Cardiovascular Disease Prevention Measures Research Articles

Preventing aggressive prostate cancer with proven cardiovascular disease preventive methods.

Cardiovascular disease (CVD) has been the number one cause of death in the U.S. for 114 of the last 115 years. Risk factors for prostate cancer have primarily mirrored risk proven risk factors for CVD, especially aggressive disease. Obesity, dyslipidemia, glucose intolerance, metabolic syndrome, unhealthy dietary habits or caloric excess, lack of physical activity, and inflammation are just some of these shared risk factors. The evidence also suggests proven CVD preventive measures are identical to prostate cancer preventive measures, especially in regard to aggressive disease. Thus, apart from lifestyle measures that can encourage optimal heart and prostate health there are potentially several dietary supplements that need to be avoided in healthy men because they may also increase the risk of prostate cancer. However, there are also several low-cost, generic, safe in the appropriate individuals, and naturally derived agents that could reduce prostate cancer risk, and these can be discussed and remembered utilizing the acronym S.A.M. (statins, aspirin, and/or metformin).

Quality cancer-survivorship care: Receipt of guideline-recommended cardiovascular disease (CVD) preventive care among healthy cancer survivors in the United States.

108 Background: Improving cancer survivorship care is a high priority research area. CVD is a major cause of mortality in cancer survivors. Preventive care reduces CVD mortality and is part of guideline recommended care for all individuals. We examined receipt of CVD preventive measures among healthy cancer survivors compared to the non-cancer population using the National Health Interview Survey (NHIS). Methods: NHIS is a population-based, annual survey designed to provide data representative of the health care received by the U.S. population. For this analysis, 1,860 survivors without CVD risk factors (hypertension, diabetes, or hyperlipidemia) were matched to 7,393 controls without CVD risk factors based on age, race, gender, and survey year. Multivariate logistic regression models examined factors associated with receipt of each preventive measure. Results: Cancer survivors were more likely than controls to visit a general doctor and a specialist during the past year (Table). Further, survivors were more likely to have received CVD preventive care (blood pressure and cholesterol check) and undergone behavior modification (tobacco cessation and exercise). Survivors > 5 years versus < 2 years from diagnosis were no better in CVD preventive measures, except slightly higher rate of exercise (51 vs. 48%, p < 0.001). On multivariate analysis, general doctor visitation was associated with receipt of blood pressure check (OR 7.0), cholesterol check (OR 2.9), smoking cessation attempt (OR 1.4) and exercise (OR 1.3); survivors vs. control were no different in CVD preventive care. Conclusions: Care by a general doctor improves receipt of CVD preventive measures for cancer survivors and non-cancer individuals alike. This study supports the integral involvement of primary care physicians in a “shared care model” for the delivery of quality cancer survivorship care. [Table: see text]

JUSTIFICATION OF A SYSTEMIC APPROACH IN THE SUDDEN CARDIAC DEATH PREVENTION: A POSSIBLE SOLUTION TO THE PROBLEM OF EXCESSIVE MORTALITY IN RUSSIA (LITERATURE REVIEW) PART I. CARDIOVASCULAR ASPECTS OF EXCESSIVE MORALITY IN RUSSIA: THE STATE OF THE PROBLEM AND POTENTIAL FOR PREVENTION

The review of the existing evidence on the problem of excessive mortality in Russia has demonstrated that the country is at the initial stage of the irreversible depopulation process. The current healthcare situation, in regard to cardiovascular disease (CVD), does not provide much hope for the effectiveness of existing measures for fatal CVD prevention. It is clear that a large-scale focussed analysis of the clinical and organisational limitations of the existing prevention systems is urgently needed. This discussion should be started in the nearest future.

Intimate partner violence and cardiovascular risk in women: a population-based cohort study.

A potential link between intimate partner violence (IPV) and cardiovascular disease (CVD) has been suggested, yet evidence is scarce. We assessed cardiovascular risk and incident prescription of cardiovascular medication by lifetime experiences of physical and/or sexual IPV and psychological IPV alone in women. A population-based cohort study of women aged 30-60 years was performed using cross-sectional data and clinical measurements from the Oslo Health Study (2000-2001) linked with prospective prescription records from the Norwegian Prescription Database (January 1, 2004 to December 31, 2009). We used age-standardized chi-square analyses to compare clinical characteristics by IPV cross-sectionally, and Cox proportional hazards regression to examine cardiovascular drug prescription prospectively. Our study included 5593 women without cardiovascular disease or drug use at baseline. Altogether 751 (13.4%) women disclosed IPV experiences: 415 (7.4%) physical and/or sexual IPV and 336 (6.0 %) psychological IPV alone. Cross-sectional analyses showed that women who reported physical and/or sexual IPV and psychological IPV alone were more often smokers compared with women who reported no IPV. Physical and/or sexual violence was associated with abdominal obesity, low high-density lipoprotein cholesterol, and elevated triglycerides. The prospective analysis showed that women who reported physical and/or sexual IPV were more likely to receive antihypertensive medication: incidence rate ratios adjusted for age were 1.27 (95% confidence interval 1.02-1.58) and 1.36 (CI 1.09-1.70) after additional adjustment for education and systolic and diastolic blood pressure, respectively. No significant differences were found for cardiovascular drugs overall or lipid modifying drugs. Our findings indicate that clinicians should assess the cardiovascular risk of women with a history of physical and/or sexual IPV, and consider including CVD prevention measures as part of their follow-up.

Community Implementation and Translation of Kaiser Permanente's Cardiovascular Disease Risk-Reduction Strategy

Since 2003, Kaiser Permanente (KP) has implemented innovative cardiovascular disease (CVD) risk-reduction clinical practices in Northern and Southern California that emphasize the use of cardioprotective medications-aspirin, angiotensin-converting enzyme inhibitors, and statins-in individuals at very high risk of experiencing heart attacks and strokes. Because an internal KP retrospective analysis demonstrated decreased morbidity and mortality among KP patients with diabetes, there is significant value in implementing this strategy in the broader community population, particularly in safety-net clinics serving the uninsured. To implement this risk-reduction clinical practice in the community, clinical and programmatic sections of KP had to connect with a set of community partners that share a similar approach of evidence-based prevention. Successful implementation required a well-planned and coordinated collaboration between KP and the community entities that allowed for and supported adaptation in local delivery structures. Forty-six ambulatory clinic sites based at community health centers and in public hospital/health systems in California's safety net have initiated KP's CVD risk-reduction program. This resulted in 1125 community-clinic patients in Southern California and 1120 patients in Northern California receiving their first prescription for at least 1 of the 3 cardiovascular medications within the first 18 months of implementation. KP Colorado, KP Georgia, and KP Northwest are also implementing these strategies in their local communities. The results of program initiation demonstrate successful translation of the KP CVD risk-reduction strategy to the broader, non-KP member community: uptake of 46 community clinic sites in 2 KP Regions, with a projection of >11,000 patients being prescribed the 3 cardioprotective medications in subsequent years and in multiple Regions. This may be a model for further spread of CVD prevention measures, and prevention programs for other diseases, to all populations throughout the US, notably underserved communities disproportionately affected by chronic conditions.

Preventing CVD in resource-poor areas: perspectives from the 'real-world'

An evolving epidemic of cardiovascular disease (CVD) is having a profound effect on the health of vulnerable populations in low-to-middle income countries with limited resources. Despite some encouraging signs (particularly initiatives from the WHO), global and regional apathy towards noncommunicable forms of CVD adds to the complexity of issues to consider when establishing cost-effective prevention programs. We present our perspective on overcoming the myriad of barriers to providing cost-effective measures for CVD prevention in a resource-poor environment through the 'prism' of our experiences in establishing the Heart of Soweto Study in South Africa.

Putting Prevention In Its Place: The Shift From Clinic To Community

Despite widespread insurance coverage for adult vaccinations, cancer screening, and cardiovascular disease prevention measures, most U.S. adults are not up to date with these routine services. This paper reports the efforts of Sickness Prevention Achieved through Regional Collaboration (SPARC), a New England-based organization working to broaden delivery of preventive measures throughout its communities. SPARC's model regards the physician practice as only one element of a network of coordinated prevention activities. SPARC began with the conceptualization of a policy challenge, designed and evaluated interventions to address that problem, and is now influencing public health policies to expand the delivery of clinical preventive services.