JAMA Cardiology,
Год журнала:
2024,
Номер
9(10), С. 935 - 935
Опубликована: Июль 17, 2024
Racial
disparities
in
cardiovascular
health,
including
sudden
cardiac
death
(SCD),
exist
among
both
the
general
and
athlete
populations.
Among
competitive
athletes,
health
outcomes
potentially
influenced
by
social
determinants
of
(SDOH)
structural
racism
remain
inadequately
understood.
This
narrative
review
centers
on
race
sports
cardiology,
addressing
racial
SCD
risk,
false-positive
screening
rates
prevalence
left
ventricular
hypertrophy,
encourages
a
reexamination
race-based
practices
such
as
interpretation
12-lead
electrocardiogram
findings.
Kidney International,
Год журнала:
2024,
Номер
105(4), С. S117 - S314
Опубликована: Март 13, 2024
This
article
is
published
as
part
of
a
supplement
sponsored
by
Kidney
Disease:
Improving
Global
Outcomes
(KDIGO).
The
opinions
or
views
expressed
in
this
are
those
the
authors
and
do
not
necessarily
reflect
recommendations
International
Society
Nephrology
Elsevier.
Dosages,
indications,
methods
use
for
products
that
referred
to
may
their
clinical
experience
be
derived
from
professional
literature
other
sources.
Circulation,
Год журнала:
2023,
Номер
148(24), С. 1982 - 2004
Опубликована: Ноя. 10, 2023
Cardiovascular-kidney-metabolic
(CKM)
syndrome
is
a
novel
construct
recently
defined
by
the
American
Heart
Association
in
response
to
high
prevalence
of
metabolic
and
kidney
disease.
Epidemiological
data
demonstrate
higher
absolute
risk
both
atherosclerotic
cardiovascular
disease
(CVD)
heart
failure
as
an
individual
progresses
from
CKM
stage
0
3,
but
optimal
strategies
for
assessment
need
be
refined.
Absolute
with
goal
match
type
intensity
interventions
predicted
expected
treatment
benefit
remains
cornerstone
primary
prevention.
Given
growing
number
therapies
our
armamentarium
that
simultaneously
address
all
3
axes,
prediction
equations
are
needed
incorporate
predictors
outcomes
relevant
context.
This
should
also
include
social
determinants
health,
which
key
upstream
drivers
CVD,
more
equitably
estimate
risk.
scientific
statement
summarizes
background,
rationale,
clinical
implications
newly
developed
sex-specific,
race-free
equations:
PREVENT
(AHA
Predicting
Risk
CVD
Events).
The
enable
10-
30-year
estimates
total
(composite
failure),
estimated
glomerular
filtration
rate
predictor,
adjust
competing
non-CVD
death
among
adults
30
79
years
age.
Additional
models
accommodate
enhanced
predictive
utility
addition
factors
when
clinically
indicated
measurement
(urine
albumin-to-creatinine
ratio
hemoglobin
A1c)
or
health
(social
deprivation
index)
available.
Approaches
implement
risk-based
prevention
using
across
various
settings
discussed.
BACKGROUND:
Cardiovascular
disease
and
stroke
are
common
costly,
their
prevalence
is
rising.
Forecasts
on
the
of
risk
factors
clinical
events
crucial.
METHODS:
Using
2015
to
March
2020
National
Health
Nutrition
Examination
Survey
2019
Medical
Expenditure
Panel
Survey,
we
estimated
trends
in
for
cardiovascular
based
adverse
levels
Life’s
Essential
8
stroke.
We
projected
through
2050,
overall
by
age
race
ethnicity,
accounting
changes
demographics.
RESULTS:
estimate
that
among
adults,
hypertension
will
increase
from
51.2%
61.0%
2050.
Diabetes
(16.3%
26.8%)
obesity
(43.1%
60.6%)
increase,
whereas
hypercholesterolemia
decline
(45.8%
24.0%).
The
prevalences
poor
diet,
inadequate
physical
activity,
smoking
improve
over
time,
sleep
worsen.
Prevalences
coronary
(7.8%
9.2%),
heart
failure
(2.7%
3.8%),
(3.9%
6.4%),
atrial
fibrillation
(1.7%
2.4%),
total
(11.3%
15.0%)
rise.
Clinical
CVD
affect
45
million
including
more
than
184
adults
2050
(>61%).
Similar
children.
Most
be
worse
people
identifying
as
American
Indian/Alaska
Native
or
multiracial,
Black,
Hispanic.
CONCLUSIONS:
many
most
established
diseases
next
30
years.
public
health
interventions
needed
effectively
manage,
stem,
even
reverse
these
trends.
JAMA,
Год журнала:
2024,
Номер
331(22), С. 1898 - 1898
Опубликована: Май 13, 2024
Identification
of
individuals
at
high
risk
for
atherosclerotic
cardiovascular
disease
within
the
population
is
important
to
inform
primary
prevention
strategies.
The
"2024
Guideline
for
the
Primary
Prevention
of
Stroke"
replaces
2014
"Guidelines
Stroke."
This
updated
guideline
is
intended
to
be
a
resource
clinicians
use
guide
various
prevention
strategies
individuals
with
no
history
stroke.
JAMA,
Год журнала:
2024,
Номер
332(12), С. 989 - 989
Опубликована: Июль 29, 2024
Importance
Since
2013,
the
American
College
of
Cardiology
(ACC)
and
Heart
Association
(AHA)
have
recommended
pooled
cohort
equations
(PCEs)
for
estimating
10-year
risk
atherosclerotic
cardiovascular
disease
(ASCVD).
An
AHA
scientific
advisory
group
recently
developed
Predicting
Risk
EVENTs
(PREVENT)
equations,
which
incorporated
kidney
measures,
removed
race
as
an
input,
improved
calibration
in
contemporary
populations.
PREVENT
is
known
to
produce
ASCVD
predictions
that
are
lower
than
those
produced
by
PCEs,
but
potential
clinical
implications
not
been
quantified.
Objective
To
estimate
number
US
adults
who
would
experience
changes
categorization,
treatment
eligibility,
or
outcomes
when
applying
existing
ACC
guidelines.
Design,
Setting,
Participants
Nationally
representative
cross-sectional
sample
7765
aged
30
79
years
participated
National
Health
Nutrition
Examination
Surveys
2011
March
2020,
had
response
rates
ranging
from
47%
70%.
Main
Outcomes
Measures
Differences
predicted
risk,
eligibility
statin
antihypertensive
therapy,
projected
occurrences
myocardial
infarction
stroke.
Results
In
a
nationally
(median
age,
53
years;
51.3%
women),
it
was
estimated
using
reclassify
approximately
half
categories
(53.0%
[95%
CI,
51.2%-54.8%])
very
few
higher
(0.41%
0.25%-0.62%]).
The
receiving
preventive
decrease
14.3
million
(95%
12.6
million-15.9
million)
therapy
2.62
2.02
million-3.21
therapy.
study
that,
over
10
years,
these
decreases
could
result
107
000
additional
Eligibility
affect
twice
many
men
women
greater
proportion
Black
White
adults.
Conclusion
Relevance
By
assigning
predictions,
application
thresholds
reduce
among
15.8
JAMA Internal Medicine,
Год журнала:
2024,
Номер
184(8), С. 963 - 963
Опубликована: Июнь 10, 2024
Importance
In
2023,
the
American
Heart
Association
(AHA)
developed
Predicting
Risk
of
Cardiovascular
Disease
Events
(PREVENT)
equations
to
estimate
10-year
risk
atherosclerotic
cardiovascular
disease
(ASCVD),
as
an
update
2013
pooled
cohort
(PCEs).
The
PREVENT
were
derived
from
contemporary
cohorts
and
removed
race
added
variables
for
kidney
function
statin
use.
Objective
To
compare
national
estimates
ASCVD
using
PCEs
how
these
affect
recommendations
primary
prevention
therapy.
Design,
Setting,
Participants
This
cross-sectional
study
included
adults
aged
40
75
years
who
participated
in
National
Health
Nutrition
Examination
Survey
2017
March
2020.
Adults
defined
eligible
use
based
on
2019
AHA/American
College
Cardiology
guideline
disease.
Data
weighted
be
nationally
representative
analyzed
December
27,
January
31,
2024.
Main
Outcomes
Measures
eligibility
therapy
PCE
calculations.
Results
sample
3785
US
(mean
[SD]
age,
55.7
[9.7]
years;
52.5%
women)
without
known
ASCVD,
20.7%
reported
current
mean
estimated
was
8.0%
(95%
CI,
7.6%-8.4%)
4.3%
4.1%-4.5%)
equations.
Across
all
sex,
racial
subgroups,
compared
with
PCEs,
lower
equations,
largest
difference
Black
(10.9%
[95%
10.1%-11.7%]
vs
5.1%
CI
4.7%-5.4%])
individuals
70
(22.8%
21.6%-24.1%]
10.2%
9.6%-10.8%]).
instead
could
reduce
number
meeting
criteria
45.4
million
40.3
million-50.4
million)
28.3
25.2
million-31.4
million).
other
words,
17.3
14.8
million-19.7
recommended
statins
would
no
longer
including
4.1
2.8
million-5.5
currently
taking
statins.
Based
44.1%
38.6%-49.5%)
statins,
equating
15.8
13.4
million-18.2
not
Conclusions
Relevance
found
that
associated
fewer
being
therapy;
however,
majority
receiving
such
did
report
