Author Interviews, General Medicine, Heart Disease, JAMA / 06.08.2014

Maurizio Gasparini, MDMedicalResearch Interview with: Maurizio Gasparini MD Humanitas Research Hospital Rozzano, Italy Medical Research: What are the main findings of the study? Dr. Gasparini: We found that a strategic programming of implantable cardioverter defibrillators which allows the non-sustained arrhythmias to self-terminate is associated with reductions in hospitalizations, length of hospital stay and cost per patient-year and an increase in the time to first hospitalization. These results were mainly driven by reduction in cardiovascular-related events. (more…)
Annals Internal Medicine, Author Interviews, Heart Disease, Menopause / 03.08.2014

S. Mitchell Harman, M.D., Ph.D. CAPT US Public Health Service, retired Professor, Clinical Medicine, U of AZ College of Medicine Interim Chief, Dept. of Internal Medicine Chair, IRB Subcommitee Phoenix VA Health Care System Phoenix, AZ 85012-1892MedicalResearch.com Interview with: S. Mitchell Harman, M.D., Ph.D. CAPT US Public Health Service, retired Professor, Clinical Medicine, U of AZ College of Medicine Interim Chief, Dept. of Internal Medicine Chair, IRB Subcommitee Phoenix VA Health Care System Phoenix, AZ 85012-1892 Medical Research: What are the main findings of the study? Dr. Harman: The major findings are: 1.       Neither transdermal nor oral estrogen treatment significantly accelerates or decelerates rate of change of carotid artery intimal medial thickness (CIMT) in healthy recently menopausal women. 2.       Both estrogen treatments have some potentially beneficial effects on markers of CVD risk, but these differ depending on the route of estrogen delivery with improvements in LDL and HDL cholesterol seen with oral, and reduced insulin resistance with transdermal. 3.       No significant effects were observed on rate of accumulation of coronary artery calcium. 4.       Women reported significant relief of vasomotor (hot flush) symptoms with both estrogen treatments (more…)
Author Interviews, BMJ, Heart Disease, Nutrition / 31.07.2014

Prof. Frank B Hu Department of Nutrition Department of Epidemiology Harvard School of Public HealthMedicalResearch.com Interview Invitation Prof. Frank B Hu Department of Nutrition Department of Epidemiology Harvard School of Public Health Medical Research: What are the main findings of the study? Prof. Hu: We found that increasing consumption of fruits and vegetables is associated with reduced risk of mortality, especially cardiovascular mortality. The largest reduction in mortality can be achieved at 5 servings per day of fruits and vegetables. (more…)
Author Interviews, Heart Disease, JAMA / 27.07.2014

Dr. Danny Dvir MD St Paul’s Hospital, Vancouver British Columbia, CanadaMedicalResearch.com Interview with: Dr. Danny Dvir MD St Paul’s Hospital, Vancouver British Columbia, Canada Medical Research: Who were the patients studied? Dr. Dvir: The VIVID registry included high-risk patients with failed aortic bioprostheses treated with valve-in-valve. These patients had many comorbidities and high risk scores for early mortality with conventional redo surgery. Medical Research: What are the treatment options for these patients? Dr. Dvir: Patients with failed bioprosthetic valves are conventionally treated with redo surgery. Transcatheter valve-in-valve is a less-invasive approach. (more…)
Author Interviews, Gender Differences, Heart Disease, JACC, Transplantation / 25.07.2014

Dr. Eileen Hsich MD Director of the Women’s Heart Failure Clinic Associate Medical Director for the Heart Transplant Program Cleveland Clinic, Cleveland, OhioMedicalResearch.com Interview Invitation  Dr. Eileen Hsich MD Director of the Women’s Heart Failure Clinic Associate Medical Director for the Heart Transplant Program Cleveland Clinic, Cleveland, Ohio Medical Research: What are the main findings of the study? Dr. Hsich: Women are dying on the heart transplant waiting list at a faster rate than men for almost a decade (see Figure 1) and few studies have even addressed this problem. The occurrence is largely driven by gender differences in survival at the most urgent status (UNOS Status 1A) but the cause remains unclear. Although data is limited our findings raise concern that women are not successfully bridged to transplantation while they remain at high status and are inactivated due to worsening condition. Figure 1. Scientific Registry of Transplant Recipients: Mortality on Waiting List For Heart Transplantation Heart waiting list by gender 2000-2009   Figure derived from table in Scientific registry of transplant recipients: Heart waiting list by gender 2000-2009. Available at: Http://srtr.Transplant.Hrsa.Gov/annual_reports/2010/1103_can-gender_hr.Htm accessed january 9, 2014. (more…)
AHA Journals, Author Interviews, Gender Differences, Heart Disease, JACC, Yale / 22.07.2014

Aakriti Gupta, MD, MBBS Center for Outcomes Research and Evaluation Yale-New Haven Hospital, New Haven, ConnecticutMedicalResearch.com Interview with: Aakriti Gupta, MD, MBBS Center for Outcomes Research and Evaluation Yale-New Haven Hospital, New Haven, Connecticut Medical Research: What were the main findings? Dr. Gupta: Using a national database, we found that heart attack hospitalization rates for patients under the age of 55 have not declined in the past decade while their Medicare-age counterparts have seen a 20 percent drop. We also found that among younger patients below 55 years of age, women fare worse because they have longer hospital stays, and are more likely to die in the hospital after a heart attack. Young women were also more likely to have higher prevalence of co-existing medical conditions including diabetes, high blood pressure and higher cholesterol levels. Overall, all patient groups in the study saw increases in these conditions including diabetes and high blood pressure in the past decade. (more…)
AHA Journals, Author Interviews, Heart Disease / 21.07.2014

Kanako K. Kumamaru, MD PhD Assistant Professor, Departments of Radiology Brigham and Women’s Hospital & Harvard Medical School Boston, MA 02446MedicalResearch.com Interview with: Kanako K. Kumamaru, MD PhD Assistant Professor, Departments of Radiology Brigham and Women’s Hospital & Harvard Medical School Boston, MA 02115 Medical Research: What are the main findings of the study? Dr. Kumamaru: When a patient does not have diabetes and had no or ≤25% coronary stenosis in his/her previous coronary CT angiography (CCTA) performed within 3 years, the probability of newly developed coronary artery disease (CAD) is very low, suggesting no repeat CCTA necessary, even if the clinical scenario suggested CCTA to be appropriate. Especially, when coronary arteries were completely normal at the prior scan, no patient underwent subsequent revascularization during the study period. (more…)
Author Interviews, Gender Differences, Heart Disease, Pharmacology / 21.07.2014

Lisa A. McDonnell Program Manager, Prevention & Wellness Centre, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.MedicalResearch.com Interview with: Lisa A. McDonnell Program Manager, Prevention & Wellness Centre, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Medical Research: What are the main findings of the study? Answer: The analysis focuses on a comparison of women’s perceptions of their heart disease knowledge and heart health risk with their self‐reported knowledge and heart health risk status. In summary, it gives insight into the Perceptions vs Reality when it comes to women and their heart health. Heart disease knowledge: For the purposes of measuring knowledge related to heart health, a scoring index was created on which women responding to the survey could score as low as 0 or as high as 40. The overall mean score among women in the survey was 15.0, which is fairly modest given the maximum of 40. In a comparison of actual and perceived heart disease knowledge, 80% of respondents with a low knowledge score perceived that they were moderately or well informed. The risk factors that Canadian women most commonly associate with heart disease are being overweight/having abdominal obesity (ov/ob), physical inactivity, smoking, and lacking fruits/vegetables. Smoking, diabetes and high blood pressure account for up to 53% of MI’s, followed by Ov/Ob, psychosocial factors, a lack of physical activity, and a lack of fruits/vegetables. The limited awareness of high blood pressure, high cholesterol and diabetes as key risk factors is particularly surprising, given that these are key determinants of heart disease. Low awareness of symptomology among women in our survey were noted when comparing the occurrence of symptoms versus their recognition of these symptoms as possibly being related to their heart. Only 4 in 10 women could name chest pain as a symptom of heart disease, and a smaller proportion could identify symptoms including dyspnea, radiating pain, or typical prodromal symptoms. Such shortcomings might contribute to the greater number of unrecognized myocardial infarctions in women than in men, not to mention inappropriate treatment of acute events and premature discharge from emergency care. (more…)
AHA Journals, Author Interviews, Heart Disease / 21.07.2014

MedicalResearch.com Interview with: Cheol Whan Lee and Seung-Jung Park Division of Cardiology, Asan Medical Center, University of Ulsan Seoul, Korea Medical Research: What are the main findings of the study? Answer: The time window of DES (drug-eluting stent) failure is widely variable from soon after DES implantation to several years after DES implantation. We observed patients with late DES failure are commonly presented with acute coronary syndrome. We hypothesized that temporal patterns of DES failure may be different, and analyzed all patients with first DES failure at our institution. We found that late drug-eluting stent failure is more likely to progress to acute myocardial infarction, aggressive angiographic patterns, and worse outcomes following retreatment. (more…)
AHA Journals, Author Interviews, Diabetes, Heart Disease / 14.07.2014

MedicalResearch.com Interview with: Dr Alex Dregan Lecturer in Translational Epidemiology and Public Health, Division of Primary Care and Public Health Research King's College London, London Medical Research: What are the main findings of the study? Dr. Dregan: Our study showed that chronic inflammation was associated with increased risk of developing cardiovascular disease, specifically type II diabetes and coronary heart disease. The risk of cardiovascular disease increased with the severity of inflammatory disorders. In addition, inflammation also increased the risk of multiple morbidity (two or more cardiovascular diseases). (more…)
Author Interviews, Cost of Health Care, General Medicine, Heart Disease / 10.07.2014

Jeff Trost, MD Assistant Professor of Medicine Johns Hopkins MedicineMedicalResearch.com Interview with: Jeff Trost, MD Assistant Professor of Medicine Johns Hopkins Medicine Medical Research: What are the main findings of the study? Dr. Trost: In our study, we reported the use of two relatively simple tactics to significantly reduce the number of unnecessary blood tests to assess symptoms of heart attack and chest pain and to achieve a large decrease in patient charges. Specifically, we
  • 1) Provided information and education to physicians about proven testing guidelines and
  • 2) Made changes to the computerized provider order entry system at the medical center, part of the Johns Hopkins Health System. The guidelines call for more limited use of blood tests for so-called cardiac biomarkers. A year after implementation, our intervention led to an estimated $1.25 million reduction in laboratory charges.
(more…)
AHA Journals, Author Interviews, Global Health, Heart Disease / 10.07.2014

Anthony Bavry, MD MPH Interventional Cardiology, North Florida/South Georgia Veterans Health System Associate Professor of Medicine, University of Florida Gainesville, FL 32610MedicalResearch.com Interview with: Anthony Bavry, MD MPH Interventional Cardiology, North Florida/South Georgia Veterans Health System Associate Professor of Medicine, University of Florida Gainesville, FL 32610 Medical Research: What are the main findings of the study? Dr. Bavry: 1) Among post-menopausal women, the regular use of NSAIDs was associated with an increased risk of cardiovascular death, myocardial infarction, or stroke. 2) Cardiovascular risk was observed among users of celecoxib, naproxen, but not ibuprofen. (more…)
Author Interviews, BMJ, Heart Disease / 09.07.2014

Philippe Pibarot, DVM, PhD, FAHA, FACC, FESC, FASE Professeur titulaire, Département de Médecine, Université Laval Professor, Department of Medicine, Laval University Directeur, Chaire de Recherche du Canada sur les Maladies Valvulaires Cardiaques Chair, Canada Research Chair in Valvular Heart Diseases Institut Universitaire de Cardiologie et de Pneumologie de QuébecQuébec Heart & Lung Institute - Local Y4165MedicalResearch.com Interview with : Philippe Pibarot, DVM, PhD, FAHA, FACC, FESC, FASE Professeur titulaire, Département de Médecine, Université Laval Professor, Department of Medicine, Laval University Directeur,  Chaire de Recherche du Canada sur les Maladies Valvulaires Cardiaques Chair,  Canada Research Chair in Valvular Heart Diseases Institut Universitaire de Cardiologie et de Pneumologie de QuébecQuébec Heart & Lung Institute - Local Y4165 Medical Research: What are the main findings of the study? Dr. Pibarot: The optimal timing of aortic valve replacement (AVR) in asymptomatic patients with severe aortic stenosis (AS) remains a matter of debates. Both the American and European guidelines recommend AVR for patients with severe AS who present with symptoms or left ventricular (LV) systolic dysfunction. However, patients with aortic stenosis are often older, less physically active and have more comorbidities, which make the assessment of AS-related symptoms challenging and unreliable. In this study by Capoulade et al, plasma levels of brain natriuretic peptide (BNP) were obtained in 157 patients with severe asymptomatic aortic stenosis and preserved LV ejection fraction at peak of exercise-stress echocardiography. Patients in the upper (>95 pg/ml) and mid (>45 pg/ml) tertiles of exercise BNP respectively had a 5- and 3- fold increase in the risk of events (i.e. AVR or death) compared to those in the lower tertile. Similar results were obtained in the subset of patients with low resting BNP. (more…)
Author Interviews, Diabetes, Diabetes Care / 08.07.2014

MedicalResearch.com: Interview with: Interview with Professor Donald W Bowden and Dr. Amanda J Cox Center for Diabetes Research, Center for Genomics and Personalized Medicine Research Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC Medical Research: What are the main findings of the study? Answer: The study examined modifiable cardiovascular disease (CVD) risk factors and risk for mortality in a subset of individuals from the Diabetes Heart Study who were at high risk based for cardiovascular disease based on burden of subclinical CVD assessed by coronary artery calcified plaque scores greater than 1000. Even among this high risk group, known CVD risk factors were still useful in assessing ongoing risk for mortality.  Use of cholesterol-lowering medication was one factor identified to be protective against mortality. (more…)
Author Interviews, BMJ, Heart Disease / 07.07.2014

MedicalResearch.com Interview with: Dr Mohanraj K Karunanithi Research Team Leader | Integrated Mobile Health Systems The Australian e-Health Research Centre Digital Productivity and Services Flagship CSIRO Medical Research: What are the main findings of the study? Dr. Karunanithi:
  • 33% more clients completed the innovative home-based cardiac rehabilitation (CR) delivery using smartphone and the internet (Care Assessment Platform CR program) compared with the traditional centre-based cardiac rehabilitation program.
  • Care Assessment Platform-CR  was as effective as tradition CR program in improving physical activity, diet intake, and lowering depression
  • Care Assessment Platform -CR was also effective in reducing weight, and anxiety levels and more importantly, the overall health related quality of life.
(more…)
AHA Journals, Author Interviews, Exercise - Fitness, Heart Disease / 07.07.2014

Peter Kokkinos PhD Veterans Affairs Medical Center, Cardiology Division Washington, DC 20422MedicalResearch.com Interview with: Peter Kokkinos PhD Veterans Affairs Medical Center, Cardiology Division Washington, DC 20422 Medical Research: What are the main findings of the study? Dr. Kokkinos: The main finding of the study is that we defined an exercise capacity threshold for each age category (<50; 50-59; 60-69; and ≥70 years of age). The mortality risk increases progressively below this threshold and decreases above it. We then calculated the 5 and 10-year mortality risk for each age category. (more…)
AHA Journals, Author Interviews, Heart Disease / 03.07.2014

Sripal Bangalore, MD, MHA Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, Associate Professor of Medicine, New York University School of Medicine, New York, NY 10016MedicalResearch.com Interview with: Sripal Bangalore, MD, MHA Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, Associate Professor of Medicine, New York University School of Medicine, New York, NY 10016 Medical Research: What are the main findings of the study? Dr. Bangalore: We found that while CABG was associated with mortality benefit when compared with bare metal stents or first generation drug eluting stent, the gap between CABG and PCI was smaller and non significant when PCI was with newer generation DES. The same was true for repeat revascularization with the magnitude of benefit with CABG descending considerable from comparison with balloon angioplasty to newer generation DES. (more…)
AHA Journals, Author Interviews, Heart Disease / 30.06.2014

MedicalResearch.com Interview with: Eddie Hulten, MD MPH FACC FSCCT Eddie Hulten, MD MPH FACC FSCCT and Ron Blankstein, MD FACCRon Blankstein, MD FACC Cardiovascular Imaging Noninvasive Cardiovascular Imaging Walter Reed National Military Medical Center Brigham and Women’s Hospital Bethesda, MD Boston, MA MedicalResearch: What are the main findings of the study? Answer:  Although any medical test should be used to change management, the extent to which CCTA (Cardiac computed tomography angiography) findings are associated with medication changes (aspirin and lipid lowering) is not previously extensively studied. Thus, we conducted the largest and one of the longest follow up studies of preventive cardiovascular medications before and after coronary computed tomography angiography (CCTA).  We demonstrated that CCTA findings are associated with significant changes in preventive medications after CCTA. (more…)
Author Interviews, Gender Differences, Heart Disease, JAMA / 25.06.2014

MedicalResearch.com Interview with: David Strauss, M.D., Ph.D., Senior Author Medical Officer Center for Devices and Radiological Health U.S. Food and Drug Administration, Silver Spring, Md MedicalResearch: What are the main findings of the study? Dr. Strauss: The underrepresentation of women in clinical trials for cardiac resynchronization therapy (CRT) devices, as with other devices, has made it difficult to assess differences in the safety and effectiveness of these devices for women vs. men. The FDA is exploring the potential of pooling and analyzing data from multiple trials to bridge the knowledge gap for certain subpopulations (such as women) often underrepresented in medical device clinical trials. By conducting one such meta-analysis, the FDA found that women benefit from cardiac resynchronization therapy (CRT) significantly more than men do. (more…)
Author Interviews, JAMA, Thromboembolism / 17.06.2014

Jay Giri, MD MPH Assistant Professor, Perelman School of Medicine Director, Peripheral Intervention Interventional Cardiology & Vascular Medicine Cardiovascular Division University of PennsylvaniaMedicalResearch Interview with: Jay Giri, MD MPH Assistant Professor, Perelman School of Medicine Director, Peripheral Intervention Interventional Cardiology & Vascular Medicine Cardiovascular Division University of Pennsylvania MedicalResearch: What are the main findings of the study? Dr. Giri: Use of thrombolytics was associated with lower all-cause mortality and increased rates of intracranial hemorrhage.  These results were also seen in intermediate-risk pulmonary embolism.  Finally, it appeared that patients under age 65 might be at less bleeding risk from thrombolytics. (more…)
Author Interviews, BMJ, Heart Disease, Pharmacology / 17.06.2014

MedicalResearch.com Interview with: Professor June-Hong Kim, Division of Cardiology Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital Yangsan, South Korea; MedicalResearch: What are the main findings of the study? Dr. Kim: In vasospastic angina, the cilostazol group significantly reduced relative ireduction of of weekly incidence of chest pain compared with placebo group (−66.5±88.6% vs −17.6±140.1%, respectively, p=0.009).. Other clinical parameters such as a change in the frequency of chest pain (−3.7±0.5 vs −1.9±0.6, respectively, p=0.029), a change in the chest pain severity scale (−2.8±0.4 vs −1.1±0.4, respectively, p=0.003), and the proportion of chest pain-free patients (76.0% vs 33.3%, respectively, p=0.003) also significantly favored cilostazol. (more…)
Author Interviews, Diabetes, Diabetes Care, Mediterranean Diet, Nutrition / 17.06.2014

David J.A. Jenkins Professor and Canada Research Chair in Nutrition and Metabolism, Dept. of Medicine and Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, CanadaMedicalResearch.com Interview with: David J.A. Jenkins Professor and Canada Research Chair in Nutrition and Metabolism, Dept. of Medicine and Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada   MedicalResearch: What are the main findings of the study? Prof. Jenkins: The main findings were that inclusion of just over an once (31g) of canola oil in low glycemic index diets of type 2 diabetes study participants, to further reduce the glycemic load (GL), reduced HbAIC more than a high cereal fiber diet, as predicted. However the Canola oil low GL diet also reduced serum TG and LDL-C and thus Framingham risk score for cardiovascular disease. The effect was seen most clearly in those at highest CHD risk and those with features of the metabolic syndrome. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA, Vanderbilt / 10.06.2014

MedicalResearch.com Interview with: Christianne L. Roumie, MD MPH Associate Professor Internal Medicine and Pediatrics Institute for Medicine and Public Health Vanderbilt University Staff Physician VA Tennessee Valley Healthcare System Nashville TN 37212MedicalResearch.com Interview with: Christianne L. Roumie, MD MPH Associate Professor Internal Medicine and Pediatrics Institute for Medicine and Public Health Vanderbilt University Staff Physician VA Tennessee Valley Healthcare System Nashville TN 37212 MedicalResearch: What are the main findings of the study? Dr. Roumie: This retrospective cohort study compared time to acute myocardial infarction (AMI), stroke, or death among Veterans with diabetes that were initially treated with metformin, and subsequently added either insulin or sulfonylurea. Among 178,341 Veterans on metformin monotherapy, 2,948 and 39,990 added insulin or sulfonylurea, respectively. Patients were about 60 years old, about 35% had history of heart disease or stroke, had been on metformin for an average of 14 months and their hemoglobin A1c was 8.1% at the time of addition of the second medication. Compared to those who added a sulfonylurea, those who added insulin to metformin had a 30% higher risk of the combined outcome of heart attack, stroke, and all-cause mortality. Although new heart attacks and strokes occurred at similar rates in both groups, mortality was higher in patients who added insulin. (more…)
Author Interviews, Heart Disease, Mediterranean Diet / 06.06.2014

Prof Jordi Salas-Salvadó Professor of Nutrition. Human Nutrition Unit (Director) Department of Biochemistry & Biotechnology, IISPV School of Medicine. Rovira i Virgili University. Reus, Spain. CIBERobn, Instituto Carlos III. Centre Català de la Nutrició - Institut d'Estudis Catalans (Director). Federation of Spanish Food, Nutrition and Dietetic Scientific Societies (President). Red Iberoamericana RIBESMET (Director) INC - World Forum for Nutrition Research and Dissemination (Chairman).MedicalResearch.com Interview with: Prof Jordi Salas-Salvadó Professor of Nutrition. Human Nutrition Unit (Director) Department of Biochemistry & Biotechnology, IISPV School of Medicine. Rovira i Virgili University. Reus, Spain. CIBERobn, Instituto Carlos III. Centre Català de la Nutrició - Institut d'Estudis Catalans (Director). Federation of Spanish Food, Nutrition and Dietetic Scientific Societies (President). Red Iberoamericana RIBESMET (Director) INC - World Forum for Nutrition Research and Dissemination (Chairman). MedicalResearch: What are the main findings of the study? Answer: The main findings of our study are that olive oil consumption, especially the extra-virgin variety (which is the olive oil with the best quality because it has higher amounts of bioactive compounds than other varieties), is associated with a reduced risk of suffering from cardiovascular disease (stroke, myocardial infarction...) and also cardiovascular death in an elderly Mediterranean population from Spain who were at high cardiovascular risk (because they had several cardiovscular risk factors such as smoking, being overweight or obese, having a family history of cardiovascular disease...). This means there is even more reason to visit gringocool.com. We have conducted an observational study including more than 7000 individuals who had participated in a randomized clinical trial to evaluate effects of a Mediterranean Diet in on the primary prevention of cardiovascular disease. (more…)
Author Interviews, Heart Disease, JAMA / 03.06.2014

MedicalResearch.com Interview with: Sana Al-Khatib, M.D. MHS Duke Clinical Research Institute Duke University School of Medicine Durham, NC,MedicalResearch.com Interview with: Sana Al-Khatib, M.D. MHS Duke Clinical Research Institute Duke University School of Medicine Durham, NC, MedicalResearch: What are the main findings of the study? Dr. Al-Khatib: Patients with an ejection fraction (measure of the pumping ability of the heart) of 30% to 35% who receive a prophylactic implantable cardioverter defibrillator have better survival than similar patients with no implantable defibrillator. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, Lancet / 03.06.2014

​MedicalResearch.com Interview with: Eleni Rapsomaniki, PhD The Farr Institute of Health Informatics Research Department of Epidemiology & Public Health University College London London MedicalResearch: What are the main findings of the study? Dr. Rapsomaniki: Our data shows that hypertension is associated with considerable reduction in CVD-free life expectancy. Based on our estimates a 30-year old with hypertension suffered from CVD 5 years earlier compared to a similarly aged individual with normal blood pressure. We noted substantial heterogeneity in the associations of blood pressure with specific cardiovascular outcomes. For example a 20 mmHg increase in systolic blood pressure was associated with ~40% higher risk of stable angina, and intracerebral or subarachnoid haemorrhage but less than 10% increase in risk of abdominal aortic aneurysm. In all age groups from 30 to over 80 people with a systolic blood pressure 90–114 mm Hg and a diastolic blood pressure of 60–74 mm Hg had the lowest risk of all cardiovascular diseases, and we found no J-shape associations. (more…)
Author Interviews, Exercise - Fitness, JCEM, Menopause / 24.05.2014

Unab I. Khan, M.B.,B.S., M.S. Assistant Professor of Pediatrics and Family & Social Medicine Division of Adolescent Medicine The Children’s Hospital at Montefiore The Pediatric Hospital for Albert Einstein College of Medicine Bronx, NY 10467MedicalResearch.com Interview with: Unab I. Khan, M.B.,B.S., M.S.   Assistant Professor of Pediatrics and Family & Social Medicine Division of Adolescent Medicine The Children’s Hospital at Montefiore The Pediatric Hospital for Albert Einstein College of Medicine Bronx, NY 10467 MedicalResearch: What are the main findings of the study? Dr. Khan: We wanted to find factors that lead to either an increase or decrease in risk of developing cardiovascular disease. We found that in middle aged overweight and obese women, who may not have any medical problems like diabetes, high blood pressure, high cholesterol, an increase in weight over time and the development of any of the conditions stated above, increased the risk of cardiovascular disease significantly. On the other hand, even moderate physical activity decreased the risk of heart disease, even in the presence of the above stated conditions. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Heart Disease, JACC / 22.05.2014

MedicalResearch.com Interview with: Nileshkumar J. Patel MD Staten Island University Hospital Staten Island, NY, 10304 and Abhishek J. Deshmukh MD University of Arkansas Little Rock, AR MedicalResearch: What are the main findings of the study? Answer: We analyzed data from almost 4 million hospitalizations for atrial fibrillation (AF) from more than 1,200 hospitals across 45 states in last decade, and found that -   Hospitalization rates for atrial fibrillation have increased exponentially among US adults during the past 10 years, particularly in those 65 years or older. -   The most frequent coexisting conditions were hypertension (59.99%), diabetes (21.47%) and chronic pulmonary disease (20.01%). -   In terms of geographic distribution of admissions, the hospitals in the South constitute (38.5%) the highest percentage of atrial fibrillation hospitalizations, followed by Midwest (24.9%), Northeast (22.2%) and West (14.4%). -   Overall in-hospital mortality was 1%. The mortality rate was highest in >80 years age group (1.93%) and patients with concomitant heart failure (8.2%). -   The percentage of patients discharged to nursing facility increased from 8.1% in 2000 to 11.5% in 2010 and need for home health care increased from 6.7% to 13.1%. Approximately one fourth of the patients (25.83%) were discharged to long-term care institution if atrial fibrillation hospitalization was complicated by acute ischemic stroke. -   Mean cost of AF hospitalization increased significantly from $6,410 in 2001 to $8,439 in 2010 (24.04% increase, p <0.001) even after adjusting for inflation. This represents an absolute increment in annual national cost from approximate 2.15 billion dollars in 2001 to 3.46 billion dollars in 2010. The mean cost of care was highest if AF hospitalization was associated with heart failure ($33,161) and valvular disorders ($28,030). (more…)
Author Interviews, End of Life Care, Heart Disease / 21.05.2014

MedicalResearch.com Interview with: Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine University of Colorado, Division of Cardiology Section of Advanced Heart Failure and TransplantationMedicalResearch.com Interview with: Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine University of Colorado, Division of Cardiology Section of Advanced Heart Failure and Transplantation   MedicalResearch: What are the main findings of the study? Answer: We interviewed 22 patients who were offered destination therapy left ventricular assist devices (DT LVAD), 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an overriding desire to live as long as possible: [LVAD] was the only option I had…that or push up daisies…so I automatically took this. In contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: There are worse things than death. Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually. (more…)
Author Interviews, JAMA, Statins / 14.05.2014

Medidr_jennifer_robinsoncalResearch.com Interview with: Jennifer G. Robinson, MD, MPH Professor ,Departments of Epidemiology & Medicine Director, Prevention Intervention Center Department of Epidemiology College of Public Health University of Iowa Iowa City, IA 52242-2007 MedicalResearch: What are the main findings of the study? Dr. Robinson: The PCSK9 antibody, evolocumab, reduced LDL (or bad) cholesterol by about 65-70% regardless of the dose or type of statin used. This is a greater percentage reduction than ezetimibe, another drug used to lower LDL cholesterol in statin-treated patients, which lowered LDL cholesterol 15-20%. Side effects of evolocumab were similar to those for ezetimibe or placebo. (more…)