 115:482-487. [PMID: 37599171 DOI: 10.1016/j.jnma.2023.07.007] [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: 01/17/2023] [Revised: 04/28/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION African Americans (AA) have been disproportionately affected with the COVID-19 disease experiencing 30%-60% of the deaths, while only making up 13% of the US population. Early data suggest that pregnant women and those with cardiovascular disease (CVD) may experience worse outcomes with severe coronavirus infection. There is an urgent need to incorporate AA and female perspectives into the design of research on the CVD complications related to COVID-19. OBJECTIVES The goal of this project was to incorporate perspectives of AA and female patients in developing research priorities and AN agenda related to COVID-19. Objectives included: (a) develop a strong, research-ready partnership capable of executing PCOR, (b) creation of a research agenda and a set of priorities on racial/sex-specific CVD disparities in COVID-19 which reflects the perspectives of AA's and women; (c) long-term objective is creation of a set of research questions suitable for clinical research using the AHA Registry. METHODS The project used principles of active and adult learning within the framework of capacity building to build a strong, patient-centered vision of research needs. Different methods of obtaining patient input were used to identify questions suitable for research using the America Heart Association COVID-19 CVD Quality Improvement Registry: focus groups and town halls to identify concerns and interests vis-à-vis CVD and COVID research; narrative medicine methods collected compelling real-life, COVID-19 health stories; a research advisory council reviewed and prioritized research questions. RESULTS Outcomes include a replicable method of obtaining patient-oriented input into the creation of a research agenda and a set of research priorities for COVID-19. Outputs include the establishment of a research advisory council and stakeholder training using the PCORI funded, PORTAL program resources; a catalogue of patient generated narratives on COVID-19 experiences in the voice of AAs and women, and a set of research questions suitable for research using the AHA Registry. CONCLUSION The project created a research ready stakeholder network, ready to develop a research agenda about COVID-19.
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Affiliation(s)
- Deborah L Crabbe
- Temple Health Sciences Campus, Lewis Katz School of Medicine at Temple University, 3401 North Broad Street, Room 947 Parkinson Pavilion, Philadelphia, PA 19140, USA.
| | | | - Alice Hausman
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Heather Gardiner
- College of Public Health, Temple University, Philadelphia, PA, USA
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10
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Graybeal AJ, Brandner CF, Aultman R, Ojo DE, Braun-Trocchio R. Differences in Perceptual and Attitudinal Body Image Between White and African-American Adults Matched for Sex, Age, and Body Composition. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01799-9. [PMID: 37749440 DOI: 10.1007/s40615-023-01799-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the differences in perceptual and attitudinal body image between White and African-American males and females matched for sex, age, BMI, and other body composition components using a combination of 3-dimensional mobile digital imaging analysis (DIA) and the Multidimensional Body-Self Relations Questionnaire-Appearance Scale (MBSRQ-AS). METHODS One-hundred non-Hispanic White (n=50) and non-Hispanic African-American (n=50) adults (M=34, F=66) matched for sex, age, BMI, and body composition components completed this cross-sectional study. Participants underwent several anthropometric assessments, completed the MBSRQ-AS, and rated their perceived appearance, ideal appearance, and the appearance they believed a partner would find societally attractive using a state of the art mobile 3-dimensional DIA produced using broad developmental populations. Body image distortion was measured as the perceived minus actual appearance, and body image dissatisfaction was defined as the ideal appearance and appearance a partner would find attractive minus the perceived appearance. RESULTS Using the DIA, only African-American females demonstrated significant body image distortion (p<0.001); reporting perceived appearances significantly lower their than their actual. Further, AA females demonstrated significantly larger differences between their ideal and perceived appearance (p=0.009), perceived larger bodies as more attractive to a potential partner (p=0.009), and reported higher ratings of appearance evaluation (p=0.001) and body area satisfaction (p=0.011) compared to White females. CONCLUSIONS After accounting for all anthropometric determinants of body image, perceptual and attitudinal body image differs between White and African-American adults with differences supporting larger body size acceptance for African-American individuals, particularly African-American females.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA.
| | - Caleb F Brandner
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Ryan Aultman
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Desiree E Ojo
- University of Incarnate Word School of Osteopathic Medicine, San Antonio, TX, 78235, USA
| | - Robyn Braun-Trocchio
- Department of Kinesiology, Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX, 76129, USA
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11
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Balaji S, Antony AK, Tonchev H, Scichilone G, Morsy M, Deen H, Mirza I, Ali MM, Mahmoud AM. Racial Disparity in Anthracycline-induced Cardiotoxicity in Breast Cancer Patients. Biomedicines 2023; 11:2286. [PMID: 37626782 PMCID: PMC10452913 DOI: 10.3390/biomedicines11082286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Breast cancer has become the most common cancer in the US and worldwide. While advances in early detection and treatment have resulted in a 40% reduction in breast cancer mortality, this reduction has not been achieved uniformly among racial groups. A large percentage of non-metastatic breast cancer mortality is related to the cardiovascular effects of breast cancer therapies. These effects appear to be more prevalent among patients from historically marginalized racial/ethnic backgrounds, such as African American and Hispanic individuals. Anthracyclines, particularly doxorubicin and daunorubicin, are the first-line treatments for breast cancer patients. However, their use is limited by their dose-dependent and cumulative cardiotoxicity, manifested by cardiomyopathy, ischemic heart disease, arrhythmias, hypertension, thromboembolic disorders, and heart failure. Cardiotoxicity risk factors, such as genetic predisposition and preexisting obesity, diabetes, hypertension, and heart diseases, are more prevalent in racial/ethnic minorities and undoubtedly contribute to the risk. Yet, beyond these risk factors, racial/ethnic minorities also face unique challenges that contribute to disparities in the emerging field of cardio-oncology, including socioeconomic factors, food insecurity, and the inability to access healthcare providers, among others. The current review will address genetic, clinical, and social determinants that potentially contribute to this disparity.
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Affiliation(s)
- Swetha Balaji
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Antu K. Antony
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Harry Tonchev
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Giorgia Scichilone
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Mohammed Morsy
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Hania Deen
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Imaduddin Mirza
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Mohamed M. Ali
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Abeer M. Mahmoud
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
- Department of Kinesiology, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
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12
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Vyas A, Desai R, Went TR, Wiltshire D, Priyadarshni S, Shalaby M, Khalife W. Cardiovascular Disease Burden and Major Adverse Cardiac Events in Young Black Patients: A National Analysis of 2 Cohorts 10 Years Apart (2017 Versus 2007). J Am Heart Assoc 2023; 12:e029895. [PMID: 37489730 PMCID: PMC10492977 DOI: 10.1161/jaha.123.029895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/12/2023] [Indexed: 07/26/2023]
Abstract
Background We aim to compare the burden of cardiovascular disease risk factors and major adverse cardiac events and in-hospital outcomes among young Black patients (aged 18-44 years) hospitalized in 2007 and 2017 using data obtained from the National Inpatient Sample database. Method and Results Comparison of the sociodemographic characteristics, comorbidities, and inpatient outcomes, including major adverse cardiac events (all-cause mortality, acute myocardial infarction, cardiogenic shock, cardiac arrest, ventricular fibrillation/flutter, pulmonary embolism, and coronary intervention), between 2017 and 2007 was performed. Multivariable analyses were performed, controlling for potential covariates. A total of 2 922 743 (mean age, 31 years; 70.3% women) admissions among young Black individuals were studied (1 341 068 in 2007 and 1 581 675 in 2017). The 2017 cohort had a younger population (mean, 30 versus 31 years; P<0.001), more male patients (30.4% versus 28.8%; P<0.001), and patients with higher nonelective admissions (76.8% versus 75%; P<0.001), and showed an increasing burden of traditional cardiometabolic comorbidities, congestive heart failure, chronic pulmonary disease, coagulopathy, depression, along with notable reductions in alcohol abuse and drug abuse, compared with the 2007 cohort. The adjusted multivariable analysis showed worsening in-hospital outcomes, including major adverse cardiac events (adjusted odds ratio [aOR], 1.21), acute myocardial infarction (aOR, 1.34), cardiogenic shock (aOR, 3.12), atrial fibrillation/flutter (aOR, 1.34), ventricular fibrillation/flutter (aOR, 1.32), cardiac arrest (aOR, 2.55), pulmonary embolism (aOR, 1.89), and stroke (aOR, 1.53). The 2017 cohort showed a decreased rate of percutaneous coronary intervention/coronary artery bypass grafting and all-cause mortality versus the 2007 cohort (P<0.001). Conclusions In conclusion, young Black patients have had an increasing burden of cardiovascular disease risk factors and worsened in-hospital outcomes, including major adverse cardiac events and stroke, in the past decade, although with improved survival odds.
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Affiliation(s)
- Ankit Vyas
- Baptist Hospitals of Southeast TexasBeaumontTX
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Giannisis A, Al-Grety A, Carlsson H, Howell JC, Hu WT, Kultima K, Nielsen HM. Plasma apolipoprotein E levels, isoform composition, and dimer profile in relation to plasma lipids in racially diverse patients with Alzheimer's disease and mild cognitive impairment. Alzheimers Res Ther 2023; 15:119. [PMID: 37400888 PMCID: PMC10316569 DOI: 10.1186/s13195-023-01262-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/14/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND The APOEε4-promoted risk of Alzheimer's disease (AD) is lower in Black/African-Americans (B/AAs), compared to non-Hispanic whites (NHWs). Previous studies reported lower plasma apolipoprotein E (apoE) levels in NHW APOEε4-carriers compared to non-carriers, and low plasma apoE levels were directly associated with an increased risk of AD and all dementia. We further showed that APOEε3/ε3 AD patients exhibited reduced plasma apoE dimers compared to corresponding control subjects. Whether plasma apoE levels and apoE dimer formation differ between races/ethnicities and therefore may help explain AD risk racial disparity remains to be elucidated. METHODS Using mass spectrometry, we determined total plasma apoE and apoE isoform levels in a cohort of B/AAs (n = 58) and NHWs (n = 67) including subjects with normal cognition (B/AA: n = 25, NHW: n = 28), mild cognitive impairment (MCI) (B/AA: n = 24, NHW: n = 24), or AD dementia (B/AA: n = 9, NHW: n = 15). Additionally, we used non-reducing western blot analysis to assess the distribution of plasma apoE into monomers/disulfide-linked dimers. Plasma total apoE, apoE isoform levels, and % apoE monomers/dimers were assessed for correlations with cognition, cerebrospinal fluid (CSF) AD biomarkers, sTREM2, neurofilament light protein (NfL), and plasma lipids. RESULTS Plasma apoE was predominantly monomeric in both racial groups and the monomer/dimer distribution was not affected by disease status, or correlated with CSF AD biomarkers, but associated with plasma lipids. Plasma total apoE levels were not related to disease status and only in the NHW subjects we observed lower plasma apoE levels in the APOEε4/ε4-carriers. Total plasma apoE levels were 13% higher in B/AA compared to NHW APOEε4/ε4 subjects and associated with plasma high-density lipoprotein (HDL) in NHW subjects but with low-density lipoprotein levels (LDL) in the B/AA subjects. Higher plasma apoE4 levels, exclusively in APOEε3/ε4 B/AA subjects, were linked to higher plasma total cholesterol and LDL levels. In the controls, NHWs and B/AAs exhibited opposite associations between plasma apoE and CSF t-tau. CONCLUSIONS The previously reported lower APOEε4-promoted risk of AD in B/AA subjects may be associated with differences in plasma apoE levels and lipoprotein association. Whether differences in plasma apoE levels between races/ethnicities result from altered APOEε4 expression or turnover, needs further elucidation.
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Affiliation(s)
- Andreas Giannisis
- Department of Biochemistry and Biophysics, Stockholm University, Svante Arrhenius Väg 16B, 114 18, Stockholm, Sweden
| | - Asma Al-Grety
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Henrik Carlsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | | | - William T Hu
- Department of Neurology, Emory University, Atlanta, GA, USA
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, and Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, USA
| | - Kim Kultima
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Henrietta M Nielsen
- Department of Biochemistry and Biophysics, Stockholm University, Svante Arrhenius Väg 16B, 114 18, Stockholm, Sweden.
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Fradin J, Kim FJ, Lu-Yao GL, Storozynsky E, Kelly WK. Review of Cardiovascular Risk of Androgen Deprivation Therapy and the Influence of Race in Men with Prostate Cancer. Cancers (Basel) 2023; 15:2316. [PMID: 37190244 PMCID: PMC10136828 DOI: 10.3390/cancers15082316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/03/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
Androgen deprivation therapy is the cornerstone of prostate cancer therapy. Recent studies have revealed an association between androgen deprivation therapy and cardiovascular adverse effects such as myocardial infarction and stroke. This review summarizes the available research on the cardiovascular risk of men using androgen deprivation therapy. We also discuss racial disparities surrounding both prostate cancer and cardiovascular disease, emphasizing the importance of biological/molecular and socioeconomic factors in assessing baseline risk in patients beginning androgen ablation. Based on the literature, we provide recommendations for monitoring patients who are at high risk for a cardiovascular adverse event while being treated on androgen deprivation therapy. This review aims to present the current research on androgen deprivation therapy and cardiovascular toxicity with an emphasis on racial disparities and provides a framework for clinicians to decrease the cardiovascular morbidity in men that are being treated with hormone therapy.
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Affiliation(s)
- James Fradin
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Felix J. Kim
- Department of Pharmacology, Physiology, and Cancer Biology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Grace L. Lu-Yao
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Eugene Storozynsky
- Jefferson Heart Institute, Department of Medicine, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - William K. Kelly
- Department of Medical Oncology and Urology, Sidney Kimmel Cancer Center, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Sandhyavenu H, Patel HP, Patel RH, Desai R, Patel AA, Patel BA, Patel J, Zahid S, Khan SU, Deshmukh A, Nasir K, DeSimone CV, Dani SS, Thakkar S. Rising trend of acute myocardial infarction among young cannabis users: A 10-year nationwide gender and race stratified analysis. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 16:200167. [PMID: 36874042 PMCID: PMC9975233 DOI: 10.1016/j.ijcrp.2022.200167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
Background The use of cannabis has massively increased among younger patients due to increasing legalization and availability. Methods We performed a retrospective nationwide study using the Nationwide inpatient sample (NIS) database to analyze the trends of acute myocardial infarction (AMI) in young cannabis users and related outcomes among patients aged 18-49 years from 2007 to 2018, using ICD-9 and ICD-10 codes. Results Out of 819,175 hospitalizations, 230,497 (28%) admissions reported using cannabis. There was a significantly higher number of males (78.08% vs. 71.58%, p < 0.0001) and African Americans (32.22% vs. 14.06%, p < 0.0001) admitted with AMI and reported cannabis use. The incidence of AMI among cannabis users consistently increased from 2.36% in 2007 to 6.55% in 2018. Similarly, the risk of AMI in cannabis users among all races increased, with the biggest increase in African Americans from 5.69% to 12.25%. In addition, the rate of AMI in cannabis users among both sexes showed an upward trend, from 2.63% to 7.17% in males and 1.62%-5.12% in females. Conclusion The incidence of AMI in young cannabis users has increased in recent years. The risk is higher among males and African Americans.
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Affiliation(s)
| | - Harsh P Patel
- Department of Internal Medicine, Louis A Weiss Memorial Hospital, Chicago, IL, USA
| | - Riddhiben H Patel
- Department of Internal Medicine, HCA Medical City Arlington, Dallas, Tx, USA
| | - Rohan Desai
- Department of Internal Medicine, Texas Tech University Health Science Center El Paso, El Paso, Tx, USA
| | - Achint A Patel
- Department of Public Health, Icahn School of Medicine Mount Sinai, New York, NY, USA
| | - Bhavin A Patel
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Jaimin Patel
- Department of Internal Medicine, GCS Medical College, Gujarat, India
| | - Salman Zahid
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Safi U Khan
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tx, USA
| | - Abhishek Deshmukh
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Khurram Nasir
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tx, USA
| | | | - Sourbha S Dani
- Department of Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Samarthkumar Thakkar
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tx, USA
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Dodoo SN, Okoh AK, Aggarwal T, Osman AF, Nkansah E, Oseni A, Odiete O, Egolum U. Disparities in health and healthcare: Impact of race on resource utilization and costs following transcatheter edge-to-edge repair. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2023; 50:13-18. [PMID: 36642556 PMCID: PMC10149584 DOI: 10.1016/j.carrev.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND This study sought to investigate health and healthcare disparities in the management of severe mitral regurgitation with transcatheter edge-to-edge repair using MitraClip and how racial differences impact resource utilization and costs. METHODS We retrospectively analyzed the National Inpatient Sample (NIS) for patients who underwent Transcatheter Edge-to-Edge Repair (TEER) using MitraClip between 2016 and 2018. The patients were stratified into four racial cohorts and study outcomes included high resource utilization (HRU), periprocedural complications, and total procedural costs. High resource utilization (HRU) was defined as length of stay (LOS) ≥7 days or a nonhome disposition at discharge. Multivariate logistic regression models were utilized to determine independent predictors of HRU. RESULTS 17,100 weighted TEER patients were segregated by race: Caucasian (n = 13,270), others (n = 1510), African Americans, AA (n = 1245) and Hispanics (n = 1075). More African Americans and Hispanics had TEER at Urban facilities (P < 0.001), which were teaching hospitals as well (P < 0.001) but were less likely to be covered by public insurance options -Medicare or Medicaid (P < 0.001). More AA (52.2 %) and Hispanics (27.6 %) were likely to be in the lowest median annual income quartile versus Caucasians (19.2 %) (P = 0.003). AA and Hispanics had higher resource utilization (HRU), prolonged length of stay, nonhome disposition at discharge, higher procedural costs and periprocedural complications versus Caucasians. The logistic regression model revealed acute kidney injury (AKI) and actual procedural costs as independent predictors of HRU in both African American and Hispanic groups. CONCLUSION Significant Health and healthcare disparities do exist among underrepresented, racial minority patients undergoing transcatheter edge-to-edge repair in the US. These disparities were associated with higher resource utilization and actual costs in patients with mitral regurgitation treated with TEER.
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Affiliation(s)
- Sheriff N Dodoo
- Division of Cardiology, Georgia Heart Institute, Northeast Georgia Medical Center, Gainesville, GA, USA.
| | - Alexis K Okoh
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Tanya Aggarwal
- Department of Internal Medicine, Northeast Georgia Medical Center, Gainesville, GA, USA
| | - Abdul-Fatawu Osman
- Department of Internal Medicine, Michigan State University-Sparrow Hospital, Lansing, MI, USA
| | - Emmanuel Nkansah
- Department of Economic and Finance, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Abdullahi Oseni
- Division of Cardiology, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | | | - Ugochukwu Egolum
- Advanced Heart Failure and Transplantation, Georgia Heart Institute, Northeast Georgia Medical Center, Gainesville, GA, USA
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White M, Malone S, Berhie G, Pizzetta C, Davidson E, Azevedo M, Hines A, Ikem F, Jones LM. Examining motivation factors for African American students' use of consumer wearables. Digit Health 2023; 9:20552076231203670. [PMID: 37928334 PMCID: PMC10624079 DOI: 10.1177/20552076231203670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/08/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose This study was initiated to examine factors that motivate African American students who use wearable devices at an HBCU in Mississippi. Method We conducted a correlational research study on undergraduate and graduate students from a southern USA university. The stratified random sample comprised a total of 239 students. The responses of the students were analyzed using the Fisher exact test to determine whether or not there was a significant association between the categorical demographic variables (age, gender, ethnicity, and student classification) and the students' motivation for using a wearable device. Results Students used wearables for one main reason, to help them increase their awareness of their health status because they understand the importance of tracking their health metrics to boost their health status and reduce risk factors for developing chronic diseases. Students also demonstrated that they understand the value of tracking health information, such as heart rate and blood pressure, as a way to reduce the prevalence and impact of risk factors that can lead to chronic diseases. Conclusions Wearables enable individuals to regularly observe, measure, and record their physical status and physiological measures, and facilitate medication adherence by enabling individuals to maintain their prescribed medication regimen adequately. The data collected and stored through these wearables can provide data that will be useful for medical personnel in their treatment of patients and in developing strategies for prevention and intervention for the larger community.
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Affiliation(s)
- Monique White
- Public Health, Informatics, and Technology, College of Health Sciences, Jackson State University, Jackson, MS, USA
| | - Shelia Malone
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Jackson State University, Jackson, MS, USA
| | - Girmay Berhie
- Public Health, Informatics, and Technology, College of Health Sciences, Jackson State University, Jackson, MS, USA
| | - Candis Pizzetta
- Department of English, Foreign Languages, and Speech Communication, College of Liberal Arts, Jackson State University, Jackson, MS, USA
| | - Edith Davidson
- Department of Business Administration, College of Business Administration, Jackson State University, Jackson, MS, USA
| | - Mario Azevedo
- Department of History and Philosophy, College of Liberal Arts, Jackson State University, Jackson, MS, USA
| | - Andre Hines
- Department of Public Policy & Administration, College of Liberal Arts, Jackson State University, Jackson, MS, USA
| | - Fidelis Ikem
- Department of Business Administration, College of Business Administration, Jackson State University, Jackson, MS, USA
| | - Lena M Jones
- Department of Public Policy & Administration, College of Liberal Arts, Jackson State University, Jackson, MS, USA
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Addison S, Yang Y, Metlock F, King M, McKoy A, Williams A, Gregory J, Gray DM, Joseph JJ, Nolan TS. The Role of Social Support in Cardiovascular Clinical Trial Participation among Black Men: Black Impact. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12041. [PMID: 36231354 PMCID: PMC9566142 DOI: 10.3390/ijerph191912041] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Attainment of the American Heart Association's Life's Simple 7 (LS7) metrics reduces cardiovascular disease (CVD) risk; yet, Black Americans have the lowest LS7 attainment among all communities, the highest rate of CVD mortality, and low clinical trial participation. Social support is positively correlated with chronic disease self-management. Here, we describe the role of social support in a single-arm pilot clinical trial of a community-based lifestyle intervention among Black American men. METHODS The 24-week intervention featured weekly team-based physical activity and LS7-themed education. Seventy-four Black men participated in the intervention; twenty agreed to participate in exit surveys via one of three semi-structured focus groups. Data were transcribed verbatim and analyzed using content analysis framed by House's social support framework. RESULTS Participants reported support from both peers and health coaches. The sub-themes of social support among peers were: (1) acknowledgement, understanding, and validation, (2) inspiration, (3) sense of community, (4) fear of disappointing fellow participants, and (5) group synergy. The sub-themes of social support from the health coaches and study team staff included: (1) contemplation of current health status, (2) racial concordance of health coaches and study team staff, (3) investment of the research team, (4) incentives, (5) access to healthcare providers, and (6) the COVID-19 pandemic. Emotional support was the most frequently discussed theme. CONCLUSIONS Social support, especially emotional support, from peers and health coaches was a driver of clinical trial participation among participants. The intervention created a positive social environment and decreased medical mistrust. This intervention may provide a framework by which to facilitate clinical trial participation among Black men.
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Affiliation(s)
- Sarah Addison
- College of Medicine, The Ohio State University, 370 W 9th Ave, Columbus, OH 43210, USA
| | - Yesol Yang
- Comprehensive Cancer Center, The Ohio State University, 460 W 10th Ave, Columbus, OH 43210, USA
| | - Faith Metlock
- College of Nursing, The Ohio State University, 1585 Neil Ave, Columbus, OH 43210, USA
| | - Mikayla King
- College of Nursing, The Ohio State University, 1585 Neil Ave, Columbus, OH 43210, USA
| | - Alicia McKoy
- Center for Cancer Health Equity, The Ohio State University, 460 W 10th Ave, Columbus, OH 43210, USA
| | - Amaris Williams
- College of Medicine, The Ohio State University, 370 W 9th Ave, Columbus, OH 43210, USA
| | - John Gregory
- National Center for Urban Solutions, The African American Male Wellness Agency, 2780 Airport Drive, Suite 333, Columbus, OH 43230, USA
| | - Darrell M. Gray
- Anthem, Inc. (Formerly The Ohio State University College of Medicine), 1310 G Street, Washington, DC 20005, USA
| | - Joshua J. Joseph
- College of Medicine, The Ohio State University, 370 W 9th Ave, Columbus, OH 43210, USA
| | - Timiya S. Nolan
- Comprehensive Cancer Center, The Ohio State University, 460 W 10th Ave, Columbus, OH 43210, USA
- College of Nursing, The Ohio State University, 1585 Neil Ave, Columbus, OH 43210, USA
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19
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Evaluating Levels of Community Participation in a University-Community Partnership: The Jackson Heart Study. Diseases 2022; 10:diseases10040068. [PMID: 36278567 PMCID: PMC9589967 DOI: 10.3390/diseases10040068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: This research was designed to evaluate the perceptions of the Jackson Heart Study (JHS) community relating to their levels of involvement in JHS activities that were developed to address health disparities and promote health education and health promotion. Methods: The participants for this study comprised 128 community members, who included JHS participants, as well as family members and other friends of the JHS who resided in the JHS community of Hinds, Madison, and Rankin Counties in Mississippi and attended the JHS Annual Celebration of Life. We used the Chi-Square test to analyze the participants’ responses to the survey questions developed to address the six areas of focus: (1) ways to increase participation in community outreach activities; (2) reasons for participating in community outreach activities; (3) interest in research participation; (4) factors influencing engagement; (5) Participants’ preferences for communicating; (6) Chronic disease prevalence. Results: Participants residing in rural counties perceived television and radio as a medium to increase participation; More female respondents cited trust working with the JSU JHS Community Outreach Center (CORC) as a reason for remaining engaged in the community outreach activities; younger participants under 66 years of age recommended social media as a way to increase participation; participants residing in the rural areas saw their participation in the community outreach activities as a way to address community health problems. Conclusions: The knowledge gained from the details provided by the JHS community members can be used to refine research studies in existence, while promoting their sustainability.
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Mathews L, Akhiwu O, Mukherjee M, Blumenthal RS, Matsushita K, Ndumele CE. Disparities in the Use of Cardiac Rehabilitation in African Americans. CURRENT CARDIOVASCULAR RISK REPORTS 2022; 16:31-41. [PMID: 35573267 PMCID: PMC9077032 DOI: 10.1007/s12170-022-00690-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/03/2022]
Abstract
Purpose of review Cardiac rehabilitation (CR) is a comprehensive outpatient program that reduces the risk of mortality and recurrent events and improves functional status and quality of life for patients recovering from acute cardiovascular disease (CVD) events. Among individuals with established CVD, African Americans have a higher risk of major cardiac events, which underscores the importance of CR use among African Americans. However, despite their high likelihood of adverse outcomes, CR is poorly utilized in African Americans with CVD. We review data on CR utilization among African Americans, barriers to participation, and the implications for policy and practice. Recent findings Although established as a highly effective secondary prevention strategy, CR is underutilized in general, but especially by African Americans. Notwithstanding efforts to increase CR participation among all groups, participation rates remain low for African Americans and other minorities compared to Non-Hispanic Whites. The low CR participation rates by African Americans can be attributed to an array of factors including differential referral patterns, access to care, and socioeconomic factors. There are several promising strategies to improve CR participation which include promoting evidence-based guidelines, reducing barriers to access, novel CR delivery modalities, including more African Americans in CR clinical research, and increasing diversity in the CR workforce. Summary African Americans with CVD events are less likely to be referred to, enroll in, and complete CR than Non-Hispanic Whites. There are many factors that impact CR participation by African Americans. Initiatives at the health policy, health system, individual, and community level will be needed to reduce these disparities in CR use.
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Affiliation(s)
- Lena Mathews
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Medicine, Baltimore, MD USA
- Division of Cardiology, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
- Department of Medicine, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
| | - Ofure Akhiwu
- Department of Medicine, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
| | - Monica Mukherjee
- Division of Cardiology, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
- Department of Medicine, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
| | - Roger S. Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD USA
- Division of Cardiology, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
- Department of Medicine, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
| | - Kunihiro Matsushita
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Medicine, Baltimore, MD USA
- Division of Cardiology, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
- Department of Medicine, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD USA
| | - Chiadi E. Ndumele
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Medicine, Baltimore, MD USA
- Division of Cardiology, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
- Department of Medicine, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21218 USA
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21
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Birhanu MM, Zaman SB, Thrift AG, Evans RG, Zengin A. Risk factors for incident cardiovascular events among adults in low- and middle-income countries: A systematic review and meta-analysis of prospective cohort studies. Prev Med 2022; 158:107036. [PMID: 35358600 DOI: 10.1016/j.ypmed.2022.107036] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
The relative contributions of risk factors for cardiovascular events at a population level has received little attention in low- and middle-income countries (LMICs). We estimated the population attributable fraction (PAF) of risk factors associated with incident cardiovascular events in LMICs. We searched six databases for relevant articles, supplemented with a manual search of reference lists. Articles included in the meta-analyses were those based on prospective community-based cohorts and incorporating adjusted hazard ratios (HR) or relative risks with 95% confidence intervals (95% CI) for associations between risk factors and a composite cardiovascular and/or stroke endpoint. Pooled HRs and 95% CI were calculated using the random effects model. We assessed heterogeneity using the I2 test and study quality using the Newcastle-Ottawa Scale. We calculated the PAF of each associated risk factor. The protocol was registered in PROSPERO (CRD42019122741). We identified 18 cohorts from LMICs with 1,125,846 participants, 77,045 composite cardiovascular events and 42,216 strokes. Substantial proportions of incident cardiovascular events were attributable to hypertension (HR [95% CI], 2.23 [2.01-2.48], PAF = 28%); current smoking (1.44 [1.31-1.58], PAF = 10%); and diabetes mellitus (1.93 [1.67-2.23], PAF = 8%). Other risk factors identified included number of children, depression, bone mineral density, and air pollution. A substantial proportion of incident cardiovascular events were linked to traditional metabolic and behavioural modifiable risk factors. However, other novel risk factors also appear to contribute. Targeting of these established and novel risk factors has the potential to reduce the burden of CVD in LMICs.
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Affiliation(s)
- Mulugeta Molla Birhanu
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Sojib Bin Zaman
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Amanda G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
| | - Roger G Evans
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria, Australia; Pre-clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
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22
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Johnson S. Women deserve better: A discussion on COVID‐19 and the gendered organization in the new economy. GENDER WORK AND ORGANIZATION 2022. [DOI: 10.1111/gwao.12785] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Simisola Johnson
- Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
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23
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Bogoian HR, Dotson VM. Vascular depression in Black Americans: A systematic review of the construct and its cognitive, functional, and psychosocial correlates. Clin Neuropsychol 2022; 36:431-461. [PMID: 34098846 PMCID: PMC10450356 DOI: 10.1080/13854046.2021.1933188] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
Objective: Vascular burden is associated with cognitive deficits and a form of late-life depression, vascular depression (VaDep), which is marked by decreased white matter integrity, executive dysfunction, poor treatment response, and functional disability. Older Black Americans represent a vulnerable population at risk of developing VaDep, but the literature in this group is limited. Thus, the goal of this systematic review is to summarize the existing literature that informs our understanding of VaDep in older Black Americans, including cognitive, functional, and psychosocial outcomes. Method: Following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, studies were identified that examined the relationship between vascular disease or vascular risk factors and that either had a sample of at least 75% Black participants or conducted race-specific analyses. Thirty studies met all inclusion criterion based on review of both authors. Results: Overall, studies support the construct of VaDep in older Black Americans. There is preliminary support for VaDep-related cognitive and functional deficits, and mixed findings regarding racial disparities in prevalence of VaDep. Conclusion: This review underscores the need for further neuroimaging and neuropsychological research in Black older adults with comorbid depression and vascular disease. Findings also highlight the importance of screening for depressive symptoms in Black individuals with multiple vascular risk factors.
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Affiliation(s)
- Hannah R Bogoian
- Department of Psychology, Georgia State University, Atlanta, USA
| | - Vonetta M Dotson
- Department of Psychology, Georgia State University, Atlanta, USA
- Neuroscience Institute, Georgia State University, Atlanta, USA
- Gerontology Institute, Georgia State University, Atlanta, USA
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24
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Clifford G, Nguyen T, Shaw C, Newton B, Francis S, Salari M, Evans C, Jones C, Akintobi TH, Taylor H. An Open-Source Privacy-Preserving Large-Scale Mobile Framework for Cardiovascular Health Monitoring and Intervention Planning With an Urban African American Population of Young Adults: User-Centered Design Approach. JMIR Form Res 2022; 6:e25444. [PMID: 35014970 PMCID: PMC8790689 DOI: 10.2196/25444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 06/08/2021] [Accepted: 09/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are the leading cause of death worldwide and are increasingly affecting younger populations, particularly African Americans in the southern United States. Access to preventive and therapeutic services, biological factors, and social determinants of health (ie, structural racism, resource limitation, residential segregation, and discriminatory practices) all combine to exacerbate health inequities and their resultant disparities in morbidity and mortality. These factors manifest early in life and have been shown to impact health trajectories into adulthood. Early detection of and intervention in emerging risk offers the best hope for preventing race-based differences in adult diseases. However, young-adult populations are notoriously difficult to recruit and retain, often because of a lack of knowledge of personal risk and a low level of concern for long-term health outcomes. OBJECTIVE This study aims to develop a system design for the MOYO mobile platform. Further, we seek to addresses the challenge of primordial prevention in a young, at-risk population (ie, Southern-urban African Americans). METHODS Urban African Americans, aged 18 to 29 years (n=505), participated in a series of co-design sessions to develop MOYO prototypes (ie, HealthTech Events). During the sessions, participants were orientated to the issues of CVD risk health disparities and then tasked with wireframing prototype screens depicting app features that they considered desirable. All 297 prototype screens were subsequently analyzed using NVivo 12 (QSR International), a qualitative analysis software. Using the grounded theory approach, an open-coding method was applied to a subset of data, approximately 20% (5/25), or 5 complete prototypes, to identify the dominant themes among the prototypes. To ensure intercoder reliability, 2 research team members analyzed the same subset of data. RESULTS Overall, 9 dominant design requirements emerged from the qualitative analysis: customization, incentive motivation, social engagement, awareness, education, or recommendations, behavior tracking, location services, access to health professionals, data user agreements, and health assessment. This led to the development of a cross-platform app through an agile design process to collect standardized health surveys, narratives, geolocated pollution, weather, food desert exposure data, physical activity, social networks, and physiology through point-of-care devices. A Health Insurance Portability and Accountability Act-compliant cloud infrastructure was developed to collect, process, and review data, as well as generate alerts to allow automated signal processing and machine learning on the data to produce critical alerts. Integration with wearables and electronic health records via fast health care interoperability resources was implemented. CONCLUSIONS The MOYO mobile platform provides a comprehensive health and exposure monitoring system that allows for a broad range of compliance, from passive background monitoring to active self-reporting. These study findings support the notion that African Americans should be meaningfully involved in designing technologies that are developed to improve CVD outcomes in African American communities.
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Affiliation(s)
- Gari Clifford
- Department of Biomedical Informatics, Emory University, Atlanta, GA, United States
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Tony Nguyen
- Department of Biomedical Informatics, Emory University, Atlanta, GA, United States
| | - Corey Shaw
- Department of Biomedical Informatics, Emory University, Atlanta, GA, United States
| | | | - Sherilyn Francis
- Nucleus Health Communications, Atlanta, GA, United States
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Mohsen Salari
- Department of Biomedical Informatics, Emory University, Atlanta, GA, United States
| | - Chad Evans
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA, United States
| | - Camara Jones
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA, United States
| | - Tabia Henry Akintobi
- Prevention Research Center & Community Engagement, Morehouse School of Medicine, Atlanta, GA, United States
| | - Herman Taylor
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA, United States
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25
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Rout M, Lerner M, Blackett PR, Peyton MD, Stavrakis S, Sidorov E, Sanghera DK. Ethnic differences in ApoC-III concentration and the risk of cardiovascular disease: No evidence for the cardioprotective role of rare/loss of function APOC3 variants in non-Europeans. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 13:100128. [PMID: 35528316 PMCID: PMC9075110 DOI: 10.1016/j.ahjo.2022.100128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Hypertriglyceridemia is as an independent risk factor for cardiovascular disease (CVD). Apolipoprotein C-III (ApoC-III) is known to regulate triglyceride (TG) metabolism. However, the causal association between ApoC-III and CVD development is unclear. The objectives were to examine the impact of ApoC-III concentration on TG and lipoproteins and investigate the role of known rare loss-of-function APOC3 variants for modulating ApoC-III, TG concentrations and CVD risk in different ethnic groups. METHODS Plasma ApoC-III levels were measured in a multiethnic sample of 518 individuals comprising 271 Asian Indians (Sikhs), 87 Caucasians, 80 African Americans, and 80 Hispanics. RESULTS ApoC-III levels showed a robust association with TG in Asian Indians (r = 0.5, p = 1.1 × 10-23), Caucasians (r = 0.4, p = 7.2 × 10-4), and Hispanics (r = 0.9, p = 2.7x × 10-28). African Americans had lowest ApoC-III and TG concentrations and highest (44%) prevalence of coronary artery disease (CAD). ApoC-III levels correlated with fasting blood glucose (r = 0.25, p = 6.1 × 10-5) in Asian Indians and central adiposity in Hispanics (waist: r = 0.22, p = 0.05; waist-hip ratio: r = 0.24, p = 0.04). The carriers of rare variants IVS1-2G-A (rs373975305); A43T (rs147210663) and IVS3 + 1G-T (rs140621530) showed high TG but not low ApoC-III levels in Asian Indians and Caucasians. CONCLUSION These results highlight the challenges of generalizing antisense ApoC-III inhibition for treating atherosclerotic disease in dyslipidemia that may benefit only specific sub-populations. The observed ethnic differences in ApoC-III concentrations and CAD risk factors, emphasize in-depth genetic and metabolomics evaluations on diverse ancestries.
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Affiliation(s)
- Madhusmita Rout
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Megan Lerner
- Department of Surgery, Oklahoma University of Health Sciences Center, Oklahoma City, OK, USA
| | - Piers R. Blackett
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Marvin D. Peyton
- Department of Surgery, Oklahoma University of Health Sciences Center, Oklahoma City, OK, USA
| | - Stavros Stavrakis
- Department of Cardiology, Oklahoma University of Health Sciences Center, Oklahoma City, OK, USA
| | - Evgeny Sidorov
- Department of Neurology, University of Oklahoma Health Sciences Center, 920 S.L Young Blvd #2040, 73104 Oklahoma City, OK, USA
| | - Dharambir K. Sanghera
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Physiology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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26
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Egbuche O, Jegede O, Abe T, Wagle B, Huynh K, Hayes D, Campbell ML, Mezue K, Ram P, Nwokike SI, Desai R, Effoe V, Kpodonu J, Morgan J, Ofili E, Onwuanyi A, Echols MR. Pre-existing cardiovascular disease, acute kidney injury, and cardiovascular outcomes in hospitalized blacks with COVID-19 infection. AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE 2021; 11:212-221. [PMID: 34084656 PMCID: PMC8166582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The Corona Virus 19 (COVID-19) infection is associated with worse outcomes in blacks, although the mechanisms are unclear. We sought to determine the significance of black race, pre-existing cardiovascular disease (pCVD), and acute kidney injury (AKI) on cardiopulmonary outcomes and in-hospital mortality of COVID-19 patients. METHODS We conducted a retrospective cohort study of blacks with/without pCVD and with/without in-hospital AKI, hospitalized within Grady Memorial Hospital in Georgia between February and July 2020, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on qualitative polymerase-chain-reaction assay. The primary outcome was a composite of in-hospital cardiac events. RESULTS Of the 293 patients hospitalized with COVID-19 in this study, 71 were excluded from the primary analysis (for race/ethnicity other than black non-Hispanic). Of the 222 hospitalized COVID-19 patients included in our analyses, 41.4% were female, 78.8% had pCVD, and 30.6% developed AKI during the admission. In multivariable analyses, pCVD (OR 4.7, 95% CI 1.5-14.8, P=0.008) and AKI (OR 2.7, 95% CI 1.3-5.5, P=0.006) were associated with increased odds of in-hospital cardiac events. AKI was associated with increased odds of in-hospital mortality (OR 8.9, 95% CI 3.3-23.9, P<0.0001). The presence of AKI was associated with increased odds of ICU stay, mechanical ventilation, and acute respiratory distress syndrome (ARDS). CONCLUSION pCVD and AKI were associated with higher risk of in-hospital cardiac events, and AKI was associated with a higher risk of in-hospital mortality in blacks.
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Affiliation(s)
- Obiora Egbuche
- Division of Cardiovascular Disease, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Opeyemi Jegede
- Department of Biostatistics and Epidemiology, University of North Texas Health Science CenterFort-Worth, TX 76107, USA
| | - Temidayo Abe
- Department of Internal Medicine, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Bivek Wagle
- Department of Internal Medicine, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Ky Huynh
- Department of Internal Medicine, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Dolphurs Hayes
- Department of Internal Medicine, Morehouse School of MedicineAtlanta, GA 30310, USA
| | | | - Kenechukwu Mezue
- Division of Nuclear Cardiology, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA 02114, USA
| | - Pradhum Ram
- Division of Cardiovascular Disease, Emory University School of MedicineAtlanta, GA 30322, USA
| | - Shirley I Nwokike
- Department of Internal Medicine, Medical College of GeorgiaAugusta, GA 30912, USA
| | - Rupak Desai
- Division of Cardiovascular Disease, Atlanta VA Medical CenterDecatur, GA 30033, USA
| | - Valery Effoe
- Division of Cardiovascular Disease, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Jacques Kpodonu
- Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical SchoolBoston, MA 02215, USA
| | - Jayne Morgan
- Division of Quality and Safety, Piedmont Healthcare, Inc.Atlanta, GA 30309, USA
| | - Elizabeth Ofili
- Division of Cardiovascular Disease, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Anekwe Onwuanyi
- Division of Cardiovascular Disease, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Melvin R Echols
- Division of Cardiovascular Disease, Morehouse School of MedicineAtlanta, GA 30310, USA
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27
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Addison C, Campbell Jenkins BW, White M, Thigpen-Odom D, Fortenberry M, Wilson G, McCoy P, Young L, Woodberry C, Herron K, Clark J, Payton M, LaVigne DA. Twenty Years of Leading the Way among Cohort Studies in Community-Driven Outreach and Engagement: Jackson State University/Jackson Heart Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020696. [PMID: 33467408 PMCID: PMC7830722 DOI: 10.3390/ijerph18020696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/26/2020] [Accepted: 01/13/2021] [Indexed: 11/21/2022]
Abstract
Background: History has recorded the tremendous concerns and apprehension expressed by African Americans about participating in research studies. This review enumerates the collaborative techniques that were utilized by the Jackson State University (JSU) Jackson Heart Study (JHS) community-focused team to facilitate recruitment and retention of the JHS cohort and to implement health education and health promotion in the JHS communities. Methods: This review describes the evolution of the JSU JHS community initiatives, an innovative community-driven operation, during the period 1999–2018. Results: JSU JHS community-focused investigators published approximately 20 manuscripts, including community-led research and publications with community lead authors and co-authors, research and publications in collaboration with other JHS staff, through other JSU-funded projects. The JSU JHS community-focused unit also initiated the JHS Community Training Activities, developed the Community Health Advisory Network (CHAN), and trained and certified 137 Community Health Advisors. In addition, the JSU JHS community-focused unit developed the Collaborative Community Science Model (CCSM) that symbolized its approach to community engagement and outreach, and a Trust Scale for ascertaining African Americans’ willingness to engage in biomedical research collaborations. Conclusion: This review offers educators, public health professionals, and research investigators a useful starting point for the development, selection, or improvement of techniques to motivate, inspire, and engage community residents in a community–academia partnership that yielded maximum benefits in the areas of health education, health promotion and interventions, and biomedical research. Substantial, meaningful community engagement is possible when prioritizing elimination of health disparities and long-term improvement in health care access in the target populations.
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Affiliation(s)
- Clifton Addison
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
- Correspondence: ; Tel.: +1-601-979-8765
| | - Brenda W. Campbell Jenkins
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Monique White
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Darcel Thigpen-Odom
- Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS 39213, USA;
| | - Marty Fortenberry
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Gregory Wilson
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Pamela McCoy
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Lavon Young
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Clevette Woodberry
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Kathryn Herron
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Jermal Clark
- Jackson Heart Study, Community Outreach Center, Community Representative, Jackson State University, Jackson, MS 39213, USA;
| | - Marinelle Payton
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Donna Antoine LaVigne
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
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Smith C, Porter A, Biddle J, Balamurugan A, Smith MR. The Arkansas Minority Barber and Beauty Shop Health Initiative: Meeting People Where They Are. Prev Chronic Dis 2020; 17:E153. [PMID: 33274699 PMCID: PMC7735488 DOI: 10.5888/pcd17.200277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The Office of Health Equity at the Arkansas Department of Health created the Arkansas Minority Barber & Beauty Shop Health Initiative (ARBBS) to address cardiovascular disease (CVD) among racial/ethnic minority populations. The objective of this study was to describe CVD-related screening results for ARBBS participants and their knowledge of CVD-related risk factors, signs, and symptoms before and immediately after participation in a screening event. METHODS ARBBS screening events were held from February 2016 through June 2019 at barber and beauty shops in 14 counties in Arkansas. During each event, participants were screened for hypertension, high cholesterol, and diabetes; surveys on CVD-related knowledge were administered before (pretest) and after (posttest) screening. Onsite public health practitioners reviewed surveys and identified abnormal screening results. Participants with abnormal screening results were counseled and given a referral to follow up with a primary care physician, wellness center, or charitable clinic. The nurse coordinator followed up to confirm that a visit or appointment had been made and provide case-management services. RESULTS During the study period, 1,833 people were screened. The nurse coordinator followed up with 320 (55.7%) of 574 unique referrals. Of the 574 referrals, 418 (72.8%) were for hypertension, 156 (27.2%) for high cholesterol, and 120 (20.9%) for diabetes. The overall knowledge of risk factors and symptoms of heart attack and stroke increased significantly by 15.4 percentage points from pretest to posttest (from 76.9% to 92.3%; P < .001). The follow-up approach provided anecdotal information indicating that several participants discovered they had underlying medical conditions and were given medical or surgical interventions. CONCLUSION Through referrals and follow-ups, ARBBS participants gained greater knowledge of chronic disease prevention and risk factors. Additionally, this program screened for and identified people at risk for CVD.
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Affiliation(s)
- Chimfumnanya Smith
- Arkansas Department of Health, 4815 West Markham St, Little Rock, AR, 72205.
| | - Austin Porter
- Arkansas Department of Health, Little Rock, Arkansas.,Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Joyce Biddle
- Arkansas Department of Health, Little Rock, Arkansas
| | - Appathurai Balamurugan
- Arkansas Department of Health, Little Rock, Arkansas.,Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Brewer LC, Kumbamu A, Smith C, Jenkins S, Jones C, Hayes SN, Burke L, Cooper LA, Patten CA. A Cardiovascular Health and Wellness Mobile Health Intervention Among Church-Going African Americans: Formative Evaluation of the FAITH! App. JMIR Form Res 2020; 4:e21450. [PMID: 33200999 PMCID: PMC7709003 DOI: 10.2196/21450] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/25/2020] [Accepted: 09/30/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In light of the scarcity of culturally tailored mobile health (mHealth) lifestyle interventions for African Americans, we designed and pilot tested the Fostering African-American Improvement in Total Health (FAITH!) App in a community-based participatory research partnership with African American churches to promote cardiovascular health and wellness in this population. OBJECTIVE This report presents the results of a formative evaluation of the FAITH! App from participants in an intervention pilot study. METHODS We included 2 semistructured focus groups (n=4 and n=5) to explore participants' views on app functionality, utility, and satisfaction as well as its impact on healthy lifestyle change. Sessions were audio-recorded and transcribed verbatim, and qualitative data were analyzed by using general inductive analysis to generate themes. RESULTS In total, 6 overarching themes emerged among the 9 participants: overall impression, content usefulness, formatting, implementation, impact, and suggestions for improvement. Underpinning the themes was a high level of agreement that the intervention facilitated healthy behavioral change through cultural tailoring, multimedia education modules, and social networking. Suggestions for improvement were streamlining the app self-monitoring features, prompts to encourage app use, and personalization based on individuals' cardiovascular risk. CONCLUSIONS This formative evaluation found that the FAITH! App had high reported satisfaction and impact on the health-promoting behaviors of African Americans, thereby improving their overall cardiovascular health. Further development and testing of the app among African Americans is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT03084822; https://clinicaltrials.gov/ct2/show/NCT03084822.
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Affiliation(s)
- LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
- Center for Healthy Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, United States
| | - Ashok Kumbamu
- Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
| | - Christina Smith
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, United States
| | - Sarah Jenkins
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, United States
| | | | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Lora Burke
- School of Nursing, Department of Health and Community Systems, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lisa A Cooper
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
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Odoi EW, Nagle N, Zaretzki R, Jordan M, DuClos C, Kintziger KW. Sociodemographic Determinants of Acute Myocardial Infarction Hospitalization Risks in Florida. J Am Heart Assoc 2020; 9:e012712. [PMID: 32427043 PMCID: PMC7428988 DOI: 10.1161/jaha.119.012712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Identifying social determinants of myocardial infarction (MI) hospitalizations is crucial for reducing/eliminating health disparities. Therefore, our objectives were to identify sociodemographic determinants of MI hospitalization risks and to assess if the impacts of these determinants vary by geographic location in Florida. Methods and Results This is a retrospective ecologic study at the county level. We obtained data for principal and secondary MI hospitalizations for Florida residents for the 2005-2014 period and calculated age- and sex-adjusted MI hospitalization risks. We used a multivariable negative binomial model to identify sociodemographic determinants of MI hospitalization risks and a geographically weighted negative binomial model to assess if the strength of associations vary by location. There were 645 935 MI hospitalizations (median age, 72 years; 58.1%, men; 73.9%, white). Age- and sex-adjusted risks ranged from 18.49 to 69.48 cases/10 000 persons, and they were significantly higher in counties with low education levels (risk ratio [RR]=1.033, P<0.0001) and high divorce rate (RR, 0.995; P=0.018). However, they were significantly lower in counties with high proportions of rural (RR, 0.996; P<0.0001), black (RR, 1.026; P=0.032), and uninsured populations (RR, 0.983; P=0.040). Associations of MI hospitalization risks with education level and uninsured rate varied geographically (P for non-stationarity test=0.001 and 0.043, respectively), with strongest associations in southern Florida (RR for <high school education, 1.036-1.041; RR for uninsured rate, 0.971-0.976). Conclusions Black race, divorce, rural residence, low education level, and lack of health insurance were significant determinants of MI hospitalization risks, but associations with the latter 2 were stronger in southern Florida. Thus, interventions for addressing MI hospitalization risks need to prioritize these populations and allocate resources based on empirical evidence from global and local models for maximum efficiency and effectiveness.
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Affiliation(s)
- Evah Wangui Odoi
- Comparative and Experimental Medicine College of Veterinary Medicine The University of Tennessee Knoxville TN
| | - Nicholas Nagle
- Department of Geography The University of Tennessee Knoxville TN
| | - Russell Zaretzki
- Department of Business Analytics and Statistics The University of Tennessee Knoxville TN
| | - Melissa Jordan
- Public Health Research Division of Community Health Promotion Florida Department of Health Tallahassee FL
| | - Chris DuClos
- Environmental Public Health Tracking Division of Community Health Promotion Florida Department of Health Tallahassee FL
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Kovesdy CP. CKD in African Americans as a Complex Intertwining of Biology and Socioeconomics: An Introduction. Am J Kidney Dis 2018; 72:S1-S2. [DOI: 10.1053/j.ajkd.2018.06.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 06/25/2018] [Indexed: 11/11/2022]
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