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Burden of Psychiatric Disorders in Moyamoya Disease: A National Inpatient Perspective From 2007-2014
Conclusions: The impact of Moyamoya disease on mental health services is expected to grow, as the condition's prevalence is increasing at a rate of approximately 1.5- to 2-fold. A multidisciplinary approach between neurology, psychiatry, and primary care can improve screening and management of comorbid psychiatric disorders.PMID:36027591 | DOI:10.4088/PCC.21m03157
Source: The Primary Care Companion for CNS Disorders - August 26, 2022 Category: Primary Care Authors: Zeeshan Mansuri Krupa Patel Chintan Trivedi Saral Desai Shweta Patel Rupak Desai Ramu Vadukapuram Ashutosh Lodhi Abhishek Reddy Source Type: research

Acute Stroke Diagnosis
Am Fam Physician. 2022 Jun 1;105(6):616-624.ABSTRACTStroke accounts for significant morbidity and mortality and is the fifth leading cause of death in the United States, with direct and indirect costs of more than $100 billion annually. Expedient recognition of acute neurologic deficits with appropriate history, physical examination, and glucose testing will help diagnose stroke and rule out mimicking presentations. The National Institutes of Health Stroke Scale should be used to determine stroke severity and to monitor for evolving changes in clinical presentation. Initial neuroimaging is used to differentiate between isc...
Source: American Family Physician - June 15, 2022 Category: Primary Care Authors: Edwin Y Choi Gilberto A Nieves Darrell Edward Jones Source Type: research

Arterial Atherosclerosis: Vascular Surgery Interventions
Am Fam Physician. 2022 Jan 1;105(1):65-72.ABSTRACTAtherosclerotic vascular disease is a leading cause of death worldwide. Atherosclerotic stenosis of the internal carotid or intracranial arteries causes up to 15% of strokes. Peripheral artery disease affects up to one in five people in the United States who are 60 years and older and nearly one-half of those who are 85 years and older. Renal artery stenosis may affect up to 5% of people with isolated hypertension and up to 40% of people with other atherosclerotic diseases. All patients with atherosclerotic vascular disease should receive a comprehensive program of guidelin...
Source: American Family Physician - January 14, 2022 Category: Primary Care Authors: Jonathon M Firnhaber C S Powell Source Type: research

Health insurance status and type associated with varying levels of glycemic control in the US: The multi-ethnic study of atherosclerosis (MESA)
Diabetes is a leading cause of morbidity and mortality in the United States (US), with over 24 million individuals diagnosed in 2017 and accounting for $327 billions of healthcare spending [1]. Diabetes is a chronic condition associated with numerous complications, including renal disease, blindness, amputation, and an increased risk for cardiovascular disease and stroke [2]. However, preventive care and proper management can lead to improved glycemic control, which is not only associated with fewer complications [3 –5], but also reduced medical costs [6–8], suggesting examination of healthcare systems that improve dia...
Source: Primary Care Diabetes - December 8, 2020 Category: Primary Care Authors: Rebecca S. Gold, Jonathan T. Unkart, Robyn L. McClelland, Alain G. Bertoni, Matthew A. Allison Source Type: research

Anti-Hypertensive Medication Combinations in the United States
Conclusions: Most individuals with hypertension use between 2–5 medications and the medications comprising these regimens vary by comorbidity. The ACCOMPLISH trial suggested that certain combinations may lead to superior cardiovascular outcomes. Research comparing the efficacy of different hypertension medication combinations among individuals with different comorbidities could lead to better patient hypertensionrelated outcomes.
Source: Journal of the American Board of Family Medicine - January 5, 2020 Category: Primary Care Authors: Johansen, M. E., Yun, J., Griggs, J. M., Jackson, E. A., Richardson, C. R. Tags: Research Letters Source Type: research

Sex-Specific Mechanisms in Inflammation and Hypertension
AbstractPurpose of ReviewDespite enhanced screening and therapeutic management, hypertension remains the most prevalent chronic disease in the United States and the leading cause of heart disease, chronic kidney disease, and stroke in both men and women. It is widely accepted that hypertension is a pro-inflammatory disease and that the immune system plays a vital role in mediating hypertensive outcomes and end organ damage. Despite known discrepancies in the risk of hypertension development between men and women, preclinical models of immune-mediated hypertension were historically developed solely in male animals, leading ...
Source: Current Hypertension Reports - May 22, 2019 Category: Primary Care Source Type: research

A Clinical Prescription for Heart Health in Midlife Women
Heart disease remains the leading cause of death in women in Europe and the United States with the incidence increasing during midlife. [1] While one in thirty-one women will die from breast cancer, one in approximately two to three women will die from heart disease or stroke. [1,2], While most women are aware about traditional cardiovascular disease (CVD) risk factors, such as hypertension, dyslipidemia and diabetes, they are often unaware of sex specific risk factors that occur in midlife. [3] Clinical risk factors can vary depending on the individual personal family history and can change as a woman ages.
Source: Maturitas - November 12, 2018 Category: Primary Care Authors: Chrisandra Shufelt, Erika Dutra, Tina Torbati, Tina Ramineni Source Type: research

Hypertension guideline update: A new guideline for a new era
This article reviews the ACC/AHA Task Force on Clinical Practice Guidelines' 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Key changes include reclassification of BP stages and lowering of hypertension treatment goals.
Source: Journal of the American Academy of Physician Assistants - May 29, 2018 Category: Primary Care Tags: CME: Cardiovascular Medicine Source Type: research

Heart Failure with Preserved Ejection Fraction: Diagnosis and Management.
Abstract Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular relaxation and passive ventricular compliance, leading to a decline in stroke volume and cardiac output. Heart failure with preserved ejection fraction should be suspected in patients with typical symptoms (e.g., fatigue, weakness, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, edema) and signs (S3 heart sound, displaced apica...
Source: American Family Physician - November 1, 2017 Category: Primary Care Authors: Gazewood JD, Turner PL Tags: Am Fam Physician Source Type: research

Recurrent Ischemic Stroke: Strategies for Prevention.
Abstract Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, decreased alcohol use, and increased physical activity, are also important in the management of patients with a history of stroke or transient ischemic attack. Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke. The selection of antiplatelet therapy should be based on timing, safety, effectiveness, ...
Source: American Family Physician - October 1, 2017 Category: Primary Care Authors: Oza R, Rundell K, Garcellano M Tags: Am Fam Physician Source Type: research

Mental and Physical Health Conditions in US Combat Veterans: Results From the National Health and Resilience in Veterans Study.
Conclusions: Compared to noncombat veterans in the United States, combat veterans have elevated rates of PTSD, suicide attempt, stroke, and chronic pain independent of other sociodemographic, military, and mental health factors. Younger combat veterans have elevated rates of PTSD, suicidal ideation, and migraine headaches, while older combat veterans have elevated rates of heart disease and heart attack. These results characterize the population-based burden of mental and physical health conditions in combat veterans. They further underscore the importance of age- and condition-sensitive screening, monitoring, and treatmen...
Source: The Primary Care Companion for CNS Disorders - June 30, 2017 Category: Primary Care Tags: Prim Care Companion CNS Disord Source Type: research

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