Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 11 de 11
Filter
1.
Nutrients ; 13(11)2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1542681

ABSTRACT

Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.


Subject(s)
Cardiovascular Diseases/prevention & control , Diet, Healthy/methods , Health Promotion/methods , Australia , Cardiovascular Diseases/ethnology , Diet, Healthy/ethnology , Health Services, Indigenous , Heart Disease Risk Factors , Humans , Outcome Assessment, Health Care , Program Evaluation
3.
PLoS One ; 16(7): e0253660, 2021.
Article in English | MEDLINE | ID: covidwho-1298080

ABSTRACT

With the continuing rise of SARS-CoV2 infection globally and the emergence of various waves in different countries, understanding characteristics of susceptibility to infection, clinical severity, and outcomes remain vital. In this retrospective study, data was extracted for 39,539 patients from the de-identified Mount Sinai Health System COVID-19 database. We assessed the risk of mortality based on the presence of comorbidities and organ-specific sequelae in 7,032 CoV2 positive (+) patients. Prevalence of cardiovascular and metabolic comorbidities was high among SARS-CoV2+ individuals. Diabetes, obesity, coronary artery disease, hypertension, atrial fibrillation, and heart failure all increased overall mortality risk, while asthma did not. Ethnicity modified the risk of mortality associated with these comorbidities. With regards to secondary complications in the setting of infection, individuals with acute kidney injury and acute myocardial injury showed an increase in mortality risk. Cerebral infarcts and acute venous thromboembolic events were not associated with increased risk of mortality. Biomarkers for cardiovascular injury, coagulation, and inflammation were compared between deceased and survived individuals. We found that cardiac and coagulation biomarkers were elevated and fell beyond normal range more often in deceased patients. Several, but not all, inflammatory markers evaluated were increased in deceased patients. In summary, we identified comorbidities and sequelae along with peripheral blood biomarkers that were associated with elevated clinical severity and poor outcomes in COVID-19 patients. Overall, these findings detail the granularity of previously reported factors which may impact susceptibility, clinical severity, and mortality during the course of COVID-19 disease.


Subject(s)
Biomarkers/blood , COVID-19/pathology , Comorbidity , COVID-19/mortality , COVID-19/virology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/ethnology , Databases, Factual , Diabetes Mellitus/epidemiology , Diabetes Mellitus/ethnology , Humans , Prevalence , RNA, Viral/analysis , Real-Time Polymerase Chain Reaction , Retrospective Studies , Risk Factors , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Severity of Illness Index , Survival Analysis
4.
Curr Treat Options Oncol ; 22(6): 47, 2021 04 17.
Article in English | MEDLINE | ID: covidwho-1188176

ABSTRACT

OPINION STATEMENT: Prostate cancer is the second leading cause of cancer death in men, and cardiovascular disease is the number one cause of death in patients with prostate cancer. Androgen deprivation therapy, the cornerstone of prostate cancer treatment, has been associated with adverse cardiovascular events. Emerging data supports decreased cardiovascular risk of gonadotropin releasing hormone (GnRH) antagonists compared to agonists. Ongoing clinical trials are assessing the relative safety of different modalities of androgen deprivation therapy. Racial disparities in cardiovascular outcomes in prostate cancer patients are starting to be explored. An intriguing inquiry connects androgen deprivation therapy with reduced risk of COVID-19 infection susceptibility and severity. Recognition of the cardiotoxicity of androgen deprivation therapy and aggressive risk factor modification are crucial for optimal patient care.


Subject(s)
Antineoplastic Agents, Hormonal/adverse effects , Cardiovascular Diseases/epidemiology , Prostatic Neoplasms/drug therapy , Androstenes/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , COVID-19/epidemiology , COVID-19/pathology , Cardiotoxicity , Cardiovascular Diseases/chemically induced , Cardiovascular Diseases/ethnology , Disease Susceptibility , Gonadotropin-Releasing Hormone/agonists , Gonadotropin-Releasing Hormone/antagonists & inhibitors , Health Status Disparities , Humans , Male , Prostatic Neoplasms/ethnology , SARS-CoV-2
7.
Health Qual Life Outcomes ; 18(1): 387, 2020 Dec 14.
Article in English | MEDLINE | ID: covidwho-977679

ABSTRACT

BACKGROUND: Little is known about the impact of the global coronavirus disease-2019 (COVID-19) pandemic on patients with cardiovascular disease (CVD), the biggest global killer and major risk factor for severe COVID-19 infections. We aim to explore the indirect consequences of COVID-19 on health-related quality of life (HRQoL) of patients with CVD. METHODS: Eighty-one adult outpatients with CVD were assessed using the EQ-5D, a generic health status instrument with five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), before and during the pandemic. Changes in the EQ-5D dimensional responses were compared categorically as well as using the dimension-specific sum-score (range 1-3, with a higher score indicating worse health). The responses and sum-score were compared using the exact test of symmetry and the paired t-test, respectively. RESULTS: These patients [mean age (SD) 59.8 (10.5); 92.6% males; 56% New York Heart Association (NYHA) functional class I] had coronary artery disease (69%), heart failure (28%), or arrhythmias (15%). None experienced change in NYHA class between assessments. About 30% and 38% of patients reported problems with at least one of the EQ-5D dimensions pre-pandemic and during the pandemic, respectively. The highest increase in health problems was reported for anxiety/depression (12.5% pre-pandemic vs 23.5% during pandemic; p = 0.035) with mean domain-specific score from 1.12 (SD 0.33) to 1.25 (SD 0.46) (standardized effect size = 0.373, p = 0.012). There was no meaningful change in other dimensions as well as overall HRQoL. CONCLUSION: The COVID-19 pandemic is associated with a significant worsening of the mental health of patients with CVD.


Subject(s)
COVID-19/psychology , Cardiovascular Diseases/psychology , Health Status , Quality of Life , Activities of Daily Living , Adult , Aged , Anxiety/complications , Cardiovascular Diseases/complications , Cardiovascular Diseases/ethnology , Depression/complications , Female , Health Surveys , Humans , Longitudinal Studies , Male , Middle Aged , Pain/etiology , Pandemics , Self Care , Singapore
9.
J Racial Ethn Health Disparities ; 8(3): 566-569, 2021 06.
Article in English | MEDLINE | ID: covidwho-650004

ABSTRACT

This is a literature review where we acknowledge Richard Allen Williams, the first African American physician to win the John P. McGovern Compleat Physician Award, and recognize his achievements in race and ethnicity in healthcare. There have been significant advances in the diagnosis and treatment of cardiovascular disease; however, racial disparities continue to create inequity in the medical community especially for African Americans. Dr. Williams founded the Association of Black Cardiologists (ABC) in 1974 to address the misperception about, and the misdiagnosis and maltreatment of African American patients. He emphasized the importance of diversity and the non-biased approach to the treatment of all communities. This literary review further explores current racial disparities African Americans face during the COVID-19 pandemic. Granted that Dr. Williams' win is a step towards progress and change, there is much to be done to conquer the cultural divide in healthcare.


Subject(s)
African Americans/history , Health Equity/history , Health Status Disparities , Physicians/history , Awards and Prizes , COVID-19/ethnology , Cardiovascular Diseases/ethnology , History, 20th Century , History, 21st Century , Humans , Societies, Medical/history , United States/epidemiology
10.
J Natl Med Assoc ; 112(3): 315-323, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-603628

ABSTRACT

BACKGROUND: Cardiovascular disease related mortality is the leading cause of death in the United States, with hypertension being the most prevalent and potent risk factor. For decades hypertension has disproportionately affected African Americans, who also have a higher burden of associated comorbidities including diabetes and heart failure. METHODS: Current literature including guideline reports and newer studies on hypertension in African Americans in PubMed were reviewed. We also reviewed newer publications on the relationship between COVID-19 and cardiovascular disease. FINDINGS: While APOL1 has been theorized in the epidemiology of hypertension, the increased prevalence and associated risks are primarily due to environmental and lifestyle factors. These factors include poor diet, adverse lifestyle, and social determinants. Hypertension control can be achieved by lifestyle modifications such as low sodium diet, weight loss, and adequate physical activity. When lifestyle modifications alone do not adequately control hypertension, a common occurrence among African Americans who suffer with greater prevalence of resistant hypertension, pharmacological intervention is indicated. The efficacy of renal denervation, and the use of sodium-glucose cotransporter 2 and aminopeptidase A inhibitors, have been studied for treatment of resistant hypertension. Furthermore, the recent COVID-19 crisis has been particularly devastating among African Americans who demonstrate increased incidence and poorer health outcomes related to the disease. CONCLUSION: The disparities in outcomes, which are largely attributable to a greater prevalence of comorbidities such as hypertension and obesity, in addition to adverse environmental and socioeconomic factors, highlight the necessity of specialized clinical approaches and programs for African Americans to address longstanding barriers to equitable care.


Subject(s)
African Americans/statistics & numerical data , Cardiovascular Diseases/ethnology , Coronavirus Infections/ethnology , Healthcare Disparities/ethnology , Hypertension/ethnology , Pneumonia, Viral/ethnology , Vulnerable Populations/statistics & numerical data , Adult , Aged , COVID-19 , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Coronavirus Infections/epidemiology , Female , Health Status Disparities , Healthcare Disparities/statistics & numerical data , Humans , Hypertension/diagnosis , Hypertension/therapy , Male , Middle Aged , Needs Assessment , Pandemics , Pneumonia, Viral/epidemiology , Prevalence , Socioeconomic Factors , Survival Analysis , United States/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL