American journal of preventive cardiology最新文献

{"title":"Association between BMI and cause-specific long-term mortality in acute myocardial infarction patients","authors":"Timo Schmitz ,&nbsp;Dennis Freuer ,&nbsp;Philip Raake ,&nbsp;Jakob Linseisen ,&nbsp;Christa Meisinger","doi":"10.1016/j.ajpc.2024.100899","DOIUrl":"10.1016/j.ajpc.2024.100899","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the association between body mass index (BMI) at acute myocardial infarction (AMI) and all-cause as well as cause-specific long-term mortality.</div></div><div><h3>Methods</h3><div>The analysis was based on 10,651 hospitalized AMI patients (age 25–84 years) recorded by the population-based Myocardial Infarction Registry Augsburg between 2000 and 2017. The median follow-up time was 6.7 years [IQR: 3.5–10.0)]. Cause-specific mortality was obtained by evaluating the death certificates. In multivariable-adjusted COX regression models using cubic splines for the variable BMI, the association between BMI and cause-specific mortality (all-cause, cardiovascular, ischemic heart diseases, cancer) was investigated. Additionally, a subgroup analysis in three age groups was performed for all-cause mortality.</div></div><div><h3>Results</h3><div>Overall, there was a statistically significant U-shaped association between BMI at AMI and long-term mortality with the lowest hazard ratios (HR) found for BMI values between 25 and 30 kg/m². For cancer mortality, higher BMI values &gt; 30 kg/m² were not associated with higher mortality. In patients aged &lt;60 years, there was a significant association between BMI values &gt;35 kg/m² and increased all-cause mortality; this association was missing in 60 to 84 years old patients. For all groups and for each specific cause of mortality, lower BMI (&lt;25kg/m²) values were significantly associated with higher mortality.</div></div><div><h3>Conclusions</h3><div>Overall, a lower BMI – and also a high BMI in patients younger than 60 years - seem to be a risk factors for increased all-cause mortality after AMI. A BMI in a mid-range between 25 and 30 kg/m² is favorable in terms of long-term survival after AMI.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"21 ","pages":"Article 100899"},"PeriodicalIF":4.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global disease burden analysis of Cardiometabolic disease attributable to second-hand smoke exposure from 1990 to 2040","authors":"Yan Liu ,&nbsp;Yi Gao ,&nbsp;Guangcan Yan ,&nbsp;Yige Liu ,&nbsp;Wei Tian ,&nbsp;Yiying Zhang ,&nbsp;Shanjie Wang ,&nbsp;Bo Yu","doi":"10.1016/j.ajpc.2024.100902","DOIUrl":"10.1016/j.ajpc.2024.100902","url":null,"abstract":"<div><h3>Objective</h3><div>Secondhand smoke (SHS) is a strong but comparatively controllable cardiometabolic risk factor. This study aims to assess the present and future burden of cardiometabolic diseases (CMDs) from SHS exposure.</div></div><div><h3>Methods</h3><div>Using the Global Burden of Disease (GBD) framework, we examined mortality and disability-adjusted life year (DALY) from CMDs attributable to SHS, by age, sex, and year, including cardiovascular disease [CVD, ischemic heart disease (IHD) and/or stroke], and/or Type 2 Diabetes Mellitus (T2DM) from 1990 to 2019. The predicted death number and age-standardized mortality rate (ASMR) from 2020 to 2040 were estimated by the Bayesian age-period cohort (BAPC) model.</div></div><div><h3>Results</h3><div>SHS exposure declined until 2016 but stabilized or increased thereafter. From 1990 to 2019, CMD-related deaths and DALYs due to SHS are continuously increasing, particularly in low-middle and middle Sociodemographic Index (SDI) regions. In 2019, a significant proportion of CMD-related deaths and DALYs among females under 65 were attributed to SHS exposure. In females aged 25–29, SHS contributed to 16.12 % and 13.30 % of IHD and T2DM deaths, respectively. Surprisingly, forecasts show that annual deaths from IHD, stroke, and T2DM related to SHS exposure are anticipated to rise over the next 20 years.</div></div><div><h3>Conclusions</h3><div>SHS exposure has stopped declining in recent years. CMD-related deaths from controlled SHS have increased and are predicted to rise substantially over the next 20 years. Reducing SHS exposure could have major benefits for cardiometabolic health worldwide, especially for women under 65 years in less developed regions.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"21 ","pages":"Article 100902"},"PeriodicalIF":4.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing provider awareness of Lp(a) testing for patients at risk for cardiovascular disease: A comparative study","authors":"Wael E. Eid ,&nbsp;Emma Hatfield Sapp ,&nbsp;Callen Conroy ,&nbsp;Coby Bessinger ,&nbsp;Cassidy L. Moody ,&nbsp;Ryan Yadav ,&nbsp;Reece Tolliver ,&nbsp;Joseph Nolan ,&nbsp;Suzanne M. Francis","doi":"10.1016/j.ajpc.2024.100895","DOIUrl":"10.1016/j.ajpc.2024.100895","url":null,"abstract":"<div><h3>Background</h3><div>Lipoprotein(a) [Lp(a)] is a low-density lipoprotein variant with atherogenic, thrombogenic, and pro-inflammatory properties that may have numerous pathologic effects, including dyslipidemia. Screening for Lp(a) is clinically significant, due to its causal role in atherosclerotic cardiovascular disease (ASCVD). Among clinicians, however, there remains a general lack of both clinical awareness of Lp(a) and adequate tools to track Lp(a) testing in patients.</div></div><div><h3>Objective</h3><div>To study factors affecting Lp(a) screening by: i) determining the effectiveness of messaging providers at a large community health system about Lp(a) screening and measuring the subsequent percentage of Lp(a) tests requested; and ii) by determining the percentage of patients who obtained Lp(a) testing after being advised by the provider.</div></div><div><h3>Methods</h3><div>From December 2022 through March 2023, messages detailing the need for Lp(a) screening were sent via the Epic EHR™ to providers of patients meeting criteria for Lp(a) testing in advance of scheduled patient appointments. In this prospective study, providers were randomized into 2 groups: those receiving the pre-appointment message (Group 1) and those not receiving the pre-appointment message (Group 2).</div></div><div><h3>Results</h3><div>Sending pre-appointment messages correlated with more Lp(a) orders (16.6 % v. 4.7 %, <em>P</em> &lt; 0.001) and consequently with more tests performed (10.2 % v. 3.7 %, <em>p</em> &lt; 0.001). Among provider types, nurse practitioners and physician assistants had the highest number of Lp(a) results per order (<em>Z</em> = 16.40, <em>P</em> &lt; 0.001), achieving 30.8–39.1 % more test results, even if they did not receive the pre-appointment message. Distribution of Lp(a) values in patients was 59.7 % ≤ 29 mg/dL; 9.7 % &gt; 29 and &lt; 50mg/dL; and 30.6 % ≥ 50 mg/dL.</div></div><div><h3>Conclusion</h3><div>Providers who received pre-appointment messages via an EHR were associated with requesting more tests and consequently receiving more Lp(a) results, compared with providers who did not receive messages.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"21 ","pages":"Article 100895"},"PeriodicalIF":4.3,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of behavior change techniques in eHealth-based cardiac rehabilitation in patients with coronary artery disease: A systematic review","authors":"Emma R. Douma ,&nbsp;Tom Roovers ,&nbsp;Mirela Habibović ,&nbsp;Gert-Jan de Bruijn ,&nbsp;Jos A. Bosch ,&nbsp;Boris Schmitz ,&nbsp;Willem J. Kop ,&nbsp;on behalf of the TIMELY consortium","doi":"10.1016/j.ajpc.2024.100892","DOIUrl":"10.1016/j.ajpc.2024.100892","url":null,"abstract":"<div><h3>Background</h3><div>Participation in cardiac rehabilitation (CR) reduces risk of cardiovascular mortality, improves functional capacity and enhances quality of life in patients with coronary artery disease (CAD). eHealth-based CR can increase participation rates, but research into effective components is necessary. The objective of this systematic review was to identify effective behavior change techniques (BCTs) used in eHealth-based CR interventions.</div></div><div><h3>Methods</h3><div>A search of four databases (CINAHL, PubMed, PsychINFO, and MEDLINE) was conducted until January 10, 2023. Randomized controlled trials investigating eHealth-based interventions for patients with CAD were included. Risk of bias was assessed using the Effective Public Healthcare Practice Project tool. BCTs were coded following the Behavior Change Taxonomy. A best-evidence synthesis was conducted to determine the effectiveness of BCTs, with ratings ranging from A (strong evidence indicating either a positive effect (+) or no effect (-)) to D (no data collected).</div></div><div><h3>Results</h3><div>A total of 88 studies (25,007 participants) met the eligibility criteria. The interventions in these studies used 31 different BCTs. The most common BCTs were <em>instructions on how to perform the behavior</em> (k = 86), <em>social support</em> (k = 69) and <em>information about health consequences</em> (k = 56). The evidence for <em>action planning</em> was rated as A+ for medication adherence and diet. Conversely, for systematically decreasing the number of prompts/cues sent during an intervention, the evidence was rated as A- for physical activity, medication adherence and smoking cessation. The evidence for <em>feedback on behavior</em> was rated as A+ for medication adherence and A- for smoking cessation.</div></div><div><h3>Conclusions</h3><div>Action planning is effective as a BCT in eHealth-based CR, whereas reducing prompts/cues is not. <em>Feedback on behavior</em> may, depending on the behavior targeted, exert both positive and no effect, suggesting that BCT-behavior matching is important to optimize effectiveness of eHealth-based CR.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100892"},"PeriodicalIF":4.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Endothelial Progenitor Cells in Patients with Established Cardiovascular Disease Treated with PCSK9 Monoclonal Antibodies","authors":"Chen Gurevitz ,&nbsp;Osnat Itzhaki Ben Zadok ,&nbsp;Dorit Leshem-Lev ,&nbsp;Lital Hodeda ,&nbsp;Aviad Rotholz ,&nbsp;Ran Kornowski ,&nbsp;Alon Eisen","doi":"10.1016/j.ajpc.2024.100896","DOIUrl":"10.1016/j.ajpc.2024.100896","url":null,"abstract":"<div><h3>Background</h3><div>The role of circulating endothelial progenitor cells (cEPCs) in vascular repair and their association to cardiovascular protection is well established.</div></div><div><h3>Objectives</h3><div>We examined the effect of proprotein convertase subtilisin kexin type 9 monoclonal antibodies (PCSK9 mAb) on cEPCs in adults with hypercholesterolemia and cardiovascular disease, aiming to establish a pleotropic class effect.</div></div><div><h3>Methods</h3><div>Non-interventional prospective study in patients with cardiovascular disease treated with either evolocumab or alirocumab. Patients were sampled for cEPCs at baseline, 1- and 3-months following initiation of PCSK9 mAb. cEPCs were assessed using flow cytometry by expression of CD34/CD133 and vascular endothelial growth factor receptor (VEGFR)-2, and functionally by formation of colony forming units (CFUs) and by Mitochondrial Tetrazolium (MTT) assay, indicative of cEPCs viability.</div></div><div><h3>Results</h3><div>51 patients (median age 67 (IQR 63,74) years;63 % male, median low-density lipoprotein-cholesterol (LDL-C) 125 (102,165) mg/dL) were initiated on PCSK9 mAb therapy (evolocumab <em>n</em> = 22, alirocumab <em>n</em> = 29) for secondary prevention. Following 3-month treatment with PCSK9 mAb, there was an increase in CD34⁽⁺⁾VEGFR-2⁽⁺⁾ and CD133⁽⁺⁾VEGFR-2⁽⁺⁾ levels (0.50 % [IQR 0.30,1.04] to 1.36 % [0.89, 1.73], <em>p</em> &lt; 0.001 and 0.57 % [0.25,0.88] to 1.18 % [0.74,1.66], <em>p</em> &lt; 0.001, respectively). Functionally, increase in EPCs-CFUs was evident (0.5 [0.0,1.0] to 2.0 [1.5,2.5], <em>p</em> &lt; 0.001) with concomitant increase in MTT (0.11 [0.09,0.15] to 0.17 [0.12,0.21], <em>p</em> &lt; 0.001). Stratifying by PCSK9 mAb, both agents were associated with an increase in cEPCs level and function.</div></div><div><h3>Conclusions</h3><div>In hypercholesterolemic patients with cardiovascular disease treated with PCSK9 mAb, there is an increase in cEPCs levels and function from baseline levels. These findings, which persist in both evolocumab and alirocumab, might suggest a novel pleiotropic class effect.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100896"},"PeriodicalIF":4.3,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent class analysis of cardiac structure and function and association with premature cardiovascular disease: The Coronary Artery Risk Development in Young Adults (CARDIA) study","authors":"Michael C. Wang ,&nbsp;Toluwalase Awoyemi ,&nbsp;Norrina B. Allen ,&nbsp;Ravi Shah ,&nbsp;Matthew Nayor ,&nbsp;Yuan Luo ,&nbsp;Joao A.C. Lima ,&nbsp;Donald M. Lloyd-Jones ,&nbsp;Sadiya S. Khan","doi":"10.1016/j.ajpc.2024.100889","DOIUrl":"10.1016/j.ajpc.2024.100889","url":null,"abstract":"<div><h3>Objective</h3><div>To generate data-driven phenogroups of cardiac structure and function based on echocardiographic measures assessed in asymptomatic middle-aged adults free of CVD, and examine associations between these newly defined phenogroups and incident premature cardiovascular disease (CVD).</div></div><div><h3>Methods</h3><div>Data were analyzed from participants in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study free of CVD who underwent an echocardiogram at the Year 25 (2010-2011) in-person examination. Continuous echocardiographic measures of left heart structure, left ventricular systolic function (including strain) and diastolic function, right ventricular systolic function, and hemodynamic measures were included in latent class analysis to generate novel phenogroups. Associations between data-driven phenogroups and risk of premature CVD (coronary artery disease, stroke, or heart failure) were estimated using Cox proportional hazards regression adjusted for traditional CVD risk factors.</div></div><div><h3>Results</h3><div>Among 3361 participants, mean (standard deviation) age was 50.1 (3.6) years, 57% were female, and 46% were non-Hispanic Black. Three overall phenogroups were identified and labeled as: (1) optimal cardiac mechanics (36.2%); (2) suboptimal systolic function (38.2%); and (3) suboptimal diastolic function (25.6%). Over a median 8.9 years of follow-up, 121 premature CVD events occurred. Risk of CVD was higher in the suboptimal diastolic function group (unadjusted hazard ratio [HR] 4.08 [95% CI: 2.48, 6.71] and adjusted HR 1.95 [1.12, 3.40]) compared with the optimal group. The suboptimal systolic function group had a higher unadjusted risk of CVD (1.86 [1.10, 3.15]), which was attenuated after adjustment for CVD risk factors (1.36 [0.79, 2.36]).</div></div><div><h3>Conclusions and relevance</h3><div>Unbiased, data-driven clustering of echocardiographic measures in middle-aged adults identified distinct patterns of cardiac remodeling that were associated with risk of premature CVD. Premature CVD risk was highest with the pattern of suboptimal diastolic function. This suggests potential utility of a composite echocardiography-based index for prioritizing prevention strategies earlier in the life course.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100889"},"PeriodicalIF":4.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holistic approach to preventive cardiology: Where tradition meets innovation (Fellow's Voice)","authors":"Amanpreet Singh Wasir","doi":"10.1016/j.ajpc.2024.100891","DOIUrl":"10.1016/j.ajpc.2024.100891","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100891"},"PeriodicalIF":4.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"300,000 quitters and counting; A systematic approach to tobacco cessation","authors":"Renee Fogelberg ,&nbsp;Kelly C. Young-Wolff ,&nbsp;Jaya Nadella ,&nbsp;Mehreen Khan ,&nbsp;Yi-Fen Irene Chen ,&nbsp;Jamal S. Rana","doi":"10.1016/j.ajpc.2024.100894","DOIUrl":"10.1016/j.ajpc.2024.100894","url":null,"abstract":"<div><h3>Objective</h3><div>To describe Kaiser Permanente Northern California's (KPNC) systematic implementation of universal tobacco screening, evidence-based interventions, and performance measures to achieve long-term smoking cessation success.</div></div><div><h3>Methods</h3><div>We outline seven key components of KPNC's tobacco screening and intervention program that contributed to a significant decline in smoking prevalence. We also report changes in the prevalence of current smokers within KPNC from 2014 to 2023 using linear regression analyses.</div></div><div><h3>Results</h3><div>Key factors driving the success of the tobacco cessation program included risk-based screening algorithms, alert prompts for at-risk patients, system-wide medical champions, performance tracking, virtual coaching, widespread messaging, and comprehensive medication management. Implementing this multifaceted approach across all facilities was associated with a significant reduction in smoking prevalence, from 8.6% in 2014 to 5.8% in 2023 (p &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>Our comprehensive, system-wide approach resulted in substantial public health gains and highlights the potential of similar preventive strategies as healthcare systems transition toward value-based care.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100894"},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of cardiovascular disease and cardiovascular health with disability status in a nationally representative sample of US adults","authors":"G.J. Jerome ,&nbsp;C.L. Lilly","doi":"10.1016/j.ajpc.2024.100893","DOIUrl":"10.1016/j.ajpc.2024.100893","url":null,"abstract":"<div><div>Background: A better understanding of cardiovascular disease (CVD), and cardiovascular health (CVH) among adults with disabilities is needed to address disability related health disparities. Methods: This study analyzed National Health and Nutrition Examination Survey (NHANES) questionnaires, medical examinations, and 24-hour dietary recall data from 2013–2018 for adults age 20–79 years with and without self-reported disability. CVD was dichotomous based on self-report and CVH was assessed using American Heart Association Life's Essential 8 (LE8) comprised of four health behaviors (diet, physical activity, nicotine exposure, and sleep health) and four health factors (body mass index, blood lipids, blood glucose, and blood pressure) with higher scores indicating better CVH. Analyses incorporated the complex multistage NHANES sampling design. Results: The study included 1,300 adults with self-reported CVD and 13,656 adults who were CVD free. Separate weighted logistic regressions for age groups of 20–39, 40–59, and 60–79 years indicated adults with a disability had higher odds of CVD compared to those who were disability free (OR_adj (95 %CI) 8.0(4.6–14.1), 5.8(4.3–8.0), 2.5(1.9–3.3) respectively). Among those who were CVD free, CVH was lower for those with a disability compared to those without a disability for the total LE8 score (mean_adj(SE) 56.9(0.5) vs. 65.7(0.3), <em>p &lt;</em> .001) and all eight LE8 metrics (<em>p ≤</em> 0.004). Conclusion: These results are aligned with the call to action to improve health and wellness of persons with disabilities which should include wellness programming for health behaviors such as diet, physical activity, sleep health, and nicotine cessation.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100893"},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guideline recommended statin eligibility and use among U.S. adults ages 20 to 39 years","authors":"Shoa L. Clarke ,&nbsp;Blake Thomson","doi":"10.1016/j.ajpc.2024.100890","DOIUrl":"10.1016/j.ajpc.2024.100890","url":null,"abstract":"<div><h3>Objective</h3><div>Guidelines for statin therapy emphasize treatment of adults ages 40–75 years, with less guidance for the treatment of younger adults, ages 20–39 years. Only two class 1 recommendations for statin apply to younger adults: 1) secondary prevention and 2) severe hypercholesterolemia (LDL-C ≥ 190 mg/dL). The implementation of guidelines within this age group has not been well studied.</div></div><div><h3>Methods &amp; Results</h3><div>Here, we use data from the National Health and Nutrition Examination Survey (2013–2020) to estimate statin eligibility and use among US younger adults. Based on this nationally representative sample, we extrapolate that approximately 923,000 younger adults had a history of atherosclerotic cardiovascular disease, but only ∼24 % were on statin. Among younger adults in the primary prevention group, we extrapolate that at least 1.09 million had severe hypercholesterolemia. To expand on this analysis, we calculated untreated LDL-C values for individuals on statin using two methods, and we estimate that only ∼11–20 % of younger adults with severe hypercholesterolemia were on statin. Lastly, among untreated younger adults with a class 1 indication for statin, fewer than 25 % reported that a doctor or healthcare provider had recommended cholesterol medication.</div></div><div><h3>Conclusion</h3><div>The implementation of class 1 recommendations for statin treatment in younger adults is poor. While efforts to improve risk prediction in the young have recently received significant attention, our results indicate that identifying high risk younger adults is insufficient. We must also improve guideline-recommended treatment in this age group.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100890"},"PeriodicalIF":4.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}