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Vitamin D and Cardiovascular Disease: Can Novel Measures of Vitamin D Status Improve Risk Prediction and Address the Vitamin D Racial Paradox?
AbstractPurpose of ReviewThe major focus of this review article is to provide a state-of-the-art update on some emerging measures of vitamin D status and discuss how assessment of these key vitamin D metabolites might improve prognostication of risk for cardiovascular disease (CVD) outcomes.Recent FindingsVitamin D deficiency is a highly prevalent condition and relatively easy to treat with supplementation and/or modest sunlight exposure. A substantial body of experimental and epidemiological evidence suggests that vitamin D deficiency is a risk factor for CVD. Most epidemiologic studies to date have focused on total 25-hy...
Source: Current Cardiovascular Risk Reports - January 20, 2017 Category: Cardiology Source Type: research

Estrogen Therapy in 2017
AbstractPurpose of ReviewAfter the publication of the Women ’s Health Initiative, there was a dramatic reduction in prescriptions for menopausal hormonal therapy (MHT). We performed a literature search and reviewed major society guidelines to discuss recommendations and practice since 2010 regarding MHT.Recent FindingsWhile not recommended for management and prevention of chronic diseases, MHT offers relief for bothersome menopausal symptoms. For vasomotor symptoms and vaginal atrophy, low-dose estrogen therapy (systemic and vaginally, respectively) provided effective relief of symptoms and improved quality of life. For ...
Source: Current Cardiovascular Risk Reports - January 16, 2017 Category: Cardiology Source Type: research

American Indians/Alaska Natives and Cardiovascular Disease: Outcomes, Interventions, and Areas of Opportunity
AbstractPurpose of ReviewCardiovascular disease (CVD) is a reported leading cause of death among American Indians and Alaska Natives (AI/ANs) and takes a disproportionate toll on these populations. Using the electronic database PubMed, the purpose of this review is to summarize findings from CVD morbidity/mortality outcome studies, as well as CVD and CVD risk factor intervention studies among AI/ANs, published in 2014 and 2015.Recent FindingsEighteen empirical studies that focused on CVD outcomes and CVD/CVD risk factor interventions were reviewed. Four of five studies on CVD mortality found that CVD is a leading or second...
Source: Current Cardiovascular Risk Reports - January 16, 2017 Category: Cardiology Source Type: research

Chronic Total Occlusion Percutaneous Coronary Intervention
The objectives of percutaneous coronary intervention (PCI) on these lesions include relief of symptoms, improvement in left ventricular function and remodeling, and potential decrease in mortality. There are currently no randomized trials that have assessed outcomes in patients with CTOs treated with complex PCI compared to medical therapy or coronary artery bypass graft surgery. However, several ongoing investigations aim to evaluate a large range of outcomes and new technology and techniques in CTO PCI, offering the promise of stronger evidence-based guidelines for the care of these complex patients. In this article, we ...
Source: Current Cardiovascular Risk Reports - November 25, 2016 Category: Cardiology Source Type: research

Defining and Diagnosing Elevated Blood Pressure in Children and Adolescents
AbstractPediatric hypertension is one of the top ten chronic diseases of children and adolescents, affecting millions of children and adolescents across the USA. The majority of pediatric hypertension and elevated blood pressures in the pediatric population are under recognized and underdiagnosed. Here, we review the current definitions of elevated blood pressure and hypertension in the pediatric population. We also review and discuss approaches and tools to assistant in the recognition of elevated blood pressures and outstanding issues related to blood pressure definitions and diagnoses. Improved understanding of the defi...
Source: Current Cardiovascular Risk Reports - November 15, 2016 Category: Cardiology Source Type: research

Hypertension in Children: Motivating Improvement in Clinical Practice
AbstractHypertension in children is a common and serious problem associated with target organ damage including left ventricular hypertrophy (LVH), increased carotid intima-media thickness (CIMT), and microalbuminuria. Unfortunately, there is ample evidence that the problem goes unrecognized in clinical practice. There are multiple reasons for this including the complexity of blood pressure standards in children, a lack of knowledge among clinicians, skepticism about the importance of hypertension in children, conflicting screening recommendations, and discomfort among clinicians, patients, and families with pharmacotherapy...
Source: Current Cardiovascular Risk Reports - October 25, 2016 Category: Cardiology Source Type: research

Door to Unload: a New Paradigm for the Management of Cardiogenic Shock
AbstractCardiogenic shock (CS) remains the most common cause of in-hospital mortality in the setting of acute myocardial infarction (AMI). Recent data have identified several concerning trends in the field of AMI-CS that include an overall increase in mortality, an increase in patient complexity, minimal use of acute mechanical circulatory support (AMCS) devices with the majority being implanted as a bailout option. In this review, we will discuss recent trends in CS and the rationale for the use of acute mechanical circulatory support pumps early in the clinical treatment of CS. (Source: Current Cardiovascular Risk Reports)
Source: Current Cardiovascular Risk Reports - October 23, 2016 Category: Cardiology Source Type: research

Role of Statins in Glucose Homeostasis and Insulin Resistance
AbstractStatins are widely used for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD), and, under the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol treatment guidelines, more individuals are eligible for statin therapy. In this review, we summarize evidence for a mild increase in serum glucose and increased incidence of diabetes associated with statins, the hypothesized mechanisms by which statins may impair glucose homeostasis, the risk of diabetes associated with particular statins, and the net effect on ASCVD risk. As emphasized by the ACC/AHA gui...
Source: Current Cardiovascular Risk Reports - October 21, 2016 Category: Cardiology Source Type: research

Genetic Predispositions to Heart Failure
AbstractHeart failure can be caused by either acquired or inherited cardiovascular diseases. With the rising incidence of heart failure (HF), there is a need to further understand the molecular pathogenesis of HF. There has been growing interest in the role of genetic predisposition for developing HF, not only in inherited cardiomyopathies but also in acquired cardiovascular diseases. There have been expanding knowledge bases in specific pathogenic variants of sarcomeric genes, as well as genes encoding structural and cytoskeleton proteins, ion channels, calcium cycling proteins, nuclear proteins or transcriptomic factors,...
Source: Current Cardiovascular Risk Reports - October 19, 2016 Category: Cardiology Source Type: research

Cardiogenic Shock in Older Adults
AbstractCardiogenic shock, a shock state with underlying cardiovascular insult as the precipitating event, carries a high mortality irrespective of the actual inciting pathology. This remains one disease entity in cardiovascular medicine that has not seen vast improvements over the past several decades. With the exception of the realization of the importance of early revascularization in the setting of acute myocardial infarction, there have been few breakthroughs in the treatment of this devastating condition. How to optimize outcomes for older adults with cardiogenic shock is an even more challenging task as the studies ...
Source: Current Cardiovascular Risk Reports - October 19, 2016 Category: Cardiology Source Type: research

Biomarkers and Cancer Therapy-Related Cardiac Dysfunction
AbstractCancer is a leading cause of morbidity and mortality, but improvements in therapy have translated to better outcomes. Despite this, patients exposed to certain cancer therapies may develop cardiac toxicity. Among cancer survivors, cardiovascular disease is currently the second leading cause of morbidity and mortality. The spectrum of cardiac disease is broad, including asymptomatic left ventricular dysfunction through cardiac failure, among other cardiovascular events. Novel imaging techniques such as speckle tracking/strain and three-dimensional echocardiogram are useful for evaluating cancer therapy-induced cardi...
Source: Current Cardiovascular Risk Reports - October 17, 2016 Category: Cardiology Source Type: research

Ethnic Enclaves and Type II Diabetes: a Focus on Latino/Hispanic Americans
AbstractDiabetes disproportionately impacts the Latino population and while individual traditional risk factors are key, additional external factors, such as neighborhoods, may also affect diabetes rates. This review examines the role of living in an ethnic enclave, a neighborhood with a high Latino concentration, on diabetes and its risk factors for the Latino population in the United States (U.S.). Studies fail to find an association between living in an ethnic enclave and diabetes, despite research demonstrating that enclaves have a protective effect on other health outcomes for Latinos. When considering diabetes risk f...
Source: Current Cardiovascular Risk Reports - October 5, 2016 Category: Cardiology Source Type: research

Meeting the Unmet Needs of Aging Heart Failure Patients: A Role for Palliative Care
AbstractOlder patients with heart failure suffer from many symptoms. Many patients and their families not only face heart failure-related symptoms, but also financial burdens, side effects from medication and treatment, changes in their normal routine, difficult medical decisions, and limited social support. Palliative care aims to alleviate the pain and distress associated with illnesses and these difficulties, especially in the context of chronic and progressive illness. There have been strides to increase palliative care services for heart failure patients, but many barriers exist such as misconceptions about symptom bu...
Source: Current Cardiovascular Risk Reports - September 25, 2016 Category: Cardiology Source Type: research

What Can Geriatrics Teach Cardiology?
(Source: Current Cardiovascular Risk Reports)
Source: Current Cardiovascular Risk Reports - September 23, 2016 Category: Cardiology Source Type: research

Impact of Exercise Programs on Hospital Readmission Following Hospitalization for Heart Failure: A Systematic Review
This study was a single-site randomized controlled trial that consisted of a 12-week exercise program in a cohort of 105 patients with a principal diagnosis of heart failure at a metropolitan hospital in Australia. This study revealed a reduction in 12-month all-cause and cardiovascular-related hospitalization rates. However, inferences were limited by its single-site study design, small sample size, premature termination, and high risk for selection, performance, and detection bias. As no studies have built upon the findings of this study, it remains unknown whether exercise programs can improve readmission rates among pa...
Source: Current Cardiovascular Risk Reports - September 8, 2016 Category: Cardiology Source Type: research