scholarly journals Vasoplegia after cardiopulmonary bypass: A narrative review of pathophysiology and emerging targeted therapies

2020 ◽  
Vol 8 ◽  
pp. 205031212093546
Author(s):  
Theresa J Barnes ◽  
Maxwell A Hockstein ◽  
Craig S Jabaley
Keyword(s):  
Nitric Oxide ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiopulmonary Bypass ◽  
The United States ◽  
Narrative Review ◽  
Therapeutic Interventions ◽  
Related Disease ◽  
Disease States ◽  
Pathophysiologic Mechanisms

Cardiovascular disease remains the leading cause of death in the United States, and cardiopulmonary bypass is a cornerstone in the surgical management of many related disease states. Pathophysiologic changes associated both with extracorporeal circulation and shock can beget a syndrome of low systemic vascular resistance paired with relatively preserved cardiac output, termed vasoplegia. While increased vasopressor requirements accompany vasoplegia, related pathophysiologic mechanisms may also lead to true catecholamine resistance, which is associated with further heightened mortality. The introduction of a second non-catecholamine vasopressor, angiotensin II, and non-specific nitric oxide scavengers offers potential means by which to manage this challenging phenomenon. This narrative review addresses both the definition, risk factors, and pathophysiology of vasoplegia and potential therapeutic interventions.

Cardiovascular Disease Risk Factors Among Immigrant and US-Born Adults in New York City

2021 ◽  
pp. 003335492110075
Author(s):  
Claudia Chernov ◽  
Lisa Wang ◽  
Lorna E. Thorpe ◽  
Nadia Islam ◽  
Amy Freeman ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
New York ◽  
New York City ◽  
Health Insurance ◽  
York City ◽  
The United States ◽  
Nutrition Examination Survey ◽  
Health And Nutrition

Objectives Immigrant adults tend to have better health than native-born adults despite lower incomes, but the health advantage decreases with length of residence. To determine whether immigrant adults have a health advantage over US-born adults in New York City, we compared cardiovascular disease (CVD) risk factors among both groups. Methods Using data from the New York City Health and Nutrition Examination Survey 2013-2014, we assessed health insurance coverage, health behaviors, and health conditions, comparing adults ages ≥20 born in the 50 states or the District of Columbia (US-born) with adults born in a US territory or outside the United States (immigrants, following the National Health and Nutrition Examination Survey) and comparing US-born adults with (1) adults who immigrated recently (≤10 years) and (2) adults who immigrated earlier (>10 years). Results For immigrant adults, the mean time since arrival in the United States was 21.8 years. Immigrant adults were significantly more likely than US-born adults to lack health insurance (22% vs 12%), report fair or poor health (26% vs 17%), have hypertension (30% vs 23%), and have diabetes (20% vs 11%) but significantly less likely to smoke (18% vs 27%) (all P < .05). Comparable proportions of immigrant adults and US-born adults were overweight or obese (67% vs 63%) and reported CVD (both 7%). Immigrant adults who arrived recently were less likely than immigrant adults who arrived earlier to have diabetes or high cholesterol but did not differ overall from US-born adults. Conclusions Our findings may help guide prevention programs and policy efforts to ensure that immigrant adults remain healthy.

Prevalence and Predictors of Cardiovascular Disease and Risk Factors in Transgender Persons in the United States

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Aditi Malhotra ◽  
Smadar Kort ◽  
Tara Lauther ◽  
Noelle Mann ◽  
Hal A. Skopicki ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
The United States ◽  
Transgender Persons

scholarly journals Mitochondrial Function, Biology, and Role in Disease

2016 ◽  
Vol 118 (12) ◽  
pp. 1960-1991 ◽  
Author(s):  
Elizabeth Murphy ◽  
Hossein Ardehali ◽  
Robert S. Balaban ◽  
Fabio DiLisa ◽  
Gerald W. Dorn ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Mitochondrial Function ◽  
The United States ◽  
Therapeutic Interventions ◽  
Therapeutic Approaches ◽  
Mitochondrial Defects ◽  
Exciting Time ◽  
Insight Into ◽  
Novel Therapeutic

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.

Medical Management of Atherosclerotic Risk Factors in Vascular Surgery Patients

2015 ◽  
Author(s):  
Jayer Chung
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Vascular Surgery ◽  
Medical Management ◽  
Antiplatelet Agents ◽  
The United States ◽  
Moderate Intensity ◽  
National Committee ◽  
Atherosclerotic Risk Factors

There is an epidemic of cardiovascular disease in the United States, which is responsible for approximately one death every 40 seconds in the United States. Whereas the overall mortality attributable to cardiovascular disease is decreasing, the overall prevalence of atherosclerotic risk factors is increasing. Optimal management of atherosclerotic risk factors can have profound effects on morbidity and mortality after vascular surgical procedures. This review covers risk factors for the development of atherosclerosis; the evaluation of patients with vascular disease; management of tobacco abuse, hypertension, hyperlipidemia, diabetes mellitus, and antiplatelet agents; and perioperative medical management concerns in vascular surgery. Tables highlight investigational biomarkers for atherosclerosis, behavioral modification recommendations to be used to improve smoking cessation, Eighth Joint National Committee guidelines for blood pressure management, definitions of high- and moderate-intensity statin therapy, and potential future areas of research. Algorithms lay out the effects of cigarette smoke, the proposed mechanism of statin pleiotropy as it pertains to the vasculature, and the proposed mechanisms of the role of hyperglycemia in atherogenesis. This review contains 3 figures, 6 tables, and 79 references.

Abstract 237: Prevalence of Cardiovascular Risk Factors and Cardiovascular Disease in Transgender Persons in The United States

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Aditi Malhotra ◽  
Hal A Skopicki ◽  
Smadar Kort ◽  
Noelle Mann ◽  
Puja Parikh
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Kidney Disease ◽  
The United States ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Transgender Persons

Background: There is a paucity of data regarding prevalence of cardiovascular disease (CVD) and corresponding cardiovascular (CV) risk factors in transgender individuals. We sought to assess the prevalence of CV risk factors and CVD in transgender persons in the United States. Methods: The 2018 Centers for Disease Control’s Behavioral Risk Factor Surveillance Survey was utilized to identify a cohort of 1,038 transgender individuals in the United States. Presence of CVD was noted with a single affirmative response to the following questions: “Has a health care professional ever told you that you had any of the following:” (1) a heart attack or myocardial infarction, (2) angina or coronary heart disease, (3) a stroke? Results: Among the 1,038 transgender individuals studied, a total of 145 (14.0%) had CVD while 893 (86.0%) did not. No differences in prevalence of CVD was noted in transgender individuals who transitioned from male-to-female (n=387), female-to-male (n=400), and gender nonconforming status (n=251) (15.0% vs 13.8% vs 12.7%, p=0.72). Transgender individuals with CVD were older, had lower annual income, higher rates of smoking (28.4% vs 18.1%, p=0.004), and higher rates of multiple co-morbidities including asthma (26.6% vs 17.4%, p = 0.009), skin cancer (21.8% vs 5.0%, p <0.001), non-skin cancers (16.8% vs 6.8%, p <0.001), chronic obstructive pulmonary disease (27.5% vs 7.0%, p <0.001), arthritis (65.3% vs 28.7%, p<0.001), depressive disorder (42.7% vs 31.0%, p= 0.006), chronic kidney disease (16.2% vs 3.3%, p< 0.001), and diabetes mellitus (42.0% vs 12.7%, p <0.001). No significant differences in race, health insurance status, or body mass index was noted between transgender individuals with CVD versus those without. In multivariable analysis, independent predictors of CVD in transgender individuals included older age, diabetes mellitus [odds ratio (OR) 2.82, 95% confidence interval (CI) 1.73 - 4.58], chronic kidney disease (OR 3.69, 95% CI 1.80 - 7.57), chronic obstructive pulmonary disease (OR 2.18, 95% CI 1.19 - 3.99), and depressive disorder (OR 1.82, 95% CI 1.09 - 3.03). Conclusions: In this observational contemporary study, CVD was prevalent in 14% of transgender individuals in the United States. Predictors of CVD in the transgender population exist and transgender persons should be appropriately screened for CV risk factors so as to minimize their risk of CVD.

scholarly journals The association of nativity/length of residence and cardiovascular disease risk factors in the United States

2020 ◽  
Vol 130 ◽  
pp. 105893
Author(s):  
Cheryl D. Fryar ◽  
Tala H. Fakhouri ◽  
Margaret D. Carroll ◽  
Steven M. Frenk ◽  
Cynthia L. Ogden
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
The United States ◽  
Cardiovascular Disease Risk Factors ◽  
Length Of Residence

scholarly journals Trends in Self-reported Multiple Cardiovascular Disease Risk Factors Among Adults in the United States, 1991-1999

2004 ◽  
Vol 164 (2) ◽  
pp. 181 ◽  
Author(s):  
Kurt J. Greenlund ◽  
Zhi Jie Zheng ◽  
Nora L. Keenan ◽  
Wayne H. Giles ◽  
Michele L. Casper ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
The United States ◽  
Cardiovascular Disease Risk Factors
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