scholarly journals Opioid Use and Its Relationship to Cardiovascular Disease and Brain Health: A Presidential Advisory From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Sheryl L. Chow ◽  
Comilla Sasson ◽  
Ivor J. Benjamin ◽  
Robert M. Califf ◽  
Wilson M. Compton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Health Care ◽  
Health Care Professionals ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Brain Health

The misuse of opioids continues to be epidemic, resulting in dependency and a recent upsurge in drug overdoses that have contributed to a significant decrease in life expectancy in the United States. Moreover, recent data suggest that commonly used opioids for the management of pain may produce undesirable pharmacological actions and interfere with critical medications commonly used in cardiovascular disease and stroke; however, the impact on outcomes remains controversial. The American Heart Association developed an advisory statement for health care professionals and researchers in the setting of cardiovascular and brain health to synthesize the current literature, to provide approaches for identifying patients with opioid use disorder, and to address pain management and overdose. A literature and internet search spanning from January 1, 2012, to February 15, 2021, and limited to epidemiology studies, reviews, consensus statements, and guidelines in human subjects was conducted. Suggestions and considerations listed in this document are based primarily on published evidence from this review whenever possible, as well as expert opinion. Several federal and institutional consensus documents and clinical resources are currently available to both patients and clinicians; however, none have specifically addressed cardiovascular disease and brain health. Although strategic tools and therapeutic approaches for recognition of opioid use disorder and safe opioid use are available for health care professionals who manage patients with cardiovascular disease and stroke, high-quality evidence does not currently exist. Therefore, there is an urgent need for more research to identify the most effective approaches to improve care for these patients.

scholarly journals Opioid-Associated Out-of-Hospital Cardiac Arrest: Distinctive Clinical Features and Implications for Health Care and Public Responses: A Scientific Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Cameron Dezfulian ◽  
Aaron M. Orkin ◽  
Bradley A. Maron ◽  
Jonathan Elmer ◽  
Saket Girotra ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Effective Ventilation ◽  
Hospital Cardiac Arrest

Opioid overdose is the leading cause of death for Americans 25 to 64 years of age, and opioid use disorder affects >2 million Americans. The epidemiology of opioid-associated out-of-hospital cardiac arrest in the United States is changing rapidly, with exponential increases in death resulting from synthetic opioids and linear increases in heroin deaths more than offsetting modest reductions in deaths from prescription opioids. The pathophysiology of polysubstance toxidromes involving opioids, asphyxial death, and prolonged hypoxemia leading to global ischemia (cardiac arrest) differs from that of sudden cardiac arrest. People who use opioids may also develop bacteremia, central nervous system vasculitis and leukoencephalopathy, torsades de pointes, pulmonary vasculopathy, and pulmonary edema. Emergency management of opioid poisoning requires recognition by the lay public or emergency dispatchers, prompt emergency response, and effective ventilation coupled to compressions in the setting of opioid-associated out-of-hospital cardiac arrest. Effective ventilation is challenging to teach, whereas naloxone, an opioid antagonist, can be administered by emergency medical personnel, trained laypeople, and the general public with dispatcher instruction to prevent cardiac arrest. Opioid education and naloxone distributions programs have been developed to teach people who are likely to encounter a person with opioid poisoning how to administer naloxone, deliver high-quality compressions, and perform rescue breathing. Current American Heart Association recommendations call for laypeople and others who cannot reliably establish the presence of a pulse to initiate cardiopulmonary resuscitation in any individual who is unconscious and not breathing normally; if opioid overdose is suspected, naloxone should also be administered. Secondary prevention, including counseling, opioid overdose education with take-home naloxone, and medication for opioid use disorder, is important to prevent recurrent opioid overdose.

scholarly journals One Grip a Little Stronger

2003 ◽  
Vol 83 (11) ◽  
pp. 1014-1021 ◽  
Author(s):  
Pamela W Duncan
Keyword(s):  
United States ◽  
Health Care ◽  
Physical Therapy ◽  
Stroke Rehabilitation ◽  
American Heart Association ◽  
American Heart ◽  
Physical Therapist ◽  
Heart Association ◽  
The United States ◽  
Rehabilitation Research

Abstract Pamela W Duncan, PT, PhD, FAPTA Dr Duncan has actively participated in and contributed to physical therapist practice, physical therapist professional education, professional preparation of other health care providers, national policy development related to rehabilitation after stroke and aging, and scientific investigation. She has served several government appointments and provides leadership within several organizations. She served as co-chair of the Consensus Panel on Establishing Guidelines for Stroke Rehabilitation for the Agency for Health Care Policy, Research, and Education. She was a panel member on the National Institutes of Health's Total Hip Replacement Consensus Conference and served on the Strategic Planning Group for Stroke Research for the National Institute of Neurological Disorders and Stroke. She recently was appointed to serve on the Steering Committee of the Department of Education's National Institute on Disability and Rehabilitation Research and is currently on the Executive Leadership Council of the American Stroke Foundation and the Advisory Committee of the Canadian Stroke Network. She has served on committees and panels for the American Heart Association and was president of APTA's Neurology section. Dr Duncan's research activities focus on geriatric rehabilitation, stroke rehabilitation, and health outcomes measurement. She developed the Functional Reach Test, used to assess balance in older adults. In the past 20 years, she has received $13 million in research awards as principal investigator or co-investigator from agencies such as the National Institutes of Health, National Institute on Aging, American Heart Association, Department of Veteran's Affairs, and National Center for Medical Rehabilitation Research and from multiple private funding sources. Dr Duncan has disseminated her research findings in more than 80 peer-reviewed articles in 20 different journals, and she has written a book and 12 book chapters. Dr Duncan's work has influenced the care and rehabilitation of patients in the United States and worldwide. Physical therapy education programs across the country incorporate her findings and professional vision into the preparation of the next generation of physical therapists. APTA has awarded Dr Duncan the Marian Williams Award for Research in Physical Therapy, the Catherine Worthingham Fellowship Award, and the Mary McMillan Scholarship Award. She has also received research awards from the APTA Neurology Section, Sports Physical Therapy Section, and Section on Geriatrics, as well as a service award from the Neurology Section. She is an elected fellow of the Stroke Council of the American Heart Association and has given 8 invited lectureships at universities across the United States.

Identifying Properties for an Aortic Stent-Graft That Counteracts Hypertension

2018 ◽  
Author(s):  
Shannen B. Kizilski ◽  
Omid Amili ◽  
Filippo Coletti ◽  
Rumi Faizer ◽  
Victor H. Barocas
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Stent Graft ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Aortic Stent Graft

In 2017, the American Heart Association reported that one third of deaths in the United States, and 31% of deaths worldwide, are attributed to cardiovascular disease (CVD) [1]. A risk factor pervasive across most types of CVD is chronic high blood pressure, or hypertension [2].

scholarly journals Advancing Healthcare Reform: The American Heart Association’s 2020 Statement of Principles for Adequate, Accessible, and Affordable Health Care: A Presidential Advisory From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 141 (10) ◽  
Author(s):  
John J. Warner ◽  
Ivor J. Benjamin ◽  
Keith Churchwell ◽  
Grace Firestone ◽  
Timothy J. Gardner ◽  
...  
Keyword(s):  
Health Care ◽  
Biomedical Research ◽  
American Heart Association ◽  
Healthcare Reform ◽  
American Heart ◽  
Healthcare Delivery ◽  
Heart Association ◽  
The United States ◽  
Delivery Systems ◽  
Healthcare Delivery Systems

The mission of the American Heart Association is to be a relentless force for a world of longer, healthier lives. The American Heart Association has consistently prioritized the needs and perspective of the patient in taking positions on healthcare reform while recognizing the importance of biomedical research, providers, and healthcare delivery systems in advancing the care of patients and the prevention of disease. The American Heart Association’s vision for healthcare reform describes the foundational changes needed for the health system to serve the best interests of patients and to achieve health care and coverage that are adequate, accessible, and affordable for everyone living in the United States. The American Heart Association is committed to advancing the dialogue around healthcare reform and has prepared this updated statement of our principles, placed in the context of the advances in coverage and care that have occurred after the passage of the Affordable Care Act, the rapidly changing landscape of healthcare delivery systems, and our evolving recognition that efforts to prevent cardiovascular disease can have synergistic benefit in preventing other diseases and improving overall well-being. These updated principles focus on expanding access to affordable health care and coverage; enhancing the availability of evidence-based preventive services; eliminating disparities that limit the availability and equitable delivery of health care; strengthening the public health infrastructure to respond to social determinants of health; prioritizing and accelerating investments in biomedical research; and growing a diverse, culturally competent health and healthcare workforce prepared to meet the challenges of delivering high-value health care.

scholarly journals Workplace Wellness Recognition for Optimizing Workplace Health

Circulation ◽  
2015 ◽  
Vol 131 (20) ◽  
Author(s):  
Gregg C. Fonarow ◽  
Chris Calitz ◽  
Ross Arena ◽  
Catherine Baase ◽  
Fikry W. Isaac ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Stroke Prevention ◽  
American Heart Association ◽  
Cardiovascular Health ◽  
American Heart ◽  
Heart Association ◽  
Wellness Programs ◽  
The United States ◽  
Workplace Wellness ◽  
Workplace Wellness Programs

The workplace is an important setting for promoting cardiovascular health and cardiovascular disease and stroke prevention in the United States. Well-designed, comprehensive workplace wellness programs have the potential to improve cardiovascular health and to reduce mortality, morbidity, and disability resulting from cardiovascular disease and stroke. Nevertheless, widespread implementation of comprehensive workplace wellness programs is lacking, and program composition and quality vary. Several organizations provide worksite wellness recognition programs; however, there is variation in recognition criteria, and they do not specifically focus on cardiovascular disease and stroke prevention. Although there is limited evidence to suggest that company performance on employer health management scorecards is associated with favorable healthcare cost trends, these data are not currently robust, and further evaluation is needed. As a recognized national leader in evidence-based guidelines, care systems, and quality programs, the American Heart Association/American Stroke Association is uniquely positioned and committed to promoting the adoption of comprehensive workplace wellness programs, as well as improving program quality and workforce health outcomes. As part of its commitment to improve the cardiovascular health of all Americans, the American Heart Association/American Stroke Association will promote science-based best practices for comprehensive workplace wellness programs and establish benchmarks for a national workplace wellness recognition program to assist employers in applying the best systems and strategies for optimal programming. The recognition program will integrate identification of a workplace culture of health and achievement of rigorous standards for cardiovascular health based on Life’s Simple 7 metrics. In addition, the American Heart Association/American Stroke Association will develop resources that assist employers in meeting these rigorous standards, facilitating access to high-quality comprehensive workplace wellness programs for both employees and dependents, and fostering innovation and additional research.

scholarly journals The impact of project ECHO on physician preparedness to treat opioid use disorder: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hunter M. Puckett ◽  
Jenny S. Bossaller ◽  
Lincoln R. Sheets
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Professionals ◽  
Underserved Populations ◽  
Medical Condition ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Project Echo ◽  
The Impact

AbstractOpioid use disorder (OUD) is a medical condition that has evolved into a serious and deadly epidemic in the United States. Both medical and psychological interventions are called for to end this growing epidemic, but too few health care professionals are trained to treat OUD. One proven model of training physicians and cross-disciplinary teams in treating a variety of disorders is exemplified by Project ECHO (Extension for Community Healthcare Outcomes), a collaborative tele-mentoring program in which specialists train health-care workers to treat medical conditions, especially those that affect underserved populations. This systematic review found that Project ECHO has the potential to effectively extend current services to patients suffering from OUD, but that there is also a gap in knowledge regarding this type of training. The articles that we reviewed all presented evidence that Project ECHO improves healthcare provider preparedness to treat OUD, especially in regard to improving knowledge and self-efficacy.

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