Cardiovascular Diseases Commons^™

Interventions To Promote Physical Activity And Dietary Lifestyle Changes For Cardiovascular Risk Factor Reduction In Adults: A Scientific Statement From The American Heart Association, Nancy Trygar Artinian, Gerald F. Fletcher, Dariush Mozaffarian, Penny Kris-Etherton, Linda Van Horn, Alice H. Lichtenstiein, Shiriki Kumanyika, William E. Kraus, Jerome J. Fleg, Nancy S. Redeker, Janet C. Meininger, Joanne Banks, Eileen M. Stuart-Shor, Barbara J. Fletcher, Todd D. Miller, Suzanne Hughes, Lynn T. Braun, Laurie A. Kopin, Kathy Berra, Laura L. Hayman, Linda J. Ewing, Philip A. Ades, J. Larry Durstine, Nancy Houston-Miller, Lora E. Burke, American Heart Association Prevention Committee Of The Council On Cardiovascular Nursing

Nursing Faculty Research Publications

Even modest sustained lifestyle changes can substantially reduce cardiovascular disease (CVD) morbidity and mortality. Because many of the beneficial effects of lifestyle changes accrue over time, long-term adherence maximizes individual and population benefits. Interventions targeting dietary patterns, weight reduction, and new PA habits often result in impressive rates of initial behavior changes, but frequently are not translated into long-term behavioral maintenance. Both adoption and maintenance of new cardiovascular risk-reducing behaviors pose challenges for many individuals. According to the National Center for Health Statistics, life expectancy could increase by almost 7 years if all forms of major CVD were eliminated.5 Improvements …

Body Mass Index, Treatment Practices, And Mortality In Patients With Acute Heart Failure, Timothy Fitzgibbons, Olga Hardy, Darleen Lessard, Joel Gore, Jorge Yarzebski, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVES: Obesity is associated with an increased risk of heart failure (HF). Among patients presenting with acute HF, however, differences in clinical characteristics, treatment regimens, and short-term prognosis of varying weights are largely unknown, particularly from a broader population-based perspective. METHODS: A total of 3722 patients admitted with acute HF to 11 greater Worcester (Massachusetts, USA) hospitals during 1995 and 2000 were categorized as being lean (n = 216), normal weight (n = 1465), overweight (n = 1007), or obese (n = 1034) at the time of hospitalization. RESULTS: Obese patients with decompensated HF were significantly younger (mean age = …

Sex Differences In Symptom Presentation Associated With Acute Myocardial Infarction: A Population-Based Perspective, Robert Goldberg, Caitlin O'Donnell, Jorge Yarzebski, Carol Bigelow, Judith Savageau, Joel Gore

Jorge L. Yarzebski

OBJECTIVES: To describe sex differences in symptom presentation after acute myocardial infarction (AMI) while controlling for differences in age and other potentially confounding factors. BACKGROUND: Although several studies have examined sex differences in diagnosis, management, and survival after AMI, limited data exist about possible sex differences in symptom presentation in the setting of AMI. METHODS: Community-based study of patients hospitalized with confirmed AMI in all 16 metropolitan Worcester, Mass., hospitals (1990 census population = 437,000). Men (n = 810) and women (n = 550) hospitalized with validated AMI in 1986 and 1988 comprised the study sample. RESULTS: After simultaneously controlling …

Differences In Discharge Medication After Acute Myocardial Infarction In Patients With Hmo And Fee-For-Service Medical Insurance, Danny Mccormick, Jerry Gurwitz, Judith Savageau, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVE: To assess the impact of fee-for-service (FFS) versus HMO medical insurance coverage on receipt of aspirin, beta-blockers, and calcium channel blockers at the time of hospital discharge following an acute myocardial infarction. DESIGN: Prospective, population-based study. SETTING: All 16 community and tertiary care hospitals in the metropolitan area of Worcester, Massachusetts. PATIENTS: The study population consisted of patients under 65 years of age hospitalized with a validated acute myocardial infarction in all hospitals in the Worcester (Massachusetts) Standard Metropolitan Statistical Area (1990 census estimate, 437,000) during 1986, 1988, 1990, 1991, and 1993. MEASUREMENTS AND MAIN RESULTS: After adjustment for …

Use Of Lipid-Lowering Medication In Patients With Acute Myocardial Infarction (Worcester Heart Attack Study), Robert Goldberg, Ira Ockene, Jorge Yarzebski, Judith Savageau, Joel Gore

Jorge L. Yarzebski

As part of a population-based longitudinal study, we examined the use of lipid-lowering medication in 3,824 patients hospitalized with acute myocardial infarction in the Worcester, Massachusetts metropolitan area between 1986 and 1993. The rate of utilization of lipid-lowering medication either before (1.8%) or during hospitalization (1.9%) for acute myocardial infarction was low.

Multidecade-Long Trends (1986-2005) In The Utilization Of Coronary Reperfusion And Revascularization Treatment Strategies In Patients Hospitalized With Acute Myocardial Infarction: A Community-Wide Perspective, Jared Wasser, Robert Goldberg, Frederick Spencer, Jorge Yarzebski, Joel Gore

Jorge L. Yarzebski

OBJECTIVES: The objectives of our community-wide investigation were to describe multidecade-long trends (1986-2005) in the utilization of thrombolytic therapy, percutaneous coronary interventions, and coronary artery bypass graft surgery in patients hospitalized with acute myocardial infarction (AMI). METHODS: The study sample consisted of 9422 greater Worcester (MA) residents hospitalized with confirmed AMI at all metropolitan Worcester medical centers in 11 annual periods between 1986 and 2005. RESULTS: Increases in the utilization of percutaneous coronary interventions were observed between 1986 (2.0%) and 2005 (50.7%) with the most rapid increases beginning in the late 1990s. Utilization of coronary artery bypass graft surgery during …

Long-Term Trends In The Use Of Coronary Reperfusion Strategies In Acute Myocardial Infarction: A Community-Wide Perspective, Robert Goldberg, Frederick Spencer, Joseph Okolo, Darleen Lessard, Jorge Yarzebski, Joel Gore

Jorge L. Yarzebski

BACKGROUND: The objectives of our study were to examine long-term (1986-2003) trends in the use of percutaneous coronary interventions (PCI) and thrombolytic therapy in the management of patients hospitalized with acute myocardial infarction (AMI) while our secondary study goal was to examine factors associated with use of these coronary reperfusion strategies. While there have been considerable changes in the management of patients hospitalized with AMI over time, limited contemporary data are available about changing trends in the use of different coronary reperfusion strategies, particularly from the more generalizable perspective of a population-based investigation. METHODS: The study sample consisted of 9,422 …

Use Of Do-Not-Resuscitate Orders In Patients With Kidney Disease Hospitalized With Acute Myocardial Infarction, Joline Chen, Jonathan Sosnov, Darleen Lessard, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Patients with kidney disease are at increased risk for adverse health outcomes in comparison to patients without kidney disease. Therefore, patients with kidney disease may have greater use of do-not-resuscitate (DNR) orders than patients without kidney disease in the setting of an acute illness. We examined the association between advanced kidney disease and use of DNR orders in patients admitted with an acute myocardial infarction (AMI) to all greater Worcester, MA, hospitals as part of an epidemiological study.

METHODS: Use of DNR orders in 4,033 Worcester residents hospitalized with AMI at 11 greater Worcester medical centers during 1997, 1999, …

Treatment Practices And Outcomes Of Patients With Established Peripheral Arterial Disease Hospitalized With Acute Myocardial Infarction In A Community Setting, Frederick Spencer, Darleen Lessard, Chyke Doubeni, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: There are little contemporary data available describing the hospital and long-term outcomes of patients with peripheral arterial disease (PAD) who are hospitalized with acute myocardial infarction (AMI). The objectives of our population-based study were to examine the hospital and long-term outcomes, as well as the use of different treatment practices, among patients with established PAD who were hospitalized with AMI. METHODS: The study sample consisted of 4480 patients hospitalized with AMI at all Worcester, Mass, medical centers in 4 alternate years between 1997 and 2003. RESULTS: Among the metropolitan Worcester residents hospitalized with AMI, 13.5% had a history of …

Excess Body Weight, Clinical Profile, Management Practices, And Hospital Prognosis In Men And Women After Acute Myocardial Infarction, Robert Goldberg, Jiang Cui, Barbara Olendzki, Frederick Spencer, Jorge Yarzebski, Darleen Lessard, Joel Gore

Jorge L. Yarzebski

BACKGROUND: Excess body weight is increasingly being recognized as a major health problem in American men and women. It is unclear, however, whether body weight is associated with the demographic and clinical profile, treatment of, and hospital prognosis after acute myocardial infarction (AMI).

METHODS: Nonconcurrent prospective epidemiologic investigation of Worcester (Massachusetts) metropolitan residents hospitalized at all 11 greater Worcester medical centers with validated AMI in 1997, 1999, 2001, and 2003.

RESULTS: A total of 2008 men and 1505 women were hospitalized with confirmed AMI during the 4 study periods. Approximately 41% of men and 29% of women were classified as …

Validation Of A Stroke Symptom Questionnaire For Epidemiological Surveys., Paulo A. Lotufo

Paulo A Lotufo

CONTEXT AND OBJECTIVE:Stroke is a relevant issue within public health and requires epidemiological surveillance tools. The aim here was to validate a questionnaire for evaluating individuals with stroke symptoms in the Stroke Morbidity and Mortality Study (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral, EMMA), São Paulo, Brazil.DESIGN AND SETTING:This was a cross-sectional study performed among a sample of the inhabitants of Butantã, an area in the western zone of the city of São Paulo.METHODS:For all households in the coverage area of a primary healthcare unit, household members over the age of 35 years answered a stroke symptom questionnaire …

Socioeconomic Status And Coronary Heart Disease Mortality In The City Of Sao Paulo, Brazil (1996 To 2007), Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Polyheart: Cardiovascular Disease Risk Assessment, Katherine Vaughan

Kinesiology and Public Health

Cardiovascular disease (CVD) is the leading cause of death in ‘Western Civilization.’ Lifestyle modification (ie regular exercise and healthy diet) greatly reduces the risk for CVD. It is unclear whether faculty at Cal Poly, who are exposed to positive benefits of lifestyle modification are at risk for CVD. The purpose of this study was to assess Cal Poly’s faculties’ cardiovascular health status, as specified by the American College of Sports Medicine’s (ACSM) seven cardiovascular disease risk factors. Both the researchers and participants benefit from this study because awareness of CVD risk factors may help prevent progression of risk factors and …

Fetal Programming By Nicotine Increases Cardiac Susceptibility To Ischemic Injury, Jennifer Charlotte Alexie Lawrence

Loma Linda University Electronic Theses, Dissertations & Projects

Fetal programming is the area of study that focuses on the prenatal origins of adult onset disorders. Previous studies have associated an adverse prenatal environment with the onset of physiologic and metabolic diseases during adulthood. Fetal malnutrition, hypoxia, and exposure to drugs - such as cocaine and nicotine - have been associated with adult disease states. Cigarette smoking is the number one cause of preventable death in the developed world. Among the many dangerous chemicals found in tobacco products is nicotine, the compound responsible for the addictive nature of tobacco use. Nicotine use during pregnancy is a known cause of …

Cardiovascular Risk Assessment - From Individual Risk Prediction To Estimation Of Global Risk And Change In Risk In The Population, John A. Batsis, Francisco Lopez-Jimenez

Dartmouth Scholarship

Cardiovascular disease is the most common cause of death and risk prediction formulae such as the Framingham Risk Score have been developed to easily identify patients at high risk that may require therapeutic interventions. Using cardiovascular risk formulae at a population level to estimate and compare average cardiovascular risk among groups has been recently proposed as a way to facilitate surveillance of net cardiovascular risk and target public health interventions. Risk prediction formulas may help to compare interventions that cause effects of different magnitudes and directions in several cardiovascular risk factors, because these formulas assess the net change in risk …

Effect Of Calcium Supplements On Risk Of Myocardial Infarction And Cardiovascular Events: Meta-Analysis, Mark J. Bolland, Allison Avenell, John A. Baron, A. Grey

Dartmouth Scholarship

Objective: To investigate whether calcium supplements increase the risk of cardiovascular events.

Osteoporosis is a major cause of morbidity and mortality in older people. Calcium supplements margin- ally reduce the risk of fracture, and most guidelines recommend adequate calcium intake as an integral part of the prevention or treatment of osteoporosis. Consequently, calcium supplements are commonly used by people over the age of 50. Observational stu- dies suggest that high calcium intake might protect against vascular disease, and the findings are consis- tent with those of interventional studies of calcium sup- plements thatshow improvementin some vascular risk factors. In contrast, …

Non-Inferiority Trials [In Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Cardiovascular And Cancer Mortality In Brazil, Paulo A. Lotufo

Paulo A Lotufo

Cancer are not surpassing Cardiovascular Diseases. Here you have an evaluation of mortality in Brazil. The debate was ignited by paper from IARC (International Agency for Research on Cancer) that forecasts cancer deaths surpassing heart diseases rates during de 2020’s. There is no dispute about the fact that - at least in the US and other countries - the decline of mortality deaths for heart diseases presenting a faster pace compared to cancer death rates. It is an epidemiological evidence that must be analyzed and some headline fueling hype as “heart diseases as an old agenda of public health and …

Smooth Muscle Hyperplasia Due To Acta2/Myh11 Mutations: Identification Of Novel Pathology And Pathways Leading To Aneurysms And Diverse Vascular Occlusive Diseases, Christina L. Papke

Dissertations & Theses (Open Access)

Missense mutations in smooth muscle cell (SMC) specific ACTA2 (á-actin) and MYH11 (â-myosin heavy chain) cause diffuse and diverse vascular diseases, including thoracic aortic aneurysms and dissections (TAAD) and early onset coronary artery disease and stroke. The mechanism by which these mutations lead to dilatation of some arteries but occlusion of others is unknown. We hypothesized that the mutations act through two distinct mechanisms to cause varied vascular diseases: a loss of function, leading to decreased SMC contraction and aneurysms, and a gain of function, leading to increased SMC proliferation and occlusive disease. To test this hypothesis, ACTA2 mutant SMCs …

The Relationship Of A Long-Term Exercise Program And Selected Coronary Risk Factors, Maryse Wells

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to investigate body composition and blood pressure as potential risk factors for coronary artery disease after 3 years of participation in a structured exercise program. The sample group was comprised of 21 male participants (66%) and 11 (34%) female participants with a mean age of 55 years who attended the exercise program and completed health and fitness testing annually. Participants did cardiovascular, strength, and flexibility training 5 days a week with an average attendance of 70%. After 3 years, BMI, waist circumference, and percent body fat increased significantly (p < .01); blood pressure levels did not change significantly (p > .05). Low control of diet …