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Cardiovascular risk prediction and prevention

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460 papers 25 to 100 followers
By Jamie Jarmul Md / PhD student at UNC - Chapel Hill, PhD in Health Policy and Management
Adina Hayek, Rohina Joshi, Tim Usherwood, Ruth Webster, Baldeep Kaur, Bandana Saini, Carol Armour, Ines Krass, Tracey-Lea Laba, Christopher Reid, Louise Shiel, Charlotte Hespe, Fred Hersch, Stephen Jan, Serigne Lo, David Peiris, Anthony Rodgers, Anushka Patel
BACKGROUND: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; and access to a pharmacy-based program to support long-term medication adherence and lifestyle modification...
2016: Implementation Science: IS
Aidan G O'Keeffe, Irwin Nazareth, Irene Petersen
BACKGROUND: Statins are widely prescribed for the primary prevention of cardiovascular disease. Guidelines exist for statin prescriptions, but there is little recent analysis concerning prescription trends over time and how these vary with respect to demographic variables. METHODS AND RESULTS: Using The Health Improvement Network primary care database, statin therapy initiation and statin prescription prevalence rates were calculated using data from 7,027,711 individuals across the UK for the years 1995 to 2013, overall and stratified by sex, age group, and socioeconomic deprivation level (Townsend score)...
2016: Clinical Epidemiology
Lotte Kaasenbrood, Neil R Poulter, Peter S Sever, Helen M Colhoun, Shona J Livingstone, S Matthijs Boekholdt, Sara L Pressel, Barry R Davis, Yolanda van der Graaf, Frank L J Visseren
BACKGROUND: In this study, we aimed to translate the average relative effect of statin therapy from trial data to the individual patient with type 2 diabetes mellitus by developing and validating a model to predict individualized absolute risk reductions (ARR) of cardiovascular events. METHODS AND RESULTS: Data of 2725 patients with type 2 diabetes mellitus from the Lipid Lowering Arm of the Anglo Scandinavian Cardiac Outcomes Trial (ASCOT-LLA) study (atorvastatin 10 mg versus placebo) were used for model derivation...
May 2016: Circulation. Cardiovascular Quality and Outcomes
Thanh-Huyen T Vu, Donald M Lloyd-Jones, Kiang Liu, Jeremiah Stamler, Daniel B Garside, Martha L Daviglus
BACKGROUND: The associations of optimal levels of all major cardiovascular disease risk factors, that is, low risk, in younger age with subsequent cardiovascular disease morbidity and mortality have been well documented. However, little is known about associations of low-risk profiles in younger age with functional disability in older age. METHODS AND RESULTS: The sample included 6014 participants from the Chicago Heart Association Detection Project in Industry Study...
July 2016: Circulation. Cardiovascular Quality and Outcomes
Alexandra M Hajduk, Sarwat I Chaudhry
Sedentary behavior is an emerging risk factor for cardiovascular disease (CVD) and may be particularly relevant to the cardiovascular health of older adults. This scoping review describes the existing literature examining the prevalence of sedentary time in older adults with CVD and the association of sedentary behavior with cardiovascular risk in older adults. We found that older adults with CVD spend >75 % of their waking day sedentary, and that sedentary time is higher among older adults with CVD than among older adults without CVD...
January 2016: Current Cardiovascular Risk Reports
Sabrina Siregar, Daan Nieboer, Yvonne Vergouwe, Michel I M Versteegh, Luc Noyez, Alexander B A Vonk, Ewout W Steyerberg, Johanna J M Takkenberg
BACKGROUND: The predictive performance of static risk prediction models such as EuroSCORE deteriorates over time. We aimed to explore different methods for continuous updating of EuroSCORE (dynamic modeling) to improve risk prediction. METHODS AND RESULTS: Data on adult cardiac surgery from 2007 to 2012 (n=95 240) were extracted from the Netherlands Association for Cardio-Thoracic Surgery database. The logistic EuroSCORE predicting in-hospital death was updated using 6 methods: recalibrating the intercept of the logistic regression model; recalibrating the intercept and joint effects of the prognostic factors; re-estimating all prognostic factor effects, re-estimating all prognostic factor effects, and applying shrinkage of the estimates; applying a test procedure to select either of these; and a Bayesian learning strategy...
March 2016: Circulation. Cardiovascular Quality and Outcomes
Javier Valero-Elizondo, Joseph A Salami, Oluseye Ogunmoroti, Chukwuemeka U Osondu, Ehimen C Aneni, Rehan Malik, Erica S Spatz, Jamal S Rana, Salim S Virani, Ron Blankstein, Michael J Blaha, Emir Veledar, Khurram Nasir
BACKGROUND: The American Heart Association's 2020 Strategic Goals emphasize the value of optimizing risk factor status to reduce the burden of morbidity and mortality. In this study, we aimed to quantify the overall and marginal impact of favorable cardiovascular risk factor (CRF) profile on healthcare expenditure and resource utilization in the United States among those with and without cardiovascular disease (CVD). METHODS AND RESULTS: The study population was derived from the 2012 Medical Expenditure Panel Survey (MEPS)...
March 2016: Circulation. Cardiovascular Quality and Outcomes
Angela Pirillo, Alberico Luigi Catapano
Despite the efficacy of statins in reducing cardiovascular events in both primary and secondary prevention, the adherence to statin therapy is not optimal, mainly due to the occurrence of muscular adverse effects. Several risk factors may concur to the development of statin-induced myotoxicity, including patient-related factors (age, sex, and race), statin properties (dose, lipophilicity, and type of metabolism), and the concomitant administration of other drugs. Thus, the management of patients intolerant to statins, particularly those at high or very high cardiovascular risk, involves alternative therapies, including the switch to another statin or the use of intermittent dosage statin regimens, as well as nonstatin lipid lowering drugs (ezetimibe and fibrates) or new hypolipidemic drugs such as PCSK9 monoclonal antibodies, the antisense oligonucleotide against the coding region of human apolipoprotein B mRNA (mipomersen), and microsomal triglyceride transfer protein inhibitor lomitapide...
May 2015: Current Cardiology Reports
Barbara T Alexander, John Henry Dasinger, Suttira Intapad
Low birth weight serves as a crude proxy for impaired growth during fetal life and indicates a failure for the fetus to achieve its full growth potential. Low birth weight can occur in response to numerous etiologies that include complications during pregnancy, poor prenatal care, parental smoking, maternal alcohol consumption, or stress. Numerous epidemiological and experimental studies demonstrate that birth weight is inversely associated with blood pressure and coronary heart disease. Sex and age impact the developmental programming of hypertension...
April 2015: Comprehensive Physiology
Antonino Tuttolomondo, Carlo Maida, Antonio Pinto
Diabetic foot ulcerations have been extensively reported as vascular complications of diabetes mellitus associated with a high degree of morbidity and mortality; in fact, some authors showed a higher prevalence of major, previous and new-onset, cardiovascular, and cerebrovascular events in diabetic patients with foot ulcers than in those without these complications. This is consistent with the fact that in diabetes there is a complex interplay of several variables with inflammatory metabolic disorders and their effect on the cardiovascular system that could explain previous reports of high morbidity and mortality rates in diabetic patients with amputations...
2015: Journal of Diabetes Research
Edward H Ip, Achmad Efendi, Geert Molenberghs, Alain G Bertoni
BACKGROUND: Epidemiological studies about cardiovascular diseases often rely on methods based on time-to-first-event for data analysis. Without taking into account multiple event-types and the recurrency of a specific cardiovascular event, this approach may underestimate the overall cardiovascular burden of some risk factors, if that is the goal of the study. METHODS: In this study we compare four different statistical approaches, all based on the Weibull distribution family of survival model, in analyzing cardiovascular risk factors...
2015: BMC Medical Research Methodology
Allan D Sniderman, Michael Pencina, George Thanassoulis
PURPOSE OF REVIEW: Whether a factor significantly increases the area under the curve (AUC) of a receiver operating characteristic analysis has become the standard test of its utility. Thus, in many studies, apolipoprotein B and LDL particle number have not increased the AUC significantly beyond that produced by the conventional markers, and guideline groups have concluded on this basis that they should not be added to routine clinical practice. This article demonstrates this conclusion to be invalid...
June 2015: Current Opinion in Lipidology
Francisco Arrieta, Pedro Iglesias, Juan Pedro-Botet, Francisco Javier Tébar, Emilio Ortega, Andreu Nubiola, Jose Luis Pardo, Gonzálo Fernando Maldonado, Juan Carlos Obaya, Pablo Matute, Romina Petrecca, Nuria Alonso, Elena Sarabia, Victor Sánchez-Margalet, José Juan Alemán, Jorge Navarro, Antonio Becerra, Santiago Duran, Manuel Aguilar, Fernando Escobar-Jiménez
The present paper updates the Clinical Practice Recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. This is a medical consensus agreed by an independent panel of experts from the Spanish Society of Diabetes (SED). Several consensuses have been proposed by scientific and medical Societies to achieve clinical goals. However, the risk score for general population may lack sensitivity for individual assessment or for particular groups at risk, such as diabetics. Traditional risk factors together with non-traditional factors are reviewed throughout this paper...
July 2015: Clínica e Investigación en Arteriosclerosis
Colin J Yi, Colin O Wu, Michael Tee, Chia-Ying Liu, Gustavo J Volpe, Martin R Prince, Gregory W Hundley, Antoinette S Gomes, Rob J van der Geest, Susan Heckbert, João A Lima, David A Bluemke
BACKGROUND: Risk scores for cardiovascular disease (CVD) are in common use to integrate multiple cardiovascular risk factors in order to identify individuals at greatest risk for disease. The purpose of this study was to determine if individuals at greater cardiovascular risk have T1 mapping indices by cardiovascular magnetic resonance (CMR) indicative of greater myocardial fibrosis. METHODS: CVD risk scores for 1208 subjects (men, 50.8%) ages 55-94 years old were evaluated in the Multiethnic Study of Atherosclerosis (MESA) at six centers...
2015: Journal of Cardiovascular Magnetic Resonance
Carlos Brotons, Eva Calvo-Bonacho, Irene Moral, Mireia Puig, María T Garcia-Margallo, María V Cortés-Arcas, Carlos Catalina-Romero, Luis Quevedo-Aguado, Luis M Ruilope
BACKGROUND: Recent guidelines recommend assessment of lifetime cardiovascular risk on the basis of traditional risk factors in adults who are not at high short-term risk. The aim of this study is to determine the implications of estimating the lifetime cardiovascular risk in individuals in a large occupational cohort in Spain. DESIGN: National cross-sectional study in an occupational cohort with an in-person interview including laboratory tests. METHODS: Volunteer workers who were examined between January 2011 and December 2011 were included...
April 2016: European Journal of Preventive Cardiology
JoAnn Grif Alspach
No abstract text is available yet for this article.
April 2015: Critical Care Nurse
Niclas Freund, Bernhard C Friedli, Therese Junker, Martin Zimmermann, Michael J Zellweger
BACKGROUND: "CardioTest (®) " is a tool for cardiovascular risk assessment. The aim of this study was to evaluate if this test used in Swiss pharmacies provides risk stratification and if it had impact on individual behaviour. METHODS: Individuals were evaluated (blood pressure, body waist circumference, random blood samples and coronary artery disease risk factors). The cardiovascular risk was calculated (AGLA Risk Score (ARS) a modified PROCAM Score) and participants were informed about their result...
2015: Open Cardiovascular Medicine Journal
Stephen J Nicholls, Leonard Kritharides
No abstract text is available yet for this article.
April 7, 2015: Journal of the American College of Cardiology
Leslee J Shaw, Jagat Narula, Y Chandrashekhar
No abstract text is available yet for this article.
April 7, 2015: Journal of the American College of Cardiology
Fuschia M Sirois
Personality is an important epidemiological factor for understanding health outcomes. This study investigated the associations of trait procrastination with hypertension and cardiovascular disease (HT/CVD) and maladaptive coping by testing an extension of the procrastination-health model among individuals with and without HT/CVD. Individuals with self-reported HT/CVD (N = 182) and healthy controls (N = 564), from a community sample, completed an online survey including measures of personality, coping, and health outcomes...
June 2015: Journal of Behavioral Medicine
2015-03-31 16:56:30
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