Cardiovascular Diseases Commons^™

The Roles Of An Evidence-Based Weight Management Protocol In Hypertension Control, Belinda Akakpo Maxwell

Doctor of Nursing Practice Final Manuscripts

The Roles of an Evidence-Based Weight Management Protocol in Hypertension Control

Abstract

Purpose: The purpose of this project is to evaluate the impact of a healthcare provider-led protocol for patients with hypertension (HTN) and weight loss needs to improve weight control, cardiovascular risk and quality of life.

Background: Evidence shows that a 1.2-kg weight loss can reduce systolic blood pressure (SBP) by 3.8mmHg. Thus, a 10kg (22lbs) weight loss is likely to yield a SBP decrease of as much as 32mmHg. Such results would positively impact quality of life and costs. The simple approach of instructing patients to eat less …

The Effect Of Antihypertensive Medications Dosing On Blood Pressure Control And Left Ventricular Hypertrophy In Children With Chronic Kidney Disease, Benjamin A. Matta

Research Days

No abstract provided.

Typical Diet Quality In New Zealand Compared To Other Westernized Countries With An Emphasis On Chronic Disease, Emily Kollar

Honors Projects

The diet quality was analyzed for people living in New Zealand and people living in other Westernized Countries (United States, Canada, Western Europe) based on the dietary guidelines. Diet quality was analyzed by looking at consumption of food groups such as fruits, vegetables, meat, and seafood as well as nutrients such as saturated/trans/unsaturated fat, sodium, and added sugars. These nutrients have been linked to certain health outcomes and chronic disease; therefore, the prevalence of chronic disease was researched to determine if there was a correlation between New Zealand's diet and their chronic disease rates in comparison to other Westernized countries.

Health Literacy Screening To Increase Antihypertensive Medication Adherence, Boyann Bonjean

Evidence-Based Practice Project Reports

Hypertension contributes to the risk of developing cardiovascular disease (CVD), stroke, heart attack, and chronic kidney disease (CKD) (Abegaz et al., 2016; Weir, 2014; Whelton et al., 2017). Evidence indicates that 30 to 50% of people who are prescribed antihypertensive medication therapy are nonadherent (Hedna et al., 2015). Non-adherence to antihypertensive medications is a major contributor to hypertension treatment failure (Al Ghurair et al., 2012; Hu, 2016; Whelton et al., 2017). Evidence has shown that low health literacy may impact antihypertensive therapy (Slade, 2017). The purpose of this EBP project was to provide an organizational change by implementing a health …

Rising Rural Body-Mass Index Is The Main Driver Of The Global Obesity Epidemic In Adults, Con Burns, Tara Coppinger, Janette Walton, Et Al

Publications

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to …

Evaluation Of The Role Of Microvascular Pathology On Peripheral Artery Disease, Constance Mietus

Theses & Dissertations

Background: Peripheral Artery Disease (PAD) begins with atherosclerotic narrowing of arteries, including those that supply the legs. Individuals with PAD experience pain during walking, which becomes increasingly limiting. Studies from our group and others have shown that a myopathy is present in the skeletal muscle of PAD patients, and is characterized by myofiber degeneration, fibrosis, and remodeling of vessels ranging from 50 – 150 mm in diameter. However, microvascular pathology, particularly of the smallest microvessels (5 – 15 mm in diameter) remains poorly characterized. Furthermore, little is known about the relationships between microvascular architecture, microperfusion, and patient walking performance. We …

Effects Of Macrophages With Dying Heart Cells, Shannon Alexander

CURCE Annual Undergraduate Conference

Cardiovascular disease involves degraded or dying cells, caused from myocardial infarction, commonly known as a heart attack. When cardiomyocytes, or heart muscle cells, do not receive a high supply of nutrients and oxygenated blood, proper heart functioning is affected, resulting in MI. One cause of this is atherosclerosis. This is a disease when the arterial lumen becomes narrowed due to plaque build-up. Plaque forms when fat, cholesterol, protein, calcium, and white blood cell deposits gradually build up in the inner artery walls, which progressively impedes the arterial blood flow supply, eventually causing organ cell death. The lipids, and most especially …

A Lifestyle Modification Program For Adult Patients With Coronary Artery Disease, Amanda M. Yarbrough

Evidence-Based Practice Project Reports

As a leading cause of death worldwide, coronary artery disease affects people of all races and ethnicities. The foundation for the prevention of secondary fatal cardiac events, such as stroke or myocardial infarction, is lifestyle modification to effectively lower cholesterol levels. Lifestyle change impacts diet, physical activity, smoking habits, vital sign measures, and stress management. The purpose of this evidence-based practice project was to reduce implement a lifestyle intervention to lower LDL-C levels and promote healthier lifestyles. This practice change was developed utilizing Stetler’s Research Utilization model to promote evidence-based practice changes in the clinical setting. Nola Pender’s Health Promotion …

Cardio-Metabolic Disease Risk Factors Among South Asian Labour Migrants To The Middle East: A Scoping Review And Policy Analysis, Shiva Raj Mishra, Saruna Ghimire, Chandni Joshi, Bishal Gyawali, Archana Shrestha, Dinesh Neupane, Sudesh Raj Sharma, Yashashwi Pokharel, Salim S. Virani

Office of the Provost

This paper aims to explore the burgeoning burden of cardiovascular and metabolic disease (CMD) risk factors among South Asian labor migrants to the Middle East. We conducted a qualitative synthesis of literature using PubMed/Medline and grey literature searches, supplemented by a policy review of policies from the South Asian countries. We found a high burden of cardio-metabolic risk factors among the migrants as well as among the populations in the home and the host countries. For example, two studies reported the prevalence of diabetes mellitus (DM) ranging between 9 and 17% among South Asian migrants. Overweight and obesity were highly …

Atypical Presentation Of Stemi With Cardiac Tamponade Related To Malignancy, Matthew J. Johnson, Rohan Penmetcha

Rowan-Virtua Research Day

Cardiac tamponade and myocardial infarction are rare as the initial presentation of a malignancy. Here, we describe a case with an atypical presentation of a myocardial infarction due to a thrombus in the right coronary artery occurring in the setting of a pericardial effusion causing tamponade physiology related to malignancy. We present this unique case of myocardial infarction and cardiac tamponade as this was not caused by a type-A aortic dissection. In conclusion, we suggest that malignancy be considered in the differential diagnosis when these findings present together.

The Relationship Of Cardiovascular Disease To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes Mellitus, Meet Shah, Shmilah Choudhary, Sanath Shetty, Terrie Ginsberg, Matthew H. Mclaughlin

Rowan-Virtua Research Day

Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes (T2DM) would help identify patients at risk of rehospitalization. The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM.Factors to be investigated are: patient demographics and whether the patient was hospitalized for cardiovascular disease. Participants were older adults>65 years old with T2DM, admitted to …

Coronary No-Reflow Following Percutaneous Intervention, Yaser Khalid, Harsh Patel, Adam Levine

Rowan-Virtua Research Day

Normally, coronary revascularization with a percutaneous coronary intervention (PCI) leads to restoration of normal coronary blood flow through the coronary arteries, with reperfusion of the myocardium. However, there is a group of patients who do not benefit from the prompt restoration of antegrade flow, as they fail to show resolution of the indirect signs of ischemia such as electrocardiographic (ECG) changes and improvements in perfusion abnormalities. This condition is referred to as the “no-reflow phenomenon.” In this case report, we will discuss the case of a patient who developed coronary no-reflow immediately following PCI.

A Case Of Atraumatic Posterior Thigh Compartment Syndrome, Nailah Mubin, Brian Katt

Rowan-Virtua Research Day

Compartment syndrome(CS) occurs when intra-compartmental pressures exceeds to a point where arterial, venous and lymphatic circulation of local tissues, muscles and nerves is compromised. CS is most common after a traumatic injury and usually occurs in the leg or forearm and less commonly in the thigh. Thigh compartment syndrome is rare due to its larger size and more compliant borders. We present a case of nontraumatic compartment syndrome in the posterior thigh associated with rhabdomyolysis and a sciatic nerve palsy which then required emergent fasciotomy. The patient's course was further complicated by acute renal failure due to the rhabdomyolysis and …

Maternal Morbidity Outcomes In Idiopathic Moyamoya Syndrome In New York State, Hajere J. Gatollari, Amelia K. Boehme, E. Sander Connolly, Alexander M. Friedman, Mitchell S.V. Elkind, Joshua Z. Willey, Eliza C. Miller

Rowan-Virtua Research Day

Background: Pregnancy is associated with an increased risk of stroke in young women. Idiopathic moyamoya syndrome (IMMS) is a rare condition characterized by progressive narrowing of large cerebral arteries resulting in flimsy collaterals prone to rupture or thrombosis. Data are limited on pregnancy outcomes in women with IMMS. We hypothesized that IMMS would be associated with increased pregnancy morbidity, including stroke.

Conclusion: Pregnancies within 1 year prior or any time after IMMS diagnosis did not have increased maternal morbidity compared to unexposed pregnancies after adjusting for age and clustering of women with multiple pregnancies. Prospective studies are needed to better …

Cardio-Metabolic Disease Risk Factors Among South Asian Labour Migrants To The Middle East: A Scoping Review And Policy Analysis, Shiva Raj Mishra, Saruna Ghimire, Chandni Joshi, Bishal Gyawali, Archana Shrestha, Dinesh Neupane, Sudesh Raj Sharma, Yashashwi Pokharel, Salim S. Virani

School of Public Health Faculty Research

This paper aims to explore the burgeoning burden of cardiovascular and metabolic disease (CMD) risk factors among South Asian labor migrants to the Middle East. We conducted a qualitative synthesis of literature using PubMed/Medline and grey literature searches, supplemented by a policy review of policies from the South Asian countries. We found a high burden of cardio-metabolic risk factors among the migrants as well as among the populations in the home and the host countries. For example, two studies reported the prevalence of diabetes mellitus (DM) ranging between 9 and 17% among South Asian migrants. Overweight and obesity were highly …

Left Atrial Model, Borna Sobati, Sarah Porello, Tess Pate

Biomedical Engineering

The objective is to produce an electrophysiological model of an adult human left atrium. This model will be used to test mapping probe catheters used for locating cardiac arrhythmias against current technology used in practice. Dr. Chris Porterfield requested this model and other physicians or probe catheter manufacturers may also use this product in the future. Dr. Porterfield also discussed the possibility of future senior project groups using the model as a bench test for designing new catheter tips. The model will precisely simulate electrical behaviors of the heart in normal as well as arrhythmic conditions. Ideally, the model will …

Biomarkers Of Dietary Omega-6 Fatty Acids And Incident Cardiovascular Disease And Mortality: An Individual-Level Pooled Analysis Of 30 Cohort Studies, Matti Marklund, Jason H. Y. Wu, Fumiaki Imamura, Liana C. Del Gobbo, Amanda Fretts, Janette De Goede, Peilin Shi, Nathan L. Tintle, Maria Wennberg, Stella Aslibekyan, Tzu-An Chen, Marcia C. De Oliveira Otto, Yoichiro Hirakawa, Helle Højmark Eriksen, Janine Kroger, Federica Laguzzi, Maria Lankinen, Rachel A. Murphy, Kiesha Prem, Cecelia Samieri, Jyrki Virtanen, Alexis C. Wood, Kerry Wong, Wei-Sin Yang, Xia Zhou, Ana Baylin, Jolanda M. A. Boer, Ingeborg A. Brouwer, Hannia Campos, Paulo H. M. Chaves, Kuo-Liong Chien, Ulf De Faire, Luc Djousse, Gudny Eiriksdottir, Naglaa El-Abbadi, Nita G. Fouruhi, J. Michael Gaziano, Johanna M. Geleijnse, Bruna Gigante, Graham Giles, Eliseo Guallar, Vilmundur Gudnason, Tamara Harris, William S. Harris, Catherine Helmer, Mai-Lis Hellenius, Allison Hodge, Frank B. Hu, Paul F. Jacques, Jan-Hakan Jansson, Anya Kalsbeek, Kay-Tee Khaw, Woon-Puay Koh, Markku Laakso, Karin Leander, Hung-Ju Lin, Lars Lind, Robert Luben, Juhua Luo, Barbara Mcknight, Jaakko Mursu, Toshiharu Ninomiya, Kim Overvad, Bruce M. Psaty, Eric Rimm, Matthias B. Schulze, David Siscovick, Michael Skjelbo Nielsen, Albert V. Smith, Brian T. Steffen, Lyn Steffen, Qi Sun, Johan Sundstrom, Michael Y. Tsai, Hugh Tunstall-Pedoe, Matti I. J. Uusitupa, Rob M. Van Dam, Jenna Veenstra, Monique Verschuren, Nick Wareham, Walter Willett, Mark Woodward, Jian-Min Yuan, Renata Micha, Rozenn N. Lemaitre, Dariush Mozaffarian, Ulf Risérus

Faculty Work Comprehensive List

BACKGROUND: Global dietary recommendations for and cardiovascular effects of linoleic acid, the major dietary omega-6 fatty acid, and its major metabolite, arachidonic acid, remain controversial. To address this uncertainty and inform international recommendations, we evaluated how in vivo circulating and tissue levels of linoleic acid (LA) and arachidonic acid (AA) relate to incident cardiovascular disease (CVD) across multiple international studies.

METHODS: We performed harmonized, de novo, individual-level analyses in a global consortium of 30 prospective observational studies from 13 countries. Multivariable-adjusted associations of circulating and adipose tissue LA and AA biomarkers with incident total CVD and subtypes (coronary heart disease, …

Kounis Syndrome: A Simple Mri With Contrast Turned Into A Life Threatening Condition, Ahmed Amro, Kanaan Mansoor, Mohammad Amro, Amal Sobeih, Mehiar El-Hamdani

Marshall Journal of Medicine

Kounis syndrome [KS] is a hypersensitivity coronary disorder induced by various allergens. It is a rare condition which has been reported in every age group (2-90 years), every race and geographic location, its incidence has been reported to range from 7.9 to 19.4 per 100,000. The presentation of the detrimental effects of KS on coronary arteries ranges from vasospastic angina to allergic myocardial infarction.

Drugs are the major iatrogenic cause of KS, but virtually everything in the environment around us can cause KS. In recent years contrast mediums used in the radiologic investigation have come forth as a leading cause …

The Effect Of Antihypertensive Dosing On Hypertension In Children With Chronic Kidney Disease, Benjamin A. Matta, Uri S. Alon, Bradley Warady Md, Tarak Srivastava, Darcy Weidemann

Posters

Background

Hypertension (HTN) is a highly prevalent and major risk factor for poor cardiovascular and renal outcomes in chronic kidney disease (CKD). Previous research suggests that HTN is underdiagnosed and undertreated in children with CKD. To our knowledge no studies have investigated the effect of antihypertensive (antiHTN) dose on blood pressure (BP) control in this population.

Objective

To determine the effect of antiHTN dose on HTN status in children with CKD.

Methods

Study population: 255 participants studied in the Chronic Kidney Disease in Children (CKiD) study at their 3rd visit, taking at least 1 antiHTN drug.

Cumulative Drug Dose Index …

Representing The Patient Experience Of Heart Failure Through Empathy, Journey And Stakeholder Mapping, Leanna Woods, Jed Duff, Erin Roehrer, Kim Walker, Elizabeth Cummings

Patient Experience Journal

Heart failure is a long-term condition requiring those affected to manage numerous self-care related activities. People with heart failure report multiple challenges accommodating self-care activities in their every-day life. The aim of this study is to (1) understand the experience of people with heart failure and their caregivers in the local patient population, and (2) visually represent these experiences to inform the design of a mobile health intervention supporting self-care. Seven patients and four family caregivers were interviewed using an empathic approach. Data was collected using rapid design methods including an empathy map to uncover patient and caregiver perspectives and …