Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA / 07.08.2020

MedicalResearch.com Interview with: Ty J. Gluckman, M.D., FACC Providence St Joseph Health Portland, Oregon MedicalResearch.com: What is the background for this study? Response: In spite of significant decreases in the incidence of coronary artery disease, an estimated 800,000 Americans are expected to be diagnosed with an acute myocardial infarction (AMI) this year.  For large numbers of these patients, substantial benefit is afforded by early diagnosis and treatment.  Accordingly, multiple campaigns have been launched over time to increase public awareness about the symptoms and signs of AMI and the need to seek immediate medical attention. The COVID-19 pandemic has profoundly changed health care delivery worldwide.  While early attention was disproportionately focused on efforts to “flatten the curve”, recent reports have revealed a disturbing finding—a substantial decrease in the hospitalization rate for AMI.  Most worrisome among potential reasons for this has been reluctance of patients with an AMI to seek medical attention out of fear that they become infected with SARS-CoV-2. To better understand the impacts associated with this, we performed a retrospective, cross-sectional study of all AMI hospitalizations in a large multistate health care system (Providence St. Joseph Health).  We sought to define changes in AMI case rates, patient demographics, cardiovascular comorbidities, treatment approaches and in-hospital outcomes during the pandemic. (more…)
Author Interviews, Endocrinology, Heart Disease, Women's Heart Health / 05.08.2020

MedicalResearch.com Interview with: Dr.  Clare Oliver-Williams PhD University of Cambridge MedicalResearch.com: What is the background for this study? Response: Women with PCOS are known to be at greater risk of CVD, however the some symptoms (menstrual irregularity) of PCOS are specific to reproductive age women. This raises the question of whether CVD risk varies across by age, which was the focus of my research with colleagues at the University of Copenhagen. MedicalResearch.com: What should readers take away from your report? Response: Women with PCOS were at 19% higher CVD risk than women without CVD, however once the association was stratified by age, there was no  evidence for a higher CVD risk for women older than 50.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, JAMA / 28.07.2020

MedicalResearch.com Interview with: Frank Wharam, MD, MPH Department of Population Medicine Harvard Medical School and Harvard Pilgrim Healthcare Institute Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response:  There is substantial concern that high-deductible health plans increase people’s risk of major adverse health events such as heart attack and stroke. No studies have examined this question. This study examines the effects of a transition to a high-deductible health plan on the risk of major adverse cardiovascular outcomes (myocardial infarction and stroke). The study group included individuals with risk factors for cardiovascular disease who were continuously enrolled in low-deductible (<$500) health plans during a baseline year followed by up to 4 years in high-deductible (≥$1000) plans after an employer-mandated switch. The matched control group included individuals with the same risk factors who were contemporaneously enrolled in low-deductible plans.  We examined time to first major adverse cardiovascular event, defined as myocardial infarction or stroke.  (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA, MRI / 28.07.2020

MedicalResearch.com Interview with: Assoc. Prof. Dr. Valentina Puntmann, MD, PhD, FRCP Deputy Head Goethe CVI Fellowship Programme Lead Consultant Physician, Cardiologist and Clinical Pharmacologist Institute for Experimental and Translational Cardiovascular Imaging DZHK Centre for Cardiovascular Imaging - Goethe CVI Department of Cardiology, Division of Internal Medicine University Hospital Frankfurt, Germany MedicalResearch.com: What is the background for this study? Response: Patients who recently recovered from COVID19 have been identified through the testing centre and invited to be screened for cardiac involvement with MRI. Importantly, they have not come to us because of having heart problems. In fact, none of them thought that they had had anything wrong with the heart.  They were mostly healthy, sporty and well prior to their illness. A considerable proportion had been infected while on skiing vacations. (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 14.07.2020

MedicalResearch.com Interview with: Mario Fl Gaudino MD Professor of Cardiothoracic Surgery Department of Cardiothoracic Surgery Weill Cornell Medicine  MedicalResearch.com: What is the background for this study? Response: The radial artery is currently used in less than 10% of CABG procedures in the US.  MedicalResearch.com: What are the main findings? Response: The JAMA paper provides convincing evidence that the use of the radial artery rather than the saphenous vein to complement the internal thoracic artery for CABG is associated with improved long-term outcomes.  (more…)
Author Interviews, Exercise - Fitness, Heart Disease / 08.07.2020

MedicalResearch.com Interview with: Prof. Emiliano Cè Department of Biomedical Sciences for Health University of Milan Via Giuseppe Colombo, 71(2nd Building) Milan, Italy MedicalResearch.com: What is the background for this study? Response: We investigated the effects of long-term passive stretch training of the lower limb on vascular function and stiffness of the arteries involved (femoral and popliteal) and uninvolved (brachial) in the stretching protocol. Thirty-nine healthy participants of both sexes were randomly assigned to bilateral, unilateral or control (i.e., no passive stretch training). Passive stretch training was performed on knee extensor, plantar flexor muscles, and posterior muscle chain, 5 times a week for 12 weeks. Before and after the training period, vascular function was measured by Doppler ultrasounds during single passive limb movement (i.e., passive knee flexion-extension) and flow-mediated dilation (i.e., brachial and popliteal arteries). Measures of central (carotid-femoral artery) and peripheral (carotid-radial artery) arterial stiffness were performed by applanation tonometry technique. The same technique was used to assess the pulse wave velocity at the carotid artery level.  (more…)
Author Interviews, Emergency Care, Heart Disease, Social Issues / 28.06.2020

MedicalResearch.com Interview with: Sriman Gaddam The University of Texas at Austin Austin, TX 78705 MedicalResearch.com: What is the background for this study? Response: The quality of care that patients receive from the US healthcare system continues to be influenced by socioeconomic status (SES). Given that cardiac arrest is one of the most common causes of death in the US and that the prehospital setting has an especially high mortality for cardiac arrest, we wanted to determine if the socioeconomic disparities found in the overall US healthcare system continued into the prehospital cardiac arrest setting. MedicalResearch.com: What are the main findings? Response: We found that socioeconomic disparities were present in the prehospital cardiac arrest setting. As the SES of a patient declines, so does the patient's likelihood of achieving return of spontaneous circulation (ROSC). Between the most and least wealthy patients, there was nearly a 13% difference in the probability of achieving ROSC. However, we recognized that not all patients who achieve ROSC are equal as patients can have significantly different neurological functioning depending on the length of time spent in cardiac arrest. Consequently, this paper analyzed cardiac arrest outcomes not only through the occurrence of ROSC but also through the duration of time spent in cardiac arrest. In line with the socioeconomic disparities found in ROSC occurrence, it was found that as a patient's SES declines, the duration of time spent in cardiac arrest before ROSC is achieved increases. This indicates that patients with a low SES are both more likely to not achieve ROSC and if ROSC is achieved more likely to have neurological impairment due to longer time spent in cardiac arrest compared to patients with a high SES. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease / 24.06.2020

MedicalResearch.com Interview with: Spyridon G. Deftereos MD PhD Prof. of Cardiology, Medical School National and Kapodistrian University of Athens Greece MedicalResearch.com: What is the background for this study? Response: Research on COVID-19 early revealed that inflammation plays a crucial role in the pathophysiology of the disease. Therefore, we designed GRECCO-19 study in order to evaluate the effect of colchicine, a relatively safe drug with known anti-inflammatory properties, in patients hospitalized for SARS-CoV-2 infection. (more…)
Author Interviews, Heart Disease, JAMA, Opiods, Surgical Research, University of Pennsylvania / 20.06.2020

MedicalResearch.com Interview with: Chase Brown, MD Associate Fellow, Leonard Davis Institute of Health Economics Integrated Cardiac Surgery Resident Hospital of the University of Pennsylvania Nimesh D. Desai, MD, PhD Director, Thoracic Aortic Surgery Research Program Associate Professor of Surgery Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Dr. Chase Brown:  Opioid use in the United States is a public health emergency. We know that opioids prescribed after general surgery operations to patients who never received them within the year prior to their surgery are at increased risk for continuing to take opioids months later. However, this has not been studied in patients undergoing cardiac surgery, who often times have more severe post-operative pain. Our goal in this study was to determine how many patients after cardiac surgery and are opioid naive are continuing to take opioids within 90-180 days after their surgery.   (more…)
Author Interviews, Gout, Heart Disease / 14.06.2020

MedicalResearch.com Interview with: Brian LaMoreaux, M.D., M.S. Medical Director, Medical Affairs Horizon Therapeutics MedicalResearch.com: What is the background for this study? Response: This is an independent study by Dr. Gurkipal Singh for which Horizon provided support and funding. Heart failure is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017. Dr. Gurkirpal Singh conducted this analysis on heart failure hospitalization rates in patients with gout in the US to estimate their clinical and economic impact. Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure, but there is little nationwide data on the clinical and economic consequences of these comorbidities. (more…)
Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, Heart Disease, JACC, Lipids / 23.05.2020

MedicalResearch.com Interview with: Robert P. Giugliano, MD, SM Senior Investigator, TIMI Study Group Cardiovascular Medicine Brigham and Women's Hospital Professor of Medicine Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? Response: Some prior studies had suggested that lipid lowering therapies were associated with impaired cognition.  We sought to explore this question in a prospectively designed substudy of the large FOURIER randomized, double-blind clinical trial utilizing patient self-surveys administered the end of the study to determine whether patients themselves noticed any changes in cognition over the duration of the trial. The survey tool was a shortened version of the Everyday Cognition Questionnaire (see attached) that asks patients 23 questions that assess memory and executive function (including subdomains of planning, organization, and divided attention). The questions are in the format of "Compared to the beginning of the study, has there been any change in .....", and are graded as 1=better/no change, 2=questionable/occasionally worse, 3=consistently a little worse, 4=consistently much worse. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, Race/Ethnic Diversity, Statins / 14.05.2020

MedicalResearch.com Interview with: Dr. Ankur Pandya, PhD Assistant Professor of Health Decision Science Department of Health Policy and Management Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: The 2013 ACC-AHA cholesterol treatment guidelines greatly expanded statin medication eligibility for individuals between the ages of 40-75 years without known cardiovascular disease, and there was some concern that African Americans at "intermediate risk" per those guidelines could be (arguably) overtreated with statins. The 2018 ACC-AHA guidelines included coronary artery calcium assessment for individuals at intermediate cardiovascular disease risk; those with a "zero" calcium score and no other risk factors would now change the eligibility (from indicated statin to not indicated). (more…)
Author Interviews, Emergency Care, Heart Disease, JAMA, UT Southwestern / 22.04.2020

MedicalResearch.com Interview with: Rebecca Vigen, MD, MSCS Assistant Professor of Internal Medicine UT Southwestern MedicalResearch.com: What is the background for this study? Response: Emergency department overcrowding is an urgent health priority and chest pain is a common reason for emergency department visits.  We developed a new protocol that uses high sensitivity cardiac troponin testing with a risk assessment tool that guides decisions on discharge and stress testing for patients presenting with chest pain. The protocol allows us to rule out heart attacks more quickly than the protocols utilizing an older troponin assay. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease / 12.04.2020

MedicalResearch.com Interview with: Santiago Garcia, MD FACC Interventional Cardiologist, Minneapolis Heart Institute® Researcher, Minneapolis Heart Institute Foundation® MedicalResearch.com: What is the background for this study?  Response: We analyzed and quantified ST-segment elevation myocardial infarction (STEMI) activations for 9 high-volume (>100 primary percutaneous angioplasties per year) cardiac catheterization laboratories in the US. These centers represent different geographic areas and levels of COVID-19 exposure in the US. The data analyzed was from January 1, 2019 to March 31, 2020. Participating centers included 1-Minneapolis Heart Institute, Minneapolis, MN, 2- Beaumont Hospital Royal Oak, Royal Oak, MI, 3- The Christ Hospital, Cincinnati, OH, 4- Massachusetts General Hospital, Boston, MA, 5- UMass Memorial Medical Center, Worcester, MA, 6- Iowa Heart, Des Moines, IA, 7- Northwell Health Hospital, Manhasset, NY, 8- Prairie Cardiovascular, Springfield, IL, and 9- Swedish Medical Center, Seattle, WA. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, Weight Research / 08.04.2020

MedicalResearch.com Interview with: Zhen Yang MD PhD Department of Endocrinology, Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai, China   MedicalResearch.com: What is the background for this study? Response: Hypertension is a major public health problem affecting more than 1 billion people worldwide. And it is the leading cause of mortality and disability globally. Startlingly, more than half of people with elevated blood pressure were unaware of their hypertensive status in numerous surveys, partly owing to hypertension rarely shows symptoms in the early stages. Hence, hypertension is a silent killer. (more…)
Author Interviews, Heart Disease, Lipids / 02.04.2020

MedicalResearch.com Interview with: Nathan D. Wong, PhD, FACC, FAHA, FNLA Professor and Director Heart Disease Prevention Program Division of Cardiology, University of California, Irvine MedicalResearch.com: What is the background for this study? Response: Many higher risk persons, despite guideline-recommended therapy such as statins, still suffer from cardiovascular disease events. There are few therapies available to reduce this persistent risk. The REDUCE-IT trial led by Brigham and Women’s Hospital in Boston researchers originally published in November of 2018 was landmark in showing for the first time a highly purified, stable, prescription fish oil product, icosapent ethyl (an EPA only compound marketed as Vascepa®) if given to high risk persons with either cardiovascular disease or diabetes and two or more risk factors who were on statin therapy and had elevated triglyceride levels, achieved an unprecedented 25 percent reduction in the risk of time to first cardiovascular disease events. Given that many persons often experience multiple cardiovascular events, a follow-up analysis showed that TOTAL cardiovascular events were reduced by 30 percent.  (more…)
Author Interviews, Heart Disease, Lipids / 01.04.2020

MedicalResearch.com Interview with: Professor F. J. Raal, FRCP, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism, Faculty of Health Sciences, University of the Witwatersrand MedicalResearch.com: What is the background for this study? How does Evinacumab differ from the three drugs used in triple therapy for this severe form of hypercholesterolemia? Response:      Despite available lipid lowering therapies, the vast majority of patients with homozygous familial hypercholesterolemia are unable to achieve desirable LDL-cholesterol levels and remain at high risk for premature atherosclerotic cardiovascular disease. Unlike statins and PCSK9-inhibitors which act mainly by upregulating LDL receptor activity on the cell surface, evinacumab, a monoclonal antibody inhibitor of ANGPTL3, acts independent of the LDL receptor. (more…)
AstraZeneca, Author Interviews, Diabetes, Heart Disease, JAMA / 01.04.2020

MedicalResearch.com Interview with: John J. V. McMurray,  MD FRCP FESC FACC FAHA FRSE FMedSci British Heart Foundation Cardiovascular Research Centre University of Glasgow Glasgow, United Kingdom  Kieran F Docherty DAPA-HF investigator British Heart Foundation Cardiovascular Research Centre, University of Glasgow     MedicalResearch.com: What is the background for this study? Response: DAPA-HF was a double-blind randomized controlled trial comparing dapagliflozin 10 mg once daily with placebo in 4744 patients with heart failure and reduced ejection fraction (HFrEF). The primary outcome was a composite of time to occurrence of a worsening heart failure event (principally heart failure hospitalization) or cardiovascular death, whichever came first. Dapagliflozin reduced the primary outcome by 26% and reduced the risk of each of heart failure hospitalization and cardiovascular death individually, as well as overall mortality. Patient symptoms were also improved. The aim of the present report was to examine the effect of dapagliflozin separately in patients with and without type 2 diabetes at baseline (45/55% split in the trial). The reason for this was that dapagliflozin was originally introduced as a glucose-lowering medication for the treatment of type 2 diabetes. We find that dapagliflozin was equally beneficial in patients with and without diabetes and was as well tolerated in patients without diabetes as in those with diabetes. More remarkably, among the patients without diabetes, dapagliflozin was as effective in participants with a completely normal glycated haemoglobin (HbA1c) as in those with prediabetes. In patients with a normal HbA1c, dapagliflozin did not lead to any reduction in HbA1c, but did improve clinical outcomes.  (more…)
Author Interviews, Heart Disease, NEJM, Stanford / 31.03.2020

MedicalResearch.com Interview with: David J. Maron, MD, FACC, FAHA Clinical Professor of Medicine Chief, Stanford Prevention Research Center Director, Preventive Cardiology Stanford University School of Medicine  MedicalResearch.com: What is the background for this study? Response: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. The goals of treating patients with stable coronary disease are to reduce their risk of death and ischemic events and to improve their quality of life. All patients with coronary disease should be treated with guideline-based medical therapy (GBMT) to achieve these objectives. Before the widespread availability of drug-eluting stents, strategy trials that tested the incremental effect of revascularization added to medical therapy did not show a reduction in the incidence of death or myocardial infarction. In one trial, fractional flow reserve–guided percutaneous coronary intervention (PCI) with drug-eluting stents, added to medical therapy, decreased the incidence of urgent revascularization but not the incidence of death from any cause or myocardial infarction at a mean of 7 months, whereas the 5-year follow-up showed marginal evidence of a decrease in the incidence of myocardial infarction. (more…)
Author Interviews, Gender Differences, Heart Disease, Karolinski Institute, Opiods, PNAS / 18.03.2020

MedicalResearch.com Interview with: Mikko Myrskylä PhD Executive Director, Max Planck Institute for Demographic Research Professorial Research Fellow, London School of Economics Professor of Social Statistics University of Helsinki MedicalResearch.com: What is the background for this study? Response: Life expectancy in the U.S. increased at a phenomenal pace throughout the twentieth century, by nearly two years per decade. After 2010, however, U.S. life expectancy growth stalled and has most recently been declining. A critical question for American health policy is how to return U.S. life expectancy to its pre-2010 growth rate. Researchers and policy makers have focused on rising drug-related deaths in their search for the explanations for the stalling and declining life expectancy. (more…)
Author Interviews, Columbia, Heart Disease, Mediterranean Diet, Women's Heart Health / 13.03.2020

MedicalResearch.com Interview with: Dr. Riddhi Shah, PhD AHA SFRN Postdoctoral Research Fellow Division of Cardiology Columbia University Medical Center New York, New York MedicalResearch.com: What is the background for this study? Response: The Mediterranean Diet, characterized by higher intakes of plant foods including plant proteins, monounsaturated fat, fish, and lower consumption of animal products and saturated fat, has long been associated with reduced cardiovascular risk and greater longevity, but the molecular mechanisms underlying these associations have not been fully elucidated. We evaluated associations of an Alternate Mediterranean Diet Score, reflective of adherence to this diet pattern and adapted for US populations, and its components with markers of endothelial inflammation directly measured in endothelial cells harvested from women, including oxidative stress, nuclear factor kappa B (NFκB), and endothelial nitric oxide synthase (eNOS) gene expression. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Heart Disease, Nutrition / 05.03.2020

MedicalResearch.com Interview with: Jean-Philippe Drouin-Chartier, RD PhD Assistant Professor, Faculty of Pharmacy, Université Laval Researcher, NUTRISS Center of INAF, Université Laval Visiting Scientist, Department of Nutrition Harvard TH Chan School of Public Health  MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease (CVD) is a leading cause of death worldwide. Eggs are a major source of dietary cholesterol, but they are also an affordable source of high-quality protein, iron, unsaturated fatty acids, phospholipids, and carotenoids. However, because of the cholesterol content in eggs, the association between egg intake and CVD risk has been a topic of intense debate in the past decades. Many prospective studies on the association between egg intake and cardiovascular disease risk have provided conflicting findings. The aim of our study was to prospectively examine the association between egg consumption and risk of CVD in three cohorts of US men and women, and to conduct a systematic review and a meta-analysis of prospective cohort studies on eggs and CVD.  (more…)
Author Interviews, Heart Disease, Omega-3 Fatty Acids / 03.03.2020

MedicalResearch.com Interview with: Lee Hooper PhD, RD Reader in Research Synthesis, Nutrition & Hydration Norwich Medical School Norwich, UK  MedicalResearch.com: What is the background for this study? Response: Polyunsaturated fats are common healthy eating choices, and fish oil (long-chain omega-3 including EPA and DHA) and flaxseed (containing alpha-linolenic acid, ALA, a plant-based omega-3) supplements are commonly consumed. Worldwide cardiovascular disease was responsible for 37% of premature deaths due to non-communicable disease in 2012, and cancers were responsible for 27%.  Small effects of omega-3 and polyunsaturated fats on cardiovascular diseases and cancers could have big effects on worldwide health. (more…)
Author Interviews, Fertility, Heart Disease, JAMA, OBGYNE / 27.02.2020

MedicalResearch.com Interview with: Shi Wu Wen PhD Senior Scientist, Clinical Epidemiology Program Professor, Department of Obstetrics & Gynecology University of Ottawa MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that having a baby as a result of using assisted procedures such as IVF nearly doubles the chance that a baby will have heart problems. (more…)
Author Interviews, Heart Disease, JACC, Women's Heart Health / 26.02.2020

MedicalResearch.com Interview with: Haider Aldiwani, MD Fellow in Internal Medicine and C. Noel Bairey Merz, MD, FACC, FAHA Director Barbra Streisand Women’s Heart Center Smidt Heart Institute, Cedars-Sinai Medical Center Los Angeles, CA, 90048   MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease is the leading cause of death in women in the United States. Women are found to have a higher prevalence of ischemia but no obstructive coronary artery disease (INOCA) compared to men. These women are often labeled as “normal” and their symptoms and cardiovascular risk are not managed appropriately. Women with INOCA are higher risk of developing major adverse cardiovascular events including death, myocardial infarction (MI), stroke and heart failure hospitalization. Presenting symptoms of ischemia are variable and more often labelled “atypical” in women.  (more…)
Alzheimer's - Dementia, Author Interviews, Biomarkers, Heart Disease / 25.02.2020

MedicalResearch.com Interview with: Prof. Konstantinos Stellos, MD, DM, MRCP, DSc, FAHA, FESC Professor of Medicine, Chair of Cardiovascular Medicine, Chair of Epitranscriptomics Lead, Vascular Biology & Medicine Theme Hon. Consultant Cardiologist, Newcastle Hospitals NHS Foundation Trust Biosciences Institute Faculty of Medical Sciences Newcastle University MedicalResearch.com: What is the background for this seminar? Can you tell us a little about how amyloid is made and stored? Response: Patients are afraid that they may die due to a heart attack - a major cause of death worldwide- or if they live long they may get dementia compromising severely their quality of life in their last years of life. Many years ago we asked the question whether there is a link between these two ageing-associated diseases. For this reason we studied the clinical value of amyloid-beta peptides in patients with coronary heart disease. We chose to study the amyloid-beta peptides, which are the cleavage product of the beta- and gamma-secretases of the mother protein amyloid precursor protein, because amyloid-beta plaques in brain is the hallmark of Alzheimer's disease. Following amyloid precursor protein (APP) gene transcription, APP is cleaved in the nonamyloidogenic pathway (plasma membrane) by α- and γ- secretases or in the amyloidogenic pathway (endosomes) by β- and γ- secretases. The later pathway generates amyloid beta (Αβ) peptides that are released extracellularly. Αβ accumulation in blood or tissues may result from enhanced production/cleavage or by impaired degradation and/or clearance. The related mechanisms are depicted in Figure 2 of our publication in JACC: http://www.onlinejacc.org/content/75/8/952  (more…)
Author Interviews, Health Care Systems, Heart Disease, JAMA, Medicare / 24.02.2020

MedicalResearch.com Interview with: Rishi KWadhera, MD Beth Israel Deaconess Medical Center Harvard Medical Faculty Physicians MedicalResearch.com: What is the background for this study? Response: In recent years, the Centers for Medicare and Medicaid Services has implemented nationally mandated value-based programs to incentivize hospitals to deliver higher quality care. The Hospital Readmissions Reduction Program (HRRP), for example, has financially penalized hospitals over $2.5 billion to date for high 30-day readmission rates. In addition, the Value-Based Purchasing Program (VBP) rewards or penalizes hospitals based on their performance on multiple domains of care.  Both programs have focused on cardiovascular care. The evidence to date, however, suggests that these programs have not improved health outcomes, and there is growing concern that they may disproportionately penalize hospitals that care for sick and poor patients, rather than for poor quality care. (more…)
Author Interviews, Genetic Research, Heart Disease, Imperial College, JAMA / 19.02.2020

MedicalResearch.com Interview with: Dr. Ioanna Tzoulaki Imperial College London MedicalResearch.com: What is the background for this study? Response: Considerable progress has been made in identifying genetic variants that are associated with heart disease. We aimed to investigate whether genetic information can be used to assess the risk of individuals developing heart disease in the future and whether genetic tests can improve current risk assessment strategies which are based on easy to measure factors such as age, sex, smoking status, cholesterol levels, blood pressure and presence of type 2 diabetes. (more…)
AHA Journals, Author Interviews, Heart Disease, Stroke / 18.02.2020

MedicalResearch.com Interview with: Dorothy Sears Ph.D. Professor of Nutrition College of Health Solutions Arizona State University MedicalResearch.com: What is the background for this study? Response: Historically, heart disease among women has been understudied despite this being the number one cause of death in women. One in three women will die from heart disease.  Older women are the fasting growing population in the US and after menopause experience a dramatic increase in risk for cardiometabolic diseases such as cardiovascular disease and type 2 diabetes. For these reasons, it is critical to understand the impact of modifiable behaviors on this risk.  Accumulating evidence shows that prolonged sitting is a highly prevalent behavior, associated with cardiometabolic and mortality risk, and greatest in older adults. Thus, overweight or obese postmenopausal women who partake in prolonged sitting time likely have highly compounded cardiometabolic risk. (more…)
Author Interviews, Blood Pressure - Hypertension, Columbia, Heart Disease, JAMA / 17.02.2020

MedicalResearch.com Interview with: George Hripcsak, MD, MS Vivian Beaumont Allen Professor of Biomedical Informatics Chair, Department of Biomedical Informatics Columbia University Director, Medical Informatics Services NewYork-Presbyterian Hospital/Columbia MedicalResearch.com: What is the background for this study? Response: Diuretics are considered among the best drugs to treat hypertension, but there are no randomized studies to tell us which diuretic is best. Hydrochlorothiazide is the most frequently used diuretic for hypertension, but another drug, chlorthalidone, is gaining favor, with the most recent US hypertension guideline expressing a preference for it. Chlorthalidone is known to be longer acting and therefore perhaps more effective. Other (non-randomized) studies have been inconsistent, and some of them imply that chlorthalidone may be more effective. But other studies have shown that chlorthalidone may have more side effects. (more…)