scholarly journals Impact of the American College of Cardiology/American Heart Association Cholesterol Guidelines on Statin Eligibility Among Human Immunodeficiency Virus-Infected Individuals

2018 ◽  
Vol 5 (12) ◽  
Author(s):  
Mosepele Mosepele ◽  
Susan Regan ◽  
Joseph Massaro ◽  
James B Meigs ◽  
Markella V Zanni ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Statin Therapy ◽  
American Heart Association ◽  
American Heart ◽  
Clinical Care ◽  
Heart Association ◽  
Cvd Risk ◽  
Immunodeficiency Virus ◽  
Statin Prescription ◽  
Cholesterol Guidelines

Abstract Background Individuals with human immunodeficiency virus (HIV) face elevated cardiovascular disease (CVD) risk. There are limited data regarding the application of the American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines in HIV compared with non-HIV patients. Methods Human immunodeficiency virus-infected and demographically similar control patients were assessed for statin recommendation status by ACC/AHA and the National Cholesterol Education Program Adult Treatment Program III (ATPIII), indication for statin recommendation, actual statin prescription, and CVD event. Outcomes were atherosclerotic CVD for ACC/AHA and coronary heart disease for ATPIII. Results In a clinical care cohort of 1394 patients infected with HIV, 38.6% (538 of 1394) of patients were recommended for statin therapy by the ACC/AHA guidelines compared with 20.1% (280 of 1394) by the ATPIII guidelines. Of those recommended for statin therapy, actual statin prescription rates were 42.8% (230 of 538) for ACC/AHA and 66.4% (186 of 280) for ATPIII. Among patients infected with HIV with an incident CVD event during follow-up, statin therapy was recommended for 59.2% (42 of 71) of patients by ACC/AHA and 35.2% (25 of 71) by ATPIII, versus 71.6% (141 of 197) by ACC/AHA and 43.1% (85 of 197) by ATPIII in the control group. Conclusions In an HIV clinical care cohort, the ACC/AHA cholesterol guidelines recommend a higher proportion of patients for statin therapy and identify an increased proportion of patients with a CVD event compared with ATPIII. However, 40% of patients with a CVD event would not have been recommended for statin therapy by ACC/AHA, compared with 29% for controls. This gap in identification of patients infected with HIV at high CVD risk underscores the need for HIV-specific cardiovascular prevention strategies.

scholarly journals The Use of Sex-Specific Factors in the Assessment of Women’s Cardiovascular Risk

Circulation ◽  
2020 ◽  
Vol 141 (7) ◽  
pp. 592-599 ◽  
Author(s):  
Anandita Agarwala ◽  
Erin D. Michos ◽  
Zainab Samad ◽  
Christie M. Ballantyne ◽  
Salim S. Virani
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Increased Risk

Cardiovascular disease (CVD) is the leading cause of death among women in the United States. As compared with men, women are less likely to be diagnosed appropriately, receive preventive care, or be treated aggressively for CVD. Sex differences between men and women have allowed for the identification of CVD risk factors and risk markers that are unique to women. The 2018 American Heart Association/American College of Cardiology Multi-Society cholesterol guideline and 2019 American College of Cardiology/American Heart Association guideline on the primary prevention of CVD introduced the concept of risk-enhancing factors that are specific to women and are associated with an increased risk of incident atherosclerotic CVD in women. These factors, if present, would favor more intensified lifestyle interventions and consideration of initiation or intensification of statin therapy for primary prevention to mitigate the increased risk. In this primer, we highlight sex-specific CVD risk factors in women, stress the importance of eliciting a thorough obstetrical and gynecological history during cardiovascular risk assessment, and provide a framework for how to initiate appropriate preventive measures when sex-specific risk factors are present.

scholarly journals Epidemiology of Arterial Hypertension in Russian Federation – Importance of Choice of Criteria of Diagnosis

Kardiologiia ◽  
2019 ◽  
Vol 59 (6) ◽  
pp. 5-11 ◽  
Author(s):  
A. M. Erina ◽  
O. P. Rotar ◽  
V. N. Solntsev ◽  
S. A. Shalnova ◽  
A. D. Deev ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Russian Federation ◽  
American Heart Association ◽  
Laboratory Tests ◽  
American Heart ◽  
Heart Association ◽  
Russian Population ◽  
Cvd Risk ◽  
Gender And Age ◽  
European Society Of Cardiology

Purpose. Assessment of prevalence of arterial hypertension (AH), need for prescription of antihypertensive therapy (AHT), and efficacy of AHT in Russian population in accordance with novel guideline of the American College of Cardiology/American Heart Association (“American recommendations”) on diagnosis and treatment of AH (2017).Materials and methods. Epidemiological study ESSE-RF (ЭССЕ-РФ) was carried out in 12 regions of Russian Federation (RF) with different climatic-geographic characteristics. Number of examined residents of RF aged 25–65 years was 20 652. The sample was stratified by  gender and age. Examination included anthropometry, laboratory tests, blood pressure (BP) measurement with the OMRON tonometer. The SCORE scale was used for evaluation of risk of development of cardiovascular diseases (CVD). In  American recommendations AH was defined as  follows: 1-st degree  – systolic BP (SBP) 130–139  and/or diastolic BP (DBP) 80–89 mm Hg, 2-nd degree – BP ≥140/90 mm Hg and/or presence of AHT. In recommendations of the European Society of Cardiology (2013, 2018) (“European recommendations”) AH was defined as BP ≥140/90 mm Hg and/or presence of AHT.Results. We analyzed data of examination of  20 607  participants – 7806 men (37.9%) and 12 801  women (62.1%). According to  European recommendations AH was diagnosed in 10 347  persons (50.2%)  – 3987 men (51.1%) men and 6 360 women (49.7%). According to American recommendations AH was registered in 14 853 persons (72.1%) – 6 059 men (77.6%) and 8 794 women (68.7%). AHT received 6324 persons (61.1% of those with AH); according to American recommendations, the onset of AHT was indicated to additional 620 persons with 1-st degree AH because of high CVD risk. Among all participants with AH (on and without AHT) strengthening of AHT for achievement of target BP level was required in 77.8 and 92.6% of patients according to European and American recommendations, respectively.Conclusion. Application of novel criteria of AH diagnosis from 2017 ACC/AHA guideline to Russian population would increase prevalence of AH up to 72.1%. Onset of AHT would be indicated in 13.8% of patients with 1-st degree AH, while in 93% of patients receiving AHT its strengthening would be required. 

scholarly journals Inappropriate Telemetry Use Is Increased during the COVID-19 Era

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1610
Author(s):  
Jean Kim ◽  
Kyle Miyazaki ◽  
Yoshito Nishimura ◽  
Ryan Honda
Keyword(s):  
Decision Making ◽  
Respiratory Failure ◽  
American Heart Association ◽  
Chart Review ◽  
American Heart ◽  
Clinical Care ◽  
Retrospective Chart Review ◽  
Heart Association ◽  
Academic Hospital ◽  
The Relationship

Due to the unprecedented COVID-19 pandemic, there may be overuse of telemetry monitoring compared to the pre-pandemic period. We compared the frequency of inappropriate telemetry use in the pre-COVID-19 period (1 November 2019 to 28 February 2020) versus the peri-COVID-19 period (1 March 2020 to 30 June 2020) at a major academic hospital in Honolulu, Hawaii, by a retrospective chart review to assess for the appropriateness of the telemetry orders during this period, based on the 2017 American College of Cardiology/American Heart Association guidelines. Compared to the pre-COVID-19 period, there was a significant increase in inappropriate telemetry use during the peri-COVID-19 period (X2 (1, N = 11,727) = 6.59, p = 0.0103). However, there was no increase in the proportions of respiratory failure (4.0%) or pneumonia (2.7%) during the peri-COVID-19 period. The increase in inappropriate telemetry use may be related to the uncertainty in clinical care and decision making amid the pandemic of the new virus. Appropriate utilization of telemetry monitoring is increasingly important during the pandemic due to the limited availability of resources. Further investigation is needed to clarify the relationship between the pandemic and trends in telemetry ordering.

scholarly journals Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 142 (25) ◽  
Author(s):  
Samar R. El Khoudary ◽  
Brooke Aggarwal ◽  
Theresa M. Beckie ◽  
Howard N. Hodis ◽  
Amber E. Johnson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
American Heart Association ◽  
American Heart ◽  
Disease Risk ◽  
Heart Association ◽  
Cvd Risk ◽  
Scientific Statement ◽  
Menopause Transition

Cardiovascular disease (CVD) is the leading cause of death in women, who have a notable increase in the risk for this disease after menopause and typically develop coronary heart disease several years later than men. This observation led to the hypothesis that the menopause transition (MT) contributes to the increase in coronary heart disease risk. Over the past 20 years, longitudinal studies of women traversing menopause have contributed significantly to our understanding of the relationship between the MT and CVD risk. By following women over this period, researchers have been able to disentangle chronological and ovarian aging with respect to CVD risk. These studies have documented distinct patterns of sex hormone changes, as well as adverse alterations in body composition, lipids and lipoproteins, and measures of vascular health over the MT, which can increase a woman’s risk of developing CVD postmenopausally. The reported findings underline the significance of the MT as a time of accelerating CVD risk, thereby emphasizing the importance of monitoring women’s health during midlife, a critical window for implementing early intervention strategies to reduce CVD risk. Notably, the 2011 American Heart Association guidelines for CVD prevention in women (the latest sex-specific guidelines to date) did not include information now available about the contribution of the MT to increased CVD in women. Therefore, there is a crucial need to discuss the contemporary literature on menopause and CVD risk with the intent of increasing awareness of the significant adverse cardiometabolic health–related changes accompanying midlife and the MT. This scientific statement provides an up-to-date synthesis of the existing data on the MT and how it relates to CVD.

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