scholarly journals Future Perspectives of Cardiovascular Biomarker Utilization in Cancer Survivors: A Scientific Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Vlad G. Zaha ◽  
Salim S. Hayek ◽  
Kevin M. Alexander ◽  
Theresa M. Beckie ◽  
W. Gregory Hundley ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cardiovascular Health ◽  
Biomarker Discovery ◽  
Multimodality Imaging ◽  
Heart Association ◽  
Clinical Work ◽  
Systemic Approach ◽  
Physiological Data ◽  
Cardiovascular Tissue ◽  
Scientific Statement

Improving cancer survival represents the most significant effect of precision medicine and personalized molecular and immunologic therapeutics. Cardiovascular health becomes henceforth a key determinant for the direction of overall outcomes after cancer. Comprehensive tissue diagnostic studies undoubtedly have been and continue to be at the core of the fight against cancer. Will a systemic approach integrating circulating blood-derived biomarkers, multimodality imaging technologies, strategic panomics, and real-time streams of digitized physiological data overcome the elusive cardiovascular tissue diagnosis in cardio-oncology? How can such a systemic approach be personalized for application in day-to-day clinical work, with diverse patient populations, cancer diagnoses, and therapies? To address such questions, this scientific statement approaches a broad definition of the biomarker concept. It summarizes the current literature on the utilization of a multitude of established cardiovascular biomarkers at the intersection with cancer. It identifies limitations and gaps of knowledge in the application of biomarkers to stratify the cardiovascular risk before cancer treatment, monitor cardiovascular health during cancer therapy, and detect latent cardiovascular damage in cancer survivors. Last, it highlights areas in biomarker discovery, validation, and clinical application for concerted efforts from funding agencies, scientists, and clinicians at the cardio-oncology nexus.

scholarly journals Achieving Optimal Population Cardiovascular Health Requires an Interdisciplinary Team and a Learning Healthcare System: A Scientific Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Author(s):  
Randi E. Foraker ◽  
Catherine P. Benziger ◽  
Bailey M. DeBarmore ◽  
Crystal W. Cené ◽  
Fleetwood Loustalot ◽  
...  
Keyword(s):  
Healthcare System ◽  
Cardiovascular Health ◽  
Interdisciplinary Team ◽  
Heart Association ◽  
Evidence Base ◽  
Current Evidence ◽  
Team Approach ◽  
Learning Healthcare System ◽  
Scientific Statement ◽  
The Impact

Population cardiovascular health, or improving cardiovascular health among patients and the population at large, requires a redoubling of primordial and primary prevention efforts as declines in cardiovascular disease mortality have decelerated over the past decade. Great potential exists for healthcare systems–based approaches to aid in reversing these trends. A learning healthcare system, in which population cardiovascular health metrics are measured, evaluated, intervened on, and re-evaluated, can serve as a model for developing the evidence base for developing, deploying, and disseminating interventions. This scientific statement on optimizing population cardiovascular health summarizes the current evidence for such an approach; reviews contemporary sources for relevant performance and clinical metrics; highlights the role of implementation science strategies; and advocates for an interdisciplinary team approach to enhance the impact of this work.

scholarly journals Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association

Circulation ◽  
2017 ◽  
Vol 136 (21) ◽  
Author(s):  
Mercedes R. Carnethon ◽  
Jia Pu ◽  
George Howard ◽  
Michelle A. Albert ◽  
Cheryl A.M. Anderson ◽  
...  
Keyword(s):  
African Americans ◽  
American Heart Association ◽  
Cardiovascular Health ◽  
American Heart ◽  
Heart Association ◽  
Scientific Statement

scholarly journals Assessing and Addressing Cardiovascular Health in LGBTQ Adults: A Scientific Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 142 (19) ◽  
Author(s):  
Billy A. Caceres ◽  
Carl G. Streed ◽  
Heather L. Corliss ◽  
Donald M. Lloyd-Jones ◽  
Phoenix A. Matthews ◽  
...  
Keyword(s):  
Behavioral Interventions ◽  
Minority Stress ◽  
American Heart Association ◽  
Cardiovascular Health ◽  
American Heart ◽  
Heart Association ◽  
Future Research ◽  
Cardiovascular Research ◽  
Scientific Statement ◽  
And Gender

There is mounting evidence that lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) adults experience disparities across several cardiovascular risk factors compared with their cisgender heterosexual peers. These disparities are posited to be driven primarily by exposure to psychosocial stressors across the life span. This American Heart Association scientific statement reviews the extant literature on the cardiovascular health of LGBTQ adults. Informed by the minority stress and social ecological models, the objectives of this statement were (1) to present a conceptual model to elucidate potential mechanisms underlying cardiovascular health disparities in LGBTQ adults, (2) to identify research gaps, and (3) to provide suggestions for improving cardiovascular research and care of LGBTQ people. Despite the identified methodological limitations, there is evidence that LGBTQ adults (particularly lesbian, bisexual, and transgender women) experience disparities across several cardiovascular health metrics. These disparities vary by race, sex, sexual orientation, and gender identity. Future research in this area should incorporate longitudinal designs, elucidate physiological mechanisms, assess social and clinical determinants of cardiovascular health, and identify potential targets for behavioral interventions. There is a need to develop and test interventions that address multilevel stressors that affect the cardiovascular health of LGBTQ adults. Content on LGBTQ health should be integrated into health professions curricula and continuing education for practicing clinicians. Advancing the cardiovascular health of LGBTQ adults requires a multifaceted approach that includes stakeholders from multiple sectors to integrate best practices into health promotion and cardiovascular care of this population.

scholarly journals Cardiovascular Health in Turner Syndrome: A Scientific Statement From the American Heart Association

2018 ◽  
Vol 11 (10) ◽  
Author(s):  
Michael Silberbach ◽  
Jolien W. Roos-Hesselink ◽  
Niels H. Andersen ◽  
Alan C. Braverman ◽  
Nicole Brown ◽  
...  
Keyword(s):  
Turner Syndrome ◽  
American Heart Association ◽  
Cardiovascular Health ◽  
American Heart ◽  
Heart Association ◽  
Scientific Statement

scholarly journals 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Alice H. Lichtenstein ◽  
Lawrence J. Appel ◽  
Maya Vadiveloo ◽  
Frank B. Hu ◽  
Penny M. Kris-Etherton ◽  
...  
Keyword(s):  
Dietary Patterns ◽  
Fruits And Vegetables ◽  
Cardiovascular Health ◽  
Critical Role ◽  
Heart Association ◽  
Cardiometabolic Health ◽  
Processed Foods ◽  
Structural Racism ◽  
Scientific Statement ◽  
Targeted Marketing

Poor diet quality is strongly associated with elevated risk of cardiovascular disease morbidity and mortality. This scientific statement emphasizes the importance of dietary patterns beyond individual foods or nutrients, underscores the critical role of nutrition early in life, presents elements of heart-healthy dietary patterns, and highlights structural challenges that impede adherence to heart-healthy dietary patterns. Evidence-based dietary pattern guidance to promote cardiometabolic health includes the following: (1) adjust energy intake and expenditure to achieve and maintain a healthy body weight; (2) eat plenty and a variety of fruits and vegetables; (3) choose whole grain foods and products; (4) choose healthy sources of protein (mostly plants; regular intake of fish and seafood; low-fat or fat-free dairy products; and if meat or poultry is desired, choose lean cuts and unprocessed forms); (5) use liquid plant oils rather than tropical oils and partially hydrogenated fats; (6) choose minimally processed foods instead of ultra-processed foods; (7) minimize the intake of beverages and foods with added sugars; (8) choose and prepare foods with little or no salt; (9) if you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake; and (10) adhere to this guidance regardless of where food is prepared or consumed. Challenges that impede adherence to heart-healthy dietary patterns include targeted marketing of unhealthy foods, neighborhood segregation, food and nutrition insecurity, and structural racism. Creating an environment that facilitates, rather than impedes, adherence to heart-healthy dietary patterns among all individuals is a public health imperative.

scholarly journals Assessing and Addressing Cardiovascular Health in People Who Are Transgender and Gender Diverse: A Scientific Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Carl G. Streed ◽  
Lauren B. Beach ◽  
Billy A. Caceres ◽  
Nadia L. Dowshen ◽  
Kerrie L. Moreau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Health ◽  
American Heart ◽  
Heart Association ◽  
Gender Diverse ◽  
Cardiovascular Morbidity And Mortality ◽  
Scientific Statement ◽  
And Gender

There is growing evidence that people who are transgender and gender diverse (TGD) are impacted by disparities across a variety of cardiovascular risk factors compared with their peers who are cisgender. Prior literature has characterized disparities in cardiovascular morbidity and mortality as a result of a higher prevalence of health risk behaviors. Mounting research has revealed that cardiovascular risk factors at the individual level likely do not fully account for increased risk in cardiovascular health disparities among people who are TGD. Excess cardiovascular morbidity and mortality is hypothesized to be driven in part by psychosocial stressors across the lifespan at multiple levels, including structural violence (eg, discrimination, affordable housing, access to health care). This American Heart Association scientific statement reviews the existing literature on the cardiovascular health of people who are TGD. When applicable, the effects of gender-affirming hormone use on individual cardiovascular risk factors are also reviewed. Informed by a conceptual model building on minority stress theory, this statement identifies research gaps and provides suggestions for improving cardiovascular research and clinical care for people who are TGD, including the role of resilience-promoting factors. Advancing the cardiovascular health of people who are TGD requires a multifaceted approach that integrates best practices into research, health promotion, and cardiovascular care for this understudied population.

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