The Emergence of the Coronary Heart Disease Pandemic in the United States, 1910-1935
William G. Rothstein in The Coronary Heart Disease Pandemic in the Twentieth Century, 2017
Coronary heart disease changed from an unimportant cause of death in the early twentieth century to become a major cause of death in the 1930s. The new pandemic coronary heart disease was strikingly different from the normal disease. It produced much higher mortality rates in all adult age, sex, and race groups. Enumerations of the increases in mortality rates from coronary heart disease for all age groups during the early twentieth century pose several problems. They include the revisions in disease categories as well as the lack of availability of federal government vital statistics for the total population and individual population groups. An analysis of the increase in coronary heart disease mortality rates in the 1930s requires the use of two disease categories: the original "angina pectoris" category plus the additional new diagnostic category introduced in 1930, "diseases of the coronary arteries".
Explanations for the emergence of the coronary heart disease pandemic
William G. Rothstein in The Coronary Heart Disease Pandemic in the Twentieth Century, 2017
The emergence of coronary heart disease as a major cause of death at midcentury in the United States led to intense speculation as to its causes. The chapter describes changes in risk factors during the emerging phase of the pandemic. Risk factors for pandemic coronary heart disease differed from those for normal coronary heart disease before the pandemic. A set of important risk factors for coronary heart disease was specified in 1990 by the United States Department of Health and Human Services for its Healthy People program, which established objectives for the health of the American population in 2000. Measuring the impact of specific risk factors on coronary heart disease during the height of the pandemic must consider the basic characteristics of all risk factors. The "diet-heart hypothesis" holds that patterns of food consumption are key risk factors for coronary heart disease, especially foods containing dietary cholesterol and saturated fats.
The Peak and Decline of the Coronary Heart Disease Pandemic in the United States, 1970-2010
William G. Rothstein in The Coronary Heart Disease Pandemic in the Twentieth Century, 2017
Coronary heart disease was the leading cause of death in the adult population of the United States at the peak of the pandemic in the 1950s and 1960s. The 1950s and 1960s were the peak years of the coronary heart disease pandemic in the United States, when all age, sex, and race groups had their highest mortality rates. Coronary heart disease mortality rates stabilized for age groups 35-44 and 45-54 about 1950 and remained at that level to 1970, with slight differences by race. Minor discontinuities in the ischemic heart disease category that occurred among revisions eight, nine, and ten of the International Classification of Diseases had only a small effect on mortality rates. Mortality rates from the disease began to decrease for all of these population groups in the 1970s and stopped decreasing about 1990 for younger age groups but continued to decrease after 2000 for older age groups.
Heart Transplantation
Published in Journal of Human Behavior in the Social Environment, 2000
Shawn Lawrence, Kimberley Zittel
Heart failure has been the cause of over 40,000 deaths each year (Costanzo et al., 1995). Heart transplant is one of the treatments for heart failure. There are many aspects involved in heart transplantation. This paper will address the medical issues of heart transplantation as well as the psychosocial aspects involved for those both waiting for a heart transplant and for those who have undergone the transplantation process. The interventions used with individuals undergoing heart transplantation will be addressed. Methods of prevention of cardiovascular disease and hypertension are explored as well as the implication of heart transplantation and prevention of heart disease for social workers.
The potential role of Kv4.3 K
Published in Channels, 2014
Rong Huo, Yue Sheng, Wen-Ting Guo, De-Li Dong
Transient outward K+ current (Ito) plays a crucial role in the early phase of cardiac action potential repolarization. Kv4.3 K+ channel is an important component of Ito. The function and expression of Kv4.3 K+ channel decrease in variety of heart diseases, especially in heart hypertrophy/heart failure. In this review, we summarized the changes of cardiac Kv4.3 K+ channel in heart diseases and discussed the potential role of Kv4.3 K+ channel in heart hypertrophy/heart failure. In heart hypertrophy/heart failure of mice and rats, downregulation of Kv4.3 K+ channel leads to prolongation of action potential duration (APD), which is associated with increased [Ca2+]i, activation of calcineurin and heart hypertrophy/heart failure. However, in canine and human, Kv4.3 K+ channel does not play a major role in setting cardiac APD. So, in addition to Kv4.3 K+ channel/APD/[Ca2+]i pathway, there exits another mechanism of Kv4.3 K+ channel in heart hypertrophy and heart failure: downregulation of Kv4.3 K+ channels leads to CaMKII dissociation from Kv4.3–CaMKII complex and subsequent activation of the dissociated CaMKII, which induces heart hypertrophy/heart failure. Upregulation of Kv4.3 K+ channel inhibits CaMKII activation and its related harmful consequences. We put forward a new point-of-view that Kv4.3 K+ channel is involved in heart hypertrophy/heart failure independently of its electric function, and drugs inhibiting or upregulating Kv4.3 K+ channel might be potentially harmful or beneficial to hearts through CaMKII.
Optimal medical treatment of cardiovascular risk factors: can we prevent the development of heart failure?
Published in Expert Review of Cardiovascular Therapy, 2009
Coronary heart disease is the most common cause of heart failure. Its prevalence has increased mainly owing to the improved survival of patients after acute myocardial infarction. In patients with heart failure, the presence of coronary heart disease has been shown to be independently associated with worsened long-term outcomes, including hospitalizations and poor mortality. Coronary heart disease frequently coexists with several major risk factors for the onset and progression of heart failure, such as hypertension, diabetes, obesity and metabolic syndrome, among others. Medical efforts to reduce the incidence of heart failure burden in patients with coronary heart disease and other types of cardiomyopathies must be directed at the prevention of heart failure and coronary risk factors themselves, and not just at the improvement of the management of established disease. This article will address the impact of known risk factors in the development of coronary heart disease and heart failure.