American journal of preventive cardiology最新文献

{"title":"The influence of high exercise levels on the coronary atherosclerosis profile by computed tomography angiography and outcomes","authors":"Gudrun M Feuchtner ,&nbsp;Elias Ruf ,&nbsp;Fabian Barbieri ,&nbsp;Thomas Senoner ,&nbsp;Johannes Deeg ,&nbsp;Yannick Scharll ,&nbsp;Gerlig Widmann ,&nbsp;Pietro G. Lacaita","doi":"10.1016/j.ajpc.2025.101044","DOIUrl":"10.1016/j.ajpc.2025.101044","url":null,"abstract":"<div><h3>Background</h3><div>High exercise volumes may have deleterious effects on the cardiovascular system, and the upper thresholds for \"safe\" volumes are unclear.</div></div><div><h3>Objective</h3><div>To evaluate if high-exercise volumes influence the coronary artery disease (CAD) profile by coronary CTA, cardiovascular outcomes, compared with traditional CVRF.</div></div><div><h3>Methods</h3><div>802 patients (age 57.6 ± 10.95 years;38.1 % women) undergoing coronary CTA were enrolled. Self-reported exercise habits were collected: Type, volume (frequency/week and time/per unit); and years of training. Endpoints were: CTA: coronary stenosis severity (CADRADS); high-risk-plaque (HRP); coronary artery calcium score (CAC), and MACE.</div></div><div><h3>Results</h3><div>478 subjects were included. 100 with high-(H)-exercise level (&gt;3–5x/week and 1–3 h per unit) were propensity-score matched with 124 sedentary controls. The CVRF dyslipidemia (<em>p</em> = 0.393) and age were similar in both groups (<em>p</em> = 0.328), while arterial hypertension (<em>p</em> = 0.016), diabetes (<em>p</em> = 0.032), and the BMI (<em>p</em> &lt; 0.001) were lower in athletes. CAC (80.5 vs 107.7 AU: <em>p</em> = 0.820, CADRADS: <em>p</em> = 0.394) and MACE-rates were not different. Follow-up was 3.95±1.0 years. After matching for sex, HRP was 1.6-fold less frequent in the H-group (17 % vs 32.8 %; <em>p</em> = 0.231; OR 1.58 (95 % CI: 0.787–3.222) and smoking was more prevalent in controls. There was no difference in HRP after adjusting for all CVRF. MET was mean 8.78 ± 3.5; weekly training volume 9 h. The majority (78 %) reported &gt;5 -10 years of training.</div></div><div><h3>Conclusion</h3><div>High-exercise levels (up to 9h/week) are safe - without a deleterious impact on the coronary atherosclerosis profile.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101044"},"PeriodicalIF":4.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participation in a comprehensive cardiac rehabilitation program improves mid- and long-term prognosis in survivors of acute coronary syndrome","authors":"Csaba Sári ,&nbsp;Christian M. Heesch ,&nbsp;János Attila Kovács ,&nbsp;Attila Simon ,&nbsp;Péter Andréka","doi":"10.1016/j.ajpc.2025.101042","DOIUrl":"10.1016/j.ajpc.2025.101042","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease is the leading cause of death in developed nations. While survival rates of myocardial infarction have improved in recent decades due to advanced treatment options, secondary prevention efforts are often neglected. This study evaluates the effects of participation in a comprehensive cardiac rehabilitation program (CCR) on survival in patients presenting with acute coronary syndrome (ACS).</div></div><div><h3>Methods</h3><div>In Hungary, since January 2014, data on patients with ACS have been mandatorily entered into the National Myocardial Infarction Register. This Register now holds information on 155,000 ACS events involving over 130,000 patients. A retrospective analysis was performed on the data of said Register.</div></div><div><h3>Results</h3><div>We examined data on 76,153 ACS cases that occurred from 2014 to 2019. For the purposes of this study, we focused on early survivors, and 66,905 patients were included in our analysis (alive 30 days after the index event). The main modifiable protective factors, analyzed by binary regression model, were percutaneous coronary intervention (PCI), direct admission to a PCI-capable hospital, and participation in a comprehensive cardiac rehabilitation (CCR) program. In Hungary, such programs include supervised physical exercise as well as patient education on smoking cessation, dietary changes, and medication compliance. Our study showed that participation in CCR programs was associated with a 42 % reduction in 1-year mortality for patients with ST-elevation myocardial infarction (STEMI) and improved long-term survival rates across various patient subgroups. Despite its efficacy, the participation rate in CCR was low, with only 21 % of eligible patients completing such programs. The lowest CCR participation rate was in non-ST-elevation myocardial infarction (NSTEMI) patients who did not undergo PCI; these patients also had the highest mortality rates. Factors predicting lower participation rates were older age, male gender, NSTEMI presentation, and lack of percutaneous coronary intervention (PCI).</div></div><div><h3>Conclusion and relevance</h3><div>This study shows a significant survival benefit of participation in a comprehensive cardiac rehabilitation program in early survivors of ACS. Unexpectedly, this finding was contrasted by a very low participation rate in this highly effective and cost-effective intervention. Increasing awareness of CCR’s benefits both amongst patients and providers, as well as increasing access to and availability of CCR should significantly improve survival rates following ACS.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101042"},"PeriodicalIF":4.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of educational attainment and traditional risk factor control with cardiovascular disease","authors":"Jintao Tao ,&nbsp;Xiaohong Zhao ,&nbsp;Bo Li ,&nbsp;Huayu Sun ,&nbsp;Yuhao Hu ,&nbsp;Shuohua Chen ,&nbsp;Shouling Wu ,&nbsp;Yuntao Wu","doi":"10.1016/j.ajpc.2025.101031","DOIUrl":"10.1016/j.ajpc.2025.101031","url":null,"abstract":"<div><h3>Objective</h3><div>Cardiovascular disease (CVD) incidence is rising globally, with a significant burden in China. Educational attainment, a key socioeconomic factor, is strongly associated with CVD risk, partly due to differences in risk factor management. This study examines the association between educational attainment, cardiovascular risk factor control, and CVD incidence.</div></div><div><h3>Methods</h3><div>This study analyzed data from the Kailuan Study, which enrolled 101,510 participants (2006–2007), with 92,186 meeting the inclusion criteria. Data collection included epidemiological surveys, anthropometric measurements, blood pressure assessments, smoking status evaluations, and biochemical tests. A composite risk factor control score was based on blood pressure, fasting blood glucose, low-density lipoprotein cholesterol, smoking status, and body mass index. Participants were followed until December 31, 2022, with CVD events—including coronary heart disease (CHD) and cerebrovascular disease (CBD)—as study endpoints. Cox proportional hazards models estimated hazard ratios (HRs) and 95 % confidence intervals (CIs), and mediation analysis assessed the role of risk factor control.</div></div><div><h3>Results</h3><div>During a 14.48-year follow-up, 11,145 CVD events occurred. Lower education was associated with higher CVD risk (HR: 1.51, 95 % CI: 1.35–1.69), with risk factor control mediating 14.2 % of this association. Better risk factor management correlated with lower CVD risk, particularly among highly educated individuals.</div></div><div><h3>Conclusion</h3><div>Lower education significantly increases CVD risk, especially among those with poor risk factor control. While risk factor management mitigates some of this risk, its effect is limited, highlighting the need for comprehensive interventions, including improved health education and social support.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101031"},"PeriodicalIF":4.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of plant-based diets with subclinical cardiovascular disease in U.S. adults, 1999-2004","authors":"Audrey Ting ,&nbsp;Amelia S. Wallace ,&nbsp;Mary R. Rooney ,&nbsp;Hyunju Kim ,&nbsp;Valerie K. Sullivan ,&nbsp;Elizabeth Selvin ,&nbsp;Casey M. Rebholz","doi":"10.1016/j.ajpc.2025.101029","DOIUrl":"10.1016/j.ajpc.2025.101029","url":null,"abstract":"<div><h3>Background</h3><div>Dietary patterns currently recommended for cardiovascular health often emphasize the consumption of plant foods.</div></div><div><h3>Methods</h3><div>We included 7,708 participants from the National Health and Nutrition Examination Survey 1999-2004 aged ≥20 years who were not pregnant and did not have a self-reported history of cardiovascular disease. Dietary intake was assessed using a 24-hour dietary recall. All plant-based dietary indices [overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI)] were analyzed by quartiles and cardiac biomarkers [cardiac troponin T (cTnT), cardiac troponin I (cTnI), and N-terminal pro-B-type natriuretic peptide (NT-proBNP)] were categorized as elevated versus non-elevated using clinical cutpoints. We used logistic regression models progressively adjusted for confounders to study the associations between each plant-based diet index and elevated cardiac biomarkers. All analyses used appropriate survey weights to account for the complex study design.</div></div><div><h3>Results</h3><div>Mean age was 45 years old, 46 % were male, and 74 % were non-Hispanic White. After adjustment for sociodemographic characteristics, lifestyle behaviors, and measures of health status, there was an inverse association between adherence to hPDI (quartile 4 vs. quartile 1) and elevated cTnI (OR: 0.52, 95 % CI: 0.30, 0.90; p-trend &lt;0.01) and a positive association between uPDI and elevated cTnI (OR for quartile 4 vs. 1: 1.65, 95 % CI: 1.10, 2.46; p-trend=0.04). There were no significant associations between plant-based diet indices and elevated cTnT or NT-proBNP.</div></div><div><h3>Conclusion</h3><div>Higher adherence to a healthy plant-based diet was inversely associated with elevated cTnI and higher adherence to an unhealthy plant-based diet was positively associated with elevated cTnI in a nationally representative sample of U.S. adults. Supporting access to and adoption of healthy plant-based diets may be a useful strategy for promoting population-level cardiovascular health.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101029"},"PeriodicalIF":4.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors and outcomes associated with adherence to statins among patients with newly diagnosed cardiovascular disease","authors":"Jiang Li ,&nbsp;Satish Mudiganti ,&nbsp;Hannah Husby ,&nbsp;J B Jones ,&nbsp;Xiaowei Yan","doi":"10.1016/j.ajpc.2025.101028","DOIUrl":"10.1016/j.ajpc.2025.101028","url":null,"abstract":"<div><h3>Background</h3><div>Statin use is proven to be effective in lowering low-density lipoprotein cholesterol (LDL-C) levels and reducing risk of recurrent myocardial infarction, stroke, and mortality in individuals with established cardiovascular disease (CVD). We used medication dispensed data (e.g., SureScripts), which has been integrated with the electronic health record (EHR) to examine the factors and outcomes associated with adherence to statins.</div></div><div><h3>Methods</h3><div>This study is a secondary data analysis using longitudinal data between 1/1/2010–10/31/2021 (<em>n</em> = 1486,286 over nearly 12 years) from a large community-based health system on all primary care patients aged 35 years or older when diagnosed with the first CVD two years after their first primary care visit and had new statin prescriptions on or after CVD diagnosis. Multivariable logistic regression models were used to identify the factors associated with filling the prescription and statin adherence, respectively. Survival analysis was used to assess the association between statin adherence and LDL-C control.</div></div><div><h3>Results</h3><div>Of the 5155 patients with newly prescribed statins, a total of 3553 (68.9 %) were adherent, with insurance type, online patient portal use, race, age, statin intensity, and cardiologist visits emerging as significant predictors. Specifically, patients with PPO/FFS were less likely to fill statin prescriptions compared to those with HMO. Infrequent online patient portal use is associated with lower adherence. There is a disparity between patients race categories (Non-Hispanic Black (NHB) vs. Non-Hispanic White (NHW)) in filling the prescription and adhering to the filled prescription. Medication adherence is defined as proportion of days covered (PDC) of 80 % or greater. Adherence was positively associated with older age, high-intensity statins, and cardiologist visits. Having a visit with a cardiologist showed better adherence to the prescription and lowering of LDL values. Additionally, adhering to statins has shown a better outcome of lowering patients LDL values.</div></div><div><h3>Conclusions</h3><div>The findings emphasize demographic and healthcare factors in medication adherence and LDL control, suggesting tailored interventions for diverse populations, addressing disparities in insurance type, race, and online portal use, and involving cardiologists in medication management for improved medication adherence and clinical outcomes.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101028"},"PeriodicalIF":4.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative remnant cholesterol and major adverse cardiovascular events among adults with type 2 diabetes","authors":"Yu-Wen Qian ,&nbsp;Zhong-Yue Liu ,&nbsp;Fei Fang ,&nbsp;Jia-Min Wang ,&nbsp;Xiao-Ping Shao ,&nbsp;Yi-Ping Jia ,&nbsp;Xian Bo Wu ,&nbsp;Fu-Rong Li ,&nbsp;Wei Zhang ,&nbsp;Huan-Huan Yang ,&nbsp;Guo-Chong Chen ,&nbsp;Hai-Peng Wang","doi":"10.1016/j.ajpc.2025.101020","DOIUrl":"10.1016/j.ajpc.2025.101020","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with type 2 diabetes are prone to dyslipidemia. The relationship of cumulative exposure to elevated remnant cholesterol (RC) with major adverse cardiovascular events (MACEs) remains unclear for individuals with type 2 diabetes, especially for those with intensive lipid-lowering treatment.</div></div><div><h3>Methods</h3><div>This study included 5143 participants with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes trial, who had at least four lipid measurements over the first three years of the trial and did not have MACEs across the measurements. Cumulative RC (cumRC) was calculated considering RC levels at each measurement and the between-measurement time interval. Cox proportional hazards regression models were used to estimate HRs and 95 % CIs of MACEs associated with cumRC levels.</div></div><div><h3>Results</h3><div>During a median follow-up of 6.3 years, 472 participants developed MACEs, including 154 cardiovascular deaths, 211 with nonfatal myocardial infarction, and 148 with nonfatal stroke. After multivariable adjustment for conventional risk factors, higher levels of cumRC were associated with a higher risk of MACEs (HR_{Q4 vs. Q1} = 1.71, 95 % CI: 1.31–2.22; P-trend &lt;0.001), with similar associations for cardiovascular death (P-trend = 0.013) and nonfatal myocardial infarction (P-trend &lt;0.001), but no association for nonfatal stroke (P-trend = 0.114). The association of cumRC with the risk of MACEs was consistent across age, sex, and lipid trial assignment groups and remained after further adjusting for baseline RC.</div></div><div><h3>Conclusion</h3><div>Among adults with type 2 diabetes, cumulative exposure to elevated RC is associated with a higher risk of MACEs, even in the context of intensive lipid management.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101020"},"PeriodicalIF":4.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of wearable-based cardiac rehabilitation interventions in secondary prevention of coronary artery disease – a systematic review and meta-analysis","authors":"Theodoros Maximidou,&nbsp;Ute Mons","doi":"10.1016/j.ajpc.2025.101015","DOIUrl":"10.1016/j.ajpc.2025.101015","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the benefits of wearable activity trackers in the treatment and care of patients with coronary artery disease (CAD), we performed a systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>We systematically searched databases and trial registries until March 2025 for randomized controlled trials employing wearable devices (such as activity tracker, pedometer or accelerometer) in cardiac rehabilitation (CR) interventions in patients with CAD. The outcome data were pooled using fixed-effects meta-analysis. Subgroup analyses were conducted for risk of bias, length of follow up, type of wearable and presence of additional interventions. To assess the robustness of the main findings we carried out sensitivity analyses using random effects models and exclusion of outliers. Outcomes of interest were indicators of prognosis and prognostic factors.</div></div><div><h3>Results</h3><div>We included a total of 23 studies and synthesized data from 20 studies in meta-analyses. Meta-analysis of steps per day showed a statistically significant difference favouring the intervention (MD 1060 steps/day, 95 % CI 650 to 1460). Subgroup analyses indicated smaller effects for studies with longer follow-up periods, and for those with high risk of bias. Sensitivity analyses showed robustness of these results. Meta-analyses of rehospitalizations (RR 0.70, 95 % CI 0.52 to 0.95), 6 min walking test (MD 13.06 m, 95 % CI 0.10 to 26.03), and absolute VO₂peak (MD 0.22 L/min, 95 % CI 0.02 to 0.49) also yielded statistically significant differences favouring the intervention. Findings from other physical performance measures favoured the intervention group without reaching significance. Anthropometric outcomes presented no consistent effect.</div></div><div><h3>Conclusions</h3><div>Our results indicate that wearables significantly enhance effectiveness of CR by increasing physical activity, improving exercise capacity, and reducing rehospitalizations in CAD patients. This suggests that wearable-supported CR programs may positively affect prognosis in CAD. However, further research is needed to corroborate these findings and to ascertain the sustainability of these effects over the long term.</div></div><div><h3>Lay summary</h3><div>In our study, we found that wearable activity trackers significantly increased steps per day, improved exercise capacity and reduced rehospitalizations in patients with coronary artery disease compared to usual care. These findings suggest that the implementation of wearable activity trackers into cardiac rehabilitation might improve clinical outcomes and potentially reduce the burden of the disease.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101015"},"PeriodicalIF":4.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced oral glucose tolerance test for early detection of insulin resistance and metabolic complications in children with obesity","authors":"Urh Groselj ,&nbsp;Jan Kafol ,&nbsp;Jaka Sikonja ,&nbsp;Matej Mlinaric ,&nbsp;Robert Sket ,&nbsp;Ziga Iztok Remec ,&nbsp;Jernej Kovac ,&nbsp;Ana Drole Torkar ,&nbsp;Jasna Suput Omladic ,&nbsp;Barbka Repic Lampret ,&nbsp;Tadej Battelino ,&nbsp;Primoz Kotnik","doi":"10.1016/j.ajpc.2025.101016","DOIUrl":"10.1016/j.ajpc.2025.101016","url":null,"abstract":"<div><h3>Background and aims</h3><div>Early detection of insulin resistance (IR) and obesity-related complications is crucial for preventing type 2 diabetes. This study aimed to identify dynamic metabolic biomarkers for more precise early detection of IR and metabolic abnormalities.</div></div><div><h3>Methods</h3><div>This cross-sectional cohort study evaluated IR and metabolic biomarkers in 403 children with obesity (median age 13.18 years, 51.3 % female, 98.5 % with obesity) using an enhanced oral glucose tolerance test (eOGTT). IR was assessed via four indices, with the Matsuda Insulin Sensitivity Index (ISI-M) used as the primary measure. Participants were stratified into quartiles based on ISI-M.</div></div><div><h3>Results</h3><div>Participants with the highest IR (Q1) were older (<em>p</em> = 0.002), had a higher body mass index, were in a more advanced pubertal stage (<em>p</em> &lt; 0.001), and had significantly elevated glucose and insulin levels (<em>p</em> &lt; 0.001 for both) compared to the most insulin sensitive (Q4), with significant differences observed across all quartiles (<em>p</em> &lt; 0.050 for all). Insulin at 120 min demonstrated excellent diagnostic accuracy for IR (AUC=0.958). Triglyceride levels in Q1 showed minimal decline during the eOGTT, while greater declines were observed with increasing insulin sensitivity (<em>p</em> = 0.002 across quartiles), suggesting that a lack of decline in triglycerides may help identify IR. High-sensitivity C-reactive protein levels increased with IR (<em>p</em> = 0.024). Baseline beta-hydroxybutyrate levels were highest in the Q4 and showed the greatest absolute decrease during the eOGTT, compared to Q1 (<em>p</em> &lt; 0.001 for both).</div></div><div><h3>Conclusions</h3><div>We validated established IR markers in children with obesity, while demonstrating that eOGTT may offer improved characterization and earlier identification of those at risk for metabolic complications.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101016"},"PeriodicalIF":4.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe housing cost burden and premature cardiovascular mortality","authors":"Nishad S. Kosaraju ,&nbsp;Tanisha Choudhury ,&nbsp;Lee Stoner ,&nbsp;Aleah L. Thomas ,&nbsp;Kaitlin E. White ,&nbsp;Marcus R. Andrews ,&nbsp;Briana I. Lawrence ,&nbsp;Cameron K Ormiston ,&nbsp;Lee Mason ,&nbsp;Meredith S. Shiels ,&nbsp;Aldenise P. Ewing ,&nbsp;Yingxi Chen ,&nbsp;Jennifer K. McGee-Avila ,&nbsp;Wayne R. Lawrence","doi":"10.1016/j.ajpc.2025.101021","DOIUrl":"10.1016/j.ajpc.2025.101021","url":null,"abstract":"<div><h3>Background</h3><div>The proportion of people living in unaffordable housing in the U.S. has grown, and studies have documented a relationship between housing cost burden and poor cardiovascular health. We investigated the association between severe housing cost burden (SHCB) and premature mortality due to cardiovascular disease (CVD) and its subtypes overall and by sex. We further evaluated whether Medicaid expansion status moderated the association between SHCB and premature CVD mortality.</div></div><div><h3>Methods</h3><div>We linked county-level SHCB data from the 2016–2020 American Community Survey with mortality data ascertained from national death certificate data. SHCB was measured as the percentage of households that spend ≥50 % of their income on housing and was categorized into distribution-based quintiles (1=lowest and 5=highest). States were classified based on Medicaid expansion status (expanded, late expanded, non-expanded). Multilevel-linear mixed models, adjusting for confounders, were used to estimate the adjusted rate ratios (aRR) for the association between SHCB and premature CVD mortality.</div></div><div><h3>Results</h3><div>The highest SHCB quintile, compared to the lowest, had a 15 % higher premature CVD mortality rate (aRR=1.15; 95 %CI 1.06–1.24). Among men, the highest quintile of SHCB had a higher premature mortality rate due to ischemic heart disease (aRR=1.09; 95 %CI 1.01–1.17) and stroke (aRR=1.19; 95 %CI 1.06–1.32) compared with the lowest quintile. Compared to Medicaid expanded states, non-Medicaid expanded states had higher rates of premature CVD mortality for each SHCB quintile (Quintile 5: aRR=1.19; 95 %CI 1.02–1.36).</div></div><div><h3>Conclusion</h3><div>Our findings suggest counties with greater SHCB, especially if situated within a non-Medicaid expansion state, have higher rates of premature CVD mortality.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101021"},"PeriodicalIF":4.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing adherence challenges in long-term statin treatment among Asian populations: Current gaps and proposed solutions","authors":"Elmer Jasper B Llanes ,&nbsp;Nuntakorn Thongtang ,&nbsp;Zhen-Vin Lee ,&nbsp;Tran Hoa ,&nbsp;Ong Hean Yee ,&nbsp;Renan Sukmawan","doi":"10.1016/j.ajpc.2025.101019","DOIUrl":"10.1016/j.ajpc.2025.101019","url":null,"abstract":"<div><div>Statin therapy, known for its lipid-lowering properties, substantially lowers the risk of cardiovascular events in patients vulnerable to atherosclerotic cardiovascular disease (ASCVD) across diverse demographic groups. Despite evidence supporting their benefits, statins are often underutilized or even discontinued. Disparities in statin utilization exist across Asian countries due to healthcare system policies and economic circumstances. Addressing these disparities is essential, especially in the context of global initiatives designed to enhance affordability and raise awareness. Healthcare practitioners (HCPs) must assess ASCVD risks and take proactive measures aimed at lowering these risks, particularly through the management of low-density lipoprotein cholesterol (LDL-C) levels. It is imperative for HCPs and patients to collaborate for effective management of ASCVD risk, prioritizing improved adherence, treatment continuity, and better health outcomes. This review focuses on statin utilization and adherence in six Asian countries—Thailand, Malaysia, Philippines, Vietnam, Singapore, and Indonesia. It aims to explore the common factors that influence long-term adherence to statin treatment and also offers practical recommendations to improve adherence, ultimately leading to better cardiovascular outcomes in the Asian population.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101019"},"PeriodicalIF":4.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}