Browsing by Subject "cardiovascular disease"
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Item Cardiovascular Disease In Cancer Survivors(2023) Polter, ElizabethOver 18 million cancer survivors are living in the United States. Cancer survivors are at high risk for numerous adverse events, including cardiovascular disease (CVD). As the community of cancer survivors grows, there is a need to disentangle the complex causal relationships between cancer and CVD.In our first two manuscripts, we investigated two potential causes of CVD in cancer survivors. Manuscript 1 evaluated the associations between cancer, T-Cell immunosenescence (immune system aging), and CVD using data from the Health and Retirement Study. Prevalent cancer was strongly associated with T-cell immunosenescence, with stronger associations among participants who received chemotherapy and radiation. However, T-cell Immunosenescence was not prospectively associated with CVD or cancer. For Manuscript 2, we used the Marketscan® administrative healthcare claims databases to estimate the cardiovascular risk associated with the use of two hormone therapies, aromatase inhibitors (with ovarian suppression) and tamoxifen in premenopausal female breast cancer survivors. Although CVD events were rare in this population, enrollees who used aromatase inhibitors with ovarian suppression had an elevated risk of CVD compared to those who used tamoxifen. Finally, Manuscript 3 assessed the performance of the Pooled Cohort Equations (PCEs), risk prediction tools used to estimate ten-year cardiovascular risk and prescribe interventions. Analyses included cancer survivors and cancer-free participants in the Atherosclerosis Risk in Communities Study. Although the PCEs overestimated CVD risk in each group, we found no evidence that prediction differed by cancer history. Together, these findings provide insights that can be used to improve cardiovascular healthcare and prevention for cancer survivors.Item Circulating Magnesium and Cardiovascular Disease(2019-05) Rooney, MaryLow circulating magnesium (Mg) or hypomagnesemia is thought to be common, and is traditionally measured by circulating total Mg. Proton pump inhibitor (PPI) medication use is also common and has been linked with low circulating Mg. Both low circulating Mg and PPI use have been associated with elevated cardiovascular disease (CVD) risk. This dissertation further characterizes the complex relationship between circulating Mg and CVD among older adults. Using data from a double-blind pilot Mg supplementation randomized controlled trial, the first manuscript characterizes the interrelationship of different circulating Mg status biomarkers (ionized and total Mg) at baseline and in response to Mg supplementation. Baseline ionized and total Mg were modestly and positively associated. Mg supplementation versus placebo over 10 weeks resulted in increased concentrations of ionized and total Mg. In the second manuscript, we test cross-sectional associations of circulating total Mg with burden of atrial and ventricular arrhythmias as measured over 2 weeks on an ambulatory electrocardiographic monitoring patch in the Atherosclerosis Risk in Communities (ARIC) study. In this now elderly population, serum Mg was inversely associated with premature ventricular contraction burden. While effect estimates were in the hypothesized direction, we found little evidence of an association between circulating Mg and atrial arrhythmias. These findings were similar even among those without a history of CVD. The third manuscript explores cross-sectional associations of PPI use with circulating total Mg and prospective associations of PPI use, hypomagnesemia and CVD risk in the ARIC study. One in four participants had used a PPI within the last 2 weeks, and PPI users had a greater prevalence of hypomagnesemia than non-users. Additionally, PPI users had modestly elevated risk of CVD; however, presence of hypomagnesemia did not explain this elevated risk of CVD. Collectively, this dissertation helps refine our understanding of Mg homeostasis in relation to CVD.Item Controversial benefits of Omega-3 fatty acid (fish oil)(2009-09-18) Whitehair, LanceFish oil or omega-3 fatty acids are popular supplements. There is debt as to whether fish oil gives cardiovascular benefit particularly with mortality outcomes. A recent systematic review is referenced.Item Fish Oil(2010-10-29) Dickmann, PattyFish oil is obtained in the human diet by eating oily fish such as salmon, herring, trout, mackerel, albacore tuna, and sardines, or by consuming fish oil supplements. Contrary to popular belief, fish do not naturally produce these oils; instead, they acquire them through the ocean food chain when they consume algae, the original sources of the omega-3 fatty acids found in fish oils. Evidence from several studies suggests that omega-3 fatty acids from fish or fish oil supplements have positive effects on heart health, mental health, and infant development. It may even reduce the risk of some types of cancer. While fish oil has few reported side effects, it is important to talk to your doctor before starting fish oil supplements.Item Fish Oil, what you should know?(2009-05-01) Hoff, EmmyIt has been known for many years that fish oil has protective effects on the body. Some of the specific actions include lowering triglycerides and preventing thrombosis (or clots which can lead to heart attacks) and cardiac arrhythmias. Fish oil also decreases cholesterol accumulation in the arterial wall, inhibits inflammation and decreases platelet aggregation. Fish oil can be found in a variety of foods including salmon, trout, herring and also in flax seed, walnuts and other nuts and grains. Fish oil in an easy and natural way to increase cardiovascular health, especially in patients with risk factors including obesity, high blood pressure and high cholesterol and triglycerides.Item Life Course Evaluation of a Plant-Centered Diet and Risk of Type 2 Diabetes, Weight Gain, Cardiovascular Diseases, All-Cause Mortality, and Markers of Chronic Kidney Disease: The Coronary Artery Risk Development in Young Adults (CARDIA) Cohort(2021-01) Choi, YuniOBJECTIVE: To examine the association of plant-centered diet quality with risk of type 2 diabetes (T2D), weight gain, cardiovascular disease (CVD), all-cause mortality, and markers of chronic kidney disease (CKD)−estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (ACR).METHODS: Data from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort were used. This US multicenter, community-based prospective study involved 5,115 Black and White men and women aged 18-30 years old at baseline assessment in 1985–1986 and followed through to 2018. Diet was assessed by an interviewer-administered, validated diet history questionnaire. Plant-centered diet quality was assessed using the A Priori Diet Quality Score (APDQS); higher index scores represent higher consumption of nutritionally-rich plant foods and limited consumption of high-fat meat products and unhealthy plant foods. Cox regression models were used to assess risk of T2D, CVD, and all-cause mortality, and linear regression models were used to examine change in body size, eGFR, ACR, and combination of eGFR and ACR. RESULTS: For every 1–SD increase in the APDQS (over a 20-year period for T2D and a 13-year period for CVD), there was a reduction in subsequent risk of T2D (Hazard Ratio [HR]= 0.71; 95% CI: 0.59–0.86) and CVD (HR=0.75; 95% CI: 0.57–1.00), independent of the baseline APDQS. In addition, each 1–SD increase in the APDQS over 20 years was associated with concurrent changes in body mass index (-0.39±0.14 kg/m2; P=0.004), waist circumference (-0.90±0.27 cm; P <0.001), and body weight (-1.14±0.33 kg; P <0.001). The time-updated average APDQS was associated with lower risk of CVD (HR=0.80; 95% CI: 0.67–0.95), lower ln(ACR) (β±SE at Y30: -0.09±0.02 mg/g; P<0.001), higher eGFR (1.64±0.47 mL/min/1.73m2; P<0.001), and lower the combined markers (for ln(ACR) z-score - eGFR z-score: -0.19±0.03; P<0.001). However, there was a suggestive, but not statistically significant, inverse association between the APDQS and risk of all-cause mortality. CONCLUSIONS: Consumption of a plant-centered, high-quality diet starting in young adulthood is associated with a lower risk of developing diet-related chronic disease by middle age.Item The role of bisphosphonates: potential novel pharmaceutical therapy for reducing cardiovascular morbidity and mortality(2013-04) Chen, Yen-WenCardiovascular disease (CVD) is one of the most significant and costly public health problems in the U.S. and worldwide. In addition to the well-established risk factors, such as hypertension or diabetes, growing bodies of studies have demonstrated that vascular calcification is another strong and independent predictor of cardiovascular morbidity and mortality. The pathological process of vascular calcification includes many key modulators of bone and mineral metabolism. Hence, the question is raised regarding whether pharmacological agents for inhibiting bone loss can also provide a beneficial impact on inhibiting vascular calcification to lower CVD risks. The primary objectives of this study were to: 1) examine the association between bisphosphonate use and the risk of a composite endpoint of congestive heart failure (CHF), myocardial infarction (MI) or stroke hospitalization, and 2) examine the impact of patient adherence to bisphosphonate therapy on the risk of CHF, MI or stroke hospitalization.Item The Role of Clinical Pharmacists in Modifying Cardiovascular Disease Risk Factors(University of Minnesota, College of Pharmacy, 2014) Bagwell, Autumn; Skelley, Jessica W.; Saad, Lana; Woolley, Thomas; Dugan, DeeAnnObjective: Assess the effect of intensive clinical and educational interventions aimed at reducing risk factors for Cardiovascular Disease (CVD), implemented by clinical pharmacists, on modifying risk factors in targeted patients at high risk for CVD. Design: Patients with at least two risk factors for CHD were identified at two clinics by conducting a pre-intervention survey and were monitored over a period of 6 months with follow up conversations conducted every 4 weeks by phone and at subsequent physician visits. A post-intervention survey was conducted at the end of the study period to detect modified risk factors. Setting: The Jefferson County Public Health Department (JCHD) Participants: We followed a total of 47 patients over 6 months. The average age at baseline was 51 years old and 80% of the participants were female. The baseline average number of modifiable cardiovascular disease risk factors was 3.7. Measurements: We assessed total number of CVD risk factors, smoking behavior, blood pressure, LDL, A1C, weight, and level of physical activity (major modifiable risk factors by the American Heart Association). Results: Over a 6 month follow-up of 47 patients, statistically significant reductions occurred in total number of CVD risk factors, systolic and diastolic blood pressures, and A1C. Reductions also occurred in LDL level, weight, and changes in smoking behavior and physical activity were identified. Conclusions: Results showed that increased patient counseling on adherence and lifestyle changes along with increased disease state monitoring and medication adjustment led by a clinical pharmacist can decrease risk factors in patients with multiple risk factors for cardiovascular disease.