eCardio Hub Collection

Influenza Vaccination: Proven and Effective Cardiovascular Disease Prevention

Abstract / Description:

Influenza places a significant health burden on the US population, resulting in an estimated 140,000-810,000 hospitalizations and 12,000-61,000 deaths annually.1 Influenza is associated with acute cardiovascular events, including heart failure exacerbations,2 ischemic episodes,2 and overall cardiovascular mortality, even in people with no prior cardiac history.3 In individuals with cardiovascular risk factors who become infected with influenza, there is a significant association between influenza and acute myocardial infarction.4

Category: General CV

Date: 2020

Author: Sallyann Coleman King, MD; Amy Parker Fiebelkorn, MSN, MPH; Laurence S. Sperling, MD, FACC

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10 terms every doctor should know about BP

Abstract / Description:

The AMA has developed online tools and resources created using the latest evidence-based information to support physicians to help diagnose and manage their patientsí high BP. These resources are available to all physicians and health systems as part of?Target: BPô, a national initiative co-led by the AMA and American Heart Association (AHA). Now is the time to fight back harder with better tools. This brief glossary will help guide you through different terms to make strides in improving blood pressure control.

Category: General CV

Date: 2020

Author: Sara Berg

Category: Asian/Pacific Islander CV

Date: 2019

Author: American Heart Association

2019 Heart Disease & Stroke Statistical Update Fact SheetCongenital Cardiovascular Defects

Abstract / Description:

CCDs arise from abnormal formation of the heart or major blood vessels. CCDs range in severity from very minor abnormalities that will never require medical therapy or intervention to complex malformations, including absent or atretic portions of the heart, that could require multiple surgeries and interventions, or even cardiac transplantation. Thus, there is significant variability in their presentation and requirements for care that can have a significant impact on morbidity, mortality, and healthcare costs in children and adults.

Category: General CV

Date: 2019

Author: American Heart Association

65% of Latinos Are Losing Jobs, Money Thanks to Coronavirus

Abstract / Description:

Category: Telehealth

Date: 2016

Author: Kathleen T. Hickey,corresponding author Nicole R. Hauser, Laura E. Valente, Teresa C. Riga, Ashton P. Frulla, Ruth Masterson Creber, William Whang, Hasan Garan, Haomiao Jia, Robert R. Sciacca, and Daniel Y. Wang

Author: Oscar Calvillo-Argüelles MD, Heather J. Ross MD MHSc

Cardiac Intervention Improves Heart Disease and Clinical Outcomes in Patients With Muscular Dystrophy in a Multidisciplinary Care Setting

Abstract / Description:

Background Patients with muscular dystrophy (MD) represent a vulnerable patient population with no clearly defined care model in modern?day clinical practice to manage a high burden of heart disease and comorbidities. We demonstrate the effectiveness of cardiac interventions, namely the initiation and optimization of medical and device therapies, as part of a multidisciplinary care approach to improve clinical outcomes in patients with MD. Methods and Results We conducted a prospective cohort study at the Neuromuscular Multidisciplinary clinic following patients with dystrophinopathies, limb?girdle MD, type 1 myotonic dystrophy, and facioscapulohumeral MD. A negative control group classified as non?MD myopathies without heart disease, was also tracked. Our cohort of 185 patients (median age: 42 years; 79 [42.7%] women), included 145 patients with MD. Cardiomyopathy was present in 65.6% of the patients with dystrophinopathies (21 of 32) and 27.3% of the patients with limb?girdle MD (9 of 33). Conduction abnormalities were common in type 1 myotonic dystrophy (33.3% [20/60] patients). Cardiac intervention reversed systolic dysfunction, with left ventricular ejection fraction improving from 43% to 50.0% over a 3?year period. A sustained reduction in healthcare utilization was also observed. The number of outpatient clinic visits decreased from 3.0 to 1.5 visits per year, the duration of hospitalizations was reduced from 14.2 to 0.9 days per year, and the number of cardiac?related hospitalizations decreased from 0.4 to 0.1 hospitalizations per year associated with low mortality. Conclusions Our study demonstrates that cardiac intervention as part of a comprehensive multidisciplinary care approach to treating patients with MD leads to a sustained improvement in clinical outcomes.

Category: General CV

Date: 2020

Author: Anish Nikhanj, Haran Yogasundaram, Bailey Miskew Nichols, Janice Richman?Eisenstat, Cecile Phan, Jeffrey A. Bakal, Zaeem A. Siddiqi, and Gavin Y. Oudit

Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)

Abstract / Description:

Importance Virus infection has been widely described as one of the most common causes of myocarditis. However, less is known about the cardiac involvement as a complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Objective To describe the presentation of acute myocardial inflammation in a patient with coronavirus disease 2019 (COVID-19) who recovered from the influenzalike syndrome and developed fatigue and signs and symptoms of heart failure a week after upper respiratory tract symptoms. Design, Setting, and Participant This case report describes an otherwise healthy 53-year-old woman who tested positive for COVID-19 and was admitted to the cardiac care unit in March 2020 for acute myopericarditis with systolic dysfunction, confirmed on cardiac magnetic resonance imaging, the week after onset of fever and dry cough due to COVID-19. The patient did not show any respiratory involvement during the clinical course. Exposure Cardiac involvement with COVID-19. Main Outcomes and Measures Detection of cardiac involvement with an increase in levels of N-terminal proñbrain natriuretic peptide (NT-proBNP) and high-sensitivity troponin T, echocardiography changes, and diffuse biventricular myocardial edema and late gadolinium enhancement on cardiac magnetic resonance imaging. Results An otherwise healthy 53-year-old white woman presented to the emergency department with severe fatigue. She described fever and dry cough the week before. She was afebrile but hypotensive; electrocardiography showed diffuse ST elevation, and elevated high-sensitivity troponin T and NT-proBNP levels were detected. Findings on chest radiography were normal. There was no evidence of obstructive coronary disease on coronary angiography. Based on the COVID-19 outbreak, a nasopharyngeal swab was performed, with a positive result for SARS-CoV-2 on real-time reverse transcriptaseñpolymerase chain reaction assay. Cardiac magnetic resonance imaging showed increased wall thickness with diffuse biventricular hypokinesis, especially in the apical segments, and severe left ventricular dysfunction (left ventricular ejection fraction of 35%). Short tau inversion recovery and T2-mapping sequences showed marked biventricular myocardial interstitial edema, and there was also diffuse late gadolinium enhancement involving the entire biventricular wall. There was a circumferential pericardial effusion that was most notable around the right cardiac chambers. These findings were all consistent with acute myopericarditis. She was treated with dobutamine, antiviral drugs (lopinavir/ritonavir), steroids, chloroquine, and medical treatment for heart failure, with progressive clinical and instrumental stabilization. Conclusions and Relevance This case highlights cardiac involvement as a complication associated with COVID-19, even without symptoms and signs of interstitial pneumonia.

Category: COVID-19 Impact on Minority Health

Date: 2020

Author: Riccardo M. Inciardi, MD; Laura Lupi, MD; Gregorio Zaccone, MD; Leonardo Italia, MD; Michela Raffo, MD1; Daniela Tomasoni, MD1; Dario S. Cani, MD; Manuel Cerini, MD; Davide Farina, MD; Emanuele Gavazzi, MD; Roberto Maroldi, MD; Marianna Adamo, MD; Enrico Ammirati, MD, PhD; Gianfranco Sinagra, MD; Carlo M. Lombardi, MD; Marco Metra, MD

Cardiac Outcomes of Patients Receiving Adjuvant Weekly Paclitaxel and Trastuzumab for Node-Negative, ERBB2-Positive Breast Cancer

Abstract / Description:

Importance Trastuzumab is a life-saving therapy but is associated with symptomatic and asymptomatic left ventricular ejection fraction (LVEF) decline. We report the cardiac toxic effects of a nonanthracycline and trastuzumab-based treatment for patients with early-stage human epidermal growth factor receptor 2 (ERBB2, formerly HER2 or HER2/neu)-positive breast cancer. Objective To determine the cardiac safety of paclitaxel with trastuzumab and the utility of LVEF monitoring in patients with node-negative, ERBB2-positive breast cancer. Design, Setting, and Participants In this secondary analysis of an uncontrolled, single group study across 14 medical centers, enrollment of 406 patients with node-negative, ERBB2-positive breast cancer 3 cm, or smaller, and baseline LVEF of greater than or equal to 50% occurred from October 9, 2007, to September 3, 2010. Patients with a micrometastasis in a lymph node were later allowed with a study amendment. Median patient age was 55 years, 118 (29%) had hypertension, and 30 (7%) had diabetes. Patients received adjuvant paclitaxel for 12 weeks with trastuzumab, and trastuzumab was continued for 1 year. Median follow-up was 4 years. Interventions Treatment consisted of weekly 80-mg/m2 doses of paclitaxel administered concurrently with trastuzumab intravenously for 12 weeks, followed by trastuzumab monotherapy for 39 weeks. During the monotherapy phase, trastuzumab could be administered weekly 2-mg/kg or every 3 weeks as 6-mg/kg. Radiation and hormone therapy were administered per standard guidelines after completion of the 12 weeks of chemotherapy. Patient LVEF was assessed at baseline, 12 weeks, 6 months, and 1 year. Main Outcomes and Measures Cardiac safety data, including grade 3 to 4 left ventricular systolic dysfunction (LVSD) and significant asymptomatic LVEF decline, as defined by our study, were reported. Results Overall, 2 patients (0.5%) (95% CI, 0.1%-1.8%) developed grade 3 LVSD and came off study, and 13 (3.2%) (95% CI, 1.9%-5.4%) had significant asymptomatic LVEF decline, 11 of whom completed study treatment. Median LVEF at baseline was 65%; 12 weeks, 64%; 6 months, 64%; and 1 year, 64%. Conclusions and Relevance Cardiac toxic effects from paclitaxel with trastuzumab, manifesting as grade 3 or 4 LVSD or asymptomatic LVEF decline, were low. Patient LVEF was assessed at baseline, 12 weeks, 6 months, and 1 year, and our findings suggest that LVEF monitoring during trastuzumab therapy without anthracyclines could be simplified for many individuals. Introduction In the United States, breast cancer is the most common female cancer and the second most common cause of cancer death in women.1 Amplification or overexpression of the human epidermal growth factor receptor 2 (ERBB2, formerly HER2 or HER2/neu) oncogene is present in approximately 20% to 25% of primary invasive breast cancers.2 Trastuzumab has demonstrated a significant improvement in outcomes of women with early-stage breast cancer in key adjuvant trials, but most of these trials contained an anthracycline-based therapy followed by trastuzumab with or without a taxane in women with either node-positive or node-negative, high-risk breast cancer (usually defined as tumor size >1 cm or >2 cm).3-8 However, several studies from the pretrastuzumab era suggest a higher risk of recurrence for patients with ERBB2-positive, node-negative tumors compared with those with ERBB2-negative tumors of the same size.9-11 Recent retrospective studies have demonstrated a benefit from the combination of chemotherapy and trastuzumab in those with node-negative breast cancer and a time trend increase in the use of these agents.12-14 The most significant toxic effect of trastuzumab, especially following an anthracycline-based therapy, is symptomatic congestive heart failure (CHF) that has been reported from 0.9% to 4% and significant asymptomatic cardiac decline ranging from 4% to 19% in clinical trials.3-8,15-19 After the anthracycline phase, most symptomatic CHF and asymptomatic left ventricular ejection fraction (LVEF) decline occurred during the period of trastuzumab administration.3-8,15-19 Unlike cardiac toxic effects associated with anthracyclines, LVEF decline following trastuzumab therapy is not dose related and is considered to be mostly reversible.20 Most previous clinical trials involving trastuzumab included patients who were exposed to anthracyclines, but it is not clear how much the anthracyclines contributed to trastuzumab-mediated cardiac dysfunction. To reduce cardiac and noncardiac toxic effects with the hope of maintaining a high degree of effectiveness, we conducted a trial of weekly paclitaxel with trastuzumab in patients with early-stage ERBB2-positive breast cancer. The overall study results have been previously reported, and this article highlights the detailed cardiac data that have been collected.21

Category: Cardio-Oncology

Date: 2020

Author: Chau Dang, MD; Hao Guo, MS; Julie Najita, PhD; Denise Yardley, MD; Kelly Marcom, MD; Kathy Albain, MD; Hope Rugo, MD; Kathy Miller, MD; Matthew Ellis, MD, PhD; Iuliana Shapira, MD; Antonio C. Wolff, MD; Lisa A. Carey, MD; Beverly Moy, MD; John Groarke, MD; Javid Moslehi, MD; Ian Krop, MD, PhD; Harold J. Burstein, MD, PhD; Clifford Hudis, MD; Eric P. Winer, MD; Sara M. Tolaney, MD

Cardiac Therapy Improves Heart Function in Patients With Chemotherapy-Induced Events

Abstract / Description:

Abstract / Description:

Income and poverty measures can indicate the extent to which a community may be able to successfully adhere to COVID-19 mitigation measures (such as “stay at home” and “quarantine family members who are sick”). Lower-income individuals are more likely to be living in crowded households where there are more people than rooms, making quarantining sick family members more difficult. Low-income individuals are more likely to be working in service positions on the front line of COVID-19 including as at-home health aides for seniors, grocery store clerks, and nannies, and may not be able to “stay at home.” Lower-income individuals are more likely to experience health conditions such as high blood pressure and diabetes that may increase the likelihood of hospitalization and death among COVID-19 patients. There are a myriad of reasons why lower-income and poorer communities will be more vulnerable to the COVID-19 virus as explored in additional indicators on this webpage.

Category: COVID-19 Impact on Minority Health

Date: 2020

Author: The Data Center

Year: 2020

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Each Cigarette Brings You Closer to Addiction

Abstract / Description:

Each Cigarette Brings You Closer to Addiction

Category: Tobacco

Author: FDA Tabacco Education Resources

Early Data Shows African Americans Have Contracted and Died of Coronavirus at an Alarming Rate

Abstract / Description:

Author: Alex Hendrickson

First Lady Tammy Murphy to Host Family Festival in Atlantic City to Combat New Jerseyís Maternal and Infant Health Crisis

Abstract / Description:

On Saturday, September 7, First Lady Tammy Murphy will host a Family Festival in Atlantic City. As part of Nurture NJ, her statewide awareness campaign to combat the maternal and infant health crisis in New Jersey, the First Lady developed the Family Festival event series to target cities with high rates of maternal and infant mortality and connect mothers, fathers, grandparents, and anyone else involved in taking care of a child with state, county, and local resourcesócreating a one-stop shop for state, county, and local resources.

Category: Cardio-Obstetrics

Date: 2019

Author: Inside New Jersey - Press Release

Food Insecurity and Cardiovascular Disease Risk Factors among Mississippi Adults

Abstract / Description:

Background: Food insecurity is a public health problem. There is limited data on food insecurity in Mississippi. Methods: We analyzed data from the 2015 Mississippi Behavioral Risk Factor Surveillance System, which included the Social Context Module for 5870 respondents. Respondents who indicated that in the past 12 months they were ìalwaysî, ìusuallyî, or ìsometimesî ìworried or stressed about having enough money to buy nutritious mealsî were considered food insecure. Food insecurity was compared across sociodemographic and health characteristics using chi-square tests, and the association between food insecurity and select cardiovascular disease risk factors was assessed using logistic regression. Results: The prevalence of food insecurity was 42.9%. Compared to the referent group, Mississippi adults with high blood pressure had 51% higher odds, those with diabetes had 30% higher odds, those who were not physically active had 36% higher odds, and those who consumed fewer than five fruits and vegetables daily had 50% higher odds of being food insecure. Conclusion: Among Mississippi adults, food insecurity is associated with high blood pressure, diabetes, obesity, fruit and vegetable consumption, physical inactivity, and smoking.

Abstract / Description:

Despite the overall decline, substantial geographic disparities in cardiovascular mortality persist. Novel approaches are needed to attenuate the long-standing geographic inequalities in cardiovascular mortality in the United States, which are projected to increase.

Abstract / Description:

Cardiometabolic risk factors in children and adolescents track into adulthood and are associated with increased risk of atherosclerotic cardiovascular disease. The purpose of this review is to examine the pervasive race and ethnic disparities in cardiometabolic risk factors among Black and Hispanic youth in the United States. We focus on three traditional cardiometabolic risk factors (obesity, type 2 diabetes mellitus, and dyslipidemia) as well as on the emerging cardiometabolic risk factor of non-alcoholic fatty liver disease. Additionally, we highlight interventions aimed at improving cardiometabolic health among these minority pediatric populations. Finally, we advocate for continued research on effective prevention strategies to reduce cardiometabolic risk and avert further disparities in cardiovascular morbidity and mortality.

Category: Black/African American CV, Hispanic/Latino

Date: 2021

Health Disparities in Rural America: Current Challenges and Future Solutions

Abstract / Description:

Approximately 60 million Americans reside in rural areas of the United States. Although this represents only 20% of the US population, rural Americans have a lower life expectancy than their metropolitan counterparts.1,2 The higher rate of premature death can be traced to a higher incidence of heart disease, cancer, unintentional injury, respiratory disease, and stroke. In addition, infant mortality, alcohol and drug abuse, obesity, diabetes, and HIV infection affect a higher percentage of rural Americans compared with urban residents.3,4

Category: Equity

Date: 2020

Author: Theresa Capriotti, DO, MSN, CRNP, RN Tiffany Pearson, BSN Lillian Dufour, BSN

Health Equity Rounds: An Interdisciplinary Case Conference to Address Implicit Bias and Structural Racism for Faculty and Trainees

Abstract / Description:

Introduction: The medical community recognizes the importance of confronting structural racism and implicit bias to address health inequities. Several curricula aimed at teaching trainees about these issues are described in the literature. However, few curricula exist that engage faculty members as learners rather than teachers of these topics or target interdisciplinary audiences. Methods: We developed a longitudinal case conference curriculum called Health Equity Rounds (HER) to discuss and address the impact of structural racism and implicit bias on patient care. The curriculum engaged participants across training levels and disciplines on these topics utilizing case-based discussion, evidence-based exercises, and two relevant conceptual frameworks. It was delivered quarterly as part of a departmental case conference series. We evaluated HER's feasibility and acceptability by tracking conference attendance and administering postconference surveys. We analyzed quantitative survey data using descriptive statistics and qualitatively reviewed free-text comments. Results: We delivered seven 1-hour HER conferences at our institution from June 2016 to June 2018. A mean of 66 participants attended each HER. Most survey respondents (88% or more) indicated that HER promoted personal reflection on implicit bias, and 75% or more indicated that HER would impact their clinical practice. Discussion: HER provided a unique forum for practitioners across training levels to address structural racism and implicit bias. Our aim in dissemination is to provide meaningful tools for others to adapt at their own institutions, recognizing that HER should serve as a component of larger, multifaceted efforts to decrease structural racism and implicit bias in health care.

Abstract / Description:

Background Cancer treatment can lead to left ventricular (LV) dysfunction in female cancer survivors of reproductive age, and pregnancy-related hemodynamic stress may result in LV dysfunction or heart failure (HF). Objectives The authors performed a systematic review and meta-analysis to determine the incidence of LV systolic dysfunction or HF during or soon after pregnancy in cancer survivors and evaluated the impact of history of cancer therapeutics-related cardiac dysfunction (CTRCD). Methods We systematically searched electronic databases (MEDLINE and EMBASE) from inception to January 2020 to identify cohort studies that examined cardiac disease in pregnant cancer survivors. Meta-analysis was performed using the inverse-variance fixed effects method. Potential sources of heterogeneity were explored using subgroup analyses and meta-regression. Results Of 13,782 identified articles, 6 studies consisting of 2,016 pregnancies, predominantly in childhood cancer survivors, were included. Overall, there were 33 cardiac events. The total weighted incidence of LV dysfunction or HF with pregnancy was 1.7% (95% confidence interval [CI]: 0.9% to 2.7%) overall; 28.4% (95% CI: 14.6% to 43.9%) in those with a history of CTRCD and 0.24% (95% CI: 0% to 0.81%) in those without, translating into an odds ratio of 47.4 (95% CI: 17.9 to 125.8). Interstudy heterogeneity was low (I2 = 17.5%). Metaregression did not reveal significant sources of heterogeneity. Conclusions The incidence of LV dysfunction or HF during pregnancy in cancer survivors was low. Although risk estimates are limited by the small number of events, women with a history of CTRCD compared to those without had a 47.4-fold higher odds of experiencing pregnancy-related LV dysfunction or HF.

Category: Cardio-Obstetrics, Cardio-Oncology

Date: 2020

Author: Mark Nolan, Evangelos K. Oikonomou, Candice K. Silversides, Melissa R. Hines, Kara A. Thompson, Belinda A. Campbell, Eitan Amir, Cynthia Maxwell and Paaladinesh Thavendiranathan

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Just 1 in 4 Medicare recipients participate in cardiac rehab

Abstract / Description:

Too few Medicare recipients take part in cardiac rehabilitation despite the services being available to them, according to new research that showed women, the elderly and minorities are most likely to miss out.

Category: General CV

Date: 2020

Author: American Heart Association News

Justice, diversity, and research ethics review

Abstract / Description:

The disproportionate impact of COVID-19 on certain populations, such as Black, Latinx, and Indigenous populations in the United States, has focused attention on inequalities in health and on the need to increase enrollment of racial and ethnic minorities and other underrepresented groups in biomedical research (1). Yet too often, in the United States and globally, participant enrollment in research has not reflected the demographic composition of the general population, those affected by the health conditions being studied, or those for whom the investigational product is intended (2), with racial and ethnic minorities and the young and the elderly, among others, being consistently underrepresented (3). Underlying causes for this underrepresentation have been described (4, 5), but change has been slow. Notwithstanding the roles of other stakeholders in addressing this issue, we maintain that the specific value of institutional review boards (IRBs) and research ethics committees (RECs) in promoting diversity has been underrecognized and their authority underutilized. Here, we substantiate the role of and outline practical steps for the IRB and REC (hereafter “IRB”) to help achieve greater diversity in clinical research.

Category: Clinical trials

Date: 2021

Author: David H. Strauss, Sarah A. White, Barbara E. Bierer

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Keith Ferdinand, MD, Discusses Cardiovascular Health

Abstract / Description:

Dr. Ferdinand discusses ending disparities in cardiovascular care and barriers that keep patients from the treatment they need.

Category: General CV

Date: 2019

Author: Alliance for Patient Access

Kids Can Also Have High Cholesterol

Abstract / Description:

The Rana family learns that cholesterol can be genetic as their son get it at a young age after his father's near-fatal heart attack; KDKA's Gilma Avalos.

Category: Asian/Pacific Islander CV

Date: 2019

Author: Cleveland CBS

Know the warning signs of stroke

Abstract / Description:

Know the warning signs of stroke so you can act FAST

Category: Black/African American CV

Date: 2012

Author: Ascension Via Christi

KPIX-5 Interview about early heart attacks and genetically high Lp(a) www.TESTLpa.org

Abstract / Description:

Founders interview about genetically high lipoprotein(a) and the associated 60% plus increased risk for cardiovascular disease

Category: General CV

Date: 2019

Author: Lipoprotein a foundation

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Latinos Keep Getting Left Out of Coronavirus Relief Packages

Abstract / Description:

As the U.S. Government continues to push back against the economic downturn and the spread of COVID-19, disadvantaged groups—such as Latinos—aren’t receiving an equitable share. The recently passed $484 billion stimulus package will give millions of Americans and U.S. businesses with economic relief, in combination with past relief legislation. However, the money isn’t reaching workers who need it the most, like Latino immigrants.

Category: COVID-19 Impact on Minority Health, Hispanic/Latino

Date: 2020

Author: Josh McCormack

Lessons We’ve Learned — Covid-19 and the Undocumented Latinx Community

Abstract / Description:

In March 2020, when there were 30,000 confirmed Covid-19 cases in the United States, one of us wrote about the pandemic’s effects on undocumented immigrants.1 By August, there were about 50,000 new U.S. cases per day, and we had spent several months caring for patients with Covid-19. Today, revisiting the issues of anti-immigrant policies, limited access to care, language barriers, and the need to work elicits painful memories of the people we’ve met in the hospital and the community.

Category: COVID-19 Impact on Minority Health

Date: 2020

Author: Kathleen R. Page, M.D., and Alejandra Flores-Miller

Lessons We’ve Learned — Covid-19 and the Undocumented Latinx Community

Abstract / Description:

In March 2020, when there were 30,000 confirmed Covid-19 cases in the United States, one of us wrote about the pandemic’s effects on undocumented immigrants.1 By August, there were about 50,000 new U.S. cases per day, and we had spent several months caring for patients with Covid-19. Today, revisiting the issues of anti-immigrant policies, limited access to care, language barriers, and the need to work elicits painful memories of the people we’ve met in the hospital and the community.

Category: COVID-19 Impact on Minority Health

Date: 2020

Author: Kathleen R. Page, M.D., and Alejandra Flores-Miller

Letter to the Editor: Proposing and Meeting the Need forInterdisciplinary Cardio-oncologySubspecialty Training

Category: Cardio-Oncology

Date: 2016

Author: Sherry-Ann Brown, MD, PhD1Nicole Sandhu, MD, PhD

Level of Recommended Heart Attack Knowledge among Native Hawaiian and Pacific Islander Adults in the United States

Abstract / Description:

In this report we examine the level of knowledge about heart attack symptoms and what action to take if a heart attack is suspected among Native Hawaiian and Pacific Islander (NHPI) adults in the United States using data from the 2014 NHPI-National Health Interview Survey. Analyses include summary statistics to describe levels of heart attack knowledge and multivariate logistic regression to identify characteristics associated with having the recommended heart attack knowledge. Less than half (44.4%) of NHPI adults have the recommended heart attack knowledge. Significant differences in knowledge levels were found based on age; those aged 45ñ64 years and those aged 65 years and older were 68% and 78% more likely, respectively, to have the recommended heart attack knowledge compared those aged younger than 45 years. The level of recommended heart attack knowledge among NHPI is lower than that of the general population. Improving the heart attack knowledge of all Americans should continue to be a national priority, but efforts to target this group for heart attack knowledge improvement should be made given their high risk for heart attack.

Category: Asian/Pacific Islander CV

Date: 2020

Author: Holly Felix, PhD, Marie-Rachelle Narcisse, PhD, Brett Rowland, MA, Christopher R Long, PhD, Zoran Bursac, PhD, and Pearl A McElfish, PhDcorresponding author

Abstract / Description:

Familial hypercholesterolemia (FH) is the most common inherited cardiovascular disease and carries significant morbidity and mortality risks. Genetic testing can identify affected individuals, but some array-based assays screen only a small subset of known pathogenic variants.

Category: General CV

Date: 2021

Author: Amy C. Sturm, MS; Rebecca Truty, PhD; Thomas E. Callis, PhD; Sienna Aguilar, MS; Edward D. Esplin, MD, PhD; Sarah Garcia, MS, PhD; Eden V. Haverfield, DPhil; Ana Morales, MS; Robert L. Nussbaum, MD; Susan Rojahn, PhD; Matteo Vatta, PhD; Daniel J. Rader, MD

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Making a Difference in Disparities

Abstract / Description:

Much of cardiovascular outcomes researchóincluding the work published in this journalóaddresses healthcare disparities.1ñ3 As researchers, we frequently describe disparities and, rarely, even suggest and test strategies to reduce them. But, beyond scientific publications, what is the role of the physician and researcher as social advocate and citizen to reduce disparities? That important topic is one we rarely address. Yet it has been increasingly on our minds as Editors given the growing and complex challenges we now see to the health of our patients, which range from accessing affordable care to healthy home environments to climate change.

Category: General CV

Date: 2017

Author: Paul S. Chan, MD, MSc; John A. Spertus, MD, MPH; Brahmajee K. Nallamothu, MD, MPH

Making Anti-Racism A Core Value In Academic Medicine

Abstract / Description:

Racism, and not race, is a social determinant of health, as leadership from the Ohio State University Wexner Medical Center and Health Sciences Colleges recently declared. Acknowledging this is a foundation for structural and systemic change. Indeed, academic medical centers and health care organizations not acting to eliminate racism are perpetuating its proliferation. Within and outside our walls, we must build a culture of health that empowers populations that have historically been made vulnerable and uproots the manifestations of racism that appear in health care.

Category: Medical Education

Date: 2020

Author: J. Nwando Olayiwola Joshua J. Joseph Autumn R. Glover Harold L. Paz Darrell M. Gray, II

Abstract / Description:

Traffic-control officers employed in New York City tunnels prior to 1981 have been at increased risk of mortality from coronary heart disease. In this study, the authors assessed current coronary heart disease prevalence and evaluated associations between coronary heart disease and occupational factors among New York City bridge and tunnel officers. A clinical cardiovascular disease surveillance and cross-sectional occupational epidemiologic study was conducted. The authors used comprehensive evaluations to identify current and prior incidences of coronary heart disease. Occupational risk factors evaluated included job strain, current and historic exposure to carbon monoxide, and occupational physical inactivity. Current carbon monoxide exposure was assessed via workshift changes in carboxyhemoglobin. Coronary heart disease occurred in 29 (5.5%) of the 526 bridge and tunnel officers examined. Risk of coronary heart disease was associated positively with total years each bridge and tunnel officer work had worked in that capacity (odds ratio = 1.64 for each decade of employment, adjusted for nonoccupational coronary heart disease risk factors). Carboxyhemoglobin levels were low in the subjects, and job strain and physical inactivity were very prevalent. Occupational factors contributed to the risk of coronary heart disease in New York City bridge and tunnel officers. The authors were unable to identify the specific factors that led to the increase in risk described.

Category: Occupational Factors and CVD

Date: 2010

Author: Herbert R1, Schechter C, Smith DA, Phillips R, Diamond J, Carroll S, Weiner J, Dahms TE, Landrigan PJ.

Occupational Exposures and Cardiac Structure and Function: ECHO‐SOL (Echocardiographic Study of Latinos)

Abstract / Description:

Background Our objective was to determine associations of occupational exposures with cardiac structure and function in Hispanic/Latino adults. Methods and Results Employed participants were included (n=782; 52% women, mean age 52.9 years). Occupational exposures to burning wood, vehicle exhaust, solvents, pesticides, and metals at the current and longest‐held job were assessed by questionnaire. Survey multivariable linear regression analyses were used to model the relationship of each self‐reported exposure with echocardiographic measures of cardiac structure and function. Exposure to burning wood at the current job was associated with decreased left ventricular (LV) ejection fraction (−3.1%; standard error [SE], 1.0 [P=0.002]). When the analysis was restricted to exposure at the longest‐held job, occupational exposure to burning wood was associated with increased LV diastolic volume (6.7 mL; SE, 1.6 [P<0.0001]), decreased LV ejection fraction (−2.7%; SE, 0.6 [P<0.0001]), worse LV global longitudinal strain (1.0%; SE, 0.3 [P=0.0009]), and decreased right ventricular fractional area change (−0.02; SE, 0.004 [P<0.001]). Exposure to pesticides was associated with worse average global longitudinal strain (0.8%; SE, 0.2 [P<0.0001]). Exposure to metals was associated with worse global longitudinal strain in the 2‐chamber view (1.0%; SE, 0.5 [P=0.04]), increased stroke volume (3.6 mL; SE, 1.6 [P=0.03]), and increased LV mass indexed to BSA (9.2 g/m2; SE, 3.8 [P=0.01]) or height (4.4 g/m2.7; SE, 1.9 [P=0.02]). Conclusions Occupational exposures to burning wood, vehicle exhaust, pesticides, and metals were associated with abnormal parameters of LV and right ventricular systolic function. Reducing exposures to toxic chemicals and particulates in the workplace is a potential opportunity to prevent cardiovascular disease in populations at risk.

Category: Hispanic/Latino, Occupational Factors and CVD

Date: 2020

Author: Melissa S. Burroughs Peña, Jean Claude Uwamungu, Catherine M. Bulka, Katrina Swett, Krista M. Perreira, Mayank M. Kansal, Matthew Shane Loop, Barry E. Hurwitz, Martha Daviglus, and Carlos J. Rodriguez

Omega-3 fatty acid therapy reduces triglycerides andinterleukin-6 in hypertriglyeridemic HIV patients

Abstract / Description:

Objectives Cardiovascular disease and osteoporosis are common in HIV?infected patients and residual systemic inflammation is thought to contribute to both of these disorders. We performed a randomized placebo?controlled trial of omega?3?acid (O3A) ethyl esters in HIV?infected patients with hypertriglyceridaemia, hypothesizing that O3A would decrease serum levels of triglycerides, markers of systemic inflammation, and markers of bone turnover. Methods HIV?infected patients (n?=?48 recruited at three sites) with CD4 count >200?cells/?L, suppressed viral load, and triglycerides >200?mg/dL were randomized to placebo or 3.6?g/d of O3A. Fasting lipid profiles and markers of inflammation and bone turnover were assessed at baseline and after 8 weeks of treatment. Results Baseline HIV status, lipid profile, bone metabolism and cardiovascular risk factors were similar between the groups. Inflammatory markers were similar between the treatment groups at baseline, except for interleukin (IL)?6 and tumour necrosis factor (TNF)??, which were higher in the O3A group. The concentration of triglycerides in patients receiving O3A decreased by a median (interquartile range (IQR)) of ?34 (?149, 9.5) mg/dL vs. a median increase of 46.5 (?51, 123) mg/dL in the placebo group (P?=?0.01). The median percentage change in IL?6 was greater in the O3A group compared with the placebo group [?39% (?63, 12%) vs. 29% (10, 177%), respectively; P?=?0.006]. Similar results were observed for TNF??, but not other inflammatory or bone turnover markers. Conclusions O3A ethyl esters decreased the concentrations of triglycerides, IL?6 and TNF?? in patients with well?controlled HIV infection and hypertriglyceridaemia. Larger studies are required to confirm these findings and investigate their clinical significance.

Category: General CV

Date: 2013

Author: TS Metkus J Timpone D Leaf M Bidwell Goetz WS Harris TT Brown

One Researcher’s Reflection On Novel Virus Driven Disparities In Black Maternal Healthcare

Abstract / Description:

As a graduate student, Ira Memaj began exploring the health disparities that impact many Black Americans. The Detroit grown researcher’s first project was geared to investigating chemo-resistance in ovarian cancer cells leading her to produce over 16 publications in gynecological oncology including ovarian cancer, adhesions, and fibroids. This then inspired to her work at Wayne State University School of Medicine where she was part of a team that patented an antibody, CD11b, as a possible therapeutic agent for ovarian cancer.

Category: COVID-19 Impact on Minority Health

Date: 2020

Author: Brittany Chambers

One-year postpartum anthropometric outcomes in mothers andchildren in the LIFE-Moms lifestyle intervention clinical trials

Abstract / Description:

Background/objectives: Excess gestational weight gain (GWG) is a risk factor for maternal postpartum weight retention and excessive neonatal adiposity, especially in women with overweight or obesity. Whether lifestyle interventions to reduce excess GWG also reduce 12-month maternal postpartum weight retention and infant weight-for-length†z†score is unknown. Randomized controlled trials from the LIFE-Moms consortium investigated lifestyle interventions that began in pregnancy and tested whether there was benefit through 12 months on maternal postpartum weight retention. Subjects/methods: In LIFE-Moms, women (N?=?1150; 14.1 weeks gestation at enrollment) with overweight or obesity were randomized within each of seven trials to lifestyle intervention or standard care. Conclusion: Compared with standard care, lifestyle interventions initiated in pregnancy and focused on healthy eating, increased physical activity, and other behavioral strategies resulted in significantly less weight retention but similar infant anthropometric outcomes at 12 months postpartum in a large, diverse US population of women with overweight and obesity.

Category: Cardio-Obstetrics

Date: 2019

Author: Suzanne Phelan; Rebecca G. Clifton; Debra Haire-Joshu; Leanne M. Redman; Linda Van Horn; Mary Evans; Kaumudi Joshipura; Kimberly A. Couch; S. Sonia Arteaga; Alison G. Cahill; Kimberly L. Drews; Paul W. Franks; Dympna Gallagher; Jami L. Josefson; Samuel Klein; William C. Knowler; Corby K. Martin; Alan M. Peaceman; Elizabeth A. Thom; Rena R. Wing; Susan Z. Yanovski; Xavier Pi-Sunyer; The LIFE-Moms Research Group

Open My Heart Foundation

Abstract / Description:

Eliminating heart health disparities amongst African American women

Category: Black/African American CV

Opportunities to improve cardiovascular health in the new American workplace

Abstract / Description:

Adult working-class Americans spend on average 50% of their workday awake time at their jobs. The vast majority of these jobs involve mostly physically inactive tasks and frequent exposure to unhealthy food options. Traditionally, the workplace has been a challenging environment for cardiovascular prevention, where cardiovascular guidelines have had limited implementation. Despite the impact that unhealthy lifestyles at the workplace may have on the cardiovascular health of U.S. workers, there is currently no policy in place aimed at improving this. In this review, we discuss recent evidence on the prevalence of physical inactivity among Americans, with a special focus on the time spent at the workplace; and the invaluable opportunity that workplace-based lifestyle interventions may represent for improving the prevention of cardiovascular disease. We describe the current regulatory context, the key stakeholders involved, and present specific, guideline-inspired initiatives to be considered by both Congress and employers to improve the “cardiovascular safety” of US jobs. Additionally, we discuss how the COVID-19 pandemic has forever altered the workplace, and what lessons can be taken from this experience and applied to cardiovascular disease prevention in the new American workplace. For many Americans, long sitting hours at their job represent a risk to their cardiovascular health. We discuss how a paradigm shift in how we approach cardiovascular health, from focusing on leisure time to also focusing on work time, may help curtail the epidemic of cardiovascular disease in this country.

Category: Occupational Factors and CVD

Date: 2020

Author: Eamon Y. Duffy, Pranoti G. Hiremath, Pablo Martinez-Amezcua, Richard Safeer, Jennifer A. Schrack, Michael J. Blaha, Erin D. Michos, Roger S. Blumenthal, Seth S. Martin, Miguel Cainzos-Achirica

Optimism and cardiovascular health among African Americans in the Jackson Heart Study

Abstract / Description:

Little research has examined associations of positive psychosocial factors with the American Heart Association Life's Simple 7ô (LS7) among African Americans. This study examined the associations between positive optimistic orientation and LS7 among African Americans. Using exam 1 data (2000ñ2004) from the Jackson Heart Study, we examined cross-sectional associations of optimism (in tertiles) with LS7 components [smoking, physical activity, diet, body mass index, blood pressure, cholesterol, glucose] and a composite LS7 score (classified as poor, intermediate, ideal) among 4734 African Americans free of cardiovascular disease. Multivariable prevalence regression was used to estimate prevalence ratios (PR, 95% confidence interval-CI) of intermediate and ideal (vs. poor) individual LS7 components and composite LS7 score by optimism levels, adjusting for demographics, socioeconomic status, and depressive symptoms. For LS7 components with low prevalence, we estimated odds ratios. A greater percentage of participants with high vs. low optimism were younger, female, high SES, and not depressed. After full covariate adjustment, the prevalence ratio of ideal (vs. poor) composite LS7 score was 1.24 for participants who reported high (vs. low) optimism (95% CI 1.09ñ1.42) at exam 1. Higher levels of optimism were also associated with greater prevalence of ideal (vs. poor) physical activity and smoking. Promoting positive optimistic orientation may be an important step toward increasing the likelihood of achieving optimal cardiovascular health among African Americans.

Category: Black/African American CV

Date: 2019

Author: Author links open overlay panelMarioSimsaL·Shaunt· M.GloverabArnita F.NorwoodaChristinaJordanaYuan-IMinaLaPrincess C.BrewercLaura D.Kubzanskyd

Optimism and Life Satisfaction as Determinants for Dental and General Health BehavioróOral Health Habits Linked to Cardiovascular Risk Factors

Abstract / Description:

Abstract Oral infections and cardiovascular diseases share common biological and behavioral risk factors. Psychosocial determinants could act as a link between general health behavior and dental health behavior. Our objective was to study optimism and life satisfaction as determinants of general and dental health behavior and to evaluate whether these are connected with cardiovascular risk factors and dental diseases. The 1966 Northern Finland Birth Cohort (N = 12,058) is a general population birth cohort. In a postal questionnaire, respondents (N = 8690) were asked about their health behavior and dental status. Cardiovascular risk factors were assessed in health examinations (N = 6033). Generalized linear regression models were used in analysis. The results showed that health orientation increases with strengthening life satisfaction and optimism. Dental health behavior and general health behavior were associated with both cardiovascular risk factors and self-reported dental diseases, which support the assumption that they share a common behavioral background. Keywords cardiovascular risk factors, optimism, life satisfaction, young adults, cohort study

Abstract / Description:

People living with HIV face a higher risk of developing diseases of the heart and blood vessels compared to people without the disease. Seventy-five percent of people living with HIV are over age 45 and face significant health challenges at earlier ages than people who donít have HIV.

Category: General CV

Date: 2019

Author: American Heart Association

Q

Race/Ethnic Differences in Atherosclerotic Cardiovascular Disease Risk Factors Among Patients with Hypertension: Analysis from 143 primary care clinics

Abstract / Description:

While it is known that sex and race/ethnic disparities persist for atherosclerotic cardiovascular disease (ASCVD), disparities in risk factor control have not been well-described in primary care where ASCVD can be prevented.

Category: General CV

Date: 2021

Author: Rasha Khatib, Nicole Glowacki, Julie Lauffenburger, Alvia Siddiqi

S

Screening for High Lipoprotein(a)The Time Is Now

Abstract / Description:

In 1994, the landmark 4S trial (Scandinavian Simvastatin Survival Study) reported that lowering low-density lipoprotein (LDL) cholesterol with simvastatin reduced cardiovascular events in patients with coronary artery disease and hypercholesterolemia.1 This seminal trial crystallized our understanding of the causal role of LDL cholesterol in atherosclerosis and launched the modern era of preventive cardiology. Today, the evidence in favor of LDL cholesterol as a modifiable causal driver of atherosclerosis has never been stronger, and current therapies, such as PCSK9 inhibitors (PCSK9i), can now lower LDL cholesterol to levels never previously seen. But despite achieving very low levels of LDL cholesterol, many patients continue to have recurrent events. Although the residual risk for cardiovascular events is likely multifactorial, in certain patients a key component is a high residual burden of atherogenic lipid particles attributable to high lipoprotein(a) [Lp(a)].

Category: General CV

Date: 2019

Author: George Thanassoulis

Seth Baum, MD, Discusses Cardio Health

Abstract / Description:

N/A

Category: General CV

Date: 2018

Author: Alliance for Patient Access

Abstract / Description:

Importance Sex differences in heart failure with preserved ejection fraction (HFpEF) have been established, but insights into the mechanistic drivers of these differences are limited. Objective To examine sex differences in cardiometabolic profiles and exercise hemodynamic profiles among individuals with HFpEF. Design, Setting, and Participants This cross-sectional study was conducted at a single-center tertiary care referral hospital from December 2006 to June 2017 and included 295 participants who met hemodynamic criteria for HFpEF based on invasive cardiopulmonary exercise testing results. We examined sex differences in distinct components of oxygen transport and utilization during exercise using linear and logistic regression models. The data were analyzed from June 2018 to May 2019. Main Outcomes and Measures Resting and exercise gas exchange and hemodynamic parameters obtained during cardiopulmonary exercise testing. Results Of 295 participants, 121 (41.0%) were men (mean [SD] age, 64 [12] years) and 174 (59.0%) were women (mean [SD] age, 61 [13] years). Compared with men, women with HFpEF in this tertiary referral cohort had fewer comorbidities, including diabetes, insulin resistance, and hypertension, and a more favorable adipokine profile. Exercise capacity was similar in men and women (percent predicted peak oxygen [O2] consumption: 66% in women vs 68% in men; P?=?.38), but women had distinct deficits in components of the O2 pathway, including worse biventricular systolic reserve (multivariable-adjusted analyses: ?LVEF ??=??1.70; SE, 0.86; P?.05; ?RVEF ??=??2.39, SE=0.80; P?=?.003), diastolic reserve (PCWP/CO: ??=?0.63; SE, 0.31; P?=?.04), and peripheral O2 extraction (C(a-v)O2 ?=-0.90, SE=0.22; P?.001)). Conclusions and Relevance Despite a lower burden of cardiometabolic disease and a similar percent predicted exercise capacity, women with HFpEF demonstrated greater cardiac and extracardiac deficits, including systolic reserve, diastolic reserve, and peripheral O2 extraction. These sex differences in cardiac and skeletal muscle responses to exercise may illuminate the pathophysiology underlying the development of HFpEF and should be investigated further.

Category: General CV

Date: 2019

Author: Emily S. Lau, MD1; Thomas Cunningham, BA1; Kathryn M. Hardin, BA1; et al

Sex Differences in Cardiovascular Effectiveness of Newer Glucose? Lowering Drugs Added to Metformin in Type 2 Diabetes Mellitus

Abstract / Description:

Background Randomized controlled trials showed that newer glucose?lowering agents are cardioprotective, but most participants were men. It is unknown whether benefits are similar in women. Methods and Results Among adults with type 2 diabetes mellitus not controlled with metformin with no prior use of insulin, we assessed for sex differences in the cardiovascular effectiveness and safety of sodium?glucose?like transport?2 inhibitors (SGLT?2i), glucagon?like peptide?1 receptor agonists (GLP?1RA), dipeptidyl peptidase?4 inhibitors, initiated as second?line agents relative to sulfonylureas (reference?group). We studied type 2 diabetes mellitus American adults with newly dispensed sulfonylureas, SGLT?2i, GLP?1RA, or dipeptidyl peptidase?4 inhibitors (Marketscan?Database: 2011ñ2017). We used multivariable Cox proportional hazards models with time?varying exposure to compare time to first nonfatal cardiovascular event (myocardial infarction/unstable angina, stroke, and heart failure), and safety outcomes between drugs users, and tested for sexñdrug interactions. Among 167 254 type 2 diabetes mellitus metformin users (46% women, median age 59 years, at low cardiovascular risk), during a median 4.5?year follow?up, cardiovascular events incidence was lower in women than men (14.7 versus 16.7 per 1000?person?year). Compared with sulfonylureas, hazard ratios (HRs) for cardiovascular events were lower with GLP?1RA (adjusted HR?women: 0.57, 95% CI: 0.48ñ0.68; aHR?men: 0.82, 0.71ñ0.95), dipeptidyl peptidase?4 inhibitors (aHR?women: 0.83, 0.77ñ0.89; aHR?men: 0.85, 0.79ñ0.91) and SGLT?2i (aHR?women: 0.58, 0.46ñ0.74; aHR?men: 0.69, 0.57ñ0.83). A sex?by?drug interaction was statistically significant only for GLP?1RA (P=0.002), suggesting greater cardiovascular effectiveness in women. Compared with sulfonylureas, risks of adverse events were similarly lower in both sexes for GLP?1RA (aHR?women: 0.81, 0.73ñ0.89; aHR?men: 0.80, 0.71ñ0.89), dipeptidyl peptidase?4 inhibitors (aHR?women: 0.82, 0.78ñ0.87; aHR?men: 0.83, 0.78ñ0.87) and SGLT?2i (aHR?women: 0.68, 0.59ñ0.78; aHR?men: 0.67, 0.59ñ0.78) (all sexñdrug interactions for adverse events P>0.05). Conclusions Newer glucose?lowering drugs were associated with lower risk of cardiovascular events than sulfonylureas, with greater effectiveness of GLP?1RA in women than men. Overall, they appeared safe, with a better safety profile for SGLT?2i than for GLP?1RA regardless of sex.

Abstract / Description:

Background We evaluated the risk of cardiac death in patients with prior cancer diagnoses and compared risk by cancer type and ethnicity in a large US population. Method Utilizing the Surveillance, Epidemiology, and End Results database, data on patients with a cancer diagnosis between 2000 and 2014 were obtained. We calculated the standardized mortality ratio (SMR) of cardiac death after a cancer diagnosis and the excess risk per 10,000 person-years. We stratified the analysis according to the time interval between cancer and cardiac events, cancer site, cancer stage, and race. Results A total of 4,671,989 patients with a cancer diagnosis were included, of which 163,255 died due to cardiac causes within 10 years of diagnosis. We found a significantly higher rate of cardiac death for cancer patients [SMR=1.16, 95% confidence interval (CI) 1.15ñ1.16] compared to the general population. When observed for each cancer site, the highest SMR was after a diagnosis of hepatocellular carcinoma (SMR=2.58, 95% CI 2.45ñ2.72), pancreatic cancer (SMR=2.36, 95% CI 2.25ñ2.47), and lung cancer (SMR=2.30, 95% CI 2.27ñ2.34). Patients with metastatic disease had a higher rate of cardiac death (SMR=2.16, 95% CI 2.13ñ2.19). When stratified by ethnicity, SMR for cardiac death was 1.76, 2.28, 3.68, 2.65, and 1.84 for whites, blacks, American Indians/Alaska Natives, Asians/Pacific Islanders, and Hispanics, respectively. Conclusions Cancer patients are more vulnerable to cardiac death than the general population, especially those with nonwhite ethnicity; liver, lung, and pancreatic cancers; and history of metastasis. Healthcare providers should be aware of this risk and pay particular attention to the highest-risk groups.

Abstract / Description:

ATLANTA ó Despite the improvements that have been made in cholesterol reduction, more efforts are needed to improve usage rates of cholesterol-lowering medications in patients, including those with familial hypercholesterolemia, according to a presentation at the FH Foundationís FH Global Summit. Rear Admiral Betsy L. Thompson, MD, MSPH, DrPH, assistant surgeon of the U.S. Public Health Service and director of the division for heart disease and stroke prevention at the National Center for Chronic Disease Prevention and Health Promotion at the CDC, said the division has several goals: reduce the risk for hypertension and hypercholesterolemia, improve management and control of hypertension and hypercholesterolemia and to reduce the burden of stroke and heart disease.

Abstract / Description:

Introduction: Despite its preventability, cardiovascular disease remains a leading cause of morbidity, mortality, and health care costs in the United States. This study describes the burden, in 2016, of nonfatal and fatal cardiovascular events targeted for prevention by Million Hearts 2022, a national initiative working to prevent one million cardiovascular events during 2017ñ2021. Methods: Emergency department (ED) visits and hospitalizations were identified using Healthcare Cost and Utilization Project databases, and deaths were identified using National Vital Statistics System data. Age-standardized Million Heartsñpreventable event rates and hospitalization costs among adults aged ?18 years in 2016 are described nationally and across states, as data permit. Expected 2017ñ2021 event totals and hospitalization costs were estimated assuming 2016 values remain unchanged. Results: Nationally, in 2016, 2.2 million hospitalizations (850.9 per 100,000 population) resulting in $32.7 billion in costs, and 415,480 deaths (157.4 per 100,000) occurred. Hospitalization and mortality rates were highest among men (989.6 and 172.3 per 100,000, respectively) and non-Hispanic blacks (211.6 per 100,000, mortality only) and increased with age. However, 805,000 hospitalizations and 75,245 deaths occurred among adults aged 18ñ64 years. State-level variation occurred in rates of ED visits (from 56.4 [Connecticut] to 274.8 per 100,000 [Kentucky]), hospitalizations (484.0 [Wyoming] to 1670.3 per 100,000 [DC]), and mortality (111.2 [Vermont] to 267.3 per 100,000 [Mississippi]). Approximately 16.3 million events and $173.7 billion in hospitalization costs could occur during 2017ñ2021 without preventive intervention. Conclusions and Implications for Public Health Practice: Million Heartsñpreventable events place a considerable health and economic burden on the United States. With coordinated efforts, many of these events could be prevented in every state to achieve the initiativeís goal.

Infographic

Category: General CV

Author: American College of Cardiology

Weekday and weekend sleep duration and mortality amongmiddle-to-older aged White and Black adults in a low-income southernUS cohort

Abstract / Description:

Introduction Both short and long sleep have been associated with higher mortality. However, most studies are conducted in predominantly White or Asian populations and little is known about the sleep-mortality relationship in Blacks. Given the high prevalence of short and long sleep in Blacks, it is important to examine the health effects of sleep in this population. Methods We studied sleep duration in relation to all-cause, cardiovascular and cancer mortality in 55,375 participants age 40ñ79 at enrollment in the Southern Community Cohort Study, of whom ?2/3 are Black. Weekday and weekend sleep durations were self-reported. Mortality follow up started at baseline (2002ñ2009) and was regularly updated until 2015 via linkage to Social Security Administration and the National Death Index. We used Cox proportional hazards model adjusting for multiple covariates to estimate relative risks associated with sleep duration. Results We found U-shaped relationships between weekday and weekend sleep duration and all-cause mortality, with the effects stronger in Whites than Blacks. Risks for all-cause mortality were significantly elevated by about 25% among Whites and about 10% among Blacks reporting either less than 5 hours or more than 9 hours of sleep compared with those reporting 8 hours of sleep. The associations among Whites but not Blacks were even stronger for cardiovascular disease mortality, whereas no association between sleep duration and cancer mortality was found in either group. Conclusions Our results suggest that short and long sleep durations may be weaker predictors of total and cardiovascular mortality in Blacks than in Whites.

Category: Black/African American CV

Date: 2019

Author: Qian Xiao, PhDa,b,*,WilliamJ.Blot,PhDc, Charles E. Matthews, PhDd

What Experts Say About Narrowing COVID-19 Racial Disparities

Abstract / Description:

As the coronavirus pandemic spread across the United States, it has disproportionately struck communities of color, particularly African Americans. As a recent ProPublica Illinois article revealed, of the first 100 recorded deaths from the coronavirus in Chicago, 70 of the victims were African American.

Category: COVID-19 Impact on Minority Health

Date: 2020

Author: ProPublica

What happens during a heart attack? - Krishna Sudhir

Abstract / Description:

Approximately seven million people around the world die from heart attacks every year. And cardiovascular disease, which causes heart attacks and other problems like strokes, is the worldís leading killer. So what causes a heart attack? Krishna Sudhir examines the leading causes and treatments of this deadly disease.

Category: General CV

Date: 2017

Author: Krishna Sudhir

Abstract / Description:

Abstract Objective: To quantify the impact of cardiovascular disease and its subtypes on the premature mortality of Hispanics in the United States. Methods: We used national death records to identify deaths for the three largest Hispanic subgroups (Mexicans, Puerto Ricans, and Cubans) in the United States from 2003 to 2012 (N = 832,550). We identified all deaths from cardiovascular disease and by subtype (ie, ischemic, cerebrovascular, hypertensive and heart failure) using the underlying cause of death via ICD-10 codes. Years of potential life lost (YPLL) was calculated by age categories standardizing with the 2000 US Census population. Population estimates were calculated using linear interpolation from 2000 and 2010 US Census data. Results: After standardization, Puerto Ricans experienced the highest YPLL for all types of cardiovascular disease compared with Mexicans and Cubans (1,139 years per 100,000 compared with 868 and 841, respectively), a disparity that remained consistent over the course of a decade. Among different subcategories of cardiovascular disease, Puerto Ricans had the highest YPLL for ischemic and hypertensive heart disease, while Mexicans had the highest YPLL from cerebrovascular disease. Conclusions: In conclusion, disaggregation of Hispanic subgroups revealed marked heterogeneity in premature cardiovascular mortality. These findings suggest that measures to improve the cardiovascular health of Hispanics should incorporate subgroup status as a key part of public health strategy

Category: Hispanic/Latino

Date: 2019

Author: Lakshman Manjunath, Jiaqi Hu, Latha Palaniappan, Fatima Rodriguez

Yet Another Reason to Take Statins?

Abstract / Description:

Statin use among patients with ovarian cancer was associated with a large reduction in cancer-specific mortality, an observational study of Finnish women found. Among over 10,000 epithelial ovarian cancer patients, those that used any type of statin had a 40% reduction in ovarian cancer mortality compared with never-users (HR 0.60, 95% CI 0.54-0.66) and a 37% reduction in 5-year mortality (HR 0.63, 95% CI 0.56-0.70), reported Kala Visvanathan, MD, MHS, of Johns Hopkins Medicine in Baltimore.

Category: General CV

Date: 2020

Author: Ian Ingram

You Can't Rely On Symptoms When It Comes to High Blood Pressure

Abstract / Description:

There are many ways to measure health, but one stands out as a key to longevity and wellness: blood pressure. While it might seem like a trivial part of your yearly check-ups, the truth is that monitoring blood pressure gives you a quick and clear indicator of how your heart is doing. First, the basics: Blood pressure is just a measurement of the pressure it takes for your heart to pump blood through your body. The biggest concern for most people, especially as they age, is high blood pressure. Also known as hypertension, high blood pressure is when the pressure stays high over significant time, according to the Centers for Disease Control (CDC). High blood pressure can lead to a whole host of issues in the long term. Namely, it contributes to the leading causes of death in the US: heart disease and stroke.

Category: General CV

Date: 2019

Author: COLLEEN STINCHCOMBE

i

iAlegrate!îóA culturally adapted positive psychological intervention forHispanics/Latinos with hypertension: Rationale, design, and methods

Abstract / Description:

Growing evidence links psychological well-being (e.g., optimism) with superior cardiac health, but there remains a critical scientific gap as we do not know whether (or how) interventions to cultivate emotional well-being may reduce cardiac risk. Hispanics/Latinos in the U.S. have high cardiovascular disease risk and poorly controlled blood pressure (BP) compared to peers of European ancestry, and represent a population in need of new and innovative therapeutic approaches. This paper details the ì°AlÈgrate!î study, a cluster-randomized Phase II trial testing efficacy in improving BP of a culturally tailored positive psychological intervention designed to boost emotional well-being in Hispanics/Latinos with hypertension. A total of 126 Hispanics/Latinos aged ?18 years, fluent in English or Spanish, and with elevated sitting BP (?140/90?mmHg) will participate in one of two trial arms: (1) a positive psychological intervention, or (2) a wait-list control condition. The ì°AlÈgrate!î group-based intervention consists of 8 weekly 90ñ120-min sessions delivered in-person by a psychologist/social worker. Targeted skills include noting daily positive events, positive reappraisal of stressful events, effective expression of gratitude, performing acts of kindness, and regular practice of mindfulness and meditation, among others. The primary outcome is improvement in BP, both sitting values and 24-h ambulatory readings, as measured at baseline and 8- and 12-weeks post-baseline. Secondary outcomes include emotional well-being, engagement in healthful behaviors, and circulating levels of inflammatory markers. We hypothesize that BP control, psychological well-being, healthful behaviors, and chronic inflammation will be significantly better in the ì°AlÈgrate!î arm at follow up compared to the wait-list control group.

Category: Hispanic/Latino

Date: 2019

Author: Rosalba Hernandeza,?, Martha L. Daviglusb,c, Lizet Martineza, Ramon A. Durazo-Arvizub,d,JeffC. Huffmane, Ferney Ramirezf, Lisett Titoa, Judith T. Moskowitz

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ìAlways on the goî: A qualitative study of the perceptions ofcardiovascular disease risk among Latino cab drivers

Abstract / Description:

Background:The taxicab industry is a burgeoning occupation that predominantlyemploys immigrant males from low socioeconomic backgrounds. Factors such assedentary nature, environmental factors, high stress coupled with socioeconomicfactors may increase cardiovascular disease risk among taxicab drivers. Latinos, agrowing immigrant population make up approximately 20% of this industry. However,few studies focus on their experiences as cab drivers or on the factors that mayincrease their cardiovascular risks.Methods:This was an ethnographic qualitative study. Data was collected viaindividual interviews combined with Go?Alongs. The Go?Along is an observationalqualitative method whereby researchers accompany participants during routineactivities and make observations. Interviews and observations were transcribed andcoded to identify emerging themes.Results:Thirty?two Latino male cab drivers participated; their mean age was 45 + 12years; 47% did not finish high school; and 63% earned $30 000 or less. Time andstress emerged as dominant themes. Time constraints posed a barrier to healthyeating and physical activity. Drivers reported stress from constantly worrying abouttheir finances and personal safety. Drivers also described stress from the physical tollof driving on the body. Go?Alongs supported these themes and identified socialinteractions and environmental factors that could be leveraged for health promotion.Conclusions:This study provided an opportunity for cab drivers to describe theirperspectives on reasons why their occupation was associated with a high risk forcardiovascular disease. The Go?Alongs contributed to the understanding of the socialand environmental context that characterized cardiovascular risks in this occupation.KEYWORDScardiovascular disease risks, Go?Alongs, immigrant health, Latino health, minority menís health,qualitative study, taxicab drivers

Category: Hispanic/Latino

Date: 2019

ìAre you accepting new patients?î A pilot field experiment on telephone?based gatekeeping and Black patientsí access to pediatric care

Abstract / Description:

Study Objectives To determine whether name and accent cues that the caller is Black shape physician officesí responses to telephone?based requests for well?child visits. Method and Data In this pilot study, we employed a quasi?experimental audit design and examined a stratified national sample of pediatric and family practice offices. Our final data include information from 205 audits (410 completed phone calls). Qualitative data were blind?coded into binary variables. Our case?control comparisons using McNemar's tests focused on acceptance of patients, withholding information, shaping conversations, and misattributions. Findings Compared to the control group, ìBlackî auditors were less likely to be told an office was accepting new patients and were more likely to experience both withholding behaviors and misattributions about public insurance. The strength of associations varied according to whether the cue was based on name or accent. Additionally, the likelihood and ways office personnel communicated that they were not accepting patients varied by region. Conclusions Linguistic profiling over the telephone is an aspect of structural racism that should be further studied and perhaps integrated into efforts to promote equitable access to care. Future research should look reactions to both name and accent, taking practice characteristics and regional differences into consideration.

Category: Black/African American CV

Date: 2018

Author: Tamara G.J. Leech, PhD,corresponding author 1 Amy Irby?Shasanmi, PhD, 2 and Anne L. Mitchell, MA 3

ìiAlegrate!îóA culturally adapted positive psychological intervention for Hispanics/Latinos with hypertension: Rationale, design, and methods

Abstract / Description:

Growing evidence links psychological well-being (e.g., optimism) with superior cardiac health, but there remains a critical scientific gap as we do not know whether (or how) interventions to cultivate emotional well-being may reduce cardiac risk. Hispanics/Latinos in the U.S. have high cardiovascular disease risk and poorly controlled blood pressure (BP) compared to peers of European ancestry, and represent a population in need of new and innovative therapeutic approaches. This paper details the ì°AlÈgrate!î study, a cluster-randomized Phase II trial testing efficacy in improving BP of a culturally tailored positive psychological intervention designed to boost emotional well-being in Hispanics/Latinos with hypertension. A total of 126 Hispanics/Latinos aged ?18 years, fluent in English or Spanish, and with elevated sitting BP (?140/90?mmHg) will participate in one of two trial arms: (1) a positive psychological intervention, or (2) a wait-list control condition. The ì°AlÈgrate!î group-based intervention consists of 8 weekly 90ñ120-min sessions delivered in-person by a psychologist/social worker. Targeted skills include noting daily positive events, positive reappraisal of stressful events, effective expression of gratitude, performing acts of kindness, and regular practice of mindfulness and meditation, among others. The primary outcome is improvement in BP, both sitting values and 24-h ambulatory readings, as measured at baseline and 8- and 12-weeks post-baseline. Secondary outcomes include emotional well-being, engagement in healthful behaviors, and circulating levels of inflammatory markers. We hypothesize that BP control, psychological well-being, healthful behaviors, and chronic inflammation will be significantly better in the ì°AlÈgrate!î arm at follow up compared to the wait-list control group. Keywords: Positive psychology, Hispanic/Latino, Cardiovascular disease risk, Hypertension, Cultural adaptation, Clinical trial, Cluster randomization

Category: Hispanic/Latino

Date: 2019

Author: Rosalba Hernandez,a,? Martha L. Daviglus,b,c Lizet Martinez,a Ramon A. Durazo-Arvizu,b,d Jeff C. Huffman,e Ferney Ramirez,f Lisett Tito,a and Judith T. Moskowitzg

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‘Essential’ and unsafe: Frontline workers of color face compounded risks

Abstract / Description:

As legions of Philadelphians have been laid off or forced to work from their living rooms, Ashley Jimenez, the director of case management at two homeless shelters, has kept coming into work. She worries constantly about her clients, even more than usual. They are disproportionately elderly and afflicted with immune-compromising illnesses like HIV/AIDS. “This is a population who are … more susceptible to the COVID-19,” said Jimenez. “When I walk in those doors every day, I’m thinking, and it kind of goes two ways: How susceptible am I to them? And how susceptible are they to me?”

Category: COVID-19 Impact on Minority Health

Date: 2020

Author: Nina Feldman, Jake Blumgart

‘Those numbers take your breath away’: Covid-19 is hitting Chicago’s black neighborhoods much harder than others, officials say

Abstract / Description:

Decades of inequality and institutional racism affecting black communities is becoming evident in covid-19 data, Chicago officials said Monday, as Mayor Lori Lightfoot sounded the alarm over significant racial disparities in deaths and coronavirus cases across the city. In Chicago, black Americans account for 68 percent of the cityís 118 deaths and 52 percent of the roughly 5,000 confirmed coronavirus cases, despite making up just 30 percent of the cityís population, according to data from the Chicago Department of Public Health.

Category: COVID-19 Impact on Minority Health

Date: 2020

Author: Meagan Flynn

‘We’re flying blind’: African Americans may be bearing the brunt of Covid-19, but access to data is limited

Abstract / Description:

Stark statistics are coming to light only now and only in piecemeal fashion showing that African Americans are disproportionately affected by Covid-19. The racial divide in who gets infected, who gets tested, and who dies from Covid-19 is emerging from the few cities and states whose data are public.

Category: COVID-19 Impact on Minority Health

Date: 2020

Author: ELIZABETH COONEY

Year: 2020

“Future Patient” Telerehabilitation for Patients With Heart Failure: Protocol for a Randomized Controlled Trial

Abstract / Description:

BACKGROUND: Cardiovascular disease is the leading cause of mortality worldwide, accounting for 13%-15% of all deaths. Cardiac rehabilitation has poor compliance and adherence. Telerehabilitation has been introduced to increase patients' participation, access, and adherence with the help of digital technologies. The target group is patients with heart failure. A telerehabilitation program called "Future Patient" has been developed and consists of three phases: (1) titration of medicine (0-3 months), (2) implementation of the telerehabilitation protocols (3 months), and (3) follow-up with rehabilitation in everyday life (6 months). Patients in the Future Patient program measure their blood pressure, pulse, weight, number of steps taken, sleep, and respiration and answer questions online regarding their well-being. All data are transmitted and accessed in the HeartPortal by patients and health care professionals. OBJECTIVE: The aim of this paper is to describe the research design, outcome measures, and data collection techniques in the clinical test of the Future Patient Telerehabilitation Program for patients with heart failure. METHODS: A randomized controlled study will be performed. The intervention group will follow the Future Patient Telerehabilitation program, and the control group will follow the traditional cardiac rehabilitation program. The primary outcome is quality of life measured by the Kansas City Cardiomyopathy Questionnaire. Secondary outcomes are development of clinical data; illness perception; motivation; anxiety and depression; health and electronic health literacy; qualitative exploration of patients', spouses', and health care professionals' experiences of participating in the telerehabilitation program; and a health economy evaluation of the program. Outcomes were assessed using questionnaires and through the data generated by digital technologies. RESULTS: Data collection began in December 2016 and will be completed in October 2019. The study results will be published in peer-reviewed journals and presented at international conferences. Results from the Future Patient Telerehabilitation program are expected to be published by the spring of 2020. CONCLUSIONS: The expected outcomes are increased quality of life, increased motivation and illness perception, reduced anxiety and depressions, improved electronic health literacy, and health economics benefits. We expect the study to have a clinical impact for future telerehabilitation of patients with heart failure.

Category: Telehealth

Date: 2019

Author: Birthe Dinesen1, MSc, PhD ; Lars Dittmann2, MSc, PhD ; Josefine Dam Gade, MSc ; Cecilia Klitgaard Jørgensen, MSc ; Malene Hollingdal, MD, PhD ; Soeren Leth, MSc ; Camilla Melholt, MSc ; Helle Spindler, MSc, PhD ; Jens Refsgaard, MD, PhD

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