scholarly journals Dietary Fat and Cardiovascular Disease: Ebb and Flow Over the Last Half Century

2019 ◽  
Vol 10 (Supplement_4) ◽  
pp. S332-S339 ◽  
Author(s):  
Alice H Lichtenstein
Keyword(s):  
Cardiovascular Disease ◽  
Systematic Reviews ◽  
American Heart ◽  
Saturated Fat ◽  
Heart Association ◽  
Polyunsaturated Fat ◽  
Cvd Risk ◽  
Unsaturated Fat ◽  
The Past ◽  
The Media

ABSTRACT Dietary modification has been the cornerstone of cardiovascular disease (CVD) prevention since the middle of the last century when the American Heart Association (AHA) first issued recommendations. For the vast majority of that time the focus has been on saturated fat, with or without concomitant guidance for total or unsaturated fat. Over the past few years there has been a renewed debate about the relation between dietary saturated fat and CVD risk, prompted by a series of systematic reviews that have come to what appears to be different conclusions. This triggered a robust discourse about this controversy in the media that in turn has led to confusion in the general public. The genesis of the different conclusions among the systematic reviews has been identified in several studies on the basis of isocaloric substitution analyses. When the data were analyzed on the basis of polyunsaturated fat replacing saturated fat, there was a positive relation between dietary saturated fat and CVD. When the data were analyzed on the basis of carbohydrate replacing saturated fat, there was a null relation between dietary saturated fat and CVD. When the substitution macronutrient was not taken into consideration, the differential effects of the macronutrient substitution went unrecognized and the relations judged as null. The lack of distinction among substituted macronutrients accounted for much of what appeared to be discrepancies. Dietary guidance consistent with replacing foods high in saturated fat with foods high in unsaturated fat, first recommended more than 50 y ago, remains appropriate to this day.

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.

scholarly journals Lifestyle Strategies for Risk Factor Reduction, Prevention, and Treatment of Cardiovascular Disease

2018 ◽  
Vol 13 (2) ◽  
pp. 204-212 ◽  
Author(s):  
James M. Rippe
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Health ◽  
American Heart ◽  
Heart Association ◽  
Lifestyle Factors ◽  
Cvd Risk ◽  
Lifestyle Medicine ◽  
Ideal Cardiovascular Health ◽  
Overwhelming Evidence ◽  
The Impact

Daily habits and actions powerfully affect the risk of cardiovascular disease (CVD), in general, and coronary heart disease, in particular. Regular physical activity, sound nutrition, weight management, and not smoking cigarettes have all been demonstrated to significantly reduce the risk of CVD. In 2 large cohort studies a reduction of risk of CVD of >80% and diabetes >90% were demonstrated in individuals who followed a cluster of these lifestyle practices. The study of the impact of lifestyle factors on CVD risk has coalesced under the framework of “lifestyle medicine.” Despite the overwhelming evidence that lifestyle factors affect CVD, a distinct minority of individuals are following these practices. The American Heart Association estimates that only 5% of individuals follow all of these lifestyle factors as components of a strategy to achieve “ideal” cardiovascular health. The challenge to the medical and health care communities is to more aggressively incorporate this information into the daily practices of medicine.

scholarly journals Developing an Internally Validated Veterans Affairs Women Cardiovascular Disease Risk Score Using Veterans Affairs National Electronic Health Records

2021 ◽  
Vol 10 (5) ◽  
Author(s):  
Haekyung Jeon‐Slaughter ◽  
Xiaofei Chen ◽  
Shirling Tsai ◽  
Bala Ramanan ◽  
Ramin Ebrahimi
Keyword(s):  
Cardiovascular Disease ◽  
Risk Score ◽  
American Heart Association ◽  
American Heart ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Heart Association ◽  
Veterans Affairs ◽  
Cvd Risk ◽  
Classification Index

Background The current American College of Cardiology/American Heart Association women cardiovascular disease (CVD) risk score suboptimally estimates CVD risk for young and minority women in the military. The current study developed an internally validated CVD risk score for women military service members and veterans using the Veterans Affairs (VA) national electronic health records data. Methods and Results The study cohort included 69 574 White, Black, and Hispanic women service members and veterans aged 30 to 79 years in 2007 treated in the VA Health Care System between January 1, 2007 and December 31, 2017 (henceforth, VA women). Stratified by race and ethnicity, the new VA women CVD risk model estimated risk coefficients and 10‐year CVD risk using a time‐variant covariate Cox model. Harrell C‐statistics, calibration plots, and net classification index were used to assess accuracy and prognostic performance of the new VA women CVD risk model. The new internally validated VA women CVD risk score performed better in predicting VA women 10‐year atherosclerosis cardiovascular disease risk than the pooled cohort American College of Cardiology/American Heart Association risk score in both accuracy (White Harrell C‐statistics, 70% versus 61%; Black, 68% versus 63%) and prognostic performance (White net classification index, 0.31; 95% CI, 0.26–0.33; Black net classification index, 0.06; 95% CI, 0.03–0.09). Conclusions The proposed VA women CVD risk score improves accuracy of the existing American College of Cardiology/American Heart Association CVD risk assessment tool in predicting long‐term CVD risk for VA women, particularly in young and racial/ethnic minority women.

American College of Cardiology and American Heart Association: guideline on the primary prevention of cardiovascular disease

2020 ◽  
Vol 15 (6) ◽  
pp. 1-6
Author(s):  
Belinda Linden
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
American Heart Association Guideline ◽  
Cardiovascular Nursing ◽  
Prevention Of Cardiovascular Disease

Belinda Linden presents a quarterly overview of recently published guidance of relevance to cardiovascular nursing. A guideline on reducing cardiovascular risk through primary prevention in adults is reviewed in this update.

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