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Cardiovascular Health (cardiovascular + health)
Terms modified by Cardiovascular Health Selected AbstractsPRE-ECLAMPSIA: CONTRIBUTION OF MATERNAL CONSTITUTIONAL FACTORS AND THE CONSEQUENCES FOR CARDIOVASCULAR HEALTHCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 9 2006Anne Barden SUMMARY 1Pre-eclampsia is a serious complication of pregnancy that is potentially life threatening for both the mother and baby. It encompasses a number of abnormalities that may be present in other clinical conditions. 2A placenta is essential for the development of pre-eclampsia and can be important in the pathogenesis of pre-eclampsia. Normal pregnancy is associated with remodelling of the maternal spiral arteries, which deliver blood to the placental villous space. Remodelling involves invasion by placental cytotrophoblasts that cause the maternal spiral arteries to lose their smooth muscle and become capacitance vessels; this process, known as placentation, is complete by 20 weeks of pregnancy. Poor placentation is associated with small-for-gestational-age fetuses and some cases of pre-eclampsia. It is thought that poor placentation can result in a hypoxic placenta that releases ,toxic substances' into the maternal circulation, contributing to the maternal syndrome. A number of candidate ,toxic substances' have been proposed, but none is universally raised in pre-eclampsia. 3Although the placenta is necessary for the development of pre-eclampsia, the extent to which placental abnormalities contribute to the condition varies. It is becoming apparent that maternal constitutional factors may also be important in this syndrome. Underlying hypertension, diabetes and obesity strongly predispose to pre-eclampsia. However, a continuum of risk may exist for blood pressure, bodyweight, glucose and lipids, which, in combination with each other and some degree of placental abnormalities, may lead to the development of pre-eclampsia. 4The present review will focus on the maternal constitutional factors that define the metabolic syndrome and examine their contribution to pre-eclampsia and the long-term consequences for cardiovascular health. [source] New Beverage for Cardiovascular Health, Proposal Based on Oriental and Occidental Food Culture from a World-Wide Epidemiological StudyGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2008Emilio Hideyuki Moriguchi Objectives: To investigate whether combined isoflavones and antioxidants in oriental and occidental drinks reduce the risk of cardiovascular disease (CVD) in high-risk Japanese immigrants living in Brazil. Materials and methods: From among over 100 Japanese immigrants thirty-seven females aged 45,60 years in Porto Alegre, Brazil, were randomized after informed consent into two groups to drink 200 ml of whole soy cell juice (S) containing 7.5 g soy protein and 10 mg of isoflavones (aglycone) in peach juice or placebo peach juice (P) with 80 Kcal for 12 weeks. Health survey including 24-hour urine (24 U) examination were carried out before the randomization and after the double blind placebo controlled intervention study. Results: Both weight and body mass index (BMI) were significantly (p < 0.05, 0.01) decreased from the baseline only in the S group. Systolic blood pressure (SBP) was decreased significantly (p < 0.05) from the baseline in the S group with elevated 24 U isoflavone excretion (>10 µmol), and there was a significant (p < 0.05) inter-group difference between the S and P groups after intervention. Total and low density lipoprotein (LDL)-cholesterol (C) decreased significantly (p < 0.05) in the S group from the baseline and there was a significant difference (p < 0.05) between the S and P groups after intervention. HbA1c and atherogenic index (non-high density lipoprotein (HDL)-C/HDL-C) were significantly (p < 0.05) decreased in both groups. Conclusions: Soy isoflavones combined with fruit antioxidants, the combination of which might potentiate local nitric oxide (NO) affect, decreased SBP, total cholesterol and LDL-C. Peach juice itself improved blood glucose levels and the atherogenic index of the high-risk Japanese population in Brazil. [source] Cardiovascular Disease Is Associated with Greater Incident Dehydroepiandrosterone Sulfate Decline in the Oldest Old: The Cardiovascular Health Study All Stars StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2010Jason L. Sanders BA OBJECTIVES: To describe cross-sectional and longitudinal associations with dehydroepiandrosterone sulfate (DHEAS) and change in DHEAS with age. DESIGN: Longitudinal cohort study. SETTING: Pittsburgh, Pennsylvania. PARTICIPANTS: Cardiovascular Health Study All Stars study participants assessed in 2005/06 (N=989, mean age 85.2, 63.5% women, 16.5% African American). MEASUREMENTS: Health characteristics were assessed in 2005/06 according to DHEAS level, mean DHEAS and DHEAS change across age categories were tested, and linear and logistic regression was used to identify factors present in 1996/97 associated with continuous and categorical DHEAS change. RESULTS: Mean ± standard deviation DHEAS was 0.555 ± 0.414 ,g/mL in 1996/97 and 0.482 ± 0.449 ,g/mL in 2005/06 for women and 0.845 ± 0.520 ,g/mL in 1996/97 and 0.658 ± 0.516 ,g/mL in 2005/06 for men. In 2005/06, DHEAS was lower in women and subjects with cardiovascular disease (CVD) and chronic pulmonary disease and higher for African Americans and subjects with hypertension and high cholesterol. Mean DHEAS change was greater in men (,0.200 ,g/mL) than in women (,0.078 ,g/mL) (P<.001). Each 1-year increase in age attenuated the effect of male sex by 0.01 ,g/mL (P=.009), abolishing the sex difference in DHEAS change by age 79. Presence of CVD before the study period was associated with greater absolute DHEAS change (,=,0.04 ,g/mL, P=.04) and with the fourth quartile of DHEAS change versus the first to third quartiles (odds ratio=1.46, 95% confidence interval=1.03,2.05). CONCLUSION: DHEAS change continues into very old age, is not homogenous, is affected by sex, and is associated with prevalent CVD. Future studies should investigate factors that might accelerate DHEAS decline. [source] Cardiovascular Health in Patients With Serious Mental Illnesses: We Need to Do MoreJOURNAL OF CLINICAL HYPERTENSION, Issue 9 2007Keith C. Ferdinand MD No abstract is available for this article. [source] Cardiovascular Guidelines for Women ReleasedNURSING FOR WOMENS HEALTH, Issue 6 2001Article first published online: 28 JUL 200 This month, AWHONN is releasing the highly anticipated Cardiovascular Health for Women: Primary Prevention evidence-based clinical practice guideline. The release of the guideline coincides with news that all of AWHONN's guidelines to date have been accepted by the Agency for Healthcare Research and Quality for inclusion in the National Guideline Clearinghouse. This achievement truly demonstrates AWHONN's commitment to promoting evidence-based nursing practice to improve the health of women and newborns. Equally important is the national recognition of AWHONN as a leader in women's health, obstetric and neonatal nursing. [source] Mechanisms and Effects of Green Tea on Cardiovascular HealthNUTRITION REVIEWS, Issue 8 2007Arpita Basu PhD Green tea, rich in antioxidant and anti-inflammatory catechins, especially epigallocatechin gallate (EGCG), has been shown to reduce surrogate markers of atherosclerosis and lipid peroxidation, particularly LDL oxidation and malondialdehyde concentrations, in several in vitro, animal, and limited clinical studies. Epidemiological observations in Southeast Asian countries indicate an inverse correlation exists between habitual consumption of green tea beverages and the incidence of cardiovascular events. A few short-term clinical studies have reported its effects in attenuating biomarkers of oxidative stress and inflammation among smokers, and an ability to decrease postprandial lipemia in hypercholesterolemic subjects has also been suggested. However, further investigations are needed to confirm the potential role of green tea beverages and the safety of green tea supplements in reducing body fat, as well as other biomarkers of cardiovascular disease risks. [source] The Emerging Role of Flavonoid-Rich Cocoa and Chocolate in Cardiovascular Health and DiseaseNUTRITION REVIEWS, Issue 3 2006Mary B. Engler PhD Cocoa and chocolate have recently been found to be rich plant-derived sources of antioxidant flavonoids with beneficial cardiovascular properties. These favorable physiological effects include: antioxidant activity, vasodilation and blood pressure reduction, inhibition of platelet activity, and decreased inflammation. Increasing evidence from experimental and clinical studies using cocoa-derived products and chocolate suggest an important role for these high-flavanol-containing foods in heart and vascular protection. [source] Alcohol, Wine, and Cardiovascular HealthCLINICAL CARDIOLOGY, Issue 8 2008Matthew L. Lindberg MD Abstract Studies evaluating the health benefits of alcohol and wine have demonstrated that moderate consumption is associated with a decrease in all-cause and cardiovascular mortality. Various populations and alcoholic beverages exhibit this effect to different degrees. Alcoholic beverages exhibit multiple mechanisms that may favorably influence cardiac risk potential actions on platelets, antioxidants, fibrinolysis, and lipids. However, other data suggest that the perceived benefit of alcoholic beverages in general, and wine in particular, are the result of socioeconomic confounders. In the absence of more rigorous evidence, it is not currently possible to define the role of wine in human health. Copyright © 2008 Wiley Periodicals, Inc. [source] Apolipoprotein E Genotype and Mortality: Findings from the Cache County StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2005Kathleen M. Hayden PhD Objectives: To evaluate the association between apolipoprotein E (apo E) ,4 and mortality, the population attributable risk for mortality with ,4, and relative contributions of cardiovascular disease (CVD) and Alzheimer's disease (AD). Design: Population-based cohort study. Setting: Community-based. Participants: Permanent residents of Cache County, Utah, aged 65 and older as of January 1, 1995. Measurements: Participants were genotyped at the apo E locus using buccal-swab deoxyribonucleic acid. Cardiovascular health was ascertained using self- or proxy-report interviews at participants' residences. AD was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, and National Institute of Neurological and Communicative Disorders and Stroke,Alzheimer's Disease and Related Disorders criteria. Utah Department of Vital Statistics quarterly reports were reviewed to identify participants who died. Results: Crude evaluations showed nonsignificantly greater risk of death for ,2/2 (hazard ratio (HR)=1.66, 95% confidence interval (CI)=0.92,2.76) and ,3/4 (HR=1.11, 95% CI=0.97,1.26) genotypes and significantly greater risk for ,4/4 (HR=1.48, 95% CI=1.09,1.96). After adjustment for age, age2, sex, and education, risks increased to 1.98 (95% CI=1.08,3.35), 1.28 (95% CI=1.12,1.46), and 2.02 (95% CI=1.47,2.71), respectively, compared with ,3/3 genotypes. Adjustment for presence of any CVD did not change the risk of death for ,3/4 and ,4/4. Adjustment for AD reduced the risk of death for ,3/4 (HR=1.13, 95% CI=0.99,1.30) and ,4/4 (HR=1.59, 95% CI=1.15,2.14). The population attributable risk of death for ,3/4 and ,4/4 genotypes combined is estimated at 9.6%. Conclusion: These findings suggested that the ,2/2, ,3/4, and ,4/4 genotypes have greater early mortality risks. Further analyses showed that AD partially mediates the association between ,3/4, ,4/4, and death. [source] The effects of acute and chronic exercise on the vasculatureACTA PHYSIOLOGICA, Issue 4 2010J. J. Whyte Abstract Regular physical activity (endurance training, ET) has a strong positive link with cardiovascular health. The aim of this review is to draw together the current knowledge on gene expression in different cell types comprising the vessels of the circulatory system, with special emphasis on the endothelium, and how these gene products interact to influence vascular health. The effect beneficial effects of ET on the endothelium are believed to result from increased vascular shear stress during ET bouts. A number of mechanosensory mechanisms have been elucidated that may contribute to the effects of ET on vascular function, but there are questions regarding interactions among molecular pathways. For instance, increases in flow brought on by ET can reduce circulating levels of viscosity and haemostatic and inflammatory variables that may interact with increased shear stress, releasing vasoactive substances such as nitric oxide and prostacyclin, decreasing permeability to plasma lipoproteins as well as the adhesion of leucocytes. At this time the optimal rate-of-flow and rate-of-change in flow for determining whether anti-atherogenic or pro-atherogenic processes proceed remain unknown. In addition, the impact of haemodynamic variables differs with vessel size and tissue type in which arteries are located. While the hurdles to understanding the mechanism responsible for ET-induced alterations in vascular cell gene expression are significant, they in no way undermine the established benefits of regular physical activity to the cardiovascular system and to general overall health. This review summarizes current understanding of control of vascular cell gene expression by exercise and how these processes lead to improved cardiovascular health. [source] Improved cardiovascular health following a progressive walking and dietary intervention for type 2 diabetesDIABETES OBESITY & METABOLISM, Issue 9 2009S. T. Johnson Aim: To examine the impact of two different lifestyle programmes on cardiovascular health and glycaemic control among people with type 2 diabetes. Methods: A two-phase 24-week randomized trial. During the first phase, participants were to increase daily steps using a pedometer. At week 12, participants were randomly allocated to either an enhanced lifestyle programme (ELP) targeting walking speed or a basic lifestyle programme (BLP) targeting total daily steps. Both programmes focused on increasing the intake of low glycaemic index foods but utilized different goal setting strategies. Clinical measurements were completed at baseline, week 12 and week 24. Principal outcomes were change in resting pulse rate (PR) and glycated haemoglobin A1c (A1c) between week 12 and week 24 compared between groups using analysis of covariance. Results: Forty-one participants [mean ± s.d. : age = 56.5 ± 7.2 years, body mass index (BMI) = 32.7 ± 6.1 kg/m2] were randomized. After 12 weeks, we observed an increase in average total daily steps of 1562 (95% confidence interval: 303,2821, p = 0.02). Weight, BMI and systolic and diastolic blood pressure improved (p < 0.01 for all). No changes were observed for energy intake. At week 24, those in the ELP had a lower resting PR (71 ± 12 b.p.m.) compared with those in the BLP (78 ± 12 b.p.m.) (adjusted p = 0.03), while no group differences for total daily steps or glycaemic control were observed. Conclusions: Improvements in cardiovascular health can be expected following a pedometer-based lifestyle modification programme that progresses from walking more to walking faster. [source] CB1 receptors: emerging evidence for central and peripheral mechanisms that regulate energy balance, metabolism, and cardiovascular healthDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 7 2007Daniela Cota Abstract Insulin resistance, dyslipidaemia and obesity are the major cardiometabolic risk factors contributing to the development of type 2 diabetes and cardiovascular disease (CVD). Owing to the increasing prevalence of obesity, type 2 diabetes, and CVD, new and effective pharmacologic therapies are urgently needed. In this regard, the endogenous cannabinoid system (ECS), a neuromodulatory system involved in the regulation of various aspects of energy balance and eating behaviour through central and peripheral mechanisms, may present the potential to meet this need. In the central nervous system (CNS), cannabinoid type 1 (CB1) receptors and their respective ligands, the endocannabinoids, have a significant role in the modulation of food intake and motivation to consume palatable food. CB1 receptors have also been found in organs involved in the regulation of metabolic homeostasis, such as liver, white adipose tissue, muscle and pancreas. Dysregulation of the ECS has been associated with the development of dyslipidaemia, glucose intolerance, and obesity, and CB1 receptor blockade may have a role in ameliorating these metabolic abnormalities. Thus, pharmacologic options targeting the ECS may provide a novel, effective approach to the prevention and management of CVD, type 2 diabetes and obesity. Copyright © 2007 John Wiley & Sons, Ltd. [source] Mineral metabolism disturbances in patients with chronic kidney diseaseEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 8 2007B. Kestenbaum Abstract Background Kidney disease, especially chronic kidney disease (CKD), is a worldwide public health problem with serious adverse health consequences for affected individuals. Secondary hyperparathyroidism, a disorder characterized by elevated serum parathyroid hormone levels, and alteration of calcium and phosphorus homeostasis are common metabolic complications of CKD that may impact cardiovascular health. Materials and methods Here, we systematically review published reports from recent observational studies and clinical trials that examine markers of altered mineral metabolism and clinical outcomes in patients with CKD. Results Mineral metabolism disturbances begin early during the course of chronic kidney disease, and are associated with cardiovascular disease and mortality in observational studies. Vascular calcification is one plausible mechanism connecting renal-related mineral metabolism with cardiovascular risk. Individual therapies to correct mineral metabolism disturbances have been associated with clinical benefit in some observational studies; clinical trials directed at more comprehensive control of this problem are warranted. Conclusions There exists a potential to improve outcomes for patients with CKD through increased awareness of the Bone Metabolism and Disease guidelines set forth by the National Kidney Foundation,Kidney Disease Outcomes Quality Initiative. Future studies may include more aggressive therapy with a combination of agents that address vitamin D deficiency, parathyroid hormone and phosphorus excess, as well as novel agents that modulate circulating promoters and inhibitors of calcification. [source] Intimate partner violence and cardiovascular risk: is there a link?JOURNAL OF ADVANCED NURSING, Issue 10 2009Kelly Scott-Storey Abstract Title.,Intimate partner violence and cardiovascular risk: is there a link? Aim., This paper is a report of a study of the relationship between stress associated with intimate partner violence and smoking and cardiovascular risk. Background., Stress related to intimate partner violence persists after a woman leaves an abusive relationship. Persistent stress is associated with cardiovascular disease, the leading single cause of death among women. Smoking, an established risk factor for cardiovascular disease, is a coping mechanism commonly used to decrease the anxiety and stress of intimate partner violence. However, cardiovascular health is poorly understood in abused women. Method., Secondary analysis of data collected between 2004 and 2005 with a community sample of 309 women who had separated from an abusive partner 3 months to 3 years previously was conducted to create a descriptive profile of cardiovascular risk. Bivariate tests of association and logistic regression analysis were used to test relationships among variables. Results., Of the women, 44·1% were smokers; 53·2% had body mass indices classified as overweight or obese; 54·7% had blood pressures above normal range; and 50·8% reported cardiovascular symptoms. Neither severity of intimate partner violence nor smoking behaviours were statistically significant in explaining the presence of cardiovascular symptoms. Conclusion., The prevalence of hypertension, obesity and smoking suggests that survivors of intimate partner violence may be at heightened risk for cardiovascular disease and warrant clinical attention. Because cardiac symptoms develop as women get older, the mean age of 39 years in this sample may explain why intimate partner violence severity and smoking did not sufficiently explain the presence of cardiac symptoms. [source] The diagnosis and management of Kawasaki diseaseJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2005J Royle Abstract:, Kawasaki disease (KD) is a systemic vasculitis of childhood with a predilection for the coronary arteries. It is the predominant cause of paediatric acquired heart disease in developed countries. The aetiology of KD remains unknown and consequently there is no diagnostic test. The diagnosis is made using a constellation of clinical criteria that in isolation have poor sensitivity and specificity. Early treatment prevents overt coronary artery damage in the majority of children. The long-term effects of childhood KD on later cardiovascular health remain unknown. A recent study showed that treatment of KD in Australia is suboptimal, with late diagnosis occurring in approximately half of the cases and an unacceptably high incidence of acute cardiac involvement. These guidelines highlight the difficulties in the diagnosis of KD and offer some clues that may assist early recognition of this important paediatric disease. They also detail current treatment recommendations and the evidence on which they are based. Increased awareness of the epidemiology and spectrum of the clinical presentation of KD is essential for early recognition and optimal management. [source] Drinking Patterns and Myocardial Infarction: A Linear Dose,Response ModelALCOHOLISM, Issue 2 2009Marcia Russell Background:, The relation of alcohol intake to cardiovascular health is complex, involving both protective and harmful effects, depending on the amount and pattern of consumption. Interpretation of data available on the nature of these relations is limited by lack of well-specified, mathematical models relating drinking patterns to alcohol-related consequences. Here we present such a model and apply it to data on myocardial infarction (MI). Methods:, The dose,response model derived assumes: (1) each instance of alcohol use has an effect that either increases or decreases the likelihood of an alcohol-related consequence, and (2) greater quantities of alcohol consumed on any drinking day add linearly to these increases or decreases in risk. Risk was reduced algebraically to a function of drinking frequency and dosage (volume minus frequency, a measure of the extent to which drinkers have more than 1 drink on days when they drink). In addition to estimating the joint impact of frequency and dosage, the model provides a method for calculating the point at which risk related to alcohol consumption is equal to background risk from other causes. A bootstrapped logistic regression based on the dose,response model was conducted using data from a case-control study to obtain the predicted probability of MI associated with current drinking patterns, controlling for covariates. Results:, MI risk decreased with increasing frequency of drinking, but increased as drinking dosage increased. Rates of increasing MI risk associated with drinking dosage were twice as high among women as they were among men. Relative to controls, lower MI risk was associated with consuming < 4.55 drinks per drinking day for men (95% CI: 2.77 to 7.18) and < 3.08 drinks per drinking day for women (95% CI: 1.35 to 5.16), increasing after these cross-over points were exceeded. Conclusions:, Use of a well-specified mathematical dose,response model provided precise estimates for the first time of how drinking frequency and dosage each contribute linearly to the overall impact of a given drinking pattern on MI risk in men and women. [source] School-Based Obesity Interventions: A Literature ReviewJOURNAL OF SCHOOL HEALTH, Issue 4 2008Fadia T. Shaya PhD ABSTRACT Background:, Childhood obesity is an impending epidemic. This article is an overview of different interventions conducted in school settings so as to guide efforts for an effective management of obesity in children, thus minimizing the risk of adult obesity and related cardiovascular risk. Methods:, PubMed and OVID Medline databases were searched for school-based obesity interventions with anthropometric measures in children and adolescents between the ages of 7 and 19 years from June 1986 to June 2006. Studies were reviewed by duration, type of intervention, and defined qualitative and quantitative measures, resulting in a yield of 51 intervention studies. Results:, The interventions ranged from 4 weeks in length to as long as 8 continuing years. In total, 15 of the intervention studies exclusively utilized physical activity programs, 16 studies exclusively utilized educational models and behavior modification strategies, and 20 studies utilized both. In addition, 31 studies utilized exclusively quantitative variables like body mass indices and waist-to-hip ratios to measure the efficacy of the intervention programs, and another 20 studies utilized a combination of quantitative and qualitative measures that included self-reported physical activity and attitude toward physical activity and the tested knowledge of nutrition, cardiovascular health, and physical fitness. A total of 40 studies achieved positive statistically significant results between the baseline and the follow-up quantitative measurements. Conclusions:, No persistence of positive results in reducing obesity in school-age children has been observed. Studies employing long-term follow-up of quantitative and qualitative measurements of short-term interventions in particular are warranted. [source] Using Achievement Goal Theory to Assess an Elementary Physical Education Running ProgramJOURNAL OF SCHOOL HEALTH, Issue 6 2004Ping Xiang ABSTRACT: Using Achievement Goal Theory as a theoretical framework, this study examined an elementary physical education running program called Roadrunners and assessed relationships among achievement goals, perceived motivational climate, and student achievement behavior. Roadrunners promotes cardiovascular health, physical active lifestyles, and mastery behaviors such as persistence and effort. Students were required to run/walk once a week during the school year in their regularly scheduled physical education classes. Participants included 116 fourth graders (67 boys, 49 girls), who participated in Roadrunners since kindergarten. Near the end of spring semester, students completed a 36-item questionnaire assessing achievement goals and perceived motivational climate of Roadrunners. Student persistence/effort was assessed by the number of run/walk laps over the year-long program. Performance was measured by a timed, one-mile run. Results revealed the mastery goal related positively to student persistence/effort for Roadrunners and to their one-mile run performance. Interaction between the mastery goal and perception of a mastery-focused climate emerged as a positive predictor of student one-mile run performance. Results provided additional empirical support for mastery goals and perceptions of a mastery-focused climate as beneficial to student motivation and learning. [source] Emerging concepts in cardiovascular disease risk assessment: Where do women fit in?JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 9 2009Adjunct Instructor, CRNP Cardiovascular Nurse Practitioner, Deborah Gleeson MSN Abstract Purpose: To highlight the current limitations in the assessment of cardiovascular disease (CVD) risk for women. This article will offer the reader information on the current process for assessing CVD risk in women, the pitfalls associated with this current strategy, and the role of novel risk factors. Data sources: Extensive review of the medical literature in the area of women's cardiovascular health. Conclusions: The assessment of CVD risk for women is currently an evolving science. Limitations in the ability of the Framingham score to accurately estimate risk in women from diverse populations are increasingly recognized. Vastly different treatment goals between the genders for similar levels of risk factors have led to a re-evaluation of this strategy in women. While the Framingham score is still useful for guiding cholesterol treatment goals, the current preventive guidelines for women emphasize assessing a woman's risk throughout her lifetime. The future development of tools for improved risk stratification that incorporate novel risk factors may in fact improve our ability to appropriately risk stratify women to evidence-based therapies. Implications for practice: Utilizing the Framingham Risk Assessment Tool and further CVD risk stratification using novel markers such as high sensitivity C-reactive protein, family history, and functional capacity may identify unique subsets of women at higher risk for CVD. Nurse practitioners can be instrumental in this assessment, education, and treatment of women at risk for CVD. [source] A nutrition and health perspective on almondsJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 14 2006Chung-Yen Chen Almonds provide a nutrient-dense source of vitamin E, manganese, magnesium, copper, phosphorus, fibre, riboflavin, monounsaturated fatty acids and protein. Although almost 50% of almond weight is fat, incremental intakes of 7 g day,1 of this tree nut reduce low-density lipoprotein (LDL) cholesterol concentration by 1%, especially within the context of diets recommended by the National Cholesterol Education Program. Habitual almond consumption does not lead to weight gain, and their inclusion in low-calorie diets appears to promote more weight loss than a comparable carbohydrate-based low-calorie diet. Also, almonds have a low glycemic index and do not adversely impact insulin sensitivity. Almonds are an excellent source of bioavailable ,-tocopherol, and increasing their intake enhances the resistance of LDL against oxidation. In addition, the polyphenolic constituents of almonds have been characterised recently and found to possess antioxidant actions. While benefits of almonds for cardiovascular health and obesity-related diseases appear promising, the potential allergenic reaction among susceptible individuals can present a risk. Further research is required to achieve a better understanding of the role that the bioavailability and bioaccessibility of almond constituents and the synergy between them play in their associated health outcomes. Copyright © 2006 Society of Chemical Industry [source] Epigenetics and the embodiment of race: Developmental origins of US racial disparities in cardiovascular healthAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2009Christopher W. Kuzawa The relative contribution of genetic and environmental influences to the US black-white disparity in cardiovascular disease (CVD) is hotly debated within the public health, anthropology, and medical communities. In this article, we review evidence for developmental and epigenetic pathways linking early life environments with CVD, and critically evaluate their possible role in the origins of these racial health disparities. African Americans not only suffer from a disproportionate burden of CVD relative to whites, but also have higher rates of the perinatal health disparities now known to be the antecedents of these conditions. There is extensive evidence for a social origin to prematurity and low birth weight in African Americans, reflecting pathways such as the effects of discrimination on maternal stress physiology. In light of the inverse relationship between birth weight and adult CVD, there is now a strong rationale to consider developmental and epigenetic mechanisms as links between early life environmental factors like maternal stress during pregnancy and adult race-based health disparities in diseases like hypertension, diabetes, stroke, and coronary heart disease. The model outlined here builds upon social constructivist perspectives to highlight an important set of mechanisms by which social influences can become embodied, having durable and even transgenerational influences on the most pressing US health disparities. We conclude that environmentally responsive phenotypic plasticity, in combination with the better-studied acute and chronic effects of social-environmental exposures, provides a more parsimonious explanation than genetics for the persistence of CVD disparities between members of socially imposed racial categories. Am. J. Hum. Biol., 2009. © 2008 Wiley-Liss, Inc. [source] The unique value of primate models in translational researchAMERICAN JOURNAL OF PRIMATOLOGY, Issue 9 2009Carol A. Shively Abstract This special issue of AJP is focused on research using nonhuman primates as models to further the understanding of women's health. Nonhuman primates play a unique role in translational science by bridging the gap between basic and clinical investigations. The use of nonhuman primates in biomedical research challenges our resolve to treat all life as sacred. The scientific community has responded by developing ethical guidelines for the care and the use of primates and clarifying the responsibility of investigators to insure the physical and psychological well-being of nonhuman primates used in research. Preclinical investigations often involve the use of animal models. Rodent models have been the mainstay of biomedical science and have provided enormous insight into the workings of many mammalian systems that h ave proved applicable to human biological systems. Rodent models are dissimilar to primates in numerous ways, which may limit the generalizability to human biological systems. These limitations are much less likely in nonhuman primates and in Old World primates, in particular, Macaques are useful models for investigations involving the reproductive system, bioenergetics, obesity and diabetes, cardiovascular health, central nervous system function, cognitive and social behavior, the musculoskeletal system, and diseases of aging. This issue considers primate models of polycystic ovary syndrome; diet effects on glycemic control, breast and endometrium; estrogen, reproductive life stage and atherosclerosis; estrogen and diet effects on inflammation in atherogenesis; the neuroprotective effects of estrogen therapy; social stress and visceral obesity; and sex differences in the role of social status in atherogenesis. Unmet research needs in women's health include the use of diets in nonhuman primate studies that are similar to those consumed by human beings, primate models of natural menopause, dementia, hypertension, colon cancer, and frailty in old age, and dedicated colonies for the study of breast cancer. Am. J. Primatol. 71:715,721, 2009. © 2009 Wiley-Liss, Inc. [source] C-reactive protein: an independent predictor of cardiovascular disease in Aboriginal AustraliansAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Zhiqiang Wang Abstract Objectives: We assessed the independent contribution of C-reactive protein to the risk of cardiovascular disease in Aboriginal Australians. Methods: High sensitivity CRP levels were measured in 705 Aboriginal participants aged 20,74 years free from CVD at baseline. Participants were followed for a median of 11 years. Cox proportional hazards models were used to assess the association of CRP with the risk of developing CVD events. Results: A total of 114 participants were diagnosed with CVD. Incidence rates were 5.4 and 21.4 per 1,000 person-years for the lower (<3 mg/l) and the higher (,3 mg/l) CRP groups, respectively. After adjusting for age, sex, total cholesterol, systolic blood pressure, smoking status, diabetes, BMI and waist circumference, the association between CRP and CVD remained significant, with a hazard ratio of 2.40 (95% CI: 1.25, 4.62) for the higher CRP group relative to the lower CRP group. The population attributable risk was 52% (95% CI: 14%, 74%). Conclusions: CRP is an independent predictor of CVD in Aboriginal people. A large proportion of CVD cases are associated with elevated CRP levels. Therefore, controlling the conditions that cause inflammation may be beneficial to cardiovascular health in Aboriginal communities. [source] Prevalence of the metabolic syndrome in secondary school adolescents in Beijing, ChinaACTA PAEDIATRICA, Issue 3 2008XU Yi-Qun Abstract Aim: To estimate the prevalence and distribution of the metabolic syndrome and to determine the risk factors associated with the metabolic syndrome in secondary school adolescents. Methods: In 2006, we conducted a school-based survey in Beijing, China. Questionnaire data, anthropometric, blood pressure, and biochemical measurements were available for 2020 adolescents aged 14,16 years. The metabolic syndrome was assessed using the National Cholesterol Education Program's (NCEP) Adult Treatment Panel (ATP) criteria modified for age. Results: The overall prevalence of the metabolic syndrome among adolescents was 3.3%. In Beijing, 4.2% of boys and 2.5% of girls were affected (p < 0.05). The syndrome was present in 28.1% of obese adolescents compared with 6.0% of overweight and 0.2% of normal status (p < 0.001). Abdominal obesity and elevated blood pressure were the most common components of the metabolic syndrome in boys, and elevated triglyceride (TG) and abdominal obesity were the most common in girls. The prevalence of the metabolic syndrome was influenced by body mass index (BMI) status, father's educational degree and pubertal development. Conclusion: The metabolic syndrome and its components are frequent in overweight and obese adolescents in Beijing. Early identification and treatment of these risk factors may help target intervention to improve future cardiovascular health. [source] PRE-ECLAMPSIA: CONTRIBUTION OF MATERNAL CONSTITUTIONAL FACTORS AND THE CONSEQUENCES FOR CARDIOVASCULAR HEALTHCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 9 2006Anne Barden SUMMARY 1Pre-eclampsia is a serious complication of pregnancy that is potentially life threatening for both the mother and baby. It encompasses a number of abnormalities that may be present in other clinical conditions. 2A placenta is essential for the development of pre-eclampsia and can be important in the pathogenesis of pre-eclampsia. Normal pregnancy is associated with remodelling of the maternal spiral arteries, which deliver blood to the placental villous space. Remodelling involves invasion by placental cytotrophoblasts that cause the maternal spiral arteries to lose their smooth muscle and become capacitance vessels; this process, known as placentation, is complete by 20 weeks of pregnancy. Poor placentation is associated with small-for-gestational-age fetuses and some cases of pre-eclampsia. It is thought that poor placentation can result in a hypoxic placenta that releases ,toxic substances' into the maternal circulation, contributing to the maternal syndrome. A number of candidate ,toxic substances' have been proposed, but none is universally raised in pre-eclampsia. 3Although the placenta is necessary for the development of pre-eclampsia, the extent to which placental abnormalities contribute to the condition varies. It is becoming apparent that maternal constitutional factors may also be important in this syndrome. Underlying hypertension, diabetes and obesity strongly predispose to pre-eclampsia. However, a continuum of risk may exist for blood pressure, bodyweight, glucose and lipids, which, in combination with each other and some degree of placental abnormalities, may lead to the development of pre-eclampsia. 4The present review will focus on the maternal constitutional factors that define the metabolic syndrome and examine their contribution to pre-eclampsia and the long-term consequences for cardiovascular health. [source] | ||||||||||||||||||||||||||||