Medicine and Health Sciences Commons^™

Vascular Risk Profile And Changes Of Arterial Hypertension After Surgical Revascularization In Adult Moyamoya Patients, Patrick Haas, Lucas Moritz Wiggenhauser, Jonas Tellermann, Helene Hurth, Daniel Feucht, Marcos Tatagiba, Nadia Khan, Constantin Roder

Journal Articles

Moyamoya disease (MMD) is a rare stenoocclusive cerebral vasculopathy often treated by neurosurgical revascularization using extracranial-intracranial bypasses to prevent ischemic or hemorrhagic events. Little is known about the vascular risk profile of adult MMD patients compared to the general population. We therefore analyzed 133 adult MMD patients and compared them with data from more than 22,000 patients from the German Health Update database. Patients with MMD showed an age- and sex-adjusted increased prevalence of arterial hypertension, especially in women between 30 and 44 years and in patients of both sexes between 45 and 64 years. Diabetes mellitus was diagnosed significantly …

An Expanded Chronic Care Management Approach To Multiple Chronic Conditions In Hispanics Using Community Health Workers As Community Extenders In The Rio Grande Valley Of Texas, Juliana Z Lopez, Minjae Lee, Soo K Park, Maria E Zolezzi, Lisa A Mitchell-Bennett, Paul G Yeh, Lubeth Perez, Natalia I Heredia, David D Mcpherson, Joseph B Mccormick, Belinda M Reininger

Journal Articles

INTRODUCTION: The synergistic negative effects of type 2 diabetes (T2DM) and hypertension increases all-cause mortality and the medical complexity of management, which disproportionately impact Hispanics who face barriers to healthcare access. The Salud y Vida intervention was delivered to Hispanic adults living along the Texas-Mexico Border with comorbid poorly controlled T2DM and hypertension. The Salud y Vida multicomponent intervention incorporated community health workers (CHWs) into an expanded chronic care management model to deliver home-based follow-up visits and provided community-based diabetes self-management education.

METHODS: We conducted multivariable longitudinal analysis to examine the longitudinal intervention effect on reducing systolic and diastolic blood …

Resolution Of Severe Portopulmonary Hypertension With Inhaled Treprostinil And Liver Transplantation, Alex J Chang, Choon Hwa Goh

The Texas Heart Institute Journal

Portopulmonary hypertension is a rare condition with a poor prognosis. Prompt management is essential for liver transplantation eligibility, a potentially curative option. This report presents a case of severe portopulmonary hypertension that resolved with a conservative therapeutic regimen of tadalafil, macitentan, and inhaled treprostinil, which ultimately enabled successful liver transplantation. There was no recurrence of pulmonary hypertension after transplantation, and the patient was weaned off most pulmonary arterial hypertension therapies. This case report is the first to provide evidence that inhaled treprostinil is a safe and effective alternative to continuous intravenous prostacyclins in portopulmonary hypertension.

Hypertension In Pregnancy Among Immigrant And Swedish Women: A Cohort Study Of All Pregnant Women In Sweden, Per Wändell, Casey Crump, Xinjun Li, Nouha Saleh Stattin, Axel C Carlsson, Jan Sundquist, Kristina Sundquist

Journal Articles

BACKGROUND: Little is known about risks of hypertensive disorders of pregnancy in both first- and second-generation immigrant women in Europe and other Western countries; such knowledge may help elucidate the influence of genetic versus social factors on such risks. We aimed to study both first- and second-generation immigrant women for the presence of all types of hypertension (preexisting hypertension, gestational hypertension, preeclampsia, and eclampsia) during pregnancy.

METHODS AND RESULTS: A cohort study was conducted using data derived from the Swedish National Birth Register, the National Patient Register, and the total Population Register. We used Cox regression analysis to compute hazard …

Implementation Of A Home Blood Pressure Monitoring Program For The Management Of Hypertensive Disorders Of Pregnancy, An Observational Study In British Columbia, Canada, Karen C Tran, Sabina Freiman, Tessa Chaworth-Musters, Susan Purkiss, Colleen Foster, Nadia A Khan, Wee Shian Chan

Journal Articles

BACKGROUND: COVID-19 pandemic has influenced health care delivery. We conducted an observational study to understand how obstetric medicine (ObM) physicians utilized home blood pressure monitoring (HBPM) to manage hypertension in pregnancy.

METHODS: Pregnant participants with risk factors or diagnosis of hypertensive disorders of pregnancy (HDP) were enrolled, May 2020-December 2021, and provided with validated home blood pressure (BP) monitor. ObM physicians completed questionnaires to elicit how home BP readings were interpreted to manage HDP.

RESULTS: We enrolled 103 people: 44 antepartum patients (33.5 ± 5 years, gestational age of 24 ± 5 weeks); 59 postpartum patients (35 ± 6 years, …

Systolic Hypertension As Side Effect Of Topical Low Dose Atropine Drops, Barry Wasserman, Erik Massenzio, Karen Lee, David Plager

Wills Eye Hospital Papers

PURPOSE: To present a case of increased systemic hypertension and pupil dilation related to low dose atropine eyedrops.

OBSERVATIONS: A thirteen-year-old male with progressive myopia received atropine 0.05% ophthalmic drops to slow down myopia progression. He exhibited systemic systolic hypertension, photophobia, and bilateral nonreactive mydriasis. The atropine drops were discontinued, and his blood pressure and pupillary function normalized.

CONCLUSIONS AND IMPORTANCE: This case demonstrates sensitivity to low dose atropine with increased systemic blood pressure and pupillary dilation.

Home Blood Pressure Telemonitoring Technology For Patients With Asymptomatic Elevated Blood Pressure Discharged From The Emergency Department: Pilot Study, Karen C Tran, Meagan Mak, Laura M Kuyper, Jesse Bittman, Birinder Mangat, Heather Lindsay, Chad Kim Sing, Liang Xu, Hubert Wong, Martin Dawes, Nadia Khan, Kendall Ho

Journal Articles

BACKGROUND: Hypertension affects 1 in 5 Canadians and is the leading cause of morbidity and mortality globally. Hypertension control is declining due to multiple factors including lack of access to primary care. Consequently, patients with hypertension frequently visit the emergency department (ED) due to high blood pressure (BP). Telehealth for Emergency-Community Continuity of Care Connectivity via Home-Telemonitoring Blood Pressure is a pilot project that implements and evaluates a comprehensive home blood pressure telemonitoring (HBPT) and physician case management protocol designed as a postdischarge management strategy to support patients with asymptomatic elevated BP as they transition from the ED to home. …

Evaluating The Effect Of Maternal Non-Communicable Disease On Adverse Pregnancy Outcomes And Birthweight In Pakistan, A Facility Based Retrospective Cohort Study, Esther Wainwright, Sheikh Irfan Ahmed, Rahat Qureshi, Sana Yousuf, Raheela Khan, Matthew Elmes

Department of Obstetrics & Gynaecology

Non-communicable diseases (NCDs) claim 74% of global lives, disproportionately affecting lower and middle-income countries like Pakistan. NCDs may increase the risk of preterm birth (PTB), caesarean section (CS), and low birthweight. This study aims to determine whether the high prevalence of NCDs in Pakistan play a role in the high rates of preterm births, and CS. This retrospective cohort study from Aga Khan University Hospital, Pakistan, investigated effects of pre-existing NCDs on pregnancy outcomes of 817 pregnant women. Medical records were used to generate odds ratios for the risk of PTB, labour outcome and birthweight in women with type 1 …

Lifestyle Management Of Hypertension: International Society Of Hypertension Position Paper Endorsed By The World Hypertension League And European Society Of Hypertension, Fadi J Charchar, Priscilla R Prestes, Charlotte Mills, Siew Mooi Ching, Dinesh Neupane, Francine Z Marques, James E Sharman, Liffert Vogt, Louise M Burrell, Lyudmila Korostovtseva, Manja Zec, Mansi Patil, Martin G Schultz, Matthew P Wallen, Nicolás F Renna, Sheikh Mohammed Shariful Islam, Swapnil Hiremath, Tshewang Gyeltshen, Yook-Chin Chia, Abhinav Gupta, Aletta E Schutte, Britt Klein, Claudio Borghi, Colette J Browning, Marta Czesnikiewicz-Guzik, Hae-Young Lee, Hiroshi Itoh, Katsuyuki Miura, Mattias Brunström, Norm R C Campbell, Olutope Arinola Akinnibossun, Praveen Veerabhadrappa, Richard D Wainford, Ruan Kruger, Shane A Thomas, Takahiro Komori, Udaya Ralapanawa, Véronique A Cornelissen, Vikas Kapil, Yan Li, Yuqing Zhang, Tazeen H Jafar, Nadia Khan, Bryan Williams, George Stergiou, Maciej Tomaszewski

Journal Articles

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on …

Social Determinants Of Health And Disparities In Hypertension And Cardiovascular Diseases, Abhishek Chaturvedi, Anqi Zhu, Naga Vaishnav Gadela, Dorairaj Prabhakaran, Tazeen Jafar

Department of Medicine

High blood pressure causes over 10 million preventable deaths annually globally. Populations in low- and middle-income countries suffer the most, experiencing increased uncontrolled blood pressure and cardiovascular disease (CVD) deaths. Despite improvements in high-income countries, disparities persist, notably in the United States, where Black individuals face up to 4× higher CVD mortality than White individuals. Social determinants of health encompass complex, multidimensional factors linked to an individual's birthplace, upbringing, activities, residence, workplaces, socioeconomic and environmental structures, and significantly affect health outcomes, including hypertension and CVD. This review explored how social determinants of health drive disparities in hypertension and related CVD …

Maternal Western Diet Programs Cardiometabolic Dysfunction And Hypothalamic Inflammation Via Epigenetic Mechanisms Predominantly In The Male Offspring, Mona Elgazzaz, Clara Berdasco, Jone Garai, Melody Baddoo, Shiping Lu, Hisham Daoud, Jovanny Zabaleta, Franck Mauvais-Jarvis, Eric Lazartigues

School of Medicine Faculty Publications

Objective; Maternal exposure during pregnancy is a strong determinant of offspring health outcomes. Such exposure induces changes in the offspring epigenome resulting in gene expression and functional changes. In this study, we investigated the effect of maternal Western hypercaloric diet (HCD) programming during the perinatal period on neuronal plasticity and cardiometabolic health in adult offspring. Methods; C57BL/6J dams were fed HCD for 1 month prior to mating with regular diet (RD) sires and kept on the same diet throughout pregnancy and lactation. At weaning, offspring were maintained on either HCD or RD for 3 months resulting in 4 treatment groups …

Lessons Learnt In The First Year Of An Australian Pediatric Cardio Oncology Clinic., Claudia Toro, Ben Felmingham, Mangesh Jhadav, David S. Celermajer, Andre La Gerche, John O'Sullivan, Sanjeev Kumar, Marion K. Mateos, Joy M. Fulbright, Dinisha Govender, Lane Collier, Michael Cheung, David D. Eisenstat, Peter W. Lange, Julian Ayer, David A. Elliott, Rachel Conyers

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Modern oncological therapies together with chemotherapy and radiotherapy have broadened the agents that can cause cardiac sequelae, which can manifest for pediatric oncology patients while on active treatment. Recommendations for high-risk patients who should be monitored in a pediatric cardio-oncology clinic have previously been developed by expert Delphi consensus by our group. In 2022 we opened our first multidisciplinary pediatric cardio-oncology clinic adhering to these recommendations in surveillance and management.

OBJECTIVES: Our pediatric cardio-oncology clinic aimed to: (i) Document cardiovascular toxicities observed within a pediatric cardio-oncology clinic and. (ii) Evaluate the applicability of the Australian and New Zealand Pediatric …

Pm2.5 And Cardiovascular Diseases: State-Of-The-Art Review, Chayakrit Krittanawong, Yusuf Kamran Qadeer, Richard B. Hayes, Zhen Wang, George D. Thurston, Salim S. Virani, Carl J. Lavie

Office of the Provost

Air pollution, especially exposure to particulate matter 2.5 (PM2.5), has been associated with an increase in morbidity and mortality around the world. Specifically, it seems that PM2.5 promotes the development of cardiovascular risk factors such as hypertension and atherosclerosis, while being associated with an increased risk of cardiovascular diseases, including myocardial infarction (MI), stroke, heart failure, and arrhythmias. In this review, we seek to elucidate the pathophysiological mechanisms by which exposure to PM2.5 can result in adverse cardiovascular outcomes, in addition to understanding the link between exposure to PM2.5 and cardiovascular events. It is hypothesized that PM2.5 functions via 3 …

Characteristics And Outcomes Of Patients With Pregnancy-Related End-Stage Kidney Disease., Lauren Kucirka, Ana Angarita, Tracy Manuck, Kim Boggess, Vimal Derebail, Mollie Wood, Michelle Meyer, Dorry Segev, Monica Reynolds

Department of Obstetrics and Gynecology Faculty Papers

IMPORTANCE: The incidence of pregnancy-related acute kidney injury is increasing and is associated with significant maternal morbidity including progression to end-stage kidney disease (ESKD). Little is known about characteristics and long-term outcomes of patients who develop pregnancy-related ESKD.

OBJECTIVES: To examine the characteristics and clinical outcomes of patients with pregnancy-related ESKD and to investigate associations between pre-ESKD nephrology care and outcomes.

DESIGN, SETTING, AND PARTICIPANTS: This was a cohort study of 183 640 reproductive-aged women with incident ESKD between January 1, 2000, and November 20, 2020, from the US Renal Data System and maternal data from births captured in the …

Association Of Atherosclerotic Cardiovascular Disease, Hypertension, Diabetes, And Hyperlipidemia With Gulf War Illness Among Gulf War Veterans, Sarah T Ahmed, Ruosha Li, Peter Richardson, Saurendro Ghosh, Lea Steele, Donna L White, Alice Nono Djotsa, Kellie Sims, Elizabeth Gifford, Elizabeth R Hauser, Salim S Virani, Robert Morgan, George Delclos, Drew A Helmer

Journal Articles

BACKGROUND: Approximately 30% of the 700 000 Gulf War veterans report a chronic symptom-based illness of varying severity referred to as Gulf War illness (GWI). toxic deployment-related exposures have been implicated in the cause of GWI, some of which contribute to metabolic dysregulation and lipid abnormalities. As this cohort ages, the relationship between GWI and atherosclerotic cardiovascular disease (ASCVD) is a growing concern. We evaluated associations between GWI and ASCVD, diabetes, hyperlipidemia, and hypertension in veterans of the Gulf War (1990-1991).

METHODS AND RESULTS: Analysis of survey data collected in 2014 to 2016 from a national sample of deployed Gulf …

Lowering Of Circulating Sclerostin May Increase Risk Of Atherosclerosis And Its Risk Factors: Evidence From A Genome-Wide Association Meta-Analysis Followed By Mendelian Randomization, Jie Zheng, Eleanor Wheeler, Maik Pietzner, Till F M Andlauer, Michelle S Yau, April E Hartley, Ben Michael Brumpton, Humaira Rasheed, John P Kemp, Monika Frysz, Jamie Robinson, Sjur Reppe, Vid Prijatelj, Kaare M Gautvik, Louise Falk, Winfried Maerz, Ingrid Gergei, Patricia A Peyser, Maryam Kavousi, Paul S De Vries, Clint L Miller, Maxime Bos, Sander W Van Der Laan, Rajeev Malhotra, Markus Herrmann, Hubert Scharnagl, Marcus Kleber, George Dedoussis, Eleftheria Zeggini, Maria Nethander, Claes Ohlsson, Mattias Lorentzon, Nick Wareham, Claudia Langenberg, Michael V Holmes, George Davey Smith, Jonathan H Tobias

Journal Articles

OBJECTIVE: In this study, we aimed to establish the causal effects of lowering sclerostin, target of the antiosteoporosis drug romosozumab, on atherosclerosis and its risk factors.

METHODS: A genome-wide association study meta-analysis was performed of circulating sclerostin levels in 33,961 European individuals. Mendelian randomization (MR) was used to predict the causal effects of sclerostin lowering on 15 atherosclerosis-related diseases and risk factors.

RESULTS: We found that 18 conditionally independent variants were associated with circulating sclerostin. Of these, 1 cis signal in SOST and 3 trans signals in B4GALNT3, RIN3, and SERPINA1 regions showed directionally opposite signals for sclerostin levels and …

Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah Salim, Jasmit Shah, Jumaa Bwika, Sayed Karar

Internal Medicine, East Africa

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods: This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ …

Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah, Jasmit Shah, Jumaa Bwika, Sayed Karar

Internal Medicine, East Africa

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods: This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ …

Global Blood Pressure Screening During The Covid-19 Pandemic: Results From The May Measurement Month 2021 Campaign, Thomas Beaney, Wei Wang, Markus P Schlaich, Aletta E Schutte, George S Stergiou, Luis Alcocer, Jafar Alsaid, Alejandro Bimbo Diaz, Rafael Hernandez-Hernandez, Mohammad Ishaq, Jacek Jozwiak, Nadia Khan, Gaia Kiru, Harsha Mccardle, Augustine Nonso Odili, Wook Bum Pyun, Cesar A Romero, Jiguang Wang, Neil R Poulter, Mmm Investigators

Journal Articles

BACKGROUND: Raised blood pressure (BP) remains the biggest risk factor contributing to the global burden of disease and mortality, despite the COVID-19 pandemic. May Measurement Month (MMM), an annual global screening campaign aims to highlight the importance of BP measurement by evaluating global awareness, treatment and control rates among adults with hypertension. In 2021, we assessed the global burden of these rates during the COVID-19 pandemic.

METHODS: Screening sites were set up in 54 countries between May and November 2021 and screenees were recruited by convenience sampling. Three sitting BPs were measured, and a questionnaire completed including demographic, lifestyle and …

The Association Of Intensive Blood Pressure Treatment And Non-Fatal Cardiovascular Or Serious Adverse Events In Older Adults With Mortality: Mediation Analysis In Sprint, Ashok Krishnaswami, Michael W Rich, Min Ji Kwak, Parag Goyal, Daniel E Forman, Abdulla A Damluji, Matthew Solomon, Jamal S Rana, Deborah M Kado, Michelle C Odden

Journal Articles

AIMS: Randomized clinical trials of hypertension treatment intensity evaluate the effects on incident major adverse cardiovascular events (MACEs) and serious adverse events (SAEs). Occurrences after a non-fatal index event have not been rigorously evaluated. The aim of this study was to evaluate the association of intensive (<120 >mmHg) to standard (<140 >mmHg) blood pressure (BP) treatment with mortality mediated through a non-fatal MACE or non-fatal SAE in 9361 participants in the Systolic Blood Pressure Intervention Trial.

METHODS AND RESULTS: Logistic regression and causal mediation modelling to obtain direct and mediated effects of intensive BP treatment. Primary outcome was all-cause mortality …

Prolylcarboxypeptidase Alleviates Hypertensive Cardiac Remodeling By Regulating Myocardial Tissue Angiotensin Ii, Binh Y Nguyen, Fangchao Zhou, Pablo Binder, Wei Liu, Susanne S Hille, Xiaojing Luo, Min Zi, Hongyuan Zhang, Antony Adamson, Fozia Z Ahmed, Sam Butterworth, Elizabeth J Cartwright, Oliver J Müller, Kaomei Guan, Elizabeth M Fitzgerald, Xin Wang

Journal Articles

Background Prolonged activation of angiotensin II is the main mediator that contributes to the development of heart diseases, so converting angiotensin II into angiotensin 1-7 has emerged as a new strategy to attenuate detrimental effects of angiotensin II. Prolylcarboxypeptidase is a lysosomal pro-X carboxypeptidase that is able to cleave angiotensin II at a preferential acidic pH optimum. However, insufficient attention has been given to the cardioprotective functions of prolylcarboxylpeptidase. Methods and Results We established a CRISPR/CRISPR-associated protein 9-mediated global prolylcarboxylpeptidase-knockout and adeno-associated virus serotype 9-mediated cardiac prolylcarboxylpeptidase overexpression mouse models, which were challenged with the angiotensin II infusion (2 mg/kg …

Meta-Analysis Of The Association Between Atrial Fibrillation, Hypertension, Sleep-Disordered Breathing, And Wake-Up Stroke, Jin Zhou, Jing Xu, Aijuan Cheng, Yimiti Kadier, Xiaoli Liang, Maimaitijiang Mutailipu, Shan Sun

The Texas Heart Institute Journal

BACKGROUND: The occurrence of atrial fibrillation, circadian fluctuation in blood pressure, and oxygen desaturation at night is likely associated with the pathophysiology of wake-up stroke. Whether patients who experience wake-up strokes are candidates for thrombolysis treatment is a serious dilemma. The aim is to investigate the association between risk factors and wake-up stroke and to determine variations that are associated with the pathophysiology of wake-up stroke.

METHODS: Five major electronic databases were searched using a fitted search strategy to identify relevant studies. Odds ratios with 95% CIs were used to calculate estimates, and the Quality Assessment for Diagnostic Accuracy Studies-2 …

Postpartum Detection Of Diastolic Dysfunction And Nondipping Blood Pressure Profile In Women With Preeclampsia, Marwa Sayed, Mariam Rashed, Ahmed M Abbas, Amr Youssef, Mohamed Abdel Ghany

The Texas Heart Institute Journal

BACKGROUND: Left ventricular diastolic dysfunction and nocturnal "nondipping" of blood pressure detected via ambulatory blood pressure monitoring are predictors of increased cardiovascular morbidity.

METHODS: A prospective cohort study including normotensive women with a history of preeclampsia in their current pregnancy was conducted. All cases were subjected to 24-hour ambulatory blood pressure monitoring and 2-dimensional transthoracic echocardiography 3 months after delivery.

RESULTS: This study included 128 women with a mean (SD) age of 28.6 (5.1) years and a mean (SD) basal blood pressure of 123.1 (6.4)/74.6 (5.9) mm Hg. Among the participants, 90 (70.3%) exhibited an ambulatory blood pressure monitoring profile …

Longitudinal Associations Between Dietary Fructose And Sodium And Systolic And Diastolic Blood Pressure Among Us Black And White Adults In The Cardia Study, Rana Elhamzawy, Dragana Komnenov, Daniel Domin

Medical Student Research Symposium

Longitudinal associations between dietary fructose and sodium and systolic and diastolic blood pressure among US Black and White adults in the CARDIA study

Authors: Rana Elhamzawy, Daniel Domin, Dragana Komnenov

Hypertension is one of the leading risk factors for major adverse cardiovascular events (MACE). Likewise, suboptimal dietary habits, including high fructose and sodium intake, are major contributors to mortality. High dietary fructose alone predisposes to salt-sensitivity of blood pressure, which is an independent, significant cardiovascular risk factor. We previously showed in our rat model of fructose-salt-sensitive hypertension that even a short term (4 weeks) feeding with 20% fructose and 4% …

Lack Of Better Functional Outcome In Young Border Hispanic Patients With Acute Ischemic Stroke After Endovascular Thrombectomy Compared To Older Patients: A Retrospective Chart Review, Saisree Ravi, Sohum Desai, Sherief Ghozy, Wondwossen Tekle, Ameer E. Hassan

MEDI 9331 Scholarly Activities Clinical Years

Shortened Abstract:

Previous data indicates that young acute ischemic stroke patients have better prognosis after endovascular thrombectomy, while Hispanic patients are associated with poorer outcomes. Our goal is to study the interaction between age and Hispanic status to assess functional outcomes after endovascular thrombectomy in young versus older patients in a predominantly Hispanic population with a high prevalence of diabetes mellitus and obesity.

Our Hispanic population demonstrates no differences in sICH, mortality, and functional independence between young and older acute ischemic stroke patients after endovascular thrombectomy.

Initial Thoracic Endovascular Aortic Repair Vs Medical Therapy For Acute Uncomplicated Type B Aortic Dissection, E Hope Weissler, Oyomoare L Osazuwa-Peters, Melissa A Greiner, N Chantelle Hardy, Panagiotis Kougias, Sean M O'Brien, Daniel B Mark, W Schuyler Jones, Eric A Secemsky, Andrew M Vekstein, Sherene Shalhub, Firas F Mussa, Manesh R Patel, Sreekanth Vemulapalli

Journal Articles

IMPORTANCE: Thoracic endovascular aortic repair (TEVAR) has increasingly been used for uncomplicated type B aortic dissection (uTBAD) despite limited supporting data.

OBJECTIVE: To assess whether initial TEVAR following uTBAD is associated with reduced mortality or morbidity compared with medical therapy alone.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included Centers for Medicare & Medicaid Services inpatient claims data for adults aged 65 years or older with index admissions for acute uTBAD from January 1, 2011, to December 31, 2018, with follow-up available through December 31, 2019.

EXPOSURES: Initial TEVAR was defined as TEVAR within 30 days of admission for acute …

Characterization Of Pulmonary Vascular Remodeling And Microrna-126-Targets In Copd-Pulmonary Hypertension., Khushboo Goel, Nicholas Egersdorf, Amar Gill, Danting Cao, Scott D Collum, Soma S Jyothula, Howard J Huang, Maor Sauler, Patty J Lee, Susan Majka, Harry Karmouty-Quintana, Irina Petrache

Journal Articles

BACKGROUND: Despite causing increased morbidity and mortality, pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) patients (COPD-PH) lacks treatment, due to incomplete understanding of its pathogenesis. Hypertrophy of pulmonary arterial walls and pruning of the microvasculature with loss of capillary beds are known features of pulmonary vascular remodeling in COPD. The remodeling features of pulmonary medium- and smaller vessels in COPD-PH lungs are less well described and may be linked to maladaptation of endothelial cells to chronic cigarette smoking (CS). MicroRNA-126 (miR126), a master regulator of endothelial cell fate, has divergent functions that are vessel-size specific, supporting the survival …

Strong Structuration Analysis Of Patterns Of Adherence To Hypertension Medication, Maureen L. Seguin, Jhaki A. Mendoza, Gideon Lasco, Lia M. Palileo-Villanueva, Benjamin Palafox, Alicia Renedo, Martin Mckee, Dina Balabanova

Development Studies Faculty Publications

Achieving blood pressure control is among the highest priorities for reducing the burden of cardiovascular diseases globally. Control is poor in the Philippines; especially in socioeconomically marginalised communities. This paper explores long-term adherence to anti-hypertensive medication in these communities; identifying 4 distinct medication adherence patterns. We draw on Strong Structuration Theory to explore motivations of action for those who are consistently adherent; consistently non-adherent; and those who became more or less adherent over time. We employ longitudinal qualitative methods comprising repeat interviews and digital diaries collected over 12 months by 34 participants. Twelve participants were consistently adherent; 9 consistently non-adherent; …

The Enigma Of Primary Hypertension In Childhood, Bonita Falkner

Department of Medicine Faculty Papers

Beginning in the 1970s, hypertension in children and adolescents has been defined as systolic and/or diastolic blood pressure (BP) that is equal to or greater than the 95th percentile of the normal BP distribution in healthy children. The definition of hypertension in adults is based on longitudinal data that links a BP level with an increased risk for subsequent adverse outcomes related to hypertension including heart failure, kidney failure, stroke, or death. The statistical definition of hypertension continues to be used in childhood because there have been no data that link a BP level in childhood with a heightened risk …

Prevalent Multimorbidity Combinations Among Middle-Aged And Older Adults Seen In Community Health Centers, Ana R Quiñones, Steele H Valenzuela, Nathalie Huguet, Maria Ukhanova, Miguel Marino, Jennifer A Lucas, Jean O'Malley, Teresa D Schmidt, Robert Voss, Katherine Peak, Nathaniel T Warren, John Heintzman

Journal Articles

BACKGROUND: Multimorbidity (≥ 2 chronic diseases) is associated with greater disability and higher treatment burden, as well as difficulty coordinating self-management tasks for adults with complex multimorbidity patterns. Comparatively little work has focused on assessing multimorbidity patterns among patients seeking care in community health centers (CHCs).

OBJECTIVE: To identify and characterize prevalent multimorbidity patterns in a multi-state network of CHCs over a 5-year period.

DESIGN: A cohort study of the 2014-2019 ADVANCE multi-state CHC clinical data network. We identified the most prevalent multimorbidity combination patterns and assessed the frequency of patterns throughout a 5-year period as well as the demographic …