Preventive cardiology最新文献

{"title":"Current approaches to the challenge of coronary heart disease risk assessment: C-reactive protein mania and imaging-itis?","authors":"Ezra A Amsterdam, C Tissa Kappagoda","doi":"10.1111/j.1751-7141.2008.00024.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2008.00024.x","url":null,"abstract":"","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2008.00024.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28134777","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":"Computer confirmation of improved blood pressure control in diabetic patients.","authors":"Arthur Swislocki,&nbsp;Robert H Noth,&nbsp;Bryan Volpp,&nbsp;Joy Meier,&nbsp;David Siegel","doi":"10.1111/j.1751-7141.2009.00036.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00036.x","url":null,"abstract":"<p><p>In order to evaluate efforts to improve blood pressure (BP) control in veterans with diabetes, the authors performed a retrospective review of computerized health records in the Veterans Affairs Northern California Health Care System (VANCHCS). A total of 6624 diabetic patients with BP data were identified and a comparison was made to earlier surveys. There was an overall improvement in BP control. In a cohort of 1791 patients followed since 1999, there was a progressive improvement in both systolic BP (patients at goal increased from 28% to 35%; P<.001, chi(2)) and diastolic BP (patients at goal increased from 69% to 79%; P<.001). There was a corresponding increase in both number of drug classes used and use of antiangiotensin treatment. The authors conclude that the improvement in BP control in these veterans with diabetes was temporally associated with intensification in antihypertensive pharmacotherapy and sustained provider education and patient-specific computerized reminders.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 3","pages":"149-54"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00036.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28316584","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":"Diabetes control and cardiovascular risk, Part II: Intensive glucose control--UKPDS follow-up.","authors":"Philip R Liebson","doi":"10.1111/j.1751-7141.2008.00020.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2008.00020.x","url":null,"abstract":"","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 1","pages":"51-8"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2008.00020.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28135729","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":"Cardiovascular risk in special populations: overview.","authors":"Philip R Liebson","doi":"10.1111/j.1751-7141.2009.00038.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00038.x","url":null,"abstract":"","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 3","pages":"121-7"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00038.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28316581","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":"Control of lipids at baseline in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial.","authors":"Georgia Pambianco, Manuel Lombardero, Vera Bittner, Alan Forker, Frank Kennedy, Ashok Krishnaswami, Arshag D Mooradian, Rodica Pop-Busui, Jamal S Rana, Annabelle Rodriguez, Michael Steffes, Trevor J Orchard","doi":"10.1111/j.1751-7141.2008.00014.x","DOIUrl":"10.1111/j.1751-7141.2008.00014.x","url":null,"abstract":"<p><p>In order to examine lipids, a major treatment parameter in those with diabetes and heart disease, the authors analyzed baseline data from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial. The study consisted of 2368 participants with type 2 diabetes and coronary artery disease from 49 sites in 6 countries (2295 provided lipid measurements). Fifty-nine percent of participants had a low-density lipoprotein (LDL) cholesterol level < 100 mg/dL. Levels of total, LDL, and non-high-density lipoprotein (HDL) cholesterol and triglycerides differed by age group (younger than 55, 55-64, and 65 years and older); they were lowest in those aged 65 years. Women had higher total, LDL, and non-HDL cholesterol values. Education was associated with lower total, LDL, and non-HDL cholesterol levels. LDL cholesterol and triglyceride values were lower in the United States and Canada. Adjustment for age, sex, education level, randomization year, and medication did not eliminate these differences. Geographic variation was seen and was not fully accounted for by demographic or treatment characteristics (all P values < .05).</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 1","pages":"9-18"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2717619/pdf/nihms107173.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28134779","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":"Factors associated with low levels of subclinical vascular disease in older adults: multi-ethnic study of atherosclerosis.","authors":"Erin D Michos, Kenneth M Rice, Moyses Szklo, Gregory L Burke, David S Siscovick, Russell P Tracy, R Graham Barr, Jennifer A Nettleton, Philip Greenland, David R Jacobs, Wendy Post","doi":"10.1111/j.1751-7141.2008.00023.x","DOIUrl":"10.1111/j.1751-7141.2008.00023.x","url":null,"abstract":"<p><p>Coronary artery calcium (CAC), carotid intima-media thickness (CIMT), and reduced ankle brachial indices (ABI) are markers of subclinical vascular disease strongly associated with aging. The authors identified factors associated with low levels of subclinical vascular disease in 1824 participants 70 years and older in the Multi-Ethnic Study of Atherosclerosis. A total of 452 had low CAC (<25th percentile), 441 had low CIMT (<25th percentile), 1636 had normal ABI (>0.9), and 165 had a combination index indicating favorable values for all 3 parameters. This combination index was independently associated with younger age (odds ratio [OR] 2.5 per 1 SD [95% confidence interval (CI), 1.8-3.6]), female sex (OR 3.0 [95% CI, 1.9-4.8]), lower body mass index (OR 1.6 per 1 SD [95% CI, 1.2-2.0]), absence of hypertension (OR 1.8 [95% CI, 1.2-2.6]), absence of dyslipidemia (OR 1.6 [95% CI, 1.04-2.4]), and never-smoking (OR 1.7 [95% CI, 1.1-2.6]). No significant associations were observed for C-reactive protein, education, diet, or physical activity. Favorable levels of multiple traditional risk factors, but not several novel risk factors, were associated with subclinical markers of successful cardiovascular aging.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 2","pages":"72-9"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2932469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28202965","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":"Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial (ONTARGET): implications for reduced cardiovascular risk.","authors":"Philip R Liebson,&nbsp;Ezra A Amsterdam","doi":"10.1111/j.1751-7141.2008.00010.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2008.00010.x","url":null,"abstract":"<p><p>The recently published Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial (ONTARGET) in patients with vascular disease or high-risk diabetes, as the largest published comparative trial of these agent classes, provides further evidence concerning the comparison between the angiotensin-receptor blockers (ARBs) and the angiotensin-converting enzyme inhibitors (ACEIs). In this trial, telmisartan (an ARB) was non-inferior to ramipril (an ACEI) in reducing fatal and nonfatal cardiovascular events. Moreover, ONTARGET is an example of a high-quality noninferiority trial. However, the combination of the 2 agents was associated with more adverse effects without an increase in benefit. The study differed from several other comparative studies in which the dose and choice of ACEI was left to individual physicians. Further, in ONTARGET, the ACEI was not titrated to the maximum dose and patients with heart failure were excluded.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 1","pages":"43-50"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2008.00010.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28135728","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":"Using impedance cardiography to detect subclinical cardiovascular disease in women with multiple risk factors: a pilot study.","authors":"Arthur P Demarzo","doi":"10.1111/j.1751-7141.2008.00012.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2008.00012.x","url":null,"abstract":"<p><p>Early detection of cardiovascular disease (CVD) could initiate appropriate treatment and prevent progression. This study used impedance cardiography (ICG) waveform analysis with postural change to detect functional CVD in women older than 40 years with no history of CVD and >or=2 of the following risk factors: cigarette smoking, poor diet, physical inactivity, central adiposity, family history of premature CVD, hypertension, and dyslipidemia. A study group of 32 women underwent ICG in standing and supine positions. An age-matched control group had 20 women with an active lifestyle, no risk factors, and no history of CVD. All women in the control group had normal ICG data. All women in the study group had some abnormal ICG data, with 28 (87.5%) having multiple ICG abnormalities. ICG data indicated that 13 (40.6%) had ventricular dysfunction, 14 (43.8%) had high vascular resistive load, and 30 (93.8%) had elevated vascular pulsatile load. The data suggest that subclinical CVD, detectable by ICG, is prevalent in women older than 40 years with multiple risk factors. Abnormal ICG results could expedite the initiation of customized treatment as part of a preventive approach to CVD.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 2","pages":"102-8"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2008.00012.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28202968","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":"Predictors of health education and nonmedication treatment in adult outpatients with diagnosed cardiac conditions.","authors":"Stacie M Metz,&nbsp;Mihir Raval","doi":"10.1111/j.1751-7141.2009.00035.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00035.x","url":null,"abstract":"<p><p>The premise of this study was to assess what factors predict the provision of health education and nonmedication treatment for adult cardiac outpatients. A multivariate logistic regression analysis was carried out on 2005 National Hospital Ambulatory Medical Care Survey data to determine the odds of provision of health education or nonmedication treatment in respect to age, sex, ethnicity, body mass index, insurance type, smoking status, diabetes status, and receipt of medication in 278 cardiac patients aged 18 to 64 years who visited outpatient departments in 2005. Approximately 48% of cardiac outpatients were offered health education and 32% nonmedication therapy. Cardiac outpatients who were older, obese, and female were less likely to receive health education or nonmedication treatment during their visits. Eliminating such disparities to comprehensive cardiac outpatient care will elicit favorable outcomes to the patient and health care system.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 3","pages":"144-8"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00035.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28316583","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":"Counterpoint: Mechanical treatment of atherosclerosis is not a cure.","authors":"William R Lewis","doi":"10.1111/j.1751-7141.2009.00046.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00046.x","url":null,"abstract":"Dr Ellestad’s concern regarding the long-term effects of ischemia in medically treated patients vs revascularized patients has also occurred to me. In the early 1990s it was postulated that ischemia may be beneficial in terms of encouraging collateralization of the coronary arteries. We learned from 2 studies of silent ischemia, the Asymptomatic Cardiac Ischemia Pilot (ACIP) study and the Atenolol Silent Ischemia Study (ASIST), that ischemia in stable patients is not beneficial. The ACIP trial randomized 558 patients to angina-guided therapy (essentially no treatment), medical therapy (atenolol-nifedipine or diltiazem-isosorbide dinitrate), or revascularization (angioplasty or bypass). The 1-year mortality rate was 4.4% in the angina-guided group, 1.6% in the medical therapy group, and 0% in the revascularization group. In ASIST, 306 patients with silent ischemia were randomized to atenolol vs placebo. There was a strong trend toward improvement in hard cardiac events (risk ratio, 0.55) in the atenolol group. Compared with modern therapy, the medical treatment was grossly inadequate in that neither of these studies described how many patients were taking aspirin, none were prescribed statins, and none were taking angiotensin-converting enzyme (ACE) inhibitors. One could also argue that the use of calcium channel blockers was not beneficial and possibly harmful in patients with left ventricular (LV) dysfunction. Once we all agree that ischemia is harmful, the question becomes ‘‘Can we impact the disease and how?’’ Prior to the development of angioplasty, there were several early studies investigating coronary artery surgery to revascularize patients with stable angina. These studies were the VA Coronary Artery Bypass Surgery Cooperative Study Group, the Coronary Artery Surgery Study, and the European Coronary Surgery Study Group. Retrospective analyses of these trials suggested that survival was superior with coronary artery bypass surgery compared with medical therapy in patients with left main disease, proximal left anterior descending coronary artery disease (proximal to the first septal perforator), and 3-vessel coronary artery disease with LV dysfunction. As in the trials noted above, the use of statins and ACE inhibitors was nonexistent and calcium channel blockers were common. Following these landmark trials there have been numerous trials investigating one form of revascularization vs another, but there has been a paucity of data comparing medical and mechanical treatment of stable coronary artery disease. Over the past 2 decades, revascularization has been used to treat patients with progressively lower amounts of atherosclerotic burden. Medical and surgical therapies have advanced considerably during the past 2 decades. Statin therapy, ACE inhibitors, and antiplatelet therapy have been developed. Surgical techniques have similarly improved with the introduction of newer cardioplegia agents and techniques and the utilization of the intern","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 4","pages":"171-2"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00046.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28472782","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}