Recent Trends in Cardiovascular Mortality in the United States and Public Health Goals

Sidney, Stephen; Quesenberry, Charles P.; Jaffe, Marc G.; Sorel, Michael; Nguyen‐Huynh, Mai N.; Kushi, Lawrence H.; Go, Alan S.; Rana, Jamal S.

doi:10.1001/jamacardio.2016.1326

Cited by 437 publications

(343 citation statements)

References 21 publications

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“…Deceleration is already observed in the decline of all cardiovascular and stroke mortality rates since 2011. 22 However, the models used for this prediction have engendered debate, since taking into account continued secular trends toward risk factor reduction, coronary mortality may further decrease by 2030 by ≈27% with stroke mortality remaining unchanged. 23 Controversy persists regarding the body mass index that confers the lowest risk for cardiovascular disease and mortality.…”

Section: Risk Factor Modification and Altered Incidence Of Acute Cardmentioning

confidence: 99%

Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

2016

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The concept of "the vulnerable plaque" originated from pathological observations in patients who succumbed to fatal acute coronary syndromes. This recognition spawned a generation of research that led to achievement of considerable understanding of how complicated atherosclerotic plaques form and precipitate thrombotic events.In current practice, an increasing number of patients present with non ST-elevation myocardial infarction (NSTEMI) rather than myocardial infarction (MI) with ST-elevation Key points• An increasing number of patients presenting with myocardial infarction (MI) are diagnosed with a non ST-elevated myocardial infarction (NSTEMI) rather than a MI with ST-elevation (STEMI) and consequently survive their first event.• The shift in the clinical presentations of the acute coronary syndromes mandates a critical reassessment of the underlying mechanisms and the concept of the 3 vulnerable plaque.• The change in clinical presentation and warrant critical re-assessment of currently applied cardiovascular risk scores, pre-clinical experiments, and the usefulness of population data and samples harvested before the application of current preventive interventions.4

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Section: Risk Factor Modification and Altered Incidence Of Acute Cardmentioning

confidence: 99%

Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

2016

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“…1,2 Advanced technologies such as computed tomography (CT) scans, magnetic resonance imaging (MRI), and angiography are routinely used to identify the location of tissue ischemia or infarct and guide treatment options in conditions such as focal occlusive stroke and heart attacks. 3 However, these diagnostic technologies have drawbacks that preclude their routine utilization for primary disease risk assessment in an ambulatory setting.…”

Section: Introductionmentioning

confidence: 99%

Vascular thrombus imaging in vivo via near-infrared fluorescent nanodiamond particles bioengineered with the disintegrin bitistatin (Part II)

Gerstenhaber¹,

Barone²,

Marcinkiewicz³

et al. 2017

IJN

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The aim of this feasibility study was to test the ability of fluorescent nanodiamond particles (F-NDP) covalently conjugated with bitistatin (F-NDP-Bit) to detect vascular blood clots in vivo using extracorporeal near-infrared (NIR) imaging. Specifically, we compared NIR fluorescence properties of F-NDP with N-V (F-NDP NV ) and N-V-N color centers and sizes (100–10,000 nm). Optimal NIR fluorescence and tissue penetration across biological tissues (rat skin, porcine axillary veins, and skin) was obtained for F-NDP NV with a mean diameter of 700 nm. Intravital imaging (using in vivo imaging system [IVIS]) in vitro revealed that F-NDP NV -loaded glass capillaries could be detected across 6 mm of rat red-muscle barrier and 12 mm of porcine skin, which equals the average vertical distance of a human carotid artery bifurcation from the surface of the adjacent skin (14 mm). In vivo, feasibility was demonstrated in a rat model of occlusive blood clots generated using FeCl 3 in the carotid artery bifurcation. Following systemic infusions of F-NDP NV -Bit (3 or 15 mg/kg) via the external carotid artery or femoral vein (N=3), presence of the particles in the thrombi was confirmed both in situ via IVIS, and ex vivo via confocal imaging. The presence of F-NDP NV in the vascular clots was further confirmed by direct counting of fluorescent particles extracted from clots following tissue solubilization. Our data suggest that F-NDP NV -Bit associate with vascular blood clots, presumably by binding of F-NDP NV -Bit to activated platelets within the blood clot. We posit that F-NDP NV -Bit could serve as a noninvasive platform for identification of vascular thrombi using NIR energy monitored by an extracorporeal device.

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“…119 Advances in CVD survival no longer approach the prior rate of decline despite improvements in treatment.…”

Section: Original Research and Contributionsmentioning

confidence: 99%

Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival

Bodai¹,

Nakata²,

Wong

et al. 2018

TPJ

153

106

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By ignoring the root causes of disease and neglecting to prioritize lifestyle measures for prevention, the medical community is placing people at harm. Advanced nations, influenced by a Western lifestyle, are in the midst of a health crisis, resulting largely from poor lifestyle choices. Epidemiologic, ecologic, and interventional studies have repeatedly indicated that most chronic illnesses, including cardiovascular disease, cancer, and type 2 diabetes, are the result of lifestyles fueled by poor nutrition and physical inactivity.In this article, we describe the practice of lifestyle medicine and its powerful effect on these modern instigators of premature disability and death. We address the economic benefits of prevention-based lifestyle medicine and its effect on our health care system: A system on the verge of bankruptcy. We recommend vital changes to a disastrous course. Many deaths and many causes of pain, suffering, and disability could be circumvented if the medical community could effectively implement and share the power of healthy lifestyle choices. We believe that lifestyle medicine should become the primary approach to the management of chronic conditions and, more importantly, their prevention. For future generations, for our own health, and for the Hippocratic Oath we swore to uphold ("First do no harm"), the medical community must take action. It is our hope that the information presented will inspire our colleagues to pursue lifestyle medicine research and incorporate such practices into their daily care of patients. The time to make this change is now.

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Recent Trends in Cardiovascular Mortality in the United States and Public Health Goals

Abstract: Deceleration in the decline of all CVD, HD, and stroke mortality rates has occurred since 2011. If this trend continues, strategic goals for lowering the burden of CVD set by the American Heart Association and the Million Hearts Initiative may not be reached.

Cited by 437 publications

References 21 publications

Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

Vascular thrombus imaging in vivo via near-infrared fluorescent nanodiamond particles bioengineered with the disintegrin bitistatin (Part II)

Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival

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