Internet-based behavioral change and psychosocial care for patients with cardiovascular disease: A review of cardiac disease-specific applications

This secondary analysis of survey data examined mediating-moderating effects of allostatic load score (calculated using the Rodriquez method) on the association between nutrient-based Dietary Approaches to Stop Hypertension (DASH) diet score (Mellen Index) and the all-cause and cause-specific mortality risks among 11,630 adults ≥ 30 years of age from the 2001–2010 National Health and Nutrition Examination Surveys with no history of cardiovascular disease or cancer at baseline, and who were followed-up for ~9.35 years. Multivariable models were adjusted for demographic, socioeconomic, lifestyle, and health characteristics. All-cause, cardiovascular disease, and cancer-specific mortality rates were estimated at 6.5%, 1.1%, and 1.9%, respectively. The median DASH total score was 3.0 (range: 1–8) (with 78.3% scoring < 4.5), whereas the median allostatic load score was 3 (range: 0–9). The DASH diet, fiber, and magnesium were negatively correlated with allostatic load, whereas allostatic load predicted higher all-cause mortality, irrespective of the DASH diet. Whereas protein was protective, potassium increased all-cause mortality risk, irrespective of allostatic load. Potassium was protective against cardiovascular disease-specific mortality but was a risk factor for cancer-specific mortality. Although no moderating effects were observed, mediation by the allostatic load on cardiovascular disease-specific mortality was observed for DASH total score and selected component scores. Direct (but not indirect) effects of DASH through the allostatic load were observed for all-cause mortality, and no direct or indirect effects were observed for cancer-specific mortality. From a public health standpoint, the allostatic load may be a surrogate for the preventive effects of the DASH diet and its components on cardiovascular disease-specific mortality risk.

Download Full-text

Adolescent Body Mass Index and Cardiovascular Disease–Specific Mortality by Midlife

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2017-00329 ◽

2017 ◽

Vol 102 (8) ◽

pp. 3011-3020 ◽

Cited By ~ 11

Author(s):

Gilad Twig ◽

Dana Ben-Ami Shor ◽

Ariel Furer ◽

Hagai Levine ◽

Estela Derazne ◽

...

Keyword(s):

Cardiovascular Disease ◽

Body Mass Index ◽

Body Mass ◽

Specific Mortality ◽

Disease Specific Mortality ◽

Disease Specific

Download Full-text

Plasma YKL-40 and Total and Disease-Specific Mortality in the General Population

Clinical Chemistry ◽

10.1373/clinchem.2010.146530 ◽

2010 ◽

Vol 56 (10) ◽

pp. 1580-1591 ◽

Cited By ~ 47

Author(s):

Julia S Johansen ◽

Stig E Bojesen ◽

Anne Tybjærg-Hansen ◽

Anne K Mylin ◽

Paul A Price ◽

...

Keyword(s):

Cardiovascular Disease ◽

General Population ◽

Early Death ◽

Mortality Rates ◽

Term Survival ◽

Hazard Ratios ◽

Heart Study ◽

Specific Mortality ◽

Disease Specific Mortality ◽

Disease Specific

BACKGROUND Increased plasma YKL-40 is associated with short-term survival in patients with cardiovascular disease and cancer. We tested the hypothesis that increased plasma YKL-40 is associated with total and disease-specific mortality in the general population. METHODS We measured plasma YKL-40 in 8899 study participants, aged 20–95 years, in the Copenhagen City Heart Study from the Danish general population who were followed for 16 years: 3059 died, 2158 had ischemic cardiovascular disease, 2271 had cancer, and 2820 had other diseases associated with increased YKL-40. Hazard ratios for early death and absolute 10-year mortality rates were calculated according to plasma YKL-40 percentile groupings computed within sex and age decade: 0%–33%, 34%–66%, 67%–90%, 91%–95%, and 96%–100%. RESULTS Median survival age decreased from 83 years for participants with plasma YKL-40 in category 0%–33% to 69 years in category 96%–100% (trend, P < 0.0001). Risk of early death was increased (multifactorially adjusted hazard ratios) by 10% for YKL-40 category 34%–66%, by 30% for 67%–90%, by 70% for 91%–95%, and by 90% for 96%–100% vs YKL-40 category 0%–33% (trend, P < 0.0001). Corresponding increases in participants with ischemic cardiovascular disease were 10%, 20%, 80%, and 60% (P < 0.0001); in those with cancer were 10%, 20%, 50%, and 70% (P < 0.0001); and in those with other diseases were 10%, 20%, 40%, and 60% (P < 0.0001). Highest absolute 10-year mortality rates were 78% and 90% in women and men, respectively, who were >70 years old, smoked, and were in YKL-40 category 96%–100%. CONCLUSIONS Increased plasma YKL-40 is associated with risk of early death from cardiovascular disease, cancer, and other diseases in the general population.

Download Full-text

The Expanded Risk Score in Rheumatoid Arthritis (ERS-RA): performance of a disease-specific calculator in comparison with the traditional prediction scores in the assessment of the 10-year risk of cardiovascular disease in patients with rheumatoid arthrit

Swiss Medical Weekly ◽

10.4414/smw.2018.14656 ◽

2018 ◽

Cited By ~ 1

Author(s):

Fausto Salaffi ◽

Marina Carotti ◽

Marco Di Carlo ◽

Marika Tardella ◽

Valentina Lato ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cardiovascular Disease ◽

Risk Score ◽

Disease Specific

Download Full-text

The use of cardiovascular disease states as exclusion criteria in breast cancer trials: A 4-decade perspective.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e18053 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e18053-e18053

Author(s):

Michal Oren ◽

Ohad Oren ◽

David M. Mintzer

Keyword(s):

Breast Cancer ◽

Cardiovascular Disease ◽

Clinical Trials ◽

Cardiac Disease ◽

P Value ◽

Published Data ◽

Original Research ◽

Breast Cancer Patients ◽

Exclusion Criteria ◽

Cardiac Condition

e18053 Background: At the time of diagnosis, patients with breast cancer have a higher prevalence of cardiovascular risk factors than the general population. It is likely that the prevalence of actual cardiac disease is also increased, although no published data is available to support this claim. Individuals with breast cancer who also have heart disease are typically disqualified from clinical trials. We attempted to define the evolution of cardiovascular exclusion criteria in clinical trials of breast cancer over the decades. Methods: We searched the NEJM for original research in “breast cancer” published from 01/1980 to 12/2016. We reviewed the nature of cardiovascular disease as exclusion parameters as well as trends over time. Results: 20 RCTs were analysed, 5 from each decade (total # of patients 21,231). Mean number of cardiac exclusion criteria per study increased over the decades (1980s: 0; 1990s: 0.2; 2000s: 1; 2010s: 7). The most common cardiac exclusion criteria were CHF and recent MI (35% and 25% of studies, respectively). Factors associated with a higher likelihood of having a cardiac exclusion criteria were source of funding (industry vs. university: 77.7% vs. 18.1%, P-value 0.005) and study’s country of origin (U.S versus non-U.S: 57.1% versus 16.6%, P-value 0.02). Prior to 2010, the complete list of exclusion criteria was available with the manuscript. From 2010, it became embedded within the study’s protocol file (and not printed). Cardiovascular AEs were infrequent (1980s: 0.02%; 1990s: 0%, 2000s: 0.08%; 2010: 0.29%). Before 2000, studies described the significant cardiac toxicity in the manuscript. After 2000, a comprehensive registry of AEs contained within supplementary files became the norm. Conclusions: The use of cardiovascular exclusion criteria in clinical trials in breast cancer has become common over the past decades. Currently, it is almost impossible for a woman to enter a trial with even a single cardiac condition. Given that a sizeable fraction of breast cancer patients has cardiac disease, consideration should be given to narrowing the scope of cardiac exclusion criteria to allow more patients to participate, while making the results of those trials more broadly generalisable.

Download Full-text

PRIMARY XANTHOMA TUBEROSUM IN CHILDREN

PEDIATRICS ◽

10.1542/peds.23.1.67 ◽

1959 ◽

Vol 23 (1) ◽

pp. 67-75

Author(s):

Jack E. McCleary ◽

Louis A. Brunsting ◽

Roger L. J. Kennedy

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Angina Pectoris ◽

Cardiac Disease ◽

Blood Lipids ◽

Close Relative ◽

History Of ◽

Coronary Blood Vessels ◽

The One

A brief classification of xanthomatoses is presented. In an attempt to remove some of the confusion contributed by the several different meanings for the term "hyperlipemia," the term "hyperneutralipemia" is introduced to indicate an elevation of the concentrations of neutral fat in the serum. The term "hyperlipemia" is retained to mean an elevation of values for any of the blood lipids. The term "primary xanthoma tuberosum" designates the classic idiopathic form of xanthoma tuberosum associated with hypercholesteremia and without hyperneutralipemia. The primary purpose of this paper is to review the outcome of 11 cases of primary xanthoma tuberosum in children seen at the Mayo Clinic. Five of the eleven are known to be dead from cardiovascular disease, and one other is presumed to be dead. In five of the six patients angina pectoris developed before death. Two patients who are still living have angina pectoris, one having suffered myocardial infarction. Necropsy of four patients showed atheromatous involvement of the coronary blood vessels to be a prominent finding. Three of the patients died before they reached the age of 15 years. Two of the patients were brother and sister. Of the remaining nine patients, four gave a family history of cardiac disease occurring in a close relative early in life and five patients had relatives with cutaneous xanthomas. In the one family studied, all five members had hypercholestenemia.

Download Full-text