From the Heart to the Brain: Building Bridges to a Better Future

Stroke ◽  
2022 ◽  
Author(s):  
Mitchell S.V. Elkind

This Presidential Address was delivered at the International Stroke Conference in March 2021, during the coronavirus pandemic. Dr Elkind, the President of the American Heart Association (AHA) at the time, is a vascular neurologist with a research focus on stroke epidemiology. This address interweaves personal reflections on a career in clinical neurology, stroke research, and public health with a discussion of the role of the AHA in improving cardiovascular health at multiple levels. Throughout its history, the AHA has had leaders representing many different areas of cardiovascular science and medicine, including stroke. More recently, its focus has expanded from a traditional emphasis on cardiovascular events illness and events, like heart disease and stroke, to an appreciation of the role of the vascular system in brain health, healthy aging, cognitive decline, and dementia. During the pandemic, as the bidirectional effects of the coronavirus on cardiovascular disease has been elucidated, the benefits of a broad and multidisciplinary approach to cardiovascular disease and public health have become more apparent than ever. In addition, with growing awareness of the disproportionate effects of the pandemic on communities of color in the United States and globally, the AHA has redoubled its focus on addressing the social determinants of health, including structural racism. Central to these efforts is the construction of bridges between the generation of scientific knowledge and action for the public good. Our success will depend on the combination of basic, translational, clinical and population research with programs of public and professional education, advocacy, and social action.

2016 ◽  
Vol 118 (12) ◽  
pp. 1960-1991 ◽  
Author(s):  
Elizabeth Murphy ◽  
Hossein Ardehali ◽  
Robert S. Balaban ◽  
Fabio DiLisa ◽  
Gerald W. Dorn ◽  
...  

Cardiovascular disease is a major leading cause of morbidity and mortality in the United States and elsewhere. Alterations in mitochondrial function are increasingly being recognized as a contributing factor in myocardial infarction and in patients presenting with cardiomyopathy. Recent understanding of the complex interaction of the mitochondria in regulating metabolism and cell death can provide novel insight and therapeutic targets. The purpose of this statement is to better define the potential role of mitochondria in the genesis of cardiovascular disease such as ischemia and heart failure. To accomplish this, we will define the key mitochondrial processes that play a role in cardiovascular disease that are potential targets for novel therapeutic interventions. This is an exciting time in mitochondrial research. The past decade has provided novel insight into the role of mitochondria function and their importance in complex diseases. This statement will define the key roles that mitochondria play in cardiovascular physiology and disease and provide insight into how mitochondrial defects can contribute to cardiovascular disease; it will also discuss potential biomarkers of mitochondrial disease and suggest potential novel therapeutic approaches.


Author(s):  
Sarah Bronwen Horton

The only survey of migrant farmworkers’ health in California that used clinical exams to collect data found this occupational group had “startlingly” high rates of hypertension and risk factors for cardiovascular disease. Drawing upon the narratives of two migrant farmworking women who were both hospitalized for hypertension, this chapter explores the role of “immigration stress” and “work stress” in producing their chronic disease. While public health researchers have recently pointed to racial minorities’ physiological response to chronic discrimination as an explanation for their higher rates of hypertension, this chapter makes an analogous argument for legal minorities. It suggests that the recent trend towards heightened interior immigration enforcement subjects all noncitizens to forms of “everyday violence,” only increasing their chronic worry and “perseverative stress.” This chapter explores how the stress of being a legal minority gets under migrants’ skin, helping account for migrant farmworkers’ higher rates of chronic morbidity and mortality.


Author(s):  
Massimo Miglioretti ◽  
Francesca Mariani ◽  
Luca Vecchio

In recent decades, medical malpractice litigation experienced a large-scale expansion in the United States as well as in Europe, involving both medical and surgical specialties. Previous studies have investigated the reasons why patients decide to sue doctors for malpractice and highlighted that adverse outcome, negative communication with doctors and seeking compensation are among the major reasons for malpractice litigation. In this chapter, patient engagement is discussed as a possible method for reducing the risks of doctors being sued for medical malpractice. The results of a first qualitative study underline how an active role for patients and their engagement in the treatment definition and execution could be a way to limit the occurrence of malpractice litigations. However, a second study noted that in Italy, many patients are still struggling to become involved in the process of their care. The authors discuss the role of professional education in promoting patient engagement in Italy.


2020 ◽  
Vol 41 (1) ◽  
pp. 347-361 ◽  
Author(s):  
Jonathan M. Samet ◽  
Thomas A. Burke

The quality of the environment is a major determinant of the health and well-being of a population. The role of scientific evidence is central in the network of laws addressing environmental pollution in the United States and has been critical in addressing the myriad sources of environmental pollution and the burden of disease attributable to environmental factors. We address the shift away from reasoned action and science to a reliance on belief and document the efforts to separate regulation from science and to remove science-based regulations and policies intended to protect public health. We outline the general steps for moving from research to policy, show how each has been undermined, offer specific examples, and point to resources that document the enormity of the current efforts to set aside scientific evidence.


Author(s):  
Sydne DiGiacomo ◽  
Mohammad-Ali Jazayeri ◽  
Rajat Barua ◽  
John Ambrose

Environmental tobacco smoke (ETS) and its sequelae are among the largest economic and healthcare burdens in the United States and worldwide. The relationship between active smoking and atherosclerosis is well-described in the literature. However, the specific mechanisms by which ETS influences atherosclerosis are incompletely understood. In this paper, we highlight the definition and chemical constituents of ETS, review the existing literature outlining the effects of ETS on atherogenesis and thrombosis in both animal and human models, and briefly outline the public health implications of ETS based on these data.


2020 ◽  
Vol 21 (14) ◽  
pp. 4822
Author(s):  
Arvand Asghari ◽  
Michihisa Umetani

Obesity is currently affecting more than 40% of the Americans, and if it progresses with this rate, soon one out of two Americans will be obese. Obesity is an important risk factor for several disorders including cardiovascular disease, the first cause of death in the United States. Cancer follows as the second deadliest disease, and a link between obesity and cancer has been suggested. However, it is very hard to establish an exact connection between obesity and cancers due to the multifactorial nature of obesity. Hypercholesterolemia is a comorbidity of obesity and also linked to several cancers. Recently a cholesterol metabolite 27-hydroxycholesterol (27HC) was found to be an endogenous selective estrogen receptor modulator (SERM), which opened new doors toward several interesting studies on the role of this molecule in biological disorders. It is speculated that 27HC might be the missing link in the obesity and cancer chain. Here, we explored the effects of 27-hydroxycholesterol on obesity and cancers with a focus on the SERM capacity of 27HC.


Author(s):  
Larry Abbott Golemon

The first century of educating clergy in the United States is rightly understood as classical professional education—that is, as formation into an identity and calling to serve the wider public through specialized knowledge and skills. This book argues that pastors, priests, and rabbis were best formed into capacities of culture building through the construction of narratives, symbols, and practices that served their religious communities and the wider public. This kind of education was closely aligned with liberal arts pedagogies of studying classical texts, languages, and rhetoric in order to form habits of inquiry, interpretation, and oratory in students. The theory of culture here is indebted to Clifford Geertz and Jerome Bruner’s social-semiotic view, which identifies culture as the social construction of narrative, symbols, and practices that shape the identity and meaning-making of certain communities. The theological framework of analysis is indebted to George Lindbeck’s cultural-linguistic view, which emphasizes the role of doctrine as grammatical rules that govern narratives, doctrinal grammars, and social practices for distinct religious communities. This framework is pushed toward the renewal and reconstruction of religious frameworks by the postmodern work of Sheila Devaney and Kathryn Tanner. The book also employs several other concepts from social theory, borrowed from Jurgen Habermas, Max Weber, Pierre Bourdieu, Michael Young, and Bernard Anderson.


2012 ◽  
Vol 40 (3) ◽  
pp. 690-695 ◽  
Author(s):  
James G. Hodge ◽  
Lexi C. White ◽  
Andrew Sniegowski

Promoting and protecting the public's health in the United States and abroad are intricately tied to laws and policies. Laws provide support for public health measures, authorize specific actions among public and private actors, and empower public health officials. Laws can also inhibit or restrict efforts designed to improve communal health through protections for individual rights or structural principles of government. Advancing the health of populations through law is complex and subject to constant tradeoffs. This column seeks to explore the role of law in the interests of public health through scholarly and applied assessments across a spectrum of key issues. The first of these assessments focuses on a critical topic in emergency legal preparedness.


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