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Costs cardiovascular disease

Justin Yang, Costas A Christophi, Andrea Farioli, Dorothee M Baur, Steven Moffatt, Terrell W Zollinger, Stefanos N Kales
Importance: Cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Robust evidence indicates an association of increased physical fitness with a lower risk of CVD events and improved longevity; however, few have studied simple, low-cost measures of functional status. Objective: To evaluate the association between push-up capacity and subsequent CVD event incidence in a cohort of active adult men. Design, Setting, and Participants: Retrospective longitudinal cohort study conducted between January 1, 2000, and December 31, 2010, in 1 outpatient clinics in Indiana of male firefighters aged 18 years or older...
February 1, 2019: JAMA network open
Rashida Ginwala, Raina Bhavsar, DeGaulle I Chigbu, Pooja Jain, Zafar K Khan
Inflammation has been reported to be intimately linked to the development or worsening of several non-infectious diseases. A number of chronic conditions such as cancer, diabetes, cardiovascular disorders, autoimmune diseases, and neurodegenerative disorders emerge as a result of tissue injury and genomic changes induced by constant low-grade inflammation in and around the affected tissue or organ. The existing therapies for most of these chronic conditions sometimes leave more debilitating effects than the disease itself, warranting the advent of safer, less toxic, and more cost-effective therapeutic alternatives for the patients...
February 5, 2019: Antioxidants (Basel, Switzerland)
Jeffrey I Mechanick, Alan J Garber, George Grunberger, Yehuda Handelsman, W Timothy Garvey
The American Association of Clinical Endocrinologists (AACE) has created a dysglycemia-based chronic disease (DBCD) multimorbidity care model consisting of four distinct stages along the insulin resistance-prediabetes-type 2 diabetes (T2D) spectrum that are actionable in a preventive care paradigm to reduce the potential impact of T2D, cardiometabolic risk, and cardiovascular events. The controversy of whether there is value, cost-effectiveness, or clinical benefit of diagnosing and/or managing the prediabetes state is resolved by regarding the problem, not in isolation, but as an intermediate stage in the continuum of a progressive chronic disease with opportunities for multiple concurrent prevention strategies...
November 2018: Endocrine Practice
Daniel P Heil, Alona D Angosta, Wei Zhu, Rhigel Alforque-Tan
Filipino Americans have higher risks for developing cardiovascular disease than many other U.S. minority groups and Caucasians. As a precursor to developing a culturally-relevant physical activity (PA) intervention targeting high-risk Filipino Americans, this study sought to evaluate the energy cost and intensity of Tinikling, or bamboo dance, a popular type of Philippine folk dance. These energy cost values were directly compared to the moderate-to-vigorous PA (MVPA) cut-points commonly used to define the PA guidelines...
2019: International Journal of Exercise Science
Andreu Porta-Sánchez, Andrew C T Ha, Xuesong Wang, Fahad Almehmadi, Peter C Austin, Hadas D Fischer, Atif Al-Qubbany, Diego Chemello, Vijay Chauhan, Eugene Downar, Douglas S Lee, Kumaraswamy Nanthakumar
BACKGROUND: Catheter ablation of ventricular tachycardia (VT) can reduce the burden of ventricular arrhythmia (VA) but its effect on health care utilization and costs after such therapy is poorly known. We sought to compare the rates of cardiovascular (CV)-related hospitalizations, survival, and health care costs in patients with recurrent VT treated either with VT ablation or with medical therapy. METHODS: One-hundred implantable cardioverter-defibrillator patients with structural heart disease who underwent VT ablation were included...
February 2019: Canadian Journal of Cardiology
Pasquale Palmiero, Annapaola Zito, Maria Maiello, Annagrazia Cecere, Anna Vittoria Mattioli, Roberto Pedrinelli, Pietro Scicchitano, Marco Matteo Ciccone
Primary prevention of cardiovascular events in older adults is a relevant problem, because of lack of evidence for safe and efficacious therapy, its costs and elderly quality of life, Italy's aging population is constantly increasing, so cardiovascular disease (CVD) primary prevention in the elderly is a prime objective. Life expectancy has dramatically increased over the last 2 decades,the proportion of individuals aged 80 years and older has grown rapidly in Europe and United States,but cost / effective ratio of CVD prevention through risk factors control is debated...
February 11, 2019: Current Hypertension Reviews
M Teresa Perez-Warnisher, M Del Pilar Carballosa de Miguel, Luis M Seijo
Tobacco smoking is recognized as a major preventable cause of disease worldwide and is linked to 6 million deaths annually, 30% of which are due to cancer. The negative health consequences of smoking currently represent one of the greatest global public health challenges. Additionally, secondhand smoke, which was declared carcinogenic by the International Agency for Research on Cancer in 2004, is a major source of morbidity and premature death in nonsmokers, particularly children. Negative health effects associated with exposure to secondhand smoke have been well documented and include lung cancer, cardiovascular disease, asthma, and other respiratory diseases...
January 22, 2019: Annals of Global Health
Fabio V Lima, Dhaval Kolte, David W Louis, Kevin F Kennedy, J Dawn Abbott, Peter A Soukas, Omar N Hyder, Shafiq T Mamdani, Herbert D Aronow
There are limited contemporary data on readmission after revascularization for chronic mesenteric ischemia (CMI). This study aimed to determine the rates, reasons, predictors, and costs of 30-day readmission after endovascular or surgical revascularization for CMI. Patients with CMI discharged after endovascular or surgical revascularization during 2013 to 2014 were identified from the Nationwide Readmissions Database. The rates, reasons, length of stay, and costs of 30-day all-cause, non-elective, readmission were determined using weighted national estimates...
February 10, 2019: Vascular Medicine
Jeffrey Freeman
Treatment of older adults with type 2 diabetes (T2D) is complex because they represent a heterogeneous group with a broad range of comorbidities, functional abilities, socioeconomic status, and life expectancy. Older adults with T2D are at high risk of recurring hypoglycemia, a condition associated with marked morbidity and mortality, because their counter-regulatory mechanism to hypoglycemia is attenuated, and recurring hypoglycemic episodes can lead to hypoglycemia unawareness. In addition, polypharmacy, a result of multiple chronic comorbidities (including heart disease, stroke, and chronic kidney disease), can increase the risk of severe hypoglycemia, especially when patients are taking sulfonylureas or insulin...
February 6, 2019: Postgraduate Medicine
Jamie Sullivan, Vira Pravosud, David M Mannino, Keith Siegel, Radmila Choate, Tracie Sullivan
Background: Chronic obstructive pulmonary disease (COPD) remains a leading cause of disability and death in the United States. The "COPD in the United States" project gathered data about the impact of COPD to highlight variability across states and provide a single point of access to data for state decision makers, the public health community and advocates. This report provides a summary of COPD-related morbidity and mortality in the United States and individual states during 2014-2015 (some metrics contain data from other years)...
October 12, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
Claire T McEvoy, Sarah E Moore, Katherine M Appleton, Margaret E Cupples, Christina M Erwin, Steven J Hunter, Frank Kee, David McCance, Christopher C Patterson, Ian S Young, Michelle C McKinley, Jayne V Woodside
Adoption of a Mediterranean diet (MD) reduces cardiovascular disease (CVD) risk. However, interventions to achieve dietary behaviour change are typically resource intensive. Peer support offers a potentially low-cost approach to encourage dietary change. The primary objective of this randomised controlled trial is to explore the feasibility of peer support versus a previously tested dietetic-led intervention to encourage MD behaviour change, and to test recruitment strategies, retention and attrition in order to inform the design of a definitive trial...
May 31, 2018: International Journal of Environmental Research and Public Health
David Marlevi, Bram Ruijsink, Maximilian Balmus, Desmond Dillon-Murphy, Daniel Fovargue, Kuberan Pushparajah, Cristóbal Bertoglio, Massimiliano Colarieti-Tosti, Matilda Larsson, Pablo Lamata, C Alberto Figueroa, Reza Razavi, David A Nordsletten
Many cardiovascular diseases lead to local increases in relative pressure, reflecting the higher costs of driving blood flow. The utility of this biomarker for stratifying the severity of disease has thus driven the development of methods to measure these relative pressures. While intravascular catheterisation remains the most direct measure, its invasiveness limits clinical application in many instances. Non-invasive Doppler ultrasound estimates have partially addressed this gap; however only provide relative pressure estimates for a range of constricted cardiovascular conditions...
February 4, 2019: Scientific Reports
Raffaella Berchiolli, Francesca Tomei, Michele Marconi, Davide Maria Mocellin, Riccardo Morganti, Marta Mari, Daniele Adami, Mauro Ferrari
OBJECTIVE: Hand-assisted laparoscopic surgery (HALS) for the treatment of abdominal aortic aneurysm (AAA) has shown promising initial results compared with traditional surgery, but its efficacy remains highly debated. The aim of this monocentric, retrospective study was to investigate differences in morbidity, mortality, and reintervention rates between endovascular aneurysm repair (EVAR) and HALS, in the medium- and long-term follow-up in a highly selected population. METHODS: We treated 977 patients consecutively for nonurgent AAA from January 2006 to December 2013; among them, 615 (62...
February 1, 2019: Journal of Vascular Surgery
Rachele M Hendricks-Sturrup, Christine Y Lu
Cardiovascular disease (CVD) is the leading cause of death in the United States (US), with familial hypercholesterolemia (FH) being a major inherited and genetic risk factor for premature CVD and atherosclerosis. Genetic testing has helped patients and providers confirm the presence of known pathogenic and likely pathogenic variations in FH-associated genes. Key organizations, such as the Centers for Disease Control and Prevention (CDC), American Heart Association (AHA), FH Foundation, and National Lipid Association (NLA), have recognized the clinical utility of FH genetic testing...
February 1, 2019: Journal of Personalized Medicine
David M Cutler, Kaushik Ghosh, Kassandra L Messer, Trivellore E Raghunathan, Susan T Stewart, Allison B Rosen
We examined trends in per capita spending for Medicare beneficiaries ages sixty-five and older in the United States in the period 1999-2012 to determine why spending growth has been declining since around 2005. Decomposing spending by condition, we found that half of the spending slowdown was attributable to slower growth in spending for cardiovascular diseases. Spending growth also slowed for dementia, renal and genitourinary diseases, and aftercare for people with acute illnesses. Using estimates from the medical literature of the impact of pharmaceuticals on acute disease, we found that roughly half of the reduction in major cardiovascular events was attributable to medications controlling cardiovascular risk factors...
February 2019: Health Affairs
Ronen Arbel, Ariel Hammerman, Joseph Azuri
Evolocumab and ezetimibe, were both proven to significantly reduce the incidence of major adverse cardiovascular events (MACE), in type 2 diabetes patients with atherosclerotic cardiovascular disease and low-density lipoprotein (LDL) cholesterol >70 mg/dl despite statin therapy. Providing evolocumab for all such patients may be a significant burden on healthcare systems. Therefore, we analyzed the treatment cost of ezetimibe versus evolocumab to prevent 1 MACE. We extracted the number needed to treat (NNT) with evolocumab or with ezetimibe for avoiding MACE from the published FOURIER and IMPROVE-IT trials respectively...
January 23, 2019: American Journal of Cardiology
Ralph A DeFronzo, Silvio Inzucchi, Muhammad Abdul-Ghani, Steven E Nissen
Type 2 diabetes individuals are at high risk for macrovascular complications: myocardial infarction, stroke and cardiovascular mortality. Recent cardiovascular outcome trials have demonstrated that agents in two antidiabetic classes (SGLT2 inhibitors and GLP-1 receptor agonists) reduce major adverse cardiovascular events. However, there is strong evidence that an older and now generically available medication, the thiazolidinedione, pioglitazone, can retard the atherosclerotic process (PERISCOPE and Chicago) and reduce cardiovascular events in large randomized prospective cardiovascular outcome trials (IRIS and PROactive)...
February 1, 2019: Diabetes & Vascular Disease Research
Precious J Kilimo, Tai Le, Ngoc T Phan, Huy-Dung Han, Hoc T Hoang, Nguyen C Vu, Nga Tt Pham, Hung Cao, Cuong K Nguyen
BACKGROUND: Having mobile devices that provide patients with the ability to record and monitor the electrical activity of their heart enhances patient self-care and the early detection of irregular heartbeat (cardiac arrhythmia), yet few such devices exist in Vietnam. Challenges exist for introducing mobile electrocardiography (ECG) monitoring devices in Vietnam, including patient accessibility and affordability. A low-cost mobile ECG monitoring device designed and developed in Vietnam, which allows patients to easily measure their heart's electrical activity and navigate recordings, may be a solution...
January 31, 2019: JMIR Research Protocols
I E Chazova, T V Martynyuk, Z S Valieva, S N Nakonechnikov, S V Nedogoda, A S Salasyuk, I N Taran, S E Gratsianskaya
AIM: The aim of current study was to estimate the economic burden of the chronic thromboembolic pulmonary hypertension (CTEPH) in Russia based on patient registry. MATERIALS AND METHODS: Cost of illness study was based on data derived from CTEPH patient registry that was developed at the Division of hypertension of FSBI "National Medical Research Center of Cardiology". Demographic and clinical patient characteristics were analyzed with descriptive statistic methods...
September 20, 2018: Terapevticheskiĭ Arkhiv
Aynsley Cowie, John Buckley, Patrick Doherty, Gill Furze, Jo Hayward, Sally Hinton, Jennifer Jones, Linda Speck, Hasnain Dalal, Joseph Mills
In 2017, the British Association for Cardiovascular Prevention and Rehabilitation published its official document detailing standards and core components for cardiovascular prevention and rehabilitation. Building on the success of previous editions of this document (published in 2007 and 2012), the 2017 update aims to further emphasise to commissioners, clinicians, politicians and the public the importance of robust, quality indicators of cardiac rehabilitation (CR) service delivery. Otherwise, its overall aim remains consistent with the previous publications-to provide a precedent on which all effective cardiovascular prevention and rehabilitation programmes are based and a framework for use in assessment of variation in service delivery quality...
January 30, 2019: Heart: Official Journal of the British Cardiac Society
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