Preventive cardiology最新文献

{"title":"CLINICAL STUDY: Associations Among Cardiometabolic Risk Factor Clustering, Weight Status, and Cardiovascular Disease in an Appalachian Population","authors":"Kimberly B. Blake, A. Shankar, Suresh Madhavan, A. Ducatman","doi":"10.1111/J.1751-7141.2010.00078.X","DOIUrl":"https://doi.org/10.1111/J.1751-7141.2010.00078.X","url":null,"abstract":"Prev Cardiol. ****;**:**–**. \u0000 \u0000 \u0000 \u0000It has been suggested that within the traditional body mass index (BMI) categories there is a heterogeneous pattern of cardiometabolic risk factor clustering. The objective of this research was to determine the associations among obesity, cardiometabolic abnormalities, and cardiovascular disease (CVD) in a large population-based study of Appalachian adults. The study comprised a cross-sectional survey of Appalachian adults residing in 6 communities in Ohio and West Virginia, who were aged 18 years and older (n=14,783, 50.9% women). The authors categorized BMI into normal weight ( 5.13), or elevated C-reactive protein (>3 mg/L). They found that 25.6% of normal-weight adults displayed clustering of ≥2 cardiometabolic abnormalities; in contrast, 36.8% of overweight/obese adults displayed no clustering. Compared with normal-weight persons without clustering of cardiometabolic abnormalities (referent), the odds ratio of CVD was 1.06 (95% confidence interval [CI], 0.84–1.34) among overweight/obese individuals without cardiometabolic clustering, 2.21 (95% CI, 1.74–2.81) among normal-weight individuals with cardiometabolic clustering, and 2.45 (95% CI, 2.02–2.97) among overweight/obese individuals with cardiometabolic clustering. These results suggest that within the traditional BMI categories, there may be heterogeneity of CVD risk depending on whether there is underlying clustering of cardiometabolic abnormalities.","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"51 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82961895","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":"Gamma-glutamyl transferase: a novel cardiovascular risk biomarker.","authors":"Jennifer E Mason,&nbsp;Rodman D Starke,&nbsp;John E Van Kirk","doi":"10.1111/j.1751-7141.2009.00054.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00054.x","url":null,"abstract":"<p><p>Gamma-glutamyl transferase (GGT) is a second-generation enzymatic liver function test available for several decades, initially used as a sensitive indicator of alcohol ingestion, hepatic inflammation, fatty liver disease, and hepatitis. Longitudinal and cross-sectional investigational studies since 1990 have associated GGT with an increase in all-cause mortality, as well as chronic heart disease events such as congestive heart failure and components of the metabolic syndrome (abnormal body mass index and levels of high-density lipoprotein cholesterol, glucose, triglycerides, and systolic and diastolic blood pressure). In the upper reference range, GGT was found to be an independent biomarker of the metabolic syndrome, with a 20% per GGT quartile trend rise. Additionally, GGT was positively correlated with an 18% per quartile risk of cardiovascular events and a 26% per quartile increased risk of all-cause mortality. Furthermore, it may be considered a biomarker for \"oxidative stress\" associated with glutathione metabolism and possibly a \"proatherogenic\" marker because of its indirect relationship in the biochemical steps to low-density lipoprotein cholesterol oxidation. GGT is becoming an important addition to the multimarker approach to cardiovascular risk evaluation. It should be considered a valuable adjunct in stratifying patient risk and in assessing the aggressiveness of appropriate treatment, with hopes of preventing unnecessary cardiac events and deaths in future years.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 1","pages":"36-41"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00054.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28603802","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 warfarin use with CHADS(2) score in 441 patients with nonvalvular atrial fibrillation and no contraindications to warfarin.","authors":"Harit V Desai,&nbsp;Wilbert S Aronow,&nbsp;Kaushang Gandhi,&nbsp;Suhalia Bakerywala,&nbsp;Judy Laimuanpuii,&nbsp;Mala Sharma,&nbsp;Stephen J Peterson","doi":"10.1111/j.1751-7141.2010.00073.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2010.00073.x","url":null,"abstract":"<p><p>The authors investigated the use of warfarin at hospital discharge in 557 consecutive patients, mean age 76 years, with nonvalvular atrial fibrillation (AF) at a university hospital. Of 557 patients with AF, 116 (21%) had contraindications to warfarin. Of patients eligible for warfarin, warfarin was used in 8 of 30 patients (27%) with a CHADS(2) score of 0, in 82 of 132 patients (62%) with a CHADS(2) score of 1, in 121 of 175 patients (70%) with a CHADS(2) score of 2, in 72 of 77 patients (94%) with a CHADS(2) score of 3, and in 27 of 27 patients (100%) with a CHADS(2) score of 4 to 6. Warfarin was used in 123 of 168 patients (73%) older than 75 years, in 74 of 79 patients (94%) aged 65 to 75 years, and in 23 of 32 patients (72%) younger than 65 years. Warfarin was used in 80 of 116 patients (69%) with a glomerular filtration rate < 60 mL/min/1.73 m(2) and in 140 of 163 patients (86%) with a glomerular filtration rate ≥ 60 mL/min/1.73 m(2) . There was no significant difference in use of warfarin between men and women and between whites and nonwhites.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 4","pages":"172-4"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2010.00073.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29295810","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":"Move more, sit less: a first-line, public health preventive strategy?","authors":"Barry A Franklin,&nbsp;Jenna Brinks,&nbsp;Lucy Sternburgh","doi":"10.1111/j.1751-7141.2010.00075.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2010.00075.x","url":null,"abstract":"Despite the widely cited Centers for Disease Control and Prevention (CDC) ⁄American College of Sports Medicine (ACSM) exercise guidelines, the much-heralded surgeon general’s report, and the recently published ACSM ⁄American Heart Association exercise statement and federal physical activity guidelines (Table I), the conventional model for getting people to be more physically active (ie, structured exercise program) has been only marginally effective. Traditional exercise programs have typically reported dropout rates of 50% or more at 1 year, highlighting the compliance problem among those who voluntarily initiate exercise, regardless of health status. Other enrollees, who do not technically meet the criteria for ‘‘exercise dropout,’’ may continue exercising at a subthreshold intensity, frequency, or duration. According to the CDC, only 31% of American adults meet contemporary physical activity recommendations (ie, moderate-intensity activity for 30 min ⁄d, 5 or more d ⁄wk, or vigorous activity for 20 min ⁄d, 3 or more d ⁄wk), and 24% of the adult population reportedly engage in no leisure time physical activity. Men are more likely to meet the recommendation than women, and black and Hispanic or Latino persons demonstrate the lowest prevalence of regular leisure time physical activity: 25% and 23%, respectively. Morbidly obese individuals in particular are often completely sedentary. According to a recent report, morbidly obese adults (mean SD body mass index, 53.6 11.7 kg ⁄m) were asked to wear an activity sensor that monitored their caloric expenditure, minute-by-minute physical activity, and number of steps per day. The participants spent an average of 23 hours and 52 min ⁄d sleeping, sitting, lying down, or performing sedentary activities (<3 metabolic equivalents [METs; 1 MET=3.5 mL O2 ⁄kg ⁄min]). Collectively, these data suggest that structured exercise is not unlike other health-related behaviors in that only a fraction of those who initiate the behavior will continue, regardless of their age, sex, race, ethnicity, education level, or health status. To understand why people sometimes lack the motivation for a structured exercise commitment, one must first acknowledge a simple yet important fact: exercise is voluntary and time-consuming. Therefore, planned exercise may extend the day or compete with other valued interests and responsibilities of daily life. In addition, considerable time may be spent in transit, driving to and from a health club or recreation facility. In one study, coronary patients undergoing medically supervised gymnasium-based exercise training spent more time in their cars going to and from the programs than patients in a home training comparison group spent on their cycle ergometers. Other investigators have reported that structured rehabilitation exercise training is associated with a low caloric expenditure and has little impact on body weight and selected coronary risk factors.","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 4","pages":"203-8"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2010.00075.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29295814","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":"The thiazolidinedione controversy in cardiovascular risk.","authors":"Philip R Liebson","doi":"10.1111/j.1751-7141.2010.00082.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2010.00082.x","url":null,"abstract":"Diabetes is a strong risk factor for cardiovascular (CV) events, and it is essential that antidiabetic agents either improve CV risk or have a neutral effect. The thiazolidinediones (TZDs) have been used to sensitize end organs to insulin to produce a beneficial effect in diabetics by reducing blood glucose and glycated hemoglobin levels. Unfortunately, adverse effects of TZDs on CV outcomes have been demonstrated leading to repeated assessments by the Food and Drug Administration (FDA). Most recently, in July 2010, an advisory committee of the FDA evaluated the safety of rosiglitazone and delivered an ambiguous verdict. It indicated that the drug raised the risk of CV events compared with other diabetes drugs but recommended leaving the drug on the market with various degrees of warnings or restrictions. Because this controversy affects the scope of preventive cardiology, this clinical trial review will provide a chronologic summary of the findings and recommendations about TZDs.","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 4","pages":"209-12"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2010.00082.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29295815","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":"Will increasing referral to cardiac rehabilitation improve participation?","authors":"Thomas Boyden,&nbsp;Melvyn Rubenfire,&nbsp;Barry Franklin","doi":"10.1111/j.1751-7141.2010.00086.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2010.00086.x","url":null,"abstract":"","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 4","pages":"192-201"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2010.00086.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29310520","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":"Postprandial metabolic responses to dietary glycemic index in hypercholesterolemic postmenopausal women.","authors":"Radhika N Bukkapatnam, Lars Berglund, Erdembileg Anuurad, Sridevi Devaraj, Dianne Hyson, Flora Rafii, Catharine Malmstein, Amparo C Villablanca","doi":"10.1111/j.1751-7141.2009.00043.x","DOIUrl":"10.1111/j.1751-7141.2009.00043.x","url":null,"abstract":"<p><p>Cardiovascular disease is the leading cause of death in postmenopausal women. While diet and lifestyle remain the cornerstones of prevention, a low-fat/high-carbohydrate diet is associated with hyperglycemia and hyperlipemia-atherosclerotic risk factors affected by postprandial conditions. The objective of this study was to examine the acute response of lipids and insulin to a low-fat/high-carbohydrate meal with either a high-glycemic or a low-glycemic index in healthy postmenopausal women. Fifteen healthy postmenopausal women were enrolled in a randomized crossover dietary intervention study. Levels of glucose, triglyceride, free fatty acids (FFAs), and insulin were measured preprandially and for 240 minutes after consumption of the test meals. In response to the high-glycemic compared with the low-glycemic index meal, postprandial insulin levels had a higher peak (65.4 vs 48.1 microU/mL, respectively), the homeostasis model assessment-insulin resistance (HOMA-IR) was significantly higher (P=.014), serum triglyceride levels declined significantly (P<.001), and there was a small reduction in FFA levels, although the difference did not reach statistical significance. The results suggest a postprandial impact of glycemic index on cardiovascular metabolic biomarkers in postmenopausal women and may have implications for dietary glycemic modification of cardiovascular risk in women.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 1","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3613123/pdf/nihms-275843.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28603801","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":"Reduced executive functioning is associated with poorer outcome in cardiac rehabilitation.","authors":"Lynn S Kakos,&nbsp;Ashley J Szabo,&nbsp;John Gunstad,&nbsp;Kelly M Stanek,&nbsp;Donna Waechter,&nbsp;Joel Hughes,&nbsp;Faith Luyster,&nbsp;Richard Josephson,&nbsp;Jim Rosneck","doi":"10.1111/j.1751-7141.2009.00065.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00065.x","url":null,"abstract":"<p><p>Patients with cardiovascular disease and cognitive impairment show reduced adherence to treatment. No study has examined whether cognitive impairment may also predict reduced benefit from cardiac rehabilitation (CR). It appears that cognitively impaired patients may exhibit poorer adherence to CR and limited gains in cardiovascular fitness and/or quality of life (QOL). Forty-four older adults who enrolled in a CR program and completed measures at enrollment and discharge were included. Cognitive functioning was assessed using the Trail Making Test B. Estimated metabolic equivalents (METs) were derived from a treadmill stress test to provide a measure of cardiovascular fitness. QOL was measured with the Short Form-36 (SF-36) physical and mental component scales (PCS and MCS, respectively). Repeated measures analysis of variance showed improvements in METs [METs; F(1,36)=77.6, P<.001] and physical [SF-36 PCS; F(1,36)=14.14, P=.001)] and mental QOL [SF-36 MCS; F(1,36)=11.55, P=.002)]. Partial correlations indicated that poorer Trail Making Test B performance was associated with lower METs at discharge (r=-0.30, P<.05), but not PCS or MCS. Mini-Mental State Examination scores were not related to outcome variables. Current findings suggest that patients with poorer executive functioning derive reduced benefit from CR. CR programs may consider screening patients at baseline for low cognitive functioning to help identify those patients at greatest risk for poor outcome.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 3","pages":"100-3"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00065.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29118114","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":"LDL = 5: Virtues and dangers of multidrug therapy of low-density lipoprotein cholesterol.","authors":"William Phillips,&nbsp;Saul Schaefer","doi":"10.1111/j.1751-7141.2009.00052.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00052.x","url":null,"abstract":"<p><p>Multiple-drug therapy of dyslipidemia is frequently used to achieve treatment goals in high-risk patients with coronary artery disease. The authors report a case of a patient treated with a statin, fibrate, ezetimibe, and niacin in whom a calculated low-density lipoprotein cholesterol level of 5 mg/dL was achieved.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 2","pages":"69-71"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00052.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28910965","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":"Lipoprotein-associated phospholipase A2 mass is significantly reduced in dyslipidemic patients treated with lifestyle modification and combination lipid-modifying drug therapy.","authors":"Kota J Reddy,&nbsp;Manmeet Singh,&nbsp;Richard R Batsell,&nbsp;Joey R Bangit,&nbsp;Rekha A Miraskar,&nbsp;Misbah S Zaheer","doi":"10.1111/j.1751-7141.2009.00060.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00060.x","url":null,"abstract":"<p><p>Lipoprotein-associated phospholipase A2 (Lp-PLA(2)) mass is a novel inflammatory biomarker. In human blood, Lp-PLA(2) is predominately associated with low-density lipoprotein (LDL). This study examines the ability of lifestyle modification (diet and exercise) and combination lipid therapy to reduce Lp-PLA(2) levels while also determining the relationship between changes in LDL cholesterol and Lp-PLA(2). Thirty dyslipidemic patients who received lifestyle intervention and combination lipid therapy for an average of 6 months were included in these analyses (mean age, 60.9 years); 40% had stable angiographically established coronary artery disease, 40% had the metabolic syndrome, and 70% were men. Drug therapy included omega-3 fish oil, extended-release niacin, colesevelam hydrochloride, and a fixed combination of 10-mg ezetimibe and 40-mg simvastatin. The study revealed a 33% reduction in mean Lp-PLA(2) values (baseline 224.9+/-47.5 vs posttreatment 149.5+/-35.5 ng/mL; P<.001). Significant changes in mean LDL cholesterol from baseline (127.9+/-49.3 vs posttreatment 65.2+/-32.1 mg/dL; P<.001) were also observed. However, regression analysis revealed only a weak positive relationship between changes in LDL cholesterol and Lp-PLA(2) mass (R(2)=0.29; P<.01). Thus, Lp-PLA(2) mass is significantly reduced with lifestyle and combination lipid therapy. Changes in Lp-PLA(2) were only partially explained by the changes observed for LDL cholesterol.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 3","pages":"130-4"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00060.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29118629","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}