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Dyslipidemia
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Susan Halli-Demeter, Lynne T. Braun
Studies show that diets high in plant-based foods such as fruits, nuts, and whole grains are associated with a reduced risk of coronary artery disease and stroke due to being rich in mono- and polyunsaturated fatty acids, n-3 fatty acids, antioxidant vitamins, minerals, phytochemicals, fiber, and plant protein (Hu, 2003; Patel et al., 2017). Esselstyn and colleagues found that patients with established cardiovascular disease who followed a plant based diet for 3.7 years had significantly low rates of cardiovascular events compared to those nonadherent to the diet plan (Esselstyn et al., 2014). Data from the Atherosclerosis Risk in Communities (ARIC) study had similar findings with a 19% and 11% lower risk of cardiovascular disease mortality and all-cause mortality in those more adherent to a healthy plant-based diet (H. Kim et al., 2019). Less healthy plant-based foods such as juices, sweetened beverages, refined grains, potatoes/fries, and sweets were associated with higher heart disease risk (Satija et al., 2017). One study compared a low carbohydrate, high vegetable protein diet to a high carbohydrate lacto-ovo vegetarian diet and found similar weight loss with both diets but greater reductions with LDL-C, total cholesterol, HDL-C, and apolipoprotein B-apolipoprotein A1 ratios in the low carbohydrate group (Jenkins et al., 2009).
Successful Aging in Research
Published in Thomas S. Inui, Richard M. Frankel, Enhancing the Professional Culture of Academic Health Science Centers, 2022
Bruce M. Psaty, David S. Siscovick
The new CHS investigators participated in working groups related to their research interests. Working groups formed at the workshops, such as the Vascular Disease of the Brain Working Group, have continued to meet on a regular basis and provide opportunities for the advancement of the careers of new investigators. For some of the new CHS investigators, the workshop follow-up with the working group model provided mentorship, collaboration, and data resources not present at their local institutions. The CHS New Investigator Workshops have been so successful that the NHLBI has adopted this model for involving new investigators in other cohorts, as reflected by the summer 2008 session, which focused on CARDIA, MESA, and Framingham and the summer 2010 session, which focused on the Atherosclerosis Risk in Communities (ARIC) Study and the Women’s Health Initiative (WHI).
Patient risk assessment: Use of risk calculators
Published in John Edward Boland, David W. M. Muller, Interventional Cardiology and Cardiac Catheterisation, 2019
The Framingham heart study, while critical in developing our understanding of cardiovascular disease and establishing risk, was derived from a fairly homogenous cohort, which has been criticised for lack of diversity of the population included (e.g. no races other than white). Many guidelines have therefore looked to other scores derived from other cohorts.6 This includes the Atherosclerosis Risk in Communities (ARIC) study, which was a prospective study, held in four communities across an ethnic mix from 1897.7 The population included, and therefore assessable by this score, is the age group 45–65 with no history of cardiovascular disease. The ARIC score is a 10-year risk predictor, using gender, race (black or white), smoking status, age, total cholesterol, HDL cholesterol, SBP, hypertension medication and diabetes to calculate cardiovascular risk.
Establishing biological variation for plasma D-dimer from 25 healthy individuals
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Şerif Ercan, Müjgan Ercan Karadağ
Apart from the study cited in the 2014 database [4], only two studies have estimated the BV of D-dimer in healthy or diseased populations. One of these studies was carried out in 1995 by Atherosclerosis Risk in Communities study group in adults from U.S. communities [23]. They collected blood samples three times from 39 healthy volunteers, with a 1or 2-week interval between each sampling. For D-dimer, CVI was reported to be 17.4%, which is lower than that estimated in our study. However, BV data are not given with CI, making direct comparison difficult. The other study by Engelberger et al. [24] assessed BV of biomarkers relevant to atherosclerosis, including D-dimer, by comparing the results obtained from blood samples drawn at baseline visit and three follow-up visits at 3, 6, and 12 months. When comparing the CVI (25.2%, 95%CI: 20.2 to 30.5) and CVG (30.6%, 95%CI: 19.2 to 42.9) estimates from the study by Engelberger et al. [24] with those in our study, CIs was observed to be overlapping. However, the authors have not taken into account CVA for estimation of CVI estimate, and in addition to this, the sampling interval is very different between the two studies. Hence, the comparison of BV estimates from the two studies is not reasonable.
Right Ventricular-Pulmonary Arterial Coupling and Outcomes in Heart Failure and Valvular Heart Disease
Published in Structural Heart, 2021
Bahira Shahim, Rebecca T. Hahn
A summary of the prognostic impact of measures of RV-PA coupling and clinical outcomes are provided in Table 346,50–81 RV dysfunction has a major prognostic impact in left‐sided HF, whether in the presence of preserved ejection fraction (HFpEF) or reduced ejection fraction (HFrEF). In the Atherosclerosis Risk in Communities (ARIC) study,50 RV function quantified as RVEF and RVLS and RV-PA coupling by means of RVEF/PASP ratio, declined progressively across ACCF/AHA HF stages. RVEF/PASP was linearly associated with increased risk of incident HF or death independent of LV ejection fraction (LVEF), natriuretic peptides, and measures of LV filling pressure. Another study of 1663 patients who were categorized by LVEF <40% (HFrEF), LVEF 40–49% (HFmrEF), and LVEF ≥50% (HFpEF), TAPSE/PASP <0.36 mm/mmHg was a powerful predictor of mortality regardless of the extent of LV dysfunction.55 The correlates of RV dysfunction differed in HFrEF, HFmrEF, and HFpEF. Atrial fibrillation, high heart rate, ischemic etiology, and E‐wave deceleration time <140 ms were associated with a reduced TAPSE in HFrEF patients, whereas PASP >40 mmHg was the strongest correlate of a reduced TAPSE in HFpEF and HFmrEF patients. Conversely, Bosch et al. found both TAPSE/PASP (cutoff 0.48) and RVLS/PASP (cut‐off −0.56) strongly related to the composite endpoint of death and HFH in adjusted analysis without any difference between HFrEF and HFpEF.52
The prevalence and prognostic significance of interatrial block in the general population
Published in Annals of Medicine, 2020
Tiia Istolahti, Antti Eranti, Heini Huhtala, Leo-Pekka Lyytikäinen, Mika Kähönen, Terho Lehtimäki, Markku Eskola, Ismo Anttila, Antti Jula, Antoni Bayés de Luna, Kjell Nikus, Jussi Hernesniemi
In the Atherosclerosis Risk in Communities (ARIC) study of 45 to 64 year old male and female subjects (mean age 54 years (±5.8 y)) 0.5% had advanced IAB at baseline [4]. Similar prevalence was found in the Copenhagen ECG study of 152,759 individuals aged 50 to 90 years [5]. In the geriatric population of Ariyarajah et al. [18] the prevalence of advanced IAB was around 6% and the prevalence was even higher in 80 subjects older than 100 years in a study of Martínez-Sellés et al. [10]. They found advanced IAB in 26% and partial IAB in 20%, but they did not exclude participants with pre-existing AF (25%). In the Copenhagen ECG study, subjects with advanced IAB were much older than those without IAB, but there was only a two-year age difference between those with partial IAB and no IAB. We made similar observations: subjects with advanced IAB were more than 16 years older than those without IAB, but the difference between subjects with partial IAB and no IAB was only four years. As atrial fibrosis is considered important in IAB, it is logical that age is a contributing factor in conduction disease development. The mean age in our study (52.2 years (SD 14.6)) was close to the mean age in the ARIC-study, but we noticed a slightly higher prevalence of advanced IAB (1.0%). The difference is likely explained by the different definition of advanced IAB; we included also ECGs with two biphasic inferior leads.