AHA Journals, Author Interviews, Heart Disease, Technology, Yale / 09.11.2022

MedicalResearch.com Interview with: Lovedeep Singh Dhingra, MBBS Postdoctoral Research Associate Cardiovascular Data Science (CarDS) Lab Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Wearable devices are shown to have multiple health-related features, including heart rate and activity monitoring, ECG tracing, and blood pressure monitoring. In our analyses of the nationally-representative Health Information National Trends Survey (HINTS), we discovered that patients with and at risk of cardiovascular disease are less likely to use wearables. Older patients, patients with lower education, and patients with lower incomes are less likely to use wearables. Also, among adults with access to wearables, patients with cardiovascular disease use their devices less frequently as compared to the overall population. (more…)
AHA Journals, Author Interviews, Fertility, Heart Disease / 27.04.2022

MedicalResearch.com Interview with: Pensée Wu, MBChB, MD(Res) Senior Lecturer, Honorary Consultant Obstetrician Subspecialist in Maternal Fetal Medicine School of Medicine, Keele University Staffordshire, UK MedicalResearch.com:  What is the background for this study? What are the main findings? Response: We looked at outcomes in pregnancies conceived with assisted reproductive technology and compared those with pregnancies that were conceived naturally. Using a hospital admissions database in the U.S. called the National inpatient sample between 2008 and 2016, we included >100,000 pregnancies conceived with assisted reproductive technology and 34 million naturally conceived pregnancies. We found that women with assisted reproductive technology-conceived pregnancies had doubled the risk of acute kidney injury and arrhythmias (irregular heart beats). These women also had a 1-3-1.6-fold risk of preterm birth, Caesarean delivery and placental abruption (placenta separating from the womb). We concluded that women should be informed of these risks during pre-pregnancy counselling.  (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension / 18.03.2022

MedicalResearch.com Interview with: Paolo Palatini, M.D. Professor of Internal Medicine University of Padova Padova, Italy  MedicalResearch.com:  What is the background for this study?  Response: Up to now doctors measured blood pressure (BP) on standing only in elderly people on pharmacological treatment with the purpose of detecting orthostatic hypotension. In young-to-middle-age people BP is currently measured only in the lying or the sitting posture. Our starting point was that young borderline hypertensive people have an increased sympathetic activity and thus they might be hyperreactive to physical stimuli such as assuming the orthostatic posture which may be deleterious in the long run. This hypothesis was tested in the HARVEST, a study initiated in Italy in 1990, in which over 1200 young patients screened for stage 1 hypertension were enrolled. (more…)
AHA Journals, Blood Pressure - Hypertension, Dental Research, Menopause / 07.03.2022

MedicalResearch.com Interview with: Michael J. LaMonte, PhD, MPH Research Professor (epidemiology) Department of Epidemiology and Environmental Health School of Public Health and Health Professions Women’s Health Initiative Northeast Regional Center University at Buffalo – SUNY Buffalo, NY 14214 MedicalResearch.com:  What is the background for this study?  What are the main findings? Dr. LaMonte:  The rationale for this study was based on existing study results showing
  • (1) oral bacteria are involved with conversion of dietary nitrate (e.g., from leafy greens and beets) to nitric oxide which is a chemical involved keeping arteries healthy and maintaining blood pressure;
  • (2) rinsing the mouth with antiseptic solution (mouthwash) kills oral bacteria and results in rapid increases in systolic and diastolic blood pressure; and
  • (3) a very limited amount of epidemiological data suggest that the oral bacteria found beneath the gums (responsible for gingivitis and periodontal disease) are associated with blood pressure and history of hypertension in middle-aged adults.
Thus, we conducted our study to determine whether oral bacteria (beneath the gums) would be predictive of developing hypertension among women who were without this condition at the time the bacteria were measured. Because the bacteria (exposure) would be known to precede development of hypertension (disease), an association seen in our study would be strongly suggestive of a role for oral bacteria in the development of high blood pressure. Our primary result was for statistically significant higher risks of developing hypertension associated with 10 bacterial species, and significantly lower risks of developing hypertension associated with 5 bacterial species. Our findings were evident even after we accounted for differences in demographic factors, lifestyle factors, and clinical factors, and generally were of consistent magnitudes we examined across subgroups of older and younger women, white and black women, normal weight and overweight/obese women, those with normal or slightly elevated blood pressure at study enrollment, and those who were using or not using menopausal hormone therapy at baseline. Therefore, while our observational study evidence for an association is not equivalent to causation, the robustness of the associations between oral bacteria and hypertension risk supports a need to further understand this relationship, ideally with a clinical trial design that would provide definitive evidence to support or refute causation.  (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Race/Ethnic Diversity, Social Issues / 03.02.2022

MedicalResearch.com Interview with: Xing Gao, MPH, lead author and doctoral candidate in Dr. Mujahid's research group Mahasin Mujahid, MS, PhD, FAHA Lillian E. I. and Dudley J. Aldous Chair in the School of Public Health Associate Professor of Epidemiology Director, Epidemiology & Biostatistics Master of Public Health Program UC Berkeley, School of Public Health MedicalResearch.com:  What is the background for this study?  What are the main findings?
  • ​​Hypertension is a major risk factor for cardiovascular diseases, and persistent racial and ethnic inequities in hypertension remain an urgent public health challenge.
  • Public health researchers need a more nuanced understanding of how structural factors contribute to these inequities, which has a direct application to improving the cardiovascular health of marginalized populations.
  • This study examined associations between racial residential segregation, a product of historical and contemporary racially discriminatory policies, and hypertension in a multi-racial cohort of middle-aged and older adults. 
(more…)
AHA Journals, Author Interviews, Heart Disease, Social Issues, UCSD / 03.02.2022

MedicalResearch.com Interview with: Natalie Golaszewski, PhD Herbert Wertheim School of Public Health and Human Longevity Science University of California, San Diego La Jolla, CA 92093 MedicalResearch.com:  What is the background for this study?  Response: Social isolation and loneliness are growing public health concerns as they are associated with health conditions that increase the risk of cardiovascular disease including obesity, smoking, physical inactivity, poor diet, high blood pressure and high cholesterol. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Kidney Disease / 04.08.2021

MedicalResearch.com Interview with: Maria Luisa S. Sequeira Lopez, MD, FAHA Harrison Distinguished Professor in Pediatrics and Biology University of Virginia Charlottesville, VA 22908 MedicalResearch.com: What is the background for this study? Response: The renin-angiotensin system (RAS) is crucial in the regulation of the blood pressure (BP). Synthesis and secretion of renin is the key regulated event in the operation of the RAS. One of the main mechanisms that control renin synthesis and release is the baroreceptor mechanism whereby a decrease in blood pressure results in increased release of renin by juxtaglomerular (JG) cells. In spite of its enormous importance, the nature and location of the renal baroreceptor was still unknown. This was due in great part to the lack of appropriate in vitro and in vivo models to confidently allow tracking of the fate and isolation of renin cells, and the lack of tools to study the chromatin in scarce cells. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Columbia / 27.07.2021

MedicalResearch.com Interview with: George Hripcsak, MD, MS. Chair and Vivian Beaumont Allen Professor of Biomedical Informatics Department of Biomedical Informatics, Columbia University Irving Medical Center New York, NY MedicalResearch.com: What is the background for this study? Response: ACE inhibitors and ARBs are anti-hypertension drugs that have related yet distinct mechanisms of action, and they are both recommended as first-line therapies for treating hypertension. There have been no large head-to-head comparisons of ACE inhibitors and ARBs, although there are several studies with limited size and often restricted (e.g., high-risk) populations. While there are some conflicting results in the literature, the current evidence seems to indicate that they are similar in effectiveness but that ACE inhibitors have more side effects (e.g., cough and angioedema). (more…)
AHA Journals, Author Interviews, Obstructive Sleep Apnea, UCSF / 21.06.2021

MedicalResearch.com Interview with: Yerem Yeghiazarians, MD Professor of Medicine Leone-Perkins Family Endowed Chair in Cardiology San Francisco Board Past-President, American Heart Association Co-Director, Adult Cardiac Catheterization Laboratory Director, Peripheral Interventional Cardiology Program Director, Translational Cardiac Stem Cell Program Cardiovascular Research Institute Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research Associate Member in Experimental Therapeutics, UCSF Helen Diller Cancer Center University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea is very common, undiagnosed and undertreated. The AHA Scientific Statement was prepared to increase awareness amongst physicians and patients about this condition and to encourage more screening and therapy as appropriate. Obesity is certainly one of the significant risk factors for sleep apnea and we highlight this in the Scientific Statement: “The risk of OSA correlates with body mass index, and obesity remains the one major modifiable risk factor for OSA. In a population-based cohort study of 690 subjects, a 10% weight gain was associated with nearly 32% increase in the apnea-hypopnea index (AHI), and even modest weight control was effective in reducing the new occurrence of sleep-disordered breathing. An even stronger correlation exists between OSA and increased waist circumference and neck size. Neck sizes predisposing to OSA are usually >17 and 16 in for men and women, respectively.” (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, Memory / 21.06.2021

MedicalResearch.com Interview with: Daniel A. Nation, Ph.D., Associate Professor of Psychological Science Institute for Memory Impairments and Neurological Disorders University of California, Irvin MedicalResearch.com: What is the background for this study? Response: Hypertension is a risk factor for cognitive decline and dementia, and treatment of hypertension has been linked to decreased risk for cognitive impairment. Prior studies have attempted to identify which specific type of antihypertensive treatment conveys the most benefit for cognition, but findings have been mixed regarding this question.  We hypothesized that antihypertensive drugs acting on the brain angiotensin system may convey the greatest benefit since they affect the brain angiotensin system that has been implicated in memory function. (more…)
AHA Journals, Author Interviews, Baylor College of Medicine Houston, Blood Pressure - Hypertension, Microbiome / 30.04.2021

MedicalResearch.com Interview with: David J. Durgan, PhD Department of Anesthesiology Baylor College of Medicine Houston, TX  MedicalResearch.com: What is the background for this study? Response: Our lab and others had previously shown that gut dysbiosis is not only associated with hypertension, but actually plays a causal role. For example we have shown in both a genetic model of hypertension as well as an obstructive sleep apnea induced model of hypertension, that transplantation of their dysbiotic microbiota into normotensive recipients induced elevations in blood pressure. With this understanding our focus shifted to two new questions 1) How can we manipulate the microbiota to improve/prevent hypertension, and 2) What are the signals originating from the microbiota that have the capability to influence host blood pressure? These questions lead to the experimental design of this study. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Dental Research / 30.03.2021

MedicalResearch.com Interview with: Francesco D’Aiuto Professor/Hon Consultant Head of Periodontology Unit UCL Eastman Dental Institute  MedicalResearch.com: What is the background for this study? Response: This study was set out to further our understanding of the link between gum disease and high blood pressure. Recent evidence suggested that individuals with gum disease had a 20-70% increased risk of hypertension and systemic inflammation seemed to be a driver in mediating this association. Further research on the matter was needed. We recruited two relatively large groups of otherwise healthy participants (without a confirmed diagnosis of hypertension) who had gum disease one and healthy gums the other. We found that diagnosis of periodontitis (gum disease) was consistently linked to higher systolic blood pressure independent of other cardiovascular risk factors. (more…)
AHA Journals, Author Interviews, Heart Disease, Stroke / 12.03.2021

MedicalResearch.com Interview with: Brandon K Fornwalt, MD, PhD Associate Professor, Director Department of Imaging Science and Innovation Geisinger MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) is an abnormal heart rhythm that is associated with outcomes such as stroke, heart failure and death. If we know a patient has atrial fibrillation, we can treat them to reduce the risk of stroke by nearly two-thirds. Unfortunately, patients often don’t know they have AF. They present initially with a stroke, and we have no chance to treat them before this happens. If we could predict who is at high risk of either currently having AF or developing it in the near future, we could intervene earlier and hopefully reduce bad outcomes like stroke. Artificial intelligence approaches may be able to help with this task. (more…)
AHA Journals, Author Interviews, Genetic Research, Heart Disease / 08.03.2021

MedicalResearch.com Interview with: Giordano Bottà, PhD CEO and Co-founder Allelica The Polygenic Risk Score Company MedicalResearch.com: What is the background for this study? Response: Previous research identified that polygenic risk score (PRS) has the highest predictive power compared to other risk factors and identifies individuals with the same risk of those with familial hypercholesterolemia, but are invisible to traditional risk assessment. We explored for the first time the interplay between the main causes of atherosclerosis, LDL cholesterol and PRS.  We were interested in helping cardiologists understand why some individuals have bad arteries full of plaques while others don't in presence of the same LDL levels and no additional risk factors. Our findings explain why this is the case: LDL does not affect everyone the same. We believe that we are at the forefront of a change of paradigm in cardiovascular risk assessment: LDL levels cannot be accessed without considering the genetics of an individual. (more…)
AHA Journals, Author Interviews, Heart Disease, Race/Ethnic Diversity, Stroke / 05.03.2021

MedicalResearch.com Interview with: Fernando D Testai, MD, PhD, FAHA Associate Professor of Neurology and Rehabilitation Stroke Medical Director University of Illinois Health MedicalResearch.com: What is the background for this study? Response: Stroke constitutes a leading cause of disability and mortality in the United States. Large observational studies have shown that up to 90% of the strokes are caused by modifiable vascular risk factors, including hypertension, diabetes mellitus, and several others. In addition, previous history of stroke is one of the most powerful predictors of recurrent stroke. Thus, controlling vascular risk factors in patients with stroke is of paramount importance. To this end, the American Heart Association and the American Stroke Association have developed specific targets for blood pressure, glycemic, and cholesterol levels. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 21.12.2020

MedicalResearch.com Interview with: Chris Clark, PhD Clinical Senior Lecturer in General Practice Primary Care Research Group St Luke's Campus, Exeter MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Various individual studies have suggested that a blood pressure difference between arms is associated with increased mortality and cardiovascular events since we first reported this association in 2002. Such studies have been limited, due to smaller numbers of participants, in the conclusions that could be drawn. Therefore we sought to pool data from as many cohorts as possible to study this association in more detail.  MedicalResearch.com: What are the main findings? Should it be standard practice to measure blood pressure in both arms? Response: Systolic inter-arm difference was associated with increased all-cause and cardiovascular mortality. We found that all-cause mortality increased with inter-arm difference magnitude from a ≥5 mmHg threshold. Systolic inter-arm difference was also associated with cardiovascular events in people without pre-existing disease. This remained significant after adjustment for various internationally used cardiovascular risk scores, namely ASCVD, Framingham or QRISK2. Essentially we found that each increase of 1mmHg in inter-arm difference equated to a 1% increase for a given cardiovascular risk score. When undertaking a cardiovascular assessment, or determining which arm should be used for blood pressure measurement, it is recommended to measure both arms. (more…)
AHA Journals, Author Interviews, Heart Disease, Women's Heart Health / 30.11.2020

MedicalResearch.com Interview with: Justin A. Ezekowitz, MBBCh, MSc Professor, Department of Medicine Co-Director, Canadian VIGOUR Centre Director, Cardiovascular Research, University of Alberta Cardiologist, Mazankowski Alberta Heart Institute MedicalResearch.com: What is the background for this study? What are the main findings? Are women older, sicker when they experience heart disease? Response: Previous research looking at sex-differences in heart health has often focused on recurrent heart attack or death, however, the vulnerability to heart failure between men and women after heart attack remains unclear. Our study includes all patients from an entire health system of over 4 million people and includes information not usually available in other analyses. Women were nearly a decade older and more often had a greater number of other medical conditions when they presented to hospital for their first heart attack, and were at greater risk for heart failure after the more severe type of heart attack (also known as a ST-elevation MI). This gap between men and women has started to narrow over time. (more…)
AHA Journals, Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity, Stanford / 19.11.2020

MedicalResearch.com Interview with: Fatima Rodriguez, MD, MPH, FACC, FAHA Assistant Professor, Cardiovascular Medicine Stanford University School of Medicine Palo Alto, CA 94304 MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has magnified existing racial/ethnic disparities in the United States. The goal of this study was to leverage new data collected from the American Heart Association’s COVID-19 Cardiovascular Disease Registry to understand racial/ethnic differences in presentation and outcomes for hospitalized patients. (more…)
AHA Journals, Author Interviews, Heart Disease, University of Michigan / 17.11.2020

MedicalResearch.com Interview with: Sara Saberi, MD, MS Assistant Professor Inherited Cardiomyopathy Program Frankel Cardiovascular Center University of Michigan Hospital Michigan Medicine MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by HCM? How common is it and whom does it affect? Response: HCM is short for hypertrophic cardiomyopathy, the most common genetic myocardial disorder. It occurs in 1:500 people worldwide and because it is inherited in an autosomal dominant fashion, it affects men and women equally. HCM is characterized by unexplained left ventricular (LV) hypertrophy, hypercontractility, myofibrillar disarray and myocardial fibrosis with associated abnormalities in LV compliance and diastolic function. In some patients, there is progressive adverse cardiac remodeling, associated with chronic heart failure and atrial fibrillation as a result of diastolic dysfunction, left ventricular outflow tract (LVOT) obstruction, or less commonly, LV systolic dysfunction. Current medical management of obstructive HCM (oHCM) is limited to the use of beta blockers and non-dihydropyridine calcium channel blockers, or disopyramide, none of which have been shown to modify disease expression or outcomes after onset. Mavacamten is a first-in-class, small molecule, selective inhibitor of cardiac myosin specifically developed to target the underlying pathophysiology of HCM by reducing actin–myosin cross-bridge formation. The phase 3 EXPLORER-HCM trial showed that mavacamten improved exercise capacity, LVOT gradients, symptoms, and health status compared with placebo in patients with symptomatic oHCM. At selected study sites, participants were enrolled in a cardiac magnetic resonance (CMR) imaging substudy. CMR is the gold standard for measurement of ventricular mass, volumes and noninvasive tissue characterization, making it an ideal imaging modality to assess the effect of mavacamten on cardiac structure and function in patients with HCM. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Circadian Rhythm / 05.11.2020

MedicalResearch.com Interview with: Kazuomi Kario, MD, PhD, FACP, FACC, FAHA, FESC, FJCS Professor, Chairman Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine (JMU) JMU Center of Excellence, Cardiovascular Research and Development (JCARD) Hypertension Cardiovascular Outcome Prevention and Evidence in Asia (HOPE Asia) Network Shimotsuke, Tochigi, 329-0498, JAPAN MedicalResearch.com: What is the background for this study? Response: To date, it remains unclear whether disrupted blood pressure (BP) circadian rhythm is associated with adverse outcomes independent of nighttime BP. The JAMP study includes 6359 outpatient population who had ambulatory BP monitoring to evaluate the association between both nocturnal hypertension and nighttime BP dipping patterns and the occurrence of cardiovascular events in patients with hypertension. (more…)
AHA Journals, Author Interviews, Heart Disease, Surgical Research / 30.10.2020

MedicalResearch.com Interview with: Stavros G. Drakos, MD, PhD, FACC Professor of Cardiology Univ. of Utah Healthcare & Medical School and the Salt Lake VA Medical Center. Dr. Drakos is Medical Director of the University's Cardiac Mechanical Support/Artificial Heart Program Co-Director Heart Failure & Transplant and Director of Research for the Division of Cardiology MedicalResearch.com: What is the background for this study? Response: Heart transplantation and LVADs are first line therapies for advanced chronic heart failure. There were some earlier anecdotal observations and single center small studies from several programs in the US and overseas that left ventricular assist devices (LVADs) significantly reduce the strain on failing hearts and in some cases, using LVADs for limited periods of time has allowed hearts to “rest” and remodel their damaged structures. As a result of these repairs, described as “reverse remodeling,” heart function can improve to the point that the LVAD can be removed. The new study sought to broaden the reach of the research with a multicenter trial involving physicians and scientists at the University of Utah Health, the University of Louisville, University of Pennsylvania, the Albert Einstein College of Medicine/Montefiore Medical Center, the Cleveland Clinic, and the University of Nebraska Medical Center.  (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, NYU, Race/Ethnic Diversity / 16.09.2020

MedicalResearch.com Interview with: Aisha T. Langford, PhD, MPH Assistant Professor Department of Population Health Co-Director, CTSI Recruitment and Retention Core NYU Grossman School of Medicine NYU Langone Health New York, NY 10016 MedicalResearch.com: What is the background for this study? Response: In 2018, the American Heart Association (AHA) published an updated Scientific Statement on Resistant Hypertension. The term apparent treatment-resistant hypertension (aTRH) is used when pseudoresistance (e.g., white coat effect, medication nonadherence) cannot be excluded. The current study was designed to investigate if Black adults with aTRH, a group disproportionately affected by cardiovascular disease, receive evidence-based approaches to lower blood pressure as recommended in the 2018 AHA Scientific Statement. Specifically, we studied healthy lifestyle factors including not smoking, not consuming alcohol, ≥75 minutes of vigorous-intensity or ≥150 minutes of moderate or vigorous physical activity per week, and body mass index <25 kg/m2; and recommended antihypertensive medication classes among US Black adults. (more…)
AHA Journals, Author Interviews, COVID -19 Coronavirus, NYU / 21.05.2020

MedicalResearch.com Interview with: Shadi Yaghi, MD Assistant Professor Department of Neurology at NYU Grossman School of Medicine Director, Clinical Vascular Neurology Research, NYU Langone Health Director, Vascular Neurology, NYU Langone Hospital-Brooklyn  MedicalResearch.com: What is the background for this study? Response: Our aim was to determine the characteristics of imaging proven ischemic stroke in the setting of COVID-19 infection and compare them to those of ischemic stroke but without COVID-19 infection. (more…)
AHA Journals, Author Interviews, Pharmaceutical Companies, Stroke / 21.02.2020

MedicalResearch.com Interview with: Michael Tymianski, CM, MD, PhD, FRCSC, FAHA Head, Division of Neurosurgery, University Health Network Medical Director, Neurovascular Therapeutics Program, University Health Network Professor, Departments of Surgery and Physiology, University of Toronto Senior Scientist, Toronto Western Hospital Research Institute Director, Neuroprotection Laboratory, Toronto Western Hospital President and CEO, NoNO Inc MedicalResearch.com: What is the background for this study? How is alteplase related to and affect nerinetide? Response: Cerebral neuroprotection for acute ischemic stroke (AIS) is defined as a therapy aimed at enhancing the brain’s resilience to ischemia to improve the clinical outcome of affected individuals. Although traditionally aimed at the salvage of neurons, this term may be equally applicable to all the cellular constituents of the brain, including cells of cerebral blood vessels, neurons, and glia. Pharmacological neuroprotection (hereafter referred to as neuroprotection) would be achieved by drugs targeting one or more critical components of the ischemic cascade that lead to ischemic damage. The feasibility of neuroprotection has a strong basis in animal experiments, but research for several decades has failed to translate neuroprotective treatments from animals to humans. The disappointing results of all controlled clinical neuroprotection trials for AIS have cast doubts as to whether neuroprotection in humans is biologically possible and, given the complexities of human stroke syndromes, whether it is a clinically practicable therapy for patients experiencing AIS in the community. In the case of neuroprotection trials for acute ischemic stroke, all to date have failed to demonstrate a clinical benefit of the study agent. Our review of studies since the year 2000 shows that many were not conducted in accordance with the animal studies that supported efficacy. They enrolled a heterogeneous subject population with varying (small and large) vessel occlusions and without knowledge of the degree of completed infarctions. Most had not implemented a strategy to ensure that the treatment effect size was maximized, and all in-hospital trials enrolled in treatment windows that exceeded 4 hours, at which an important proportion of enrolled subjects cannot respond to treatment because they no longer have salvageable brain. The ESCAPE-NA1 addressed past deficiencies of AIS trials. It was based on a sound scientific foundation including extensive animal studies, and capitalized on the designs that led to success in AIS trials of endovascular thrombectomy. ESCAPE-NA1 enrolled patients proven by these past trials to have salvageable brain at the time that the treatment was given, and tested the drug in an ischemia-reperfusion scenario in which it was anticipated to be most effective. The enrollment was over 12 hours, but only including patients who had medical imaging suggestive that they still had salvageable brain. Alteplase is an agent that activates the protease plasmin in the bloodstream. Plasmin cleaves peptides at certain spots within their structure, and it is a known biological fact that plasmin is able to cleave nerinetide. What was not known at the time of the trial was the degree to which this would reduce nerinetide plasma leves in humans, and the impact that this would have on the therapeutic effects of nerinetide. This is why we conducted a very large trial in which the participants’ enrollment was stratified according to whether or not they received alteplase. This ensured that there was good balance within each stratum, thereby enabling us to make more robust conclusions. (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…)
AHA Journals, Author Interviews, Heart Disease, Menopause, Race/Ethnic Diversity, University of Pittsburgh / 05.02.2020

MedicalResearch.com Interview with: Samar R. El Khoudary, M.D., M.P.H. Associate Professor of Epidemiology and Saad Samargandy, M.P.H. Ph.D. Student University of Pittsburgh Graduate School of Public Health MedicalResearch.com: What is the background for this study? Response: Research findings suggest that women experience adverse changes in multiple clinical measures of their cardiovascular health during the menopause transition period. We were interested in evaluating the timing of critical changes in arterial stiffness and investigating potential racial differences in how arterial stiffness progresses during the menopause transition. Arterial stiffness refers to the elasticity of arteries and it measures the rate at which blood flows through arteries. Stiffer arteries can lead to dysfunction in how well the heart pumps and moves blood, and damage to the heart, kidneys and other organs. We used a subset of data from SWAN Heart, an ancillary study that enrolled women from Pittsburgh and Chicago between 2001 and 2003 and included two examinations of early markers of cardiovascular health over time. Ultimately, 339 women were included in this study, 36% black and the rest white. (more…)
AHA Journals, Author Interviews, Gender Differences, Stroke / 30.11.2019

MedicalResearch.com Interview with: Cheryl Carcel MD Research Fellow, Stroke & Women's Health Program Conjoint Senior Lecturer, Faculty of Medicine, UNSW Sydney Associate Lecturer, Sydney Medical School, The University of Sydney The George Institute for Global Health | Australia MedicalResearch.com: What is the background for this study? Response: This study builds on previous findings of differences in the presentation, treatment and outcome for women and men who experience stroke. For this analysis, we pooled five large international, multicenter, randomized controlled trials that included the following: the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT-1 and -2 studies), the alteplase-dose arm of the Enhanced Control of Hypertension and Thrombolysis Stroke study (ENCHANTED), the Head Position in Acute Stroke Trial (HeadPoST), and the Scandinavian Candesartan Acute Stroke Trial (SCAST). (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 05.11.2019

MedicalResearch.com Interview with: Rachel E. Climie PhD INSERM U970, Paris Cardiovascular Research Center (PARCC) Integrative Epidemiology of Cardiovascular Disease Team, University de Paris, Paris, France.  MedicalResearch.com: What is the background for this study? Response: It is well known that physical activity (PA) is beneficial for cardiovascular health. However, little consideration is given as to whether different domains of PA have differing associations with health outcomes. Indeed, recent work has shown that high amounts of PA at work are associated with increased risk of early death, however the underlying mechanisms are unknown. In this study, we explored the relationship between physical activity at work, during leisure time and as structured sport with baroreflex sensitivity. We distinguished between the mechanical (dependent on the stiffness of the arterial wall) and neural (nerve impulses sent by the receptors on the walls of the artery) components of the baroreflex. Importantly, baroreflex sensitivity is crucial for short- term blood pressure control and reduced baroreflex function is related to higher risk of cardiac mortality and sudden death.  (more…)
AHA Journals, Author Interviews, Environmental Risks, Heart Disease, Stroke / 26.09.2019

MedicalResearch.com Interview with: Zara Berg, Ph.D Fort Peck Community College Poplar, Montana MedicalResearch.com: What is the background for this study? Response: This study is part of the cohort that consist of the Honolulu Heart Program (HHP) and what later became the Honolulu-Asia Aging study. HHP study cardiovascular research starting in the 1960’s, which is equivalent to the Framingham Study. This study was used to establish the epidemiology parameters for cardiovascular diseases and is one of the longest longitudinal (34 years of follow-up) study on cardiovascular diseases and other diseases that effect the elderly. The participants were all Japanese that fought in WWII which is a sample size of 8,006 participants. In additional, there is multiple studies based on this cohort for the last fifty plus years, ranging from occupational exposure, cancer, neurological diseases, and cardiovascular diseases.  (more…)
AHA Journals, Author Interviews, Heart Disease, Lipids / 17.09.2019

MedicalResearch.com Interview with: Samuel S. Gidding, MD FH Foundation Pasadena, CA MedicalResearch.com: What is the background for this study? Response: Patients with familial hypercholesterolemia are at high risk for atherosclerotic heart disease but little is known about intensification of treatment and event rates in lipid specialty care in the United States. We examined data on 1900 patients, enrolled in the CASCADE FH Registry,sponsored by the Familial Hypercholesterolemia Foundation, to determine if cholesterol lowering therapy increased to improve getting patients to a lower LDL cholesterol and to look at incident cardiac events in tow groups, those with prior heart disease and those without. (more…)