Author Interviews, Genetic Research, Heart Disease / 11.08.2019

MedicalResearch.com Interview with: Ambry GeneticsNancy Niguidula, MS, DPH Doctorate in Public Health in Toxicology Ambry Genetics   MedicalResearch.com: What is the background for this study? Response: The clinical presentations of many inherited cardiovascular conditions overlap; thus, genetic testing may clarify diagnoses, help with risk stratification, facilitate appropriate clinical management decisions, and aid in identifying asymptomatic, at-risk relatives. A large number of professional societies have developed practice guidelines and recommendations for genetic testing of cardiovascular diseases. These include international and collaborative expert panels that establish genetic screening and treatment recommendations by drawing on evidence-based medicine. To further strengthen the clinical utility of cardiovascular genetic testing, the American College of Medical Genetics and Genomics (ACMG) published a guideline for 59 genes with clinical actionability that should be reported if found on whole exome sequencing, even when unrelated to the testing indication.
Author Interviews, Heart Disease, JACC / 12.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49654" align="alignleft" width="200"]J.L. Mehta, MD, PhD Distinguished Professor of Medicine and Physiology and Biophysics Stebbins Chair in Cardiology University of Arkansas for Medical Sciences Central Arkansas Veterans Healthcare System Little Rock, AR 72205 Dr. Mehta[/caption]

J.L. Mehta, MD, PhD

Distinguished Professor of Medicine and Physiology and Biophysics

Stebbins Chair in Cardiology

University of Arkansas for Medical Sciences

Central Arkansas Veterans Healthcare System

Little Rock, AR 72205

MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Aspirin is commonly used for primary prevention of cardiovascular disease events in a variety of subjects around the world. Recent studies, however, show that routine use of aspirin without assessment of risk for cardiovascular disease events may not be appropriate, and may even be harmful. 
Author Interviews, Brigham & Women's - Harvard, Dermatology, Heart Disease, JAMA / 27.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48184" align="alignleft" width="200"]Seoyoung C. Kim, MD, ScD, MSCEDirector, Program in Rheumatologic, Immunologic, and Musculoskeletal PharmacoEpidemiology Associate Professor of MedicineDivision of Pharmacoepidemiology & PharmacoeconomicsDivision of Rheumatology, Immunology and Allergy Brigham and Women's Hospital, Harvard Medical School Dr. Kim[/caption] Seoyoung C. Kim, MD, ScD, MSCE Director, Program in Rheumatologic, Immunologic, and Musculoskeletal PharmacoEpidemiology Associate Professor of Medicine Division of Pharmacoepidemiology & Pharmacoeconomics Division of Rheumatology, Immunology and Allergy Brigham and Women's Hospital Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Given a high cardiovascular (CV) risk among patients with psoriasis and psoriatic arthritis, it is important to have more information with regard to potential effect of different treatment agents on CV risk. As the number of treatment options for psoriasis and psoriatic arthritis has been rising over the few decades, it is even more crucial to have high-quality evidence on comparative safety of different treatment options so physicians and patients can choose an agent based on the benefit-risk profile of each drug they are considering.
Annals Internal Medicine, Author Interviews, Clots - Coagulation, Heart Disease / 27.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47632" align="alignleft" width="200"]Dr Vanessa Selak, MBChB, MPH, PhD, FAFPHM, FNZCPHMSenior Lecturer, Section of Epidemiology & BiostatisticsSchool of Population Health, Faculty of Medical and Health SciencesUniversity of Auckland Dr. Selak[/caption] Dr Vanessa Selak, MBChB, MPH, PhD, FAFPHM, FNZCPHM Senior Lecturer, Section of Epidemiology & Biostatistics School of Population Health Faculty of Medical and Health Sciences University of Auckland MedicalResearch.com: What is the background for this study? Response: In order to determine the balance of benefits and harms of aspirin in primary prevention there’s a need to know an individual’s risk of CVD and their risk of a major bleed without aspirin. We have lots of equations that can be used to determine, among people considering aspirin for primary prevention, an individual’s risk of CVD, but few bleeding risk equations that can be used to determine their risk of a major bleed. We sought to develop a bleeding risk equation that can be used to determine the risk of a major bleed among people in whom aspirin is being considered for the primary prevention of CVD.
Author Interviews, Blood Pressure - Hypertension, Duke, Heart Disease, JAMA / 06.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45684" align="alignleft" width="100"]Yuichiro Yano MD PhD Assistant Professor in Community and Family Medicine Duke University Dr. Yano[/caption] Yuichiro Yano MD PhD Assistant Professor in Community and Family Medicine Duke University MedicalResearch.com: What is the background for this study? Response: New blood pressure guidelines, issued in 2017 in the US, lowered the blood pressure thresholds for hypertension from systolic blood pressure/diastolic ≥140/90 mm Hg to systolic/diastolic ≥130/80 mm Hg. This change increased the prevalence of hypertension two- to three-fold among young adults. The guidelines also newly defined elevated blood pressure as, 120-129 mmHg systolic blood pressure over 80 mmHg diastolic or less. However, no study investigated that high blood pressure, as defined by the new criteria, is something that younger people should be concerned about as a potential precursor to serious problems. Our study is among the first to report that people younger than age 40 who have elevated blood pressure or hypertension are at increased risk of heart failure, strokes and blood vessel blockages as they age.
Annals Internal Medicine, Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Heart Disease, OBGYNE / 03.07.2018

MedicalResearch.com Interview with: [caption id="attachment_42854" align="alignleft" width="128"]Jennifer J. Stuart, ScD Postdoctoral Research Fellow in Reproductive & Cardiovascular Epidemiology  Department of Epidemiology Harvard T.H. Chan School of Public Health  Division of Women's Health Brigham and Women's Hospital and Harvard Medical School Dr. Stuart[/caption] Jennifer J. Stuart, ScD Postdoctoral Research Fellow in Reproductive & Cardiovascular Epidemiology Department of Epidemiology Harvard T.H. Chan School of Public Health Division of Women's Health Brigham and Women's Hospital and Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: Preeclampsia and gestational hypertension are common pregnancy complications involving high blood pressure that develops for the first time during pregnancy and returns to normal after delivery. Approximately 10 to 15% of all women who have given birth have a history of either preeclampsia or gestational hypertension. Previous studies have shown that women with a history of high blood pressure in pregnancy are more likely to develop cardiovascular disease events like heart attack and stroke later in life when compared to women with normal blood pressure in pregnancy. However, what is less clear is to what extent these women are more likely to develop chronic hypertension, diabetes, and high cholesterol and when these risk factors begin to emerge after pregnancy. We examined this question in a cohort of nearly 60,000 American women who we were able to follow for up to 50 years after their first pregnancy. Previous studies have been limited by small numbers, short follow-up, or a lack of information on shared risk factors, such as pre-pregnancy body mass index, smoking, and family history. This research was conducted within the Nurses’ Health Study II, which collected data on these pre-pregnancy factors in tens of thousands of women over several decades.
Author Interviews, Heart Disease, JAMA / 28.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42831" align="alignleft" width="163"]Dan Blumenthal, MD, MBA Assistant in Medicine, Division of Cardiology Massachusetts General Hospital Instructor in Medicine Harvard Medical School Dr. Blumenthal[/caption] Dan Blumenthal, MD, MBA Assistant in Medicine, Division of Cardiology Massachusetts General Hospital Instructor in Medicine Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: Despite dramatic advances in the treatment of cardiovascular disease (CVD) over the past half-century, CVD remains a leading cause of death and health care spending in the United States (US) and worldwide. More than 2000 Americans die of CVD each day, and more than $200 billion dollars is spent on the treatment of CVD each year in the US By 2030, over 40% of the US population is projected to have some form of CVD, at a cost of $1 trillion to the US economy. The tremendous clinical and financial burden of cardiovascular illness has helped motivated policymakers to develop policy tools that have the potential to improve health care quality and curb spending.  Alternative payment models, and specifically bundled payments—lump sum payment for defined episodes of care which typically subsume an inpatient hospitalization and some amount of post-acute care—represent a promising tool for slowing health care spending and improving health care value. Despite broad interest in implementing bundled payments to achieve these aims, our collective understanding of the effects of bundled payments on .cardiovascular disease care quality and spending, and the factors associated with success under this payment model, are limited. Medicare’s Bundled Payments of Care Improvement (BPCI) is an ongoing voluntary, national pilot program evaluating bundled payments for 48 common conditions and procedures, including several common cardiovascular conditions and interventions.   In this study, we compared hospitals that voluntarily signed up for the four most commonly subscribed cardiac bundles—those for acute myocardial infarction, congestive heart failure, coronary artery bypass graft surgery, and percutaneous coronary intervention—with surrounding control hospitals in order to gain some insight into the factors driving participation, and to assess whether the hospitals participating in these bundles were broadly representative of a diverse set of U.S. acute care hospitals. 
Author Interviews, Bone Density, Heart Disease / 21.03.2018

MedicalResearch.com Interview with: [caption id="attachment_40684" align="alignleft" width="142"]Dr. Joshua Lewis, PhD National Health and Medical Research Council Career Development Fellow, Edith Cowan University, School of Medical and Health Sciences / Centre for Kidney Research Children’s Hospital Westmead Honorary Senior Research Fellow, Sydney Medical School, School of Public Health University of Sydney Dr. Lewis[/caption] Dr. Joshua Lewis, PhD National Health and Medical Research Council Career Development Fellow, Edith Cowan University, School of Medical and Health Sciences / Centre for Kidney Research Children’s Hospital Westmead Honorary Senior Research Fellow, Sydney Medical School, School of Public Health University of Sydney  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Bone scans from bone density machines are widely used to predict future fracture risk. These scans can also be used to detect the presence and severity of abdominal aortic calcification (AAC), which is a marker of advanced atherosclerosis. We examined bone scans of over one thousand Australian women that were taken in the late 1990s using a method developed many years ago by one of the authors Dr. Kiel from the Institute for Aging Research at Hebrew SeniorLife and Harvard Medical School, and validated on scans from bone density machines by the joint first author Dr. Schousboe from the University of Minnesota. More than 2/3rd of these women had detectable AAC and women with more advanced calcification had increased likelihood of long-term cardiovascular hospitalizations and deaths as well as deaths from any cause. These finding remained significant even after adjusting for conventional cardiovascular risk factors.
AHA Journals, Author Interviews, Heart Disease, Mediterranean Diet, Nutrition, Vegetarians, Weight Research / 26.02.2018

MedicalResearch.com Interview with: “Vegetarian dan dan noodles” by Andrea Nguyen is licensed under CC BY 2.0Francesco Sofi, MD PhD Department of Experimental and Clinical Medicine University of Florence, Florence, Italy; Clinical Nutrition Unit, Careggi University Hospital Don Carlo Gnocchi Foundation Italy, Onlus IRCCS Florence, Italy  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Mediterranean and Vegetarian diets are two of the most beneficial dietary patterns for prevention of chronic degenerative diseases. No studies have been conducted in the same group of subjects, by comparing these two dietary profiles. Main results are that both diets have been found to be beneficial for cardiovascular prevention, in the same group of subjects at low risk of cardiovascular disease. In particular, vegetarian diet determined a reduction of total and LDL-cholesterol, whereas Mediterranean diet resulted in lower levels of triglycerides and some inflammatory parameters
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC / 14.11.2017

MedicalResearch.com Interview with: [caption id="attachment_37118" align="alignleft" width="150"]Avinainder Singh, M.B.B.S. Research Fellow Cardiovascular Medicine Brigham & Women's Hospital Harvard Medical School Boston, MA Dr. Singh[/caption] Avinainder Singh, M.B.B.S. Research Fellow Cardiovascular Medicine Brigham & Women's Hospital Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Overall, the incidence of myocardial infarction (MI) in the US has declined. However, it has remained stable in adults <50 years of age. We evaluated the statin eligibility of a cohort of adults who had an MI at a young age using current guidelines - the 2013 ACC/AHA guidelines for cholesterol treatment and the 2016 USPSTF guidelines on use of statins for primary prevention. In, our study we found that only 49% of these young adults would have been eligible for statin therapy prior to their MI according the 2013 ACC/AHA guidelines, and only 29% would have been eligible according to the USPSTF guidelines, despite a high prevalence of cardiovascular risk factors. These numbers were even more striking for women where only 18% were eligible for statin therapy according to the USPSTF guidelines.
Author Interviews, Diabetes, Heart Disease, JAMA, OBGYNE / 17.10.2017

MedicalResearch.com Interview with: [caption id="attachment_35407" align="alignleft" width="125"]Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Bethesda, MD 20817  Dr. Zhang[/caption] Cuilin Zhang MD, PhD Senior Investigator Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health. Bethesda, MD 20817 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gestational diabetes (GDM) is a common pregnancy complication. The American Heart Association identifies gestational diabetes as a risk factor for cardiovascular disease (CVD) in women, based on consistent evidence for the relationships between gestational diabetes and subsequent hypertension, dyslipidemia, type 2 diabetes, vascular dysfunction and atherosclerosis. Also, previous studies identify GDM as a risk factor for intermediate markers of CVD risk; however, few are prospective, evaluate hard cardiovascular disease end points, or account for shared risk factors including body weight and lifestyle.
Author Interviews, Heart Disease, JACC, NIH, Race/Ethnic Diversity / 31.05.2015

Dr. Samson Y. Gebreab, Ph.D., M.Sc. Lead Study Author and Research Scientist National Human Genome Research Institute Bethesda, MarylandMedicalResearch.com Interview with: Dr. Samson Y. Gebreab, Ph.D., M.Sc. Lead Study Author and Research Scientist National Human Genome Research Institute Bethesda, Maryland Medical Research: What is the background for this study? Dr. Gebreab: It is well known that African Americans hold a commanding lead in cardiovascular disease (CVD) mortality and morbidity compared to whites and other ethnic groups.  Furthermore, the risk for developing CVD begins early in life and extends over a lifecourse.  Previous studies have indicated the influence of both childhood and adult socioeconomic status (SES) on CVD risk. However, the impact of lifecourse socioeconomic status (both childhood and adulthood) on CVD risk in African American population is not fully understood.  The purpose of our study was to investigate the associations of different measures of lifecourse socioeconomic status with cardiovascular disease risk in African Americans and whether the associations were modified by sex and/ or age after controlling for known cardiovascular disease risk factors.  We analyzed 10-year follow-up data of African American adults who were participating in Jackson Heart Study, Jackson, MS. Medical Research: What are the main findings? Dr. Gebreab: Our findings highlights that among those of lower socioeconomic status,  women and younger (<=50 years old)  African Americans are at increased risk of CVD, including heart disease and stroke compared to their counterparts of higher socioeconomic status groups.          African American women in the lowest socioeconomic status, had more than twice the risk of developing cardiovascular disease than those in the highest socioeconomic status group.          African Americans of 50 years and younger in the lowest socioeconomic status group had more than three times higher risk of experiencing a cardiovascular disease event than those in the highest socioeconomic status group.
Author Interviews, Cost of Health Care, Heart Disease / 11.10.2013

Ankur Pandya PhD Assistant Professor of Public Health in the Division of Health Policy Department of Public Health at Weill Cornell Medical CollegeMedicalResearch.com Interview with: Ankur Pandya PhD Assistant Professor of Public Health in the Division of Health Policy Department of Public Health at Weill Cornell Medical College MedicalResearch.com: What are the main findings of the study? Dr. Pandya: Our study looked at the impact of some of the future risk factors for cardiovascular disease in the United States.  Using nine National Health and Nutrition Examination Survey waves from 1973 to 2010 we forecasted disease risk and prevalence from 2015 to 2030. We found that despite continued improvements in the disease’s treatment and declining smoking rates, increasing obesity rates, the aging population, and declining mortality from the disease should cause a rise in health care costs, disability, and reductions in the quality of life associated with increased disease prevalence.