scholarly journals Current Management Guidelines on Hyperlipidemia: The Silent Killer

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Lilly Su ◽  
Rea Mittal ◽  
Devyani Ramgobin ◽  
Rahul Jain ◽  
Rohit Jain
Keyword(s):  
Risk Factors ◽  
Statin Therapy ◽  
Treatment Options ◽  
The United States ◽  
Atherosclerotic Disease ◽  
Modifiable Risk Factors ◽  
Management Guidelines ◽  
Lipid Management ◽  
Coronary Events ◽  
New Treatment

Given the high incidence of cardiovascular events in the United States, strict control of modifiable risk factors is important. Pharmacotherapy is helpful in maintaining control of modifiable risk factors such as elevated lipids or hypercholesterolemia. Hypercholesterolemia can lead to atherosclerotic disease which may increase the risk of acute coronary events. Statin therapy has long been a mainstay in the treatment of hypercholesterolemia, but while highly regarded, statin therapy also has side effects that may lead to patient noncompliance. Therefore, various medicines are being developed to manage hypercholesterolemia. This paper will discuss the role that lipids play in the pathophysiology of atherosclerotic disease, review the current lipid management guidelines, and discuss new treatment options that are alternatives to statin therapy.

A Genomic Approach to Characterize the Vulnerable Patient – a Clinical Update

2019 ◽  
Vol 4 (3) ◽  
pp. 141-144
Author(s):  
Evelin Szabó ◽  
Zsolt Parajkó ◽  
Diana Opincariu ◽  
Monica Chițu ◽  
Nóra Raț ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Ischemia ◽  
Treatment Options ◽  
Ischemic Heart ◽  
Pathophysiological Mechanism ◽  
Ischemia And Reperfusion Injury ◽  
Myocardial Ischemia And Reperfusion ◽  
Vulnerable Patient ◽  
Traditional Risk Factors ◽  
New Treatment

Abstract Atherosclerosis is the elemental precondition for any cardiovascular disease and the predominant cause of ischemic heart disease that often leads to myocardial infarction. Systemic risk factors play an important role in the starting and progression of atherosclerosis. The complexity of the disease is caused by its multifactorial origin. Besides the traditional risk factors, genetic predisposition is also a strong risk factor. Many studies have intensively researched cardioprotective drugs, which can relieve myocardial ischemia and reperfusion injury, thereby reducing infarct size. A better understanding of abnormal epigenetic pathways in the myocardial pathology may result in new treatment options. Individualized therapy based on genome sequencing is important for an effective future medical treatment. Studies based on multiomics help to better understand the pathophysiological mechanism of several diseases at a molecular level. Epigenomic, transcriptomic, proteomic, and metabolomic research may be essential in detecting the pathological phenotype of myocardial ischemia and ischemic heart failure.

scholarly journals Age-Related Chronic Diseases and Alzheimer’s Disease in Texas: A Hispanic Focused Study

2021 ◽  
Vol 5 (1) ◽  
pp. 121-133
Author(s):  
Shyam Sheladia ◽  
P. Hemachandra Reddy
Keyword(s):  
United States ◽  
Risk Factors ◽  
Chronic Diseases ◽  
Hispanic Americans ◽  
The United States ◽  
Modifiable Risk Factors ◽  
American Population ◽  
Hispanic American ◽  
West Texas ◽  
Age Related

The emergence of age-related chronic diseases within the United States has led to the direct increase of Alzheimer’s disease (AD) as well as other neurological diseases which ultimately contribute to the development of dementia within the general population. To be specific, age-related chronic diseases such as cardiovascular disease, high cholesterol, diabetes, and kidney disease contribute greatly to the advancement and rapid progression of dementia. Furthermore, unmodifiable risk factors such as advancing age and genetics as well as modifiable risk factors such as socioeconomic status, educational attainment, exercise, and diet further contribute to the development of dementia. Current statistics and research show that minority populations such as Hispanic Americans in the United States face the greatest burden of dementia due to the increase in the prevalence of overall population age, predisposing genetics, age-related chronic diseases, low socioeconomic status, as well as poor lifestyle choices and habits. Additionally, Hispanic Americans living within Texas and the rural areas of West Texas face the added challenge of finding appropriate healthcare services. This article will focus upon the research associated with AD as well as the prevalence of AD within the Hispanic American population of Texas and rural West Texas. Furthermore, this article will also discuss the prevalence of age-related chronic diseases, unmodifiable risk factors, and modifiable risk factors which lead to the progression and development of AD within the Hispanic American population of the United States, Texas, and rural West Texas.

Abstract 615: Association Between Multiple Modifiable Risk Factors of Cardiovascular Disease and Hypertension in a Rural Population of the United States

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Hadii M Mamudu ◽  
Timir Paul ◽  
Liang Wang ◽  
Sreenivas P Veeranki ◽  
Hemang B Panchal ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Sedentary Lifestyle ◽  
Subclinical Atherosclerosis ◽  
The United States ◽  
Community Dwelling ◽  
Modifiable Risk Factors ◽  
Obesity And Diabetes ◽  
Asymptomatic Individuals ◽  
Study Participants

Background: Hypertension (HTN) is one of the major risk factors for cardiovascular diseases (CVD) that afflicts one-third of the population in United States (US). This study examined the association between multiple modifiable risk factors for HTN in a rural hard-to-reach population. Methods: During January 2011 and December 2012, 1629 community-dwelling asymptomatic individuals from central Appalachia participated in screening for subclinical atherosclerosis, during which the participants were asked to report whether a physician or health worker has informed them that they had HTN (yes/no). Additionally, baseline data consisting of two non-modifiable risk factors (sex, age) and 5 modifiable risk factors (obesity, diabetes, hypercholesterolemia, smoking, and sedentary lifestyle) were collected. Descriptive statistics involving prevalence of risk factors and multivariate logistic regression analyses to determine the strength of association between hypertension and the number of risk factors were conducted. Results: Of the 1629 study participants, about half (49.8%) had hypertension. Among hypertensive patients, 31.4% were obese and 62.3% having hypercholesterolemia. Overall, having 2 risk factors consisted the largest group of participants with HTN. After adjusting for the non-modifiable risk factors (sex, age), obesity and diabetes increased the odds of having HTN by more than two folds ([OR=2.02, CI=1.57-2.60] and [OR=2.30, CI=1.66-3.18], respectively) and hypercholesterolemia and sedentary lifestyle increased the odds for HTN by more than one fold ([OR=1.26, CI=1.02-1.56) and [OR=1.38, CI=1.12-1.70], respectively). Compared to those without HTN, having 2, 3, and 4 or 5 modifiable risk factors were significantly associated with increased odds of having HTN by about two-folds [OR=1.72, CI=1.21-2.44], two and half folds [OR=2.55, 1.74-3.74], and six folds [OR=5.96, 3.42-10.41], respectively. Conclusion: The study suggests that odds of having HTN increases with the number of modifiable risk factors for CVD. Hence, by implementing an integrated CVD program for treating and controlling modifiable risk factors of HTN would decrease the future risk of CVD and help to achieve the 2020 Impact Goal of the American Health Association.

Osteopathic considerations in pneumonia

2021 ◽  
pp. 14-20
Author(s):  
Taner B. Celebi ◽  
Jeffrey Muller ◽  
Michael J. Terzella
Keyword(s):  
United States ◽  
Risk Factors ◽  
Treatment Options ◽  
The United States ◽  
Special Consideration ◽  
Associated Risk Factors

Pneumonia contributed to nearly 3 million deaths worldwide in 2016 and 56,000 deaths in the United States alone in 2017, and as such, it is imperative for physicians to understand the causes, subtypes, associated risk factors and treatment options. This article will address each of these, as well as special consideration for the osteopathic approach to care.

Gender differences in acute coronary events

2000 ◽  
Vol 9 (3) ◽  
pp. 207-209 ◽  
Author(s):  
KB Keller ◽  
L Lemberg
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Early Detection ◽  
Early Death ◽  
Female Gender ◽  
The United States ◽  
Vascular Events ◽  
Aggressive Therapy ◽  
The Difference ◽  
Coronary Events

The most frequent cause of death among women in the United States is coronary heart disease, which claims 200,000 lives a year. The prognosis with either medical or surgical therapy is worse in females than in males. The following significant gender differences have been observed and reported: (1) the rate of early death following acute myocardial infarction is greater in women, (2) the difference between sexes remains whether or not thrombolytic therapy is used, and (3) the hospital mortality rate following coronary angioplasty, atherectomy, or bypass surgery is greater in females. The reasons for these gender differences are not clearly understood. Nevertheless, awareness of the higher morbidity and mortality in women dictates the need for early detection and more aggressive therapy of the risk factors. However, diabetes mellitus and essential hypertension are 2 well-established major risk factors for coronary disease and stroke that are more prevalent in the female gender. These 2 risk factors are cumulative and require more intensive and aggressive therapy to prevent acute vascular events, and therefore early detection is mandatory.

Changes in Statin Utilization among US Adults with Diabetes: A Population-Based Analysis of NHANES 2011-2018

2020 ◽  
Author(s):  
Abbie D. Leino ◽  
Michael P. Dorsch ◽  
Corey A. Lester
Keyword(s):  
Risk Factors ◽  
Statin Therapy ◽  
The United States ◽  
Position Statement ◽  
Population Based ◽  
Routine Care ◽  
Recent Change ◽  
Minimal Impact ◽  
Ascvd Risk ◽  
The Impact

<b>Objective:</b> The objective was to evaluate statin utilization in the United States before and after the 2015 ADA position statement, which expanded statin therapy recommendations to include all adults 40-75 years old with diabetes. <p><b>Research Design and Methods:</b> The National Health and Nutrition Examination Survey was used to obtain a representative sample. The difference-in-differences technique determined the impact of the recommendation on the proportion of people with diabetes for whom statin therapy was newly recommended. </p> <p><b>Results:</b> Among people with diabetes, the change in statin utilization in people without ASCVD risk factors controlling for change among people with ASCVD/risk factors was 6.6% (p=0.388). In the adjusted analysis, overt ASCVD, age, Black race, health insurance, a place for routine care, and total cholesterol were significantly associated with statin utilization (p<0.05). </p> <p><b>Conclusion:</b> The most recent change in statin recommendations had minimal impact on the proportion of patients receiving a statin. </p>

scholarly journals Chronic Hyperkalemia in Cardiorenal Patients: Risk Factors, Diagnosis, and New Treatment Options

2018 ◽  
Vol 9 (1) ◽  
pp. 8-21 ◽  
Author(s):  
Luca Di Lullo ◽  
Claudio Ronco ◽  
Antonio Granata ◽  
Ernesto Paoletti ◽  
Vincenzo Barbera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medical Condition ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
New Treatment ◽  
Poor Outcomes ◽  
Careful Management

Chronic hyperkalemia (HK) is a serious medical condition that often manifests in patients with chronic kidney disease (CKD) and heart failure (HF) leading to poor outcomes and necessitating careful management by cardionephrologists. CKD, HF, diabetes, and renin-angiotensin-aldosterone system inhibitors use is known to induce HK. Current therapeutic options are not optimal, as pointed out by a large number of CKD and HF patients with HK. The following review will focus on the main risk factors for developing HK and also aims to provide a guide for a correct diagnosis and present new approaches to therapy.

scholarly journals The State of Lupus Clinical Trials: Minority Participation Needed

2019 ◽  
Vol 8 (8) ◽  
pp. 1245
Author(s):  
Saira Z. Sheikh ◽  
Nicole I. Wanty ◽  
Joncel Stephens ◽  
Kristen D. Holtz ◽  
Sheryl McCalla
Keyword(s):  
Clinical Trials ◽  
African Americans ◽  
Symptom Severity ◽  
Quality Care ◽  
Treatment Options ◽  
The United States ◽  
Minority Populations ◽  
Healthcare Staff ◽  
Minority Participation ◽  
New Treatment

In the United States, the reported prevalence of lupus is 100,000 to 500,000 patients. Lupus disproportionately affects minority populations, including African Americans and Latinos, and the associated health disparities are substantial. Women are at a higher risk of lupus than men and lupus prevalence is the highest in African Americans and Latinos compared to non-Hispanic whites. African Americans and Latinos also have increased disease symptom severity, experience more lupus-related complications, and have a two- to three-fold mortality rate compared to non-Hispanic Whites. Lupus clinical trials offer opportunities for quality care and can result in new treatment options, but African Americans and Latinos are underrepresented in clinical trials because of substantial patient- and provider-side barriers. In conjunction with the limited knowledge of clinical trials that potential participants may have, the healthcare staff approaching participants have limited time to adequately educate and explain the aspects of clinical trials. Indeed, ninety percent of clinical trials fail to meet their recruitment goals on time, so a multi-faceted approach is necessary to address the issue of low minority participation in clinical trials.

scholarly journals 1167. Trends in Multi-Drug-Resistant Gonorrhea, Gonococcal Isolate Surveillance Project, United States, 1987–2016

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S352-S352
Author(s):  
Sancta St. Cyr ◽  
Ellen Kersh ◽  
Hillard Weinstock ◽  
Elizabeth Torrone
Keyword(s):  
United States ◽  
Antimicrobial Susceptibility ◽  
Treatment Options ◽  
The United States ◽  
Drug Resistant ◽  
Appropriate Treatment ◽  
High Prevalence ◽  
Agar Dilution ◽  
Male Patients ◽  
New Treatment

Abstract Background Neisseria gonorrhoeae’s ability to develop resistance to antibiotics used for treatment and a limited development of new therapies have made this organism one of three urgent threat pathogens in the United States. We provide the first report of US trends in multi-drug-resistant (MDR) and extensively-drug-resistant (XDR) gonorrhea. Methods The Gonococcal Isolate Surveillance Project (GISP) monitors trends in antimicrobial susceptibility in N. gonorrhoeae in the United States. Antimicrobial susceptibility testing by agar dilution is performed on urethral isolates from male patients at participating STD clinics. Minimum inhibitory concentration (MIC) are used to identify isolates with resistance or reduced susceptibility using the following criteria: fluoroquinolones (ciprofloxacin [MIC ≥1.0 μg/mL]) and elevated MICs to cephalosporins (cefixime [MIC ≥0.25 μg/mL], ceftriaxone [MIC ≥0.25 μg/mL]) and macrolides (azithromycin [MIC ≥1.0 μg/mL before 2005 and ≥2.0 μg/mL 2005–2016]). In this analysis, MDR is defined as resistance or elevated MICs to ≥2 classes of antimicrobials; XDR as resistance or elevated MICs to ≥3 classes. This classification excludes penicillin and tetracycline due to their long history and high prevalence of gonococcal resistance. Results During 1987–2016, 159,445 isolates were collected through GISP. In 1998, the first MDR strains were identified. Although only 0.04% of isolates that year, these isolates showed elevated MICs to both cephalosporins and macrolides. By 2010, 1.0% of GISP isolates were MDR with elevated MICs or resistance to two of the cephalosporins, macrolides, or fluoroquinolones. In 2011, the proportion of isolates that were MDR peaked at 1.3%. In 2016, after minor fluctuations, 1.1% of GISP isolates were considered MDR. Only one occurrence of XDR, in 2011, has been seen in GISP. The strain was resistant to fluoroquinolones with elevated MICs to both cephalosporins and macrolides. Conclusion MDR and XDR gonorrhea have remained low over the past three decades; however, dual treatment with cephalosporins and macrolides is the last remaining recommended therapy for N. gonorrhoeae. Until new treatment options become available, a combination of surveillance and ensuring appropriate treatment are needed to delay further resistance. Disclosures All authors: No reported disclosures.

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