1
|
Zuin M, Porcari A, Rigatelli G, Merlo M, Bilato C, Roncon L, Sinagra G. Trends of hypertrophic cardiomyopathy-related mortality in United States young adults: a nationwide 20-year analysis. J Cardiovasc Med (Hagerstown) 2024; 25:303-310. [PMID: 38358911 DOI: 10.2459/jcm.0000000000001606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
AIMS Data regarding hypertrophic cardiomyopathy (HCM)-related mortality in United States young adults, defined as those aged between 25 and 44 years, are lacking. We sought to assess the trends in HCM-related mortality among US young adults between 1999 and 2019 and determine differences by sex, race, ethnicity, urbanization and census region. METHODS Mortality data were retrieved by the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) dataset from January 1999 to December 2019. Age-adjusted mortality rates (AAMRs) were assessed using the Joinpoint regression modeling and expressed as estimated average annual percentage change (AAPC) with relative 95% confidence intervals (95% CIs). RESULTS Over 20-year period, the AAMR from HCM in US young adults linearly decreased, with no differences between sexes [AAPC: -5.3% (95% CI -6.1 to -4.6), P < 0.001]. The AAMR decrease was more pronounced in Black patients [AAPC: -6.4% (95% CI -7.6 to -5.1), P < 0.001], Latinx/Hispanic patients [AAPC: -4.8% (95% CI -7.2 to -2.36), P < 0.001] and residents of urban areas [AAPC: -5.4% (95% CI -6.2 to -4.6), P < 0.001]. The higher percentages of HCM-related deaths occurred in the South of the country and at the patient's home. CONCLUSION HCM-related mortality in US young adults has decreased over the last two decades in the United States. Subgroup analyses by race, ethnicity, urbanization and census region showed ethnoracial and regional disparities that will require further investigation.
Collapse
Affiliation(s)
- Marco Zuin
- Department of Translational Medicine, University of Ferrara, Ferrara
| | - Aldostefano Porcari
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERNGUARD-Heart
| | | | - Marco Merlo
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERNGUARD-Heart
| | - Claudio Bilato
- Department of Cardiology, West Vicenza Hospital, Arzignano
| | - Loris Roncon
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Gianfranco Sinagra
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERNGUARD-Heart
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Zimmermann K, Muramatsu N, Molina Y, Carnahan LR, Geller SE. Application of the consolidated framework for implementation research to understand implementation context of a cardiovascular disease risk-reduction intervention in rural churches. Transl Behav Med 2023; 13:236-244. [PMID: 36694377 DOI: 10.1093/tbm/ibac110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Rural populations in the USA face higher rates of cardiovascular disease (CVD) incidence and mortality relative to non-rural and often lack access to health-promoting evidence-based interventions (EBIs) to support CVD prevention and management. Partnerships with faith organizations offer promise for translating preventative EBIs in rural communities; however, studies demonstrating effective translation of EBIs in these settings are limited. We used the Consolidated Framework for Implementation Research (CFIR) and a multiple case study approach to understand the role of internal organizational context within 12 rural churches in the implementation of a 12-week CVD risk-reduction intervention followed by a 24-month maintenance program implemented in southernmost Illinois. The study involved qualitative analysis of key informant interviews collected before (n = 26) and after (n = 15) the intervention and monthly implementation reports (n = 238) from participating churches using a deductive analysis approach based on the CFIR. Internal context across participating churches varied around organizational climate and culture in four thematic areas: (i) religious basis for health promotion, (ii) history of health activities within the church, (iii) perceived need for the intervention, and (iv) church leader engagement. Faith organizations may be ideal partners in rural health promotion research but may vary in their interest and capacity to collaborate. Identifying contextual factors within community organizations is a first step to facilitating rural, community-based EBI implementation and outcomes.
Collapse
Affiliation(s)
- Kristine Zimmermann
- Department of Family and Community Medicine, Division of Health Research and Evaluation, University of Illinois College of Medicine Rockford, Rockford, IL, USA.,Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, USA
| | - Naoko Muramatsu
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, USA
| | - Yamilé Molina
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, USA.,University of Illinois Cancer Center, Chicago, IL, USA
| | - Leslie R Carnahan
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, USA.,University of Illinois Cancer Center, Chicago, IL, USA
| | - Stacie E Geller
- Department of Obstetrics and Gynecology, College of Medicine, University of Illinois, Chicago, USA.,Center for Research on Women and Gender, College of Medicine, University of Illinois, Chicago, USA
| |
Collapse
|
4
|
Vandegrift MA, Taylor-Piliae RE. Selecting a theoretical framework for chronic cardiovascular disease self-management among rural dwelling adults. Appl Nurs Res 2022; 65:151585. [DOI: 10.1016/j.apnr.2022.151585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/09/2022] [Indexed: 11/16/2022]
|
5
|
Kocanda L, Brain K, Frawley J, Schumacher TL, May J, Rollo ME, Brown LJ. The Effectiveness of Randomized Controlled Trials to Improve Dietary Intake in the Context of Cardiovascular Disease Prevention and Management in Rural Communities: A Systematic Review. J Acad Nutr Diet 2021; 121:2046-2070.e1. [PMID: 34247977 DOI: 10.1016/j.jand.2021.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 05/07/2021] [Accepted: 05/26/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dietary intake is an important modifiable risk factor for cardiovascular disease. However, to our knowledge, there are no systematic reviews of nutrition interventions in the context of cardiovascular disease prevention and management within rural communities. This is important to investigate, given the unique geographic, social, and contextual factors associated with rurality. OBJECTIVE Our primary objective was to systematically assess evidence on the effectiveness of randomized controlled trials to improve dietary intake in the context of cardiovascular disease prevention and management in rural communities. METHODS Nine electronic databases were searched from inception to June 2020, including MEDLINE, The Cochrane Library, Embase, Emcare, PsycINFO, Scopus, Rural and Remote Health, CINAHL, and AMED. Randomized controlled trials that reported results of interventions with adult, rural populations and measured change in dietary intake compared to usual care, alternative intervention, or no intervention controls were included. Included randomized controlled trials were also assessed according to the TIDieR (Template for Intervention Description and Reporting) checklist and RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. RESULTS Thirteen articles reporting results of randomized controlled trials were identified. Included articles reported a range of nutrition interventions and measured 18 dietary intake outcomes. Most studies (n = 10) demonstrated effectiveness in altering at least 1 dietary intake outcome, including fruit and/or vegetable (n = 9), fiber (n = 2), Dietary Risk Assessment score (n = 2), energy, dairy, carotene, vitamin C and sodium (all n = 1). However, there was wide variation in the reporting of intervention components (according to the TIDieR checklist) and impact (according to RE-AIM framework), resulting in difficulty interpreting the "real-world" implications of these results. CONCLUSIONS Through this systematic review, we found limited evidence of improvement in dietary intakes due to nutrition interventions in the context of cardiovascular disease prevention and management in rural communities. Fruit and/or vegetable intakes were the most frequently reported dietary intake outcomes, and most likely to be improved across the included studies. Included studies were generally not well reported, which may hinder replication by clinicians and consolidation of the evidence base by other researchers. Given the substantial burden of cardiovascular disease experienced by those living in rural areas of developed countries, additional high-quality nutrition research that acknowledges the complexities of rural health is required.
Collapse
|
6
|
Abbott LS, Graven LJ, Schluck G, Williams KJ. Stress, Social Support, and Resilience in Younger Rural Women: A Structural Equation Model. Healthcare (Basel) 2021; 9:812. [PMID: 34203165 PMCID: PMC8306437 DOI: 10.3390/healthcare9070812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 11/16/2022] Open
Abstract
Cardiovascular disease is a global public health problem and leading cause of death. Stress is a modifiable cardiovascular disease risk factor. The objectives of this study were to examine whether stress was a predictor of resilience among rural younger women and to explore whether social support mediated the relationship between acute stress and resilience and between chronic stress and resilience. The study had a cross-sectional, descriptive design. A total of 354 women were randomly recruited in the rural, southeastern United States. Survey instruments were used to collect data about acute stress, chronic stress, social support, and resilience. A structural equation model was fit to test whether social support mediated the relationship between perceived stress and resilience and between chronic stress and resilience. Chronic stress predicted family and belongingness support and all the resilience subscales: adaptability, emotion regulation, optimism, self-efficacy, and social support. Acute stress predicted the self-efficacy subscale of resilience. Family support partially mediated the relationship between chronic stress and self-efficacy. Belongingness support partially mediated the relationships between chronic stress and the social support subscale of resilience.
Collapse
Affiliation(s)
- Laurie S. Abbott
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA; (L.J.G.); (G.S.)
| | - Lucinda J. Graven
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA; (L.J.G.); (G.S.)
| | - Glenna Schluck
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA; (L.J.G.); (G.S.)
| | - Krystal J. Williams
- College of Pharmacy and Pharmaceutical Sciences, Florida Agricultural & Mechanical University, Tallahassee, FL 32307, USA;
| |
Collapse
|