Search

Usefulness of Ambulatory 7-Day ECG Monitoring for the Detection of Atrial Fibrillation and Flutter After Acute Stroke and Transient Ischemic Attack
- Denis Jabaudon,
- Juan Sztajzel,
- Katia Sievert,
- Theodor Landis and
- Roman Sztajzel
Stroke Volume 35, Issue 71 July 2004

Abstract Export Citations PDF/EPUB

Abstract
Background and Purpose— Although atrial fibrillation is the most frequent cause of cardioembolic stroke, this arrhythmia remains underdiagnosed, as it is often asymptomatic or intermittent and, thus, may not be detected on standard 12-lead ECG or even 24-hour ECG recording (Holter). In this study, we hypothesized that 7-day ambulatory ECG monitoring using an event-loop recording (ELR) device would detect otherwise occult episodes atrial fibrillation and flutter (AF) after acute stroke or transient ischemic attack (TIA).Methods— One hundred forty-nine consecutive patients admitted to our neurology department with an acute stroke or TIA were systematically screened for emboligenic arrhythmias using standard ECG. In the absence of AF on standard ECG, patients underwent 24-hour ECG recording (Holter), which was followed by a 7-day ambulatory ECG monitoring (ELR) in patients with a normal Holter. Patients with previously documented persistent AF, with primary hemorrhagic stroke, or with acute large vessel dissection were not included in the study.Results— AF was detected in 22 patients. Standard ECG identified AF in 2.7% of the cases at admission (4/149 patients) and in 4.1% of remaining patients within 5 days (6/145). Holter disclosed AF in 5% of patients with a normal standard ECG (7/139 patients), whereas ELR detected AF in 5.7% of patients with a normal standard ECG and normal Holter (5/88 patients).Conclusions— Following acute stroke or TIA, ELR identified patients with AF, which remained undetected with standard ECG and with Holter. ELR should, therefore, be considered in every patient in whom a cardioembolic mechanism is suspected.
Estimating the Population Impact of Lp(a) Lowering on the Incidence of Myocardial Infarction and Aortic Stenosis—Brief Report
- Mehdi Afshar,
- Pia R. Kamstrup,
- Ken Williams,
- Allan D. Sniderman,
- Børge G. Nordestgaard and
- George Thanassoulis
Arteriosclerosis, Thrombosis, and Vascular Biology Volume 36, Issue 121 December 2016

Abstract Export Citations PDF/EPUB

Abstract
Objective—High lipoprotein(a) (Lp[a]) is the most common genetic dyslipidemia and is a causal factor for myocardial infarction (MI) and aortic stenosis (AS). We sought to estimate the population impact of Lp(a) lowering that could be achieved in primary prevention using the therapies in development.Approach and Results—We used published data from 2 prospective cohorts. High Lp(a) was defined as ≥50 mg/dL (≈20th percentile). Relative risk, attributable risk, the attributable risk percentage, population attributable risk, and the population attributable risk percentage were calculated as measures of the population impact. For MI, the event rate was 4.0% versus 2.8% for high versus low Lp(a) (relative risk, 1.46; 95% confidence interval [CI], 1.45–1.46). The attributable risk was 1.26% (95% CI, 1.24–1.27), corresponding to 31.3% (95% CI, 31.0–31.7) of the excess MI risk in those with high Lp(a). The population attributable risk was 0.21%, representing a population attributable risk percentage of 7.13%. For AS, the event rate was 1.51% versus 0.78% for high versus low Lp(a) (relative risk, 1.95; 95% CI, 1.94–1.97). The attributable risk was 0.74% (95% CI, 0.73–0.75), corresponding to 48.8% (95% CI, 48.3–49.3) of the excess AS risk in those with high Lp(a). The population attributable risk was 0.13%, representing a population attributable risk percentage of 13.9%. In sensitivity analyses targeting the top 10% of Lp(a), the population attributable risk percentage was 5.2% for MI and 7.8% for AS.Conclusions—Lp(a) lowering among the top 20% of the population distribution for Lp(a) could prevent 1 in 14 cases of MI and 1 in 7 cases of AS, suggesting a major impact on reducing the burden of cardiovascular disease. Targeting the top 10% could prevent 1 in 20 MI cases and 1 in 12 AS cases.
Secondary Prevention After Coronary Artery Bypass Graft Surgery: A Scientific Statement From the American Heart Association
- Alexander Kulik,
- Marc Ruel,
- Hani Jneid,
- T. Bruce Ferguson,
- Loren F. Hiratzka,
- John S. Ikonomidis,
- Francisco Lopez-Jimenez,
- Sheila M. McNallan,
- Mahesh Patel,
- Véronique L. Roger,
- Frank W. Sellke,
- Domenic A. Sica and
- Lani Zimmerman
and on behalf of the American Heart Association Council on Cardiovascular Surgery and Anesthesia

Circulation Volume 131, Issue 1010 March 2015

Export Citations PDF/EPUB

Abstract
Workplace Wellness Recognition for Optimizing Workplace Health: A Presidential Advisory From the American Heart Association
- Gregg C. Fonarow,
- Chris Calitz,
- Ross Arena,
- Catherine Baase,
- Fikry W. Isaac,
- Donald Lloyd-Jones,
- Eric D. Peterson,
- Nico Pronk,
- Eduardo Sanchez,
- Paul E. Terry,
- Kevin G. Volpp and
- Elliott M. Antman
and on behalf of the American Heart Association

Circulation Volume 131, Issue 2019 May 2015

Abstract Export Citations PDF/EPUB

Abstract
The workplace is an important setting for promoting cardiovascular health and cardiovascular disease and stroke prevention in the United States. Well-designed, comprehensive workplace wellness programs have the potential to improve cardiovascular health and to reduce mortality, morbidity, and disability resulting from cardiovascular disease and stroke. Nevertheless, widespread implementation of comprehensive workplace wellness programs is lacking, and program composition and quality vary. Several organizations provide worksite wellness recognition programs; however, there is variation in recognition criteria, and they do not specifically focus on cardiovascular disease and stroke prevention. Although there is limited evidence to suggest that company performance on employer health management scorecards is associated with favorable healthcare cost trends, these data are not currently robust, and further evaluation is needed. As a recognized national leader in evidence-based guidelines, care systems, and quality programs, the American Heart Association/American Stroke Association is uniquely positioned and committed to promoting the adoption of comprehensive workplace wellness programs, as well as improving program quality and workforce health outcomes. As part of its commitment to improve the cardiovascular health of all Americans, the American Heart Association/American Stroke Association will promote science-based best practices for comprehensive workplace wellness programs and establish benchmarks for a national workplace wellness recognition program to assist employers in applying the best systems and strategies for optimal programming. The recognition program will integrate identification of a workplace culture of health and achievement of rigorous standards for cardiovascular health based on Life’s Simple 7 metrics. In addition, the American Heart Association/American Stroke Association will develop resources that assist employers in meeting these rigorous standards, facilitating access to high-quality comprehensive workplace wellness programs for both employees and dependents, and fostering innovation and additional research.
Current Science on Consumer Use of Mobile Health for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association
- Lora E. Burke,
- Jun Ma,
- Kristen M.J. Azar,
- Gary G. Bennett,
- Eric D. Peterson,
- Yaguang Zheng,
- William Riley,
- Janna Stephens,
- Svati H. Shah,
- Brian Suffoletto,
- Tanya N. Turan,
- Bonnie Spring,
- Julia Steinberger and
- Charlene C. Quinn
and on behalf of the American Heart Association Publications Committee of the Council on Epidemiology and Prevention, Behavior Change Committee of the Council on Cardiometabolic Health, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, Council on Quality of Care and Outcomes Research, and Stroke Council

Circulation Volume 132, Issue 1222 September 2015

Export Citations PDF/EPUB

Abstract
Preventing and Experiencing Ischemic Heart Disease as a Woman: State of the Science: A Scientific Statement From the American Heart Association
- Jean C. McSweeney,
- Anne G. Rosenfeld,
- Willie M. Abel,
- Lynne T. Braun,
- Lora E. Burke,
- Stacie L. Daugherty,
- Gerald F. Fletcher,
- Martha Gulati,
- Laxmi S. Mehta,
- Christina Pettey and
- Jane F. Reckelhoff
and on behalf of the American Heart Association Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council on Hypertension, Council on Lifestyle and Cardiometabolic Health, and Council on Quality of Care and Outcomes Research

Circulation Volume 133, Issue 1329 March 2016

Export Citations PDF/EPUB

Abstract
The Heart of 25 by 25: Achieving the Goal of Reducing Global and Regional Premature Deaths From Cardiovascular Diseases and Stroke: A Modeling Study From the American Heart Association and World Heart Federation
- Ralph L. Sacco,
- Gregory A. Roth,
- K. Srinath Reddy,
- Donna K. Arnett,
- Ruth Bonita,
- Thomas A. Gaziano,
- Paul A. Heidenreich,
- Mark D. Huffman,
- Bongani M. Mayosi,
- Shanthi Mendis,
- Christopher J.L. Murray,
- Pablo Perel,
- Daniel J. Piñeiro,
- Sidney C. Smith,
- Kathryn A. Taubert,
- David A. Wood,
- Dong Zhao and
- William A. Zoghbi
Circulation Volume 133, Issue 237 June 2016

Abstract Export Citations PDF/EPUB

Abstract
In 2011, the United Nations set key targets to reach by 2025 to reduce the risk of premature noncommunicable disease death by 25% by 2025. With cardiovascular disease being the largest contributor to global mortality, accounting for nearly half of the 36 million annual noncommunicable disease deaths, achieving the 2025 goal requires that cardiovascular disease and its risk factors be aggressively addressed. The Global Cardiovascular Disease Taskforce, comprising the World Heart Federation, American Heart Association, American College of Cardiology Foundation, European Heart Network, and European Society of Cardiology, with expanded representation from Asia, Africa, and Latin America, along with global cardiovascular disease experts, disseminates information and approaches to reach the United Nations 2025 targets. The writing committee, which reflects Global Cardiovascular Disease Taskforce membership, engaged the Institute for Health Metrics and Evaluation, University of Washington, to develop region-specific estimates of premature cardiovascular mortality in 2025 based on various scenarios. Results show that >5 million premature CVD deaths among men and 2.8 million among women are projected worldwide by 2025, which can be reduced to 3.5 million and 2.2 million, respectively, if risk factor targets for blood pressure, tobacco use, diabetes mellitus, and obesity are achieved. However, global risk factor targets have various effects, depending on region. For most regions, United Nations targets for reducing systolic blood pressure and tobacco use have more substantial effects on future scenarios compared with maintaining current levels of body mass index and fasting plasma glucose. However, preventing increases in body mass index has the largest effect in some high-income countries. An approach achieving reductions in multiple risk factors has the largest impact for almost all regions. Achieving these goals can be accomplished only if countries set priorities, implement cost-effective population wide strategies, and collaborate in public-private partnerships across multiple sectors.
Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association
- Marie-Pierre St-Onge,
- Jamy Ard,
- Monica L. Baskin,
- Stephanie E. Chiuve,
- Heather M. Johnson,
- Penny Kris-Etherton and
- Krista Varady
and On behalf of the American Heart Association Obesity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; and Stroke Council

Circulation Volume 135, Issue 928 February 2017

Abstract Export Citations PDF/EPUB

Abstract
Eating patterns are increasingly varied. Typical breakfast, lunch, and dinner meals are difficult to distinguish because skipping meals and snacking have become more prevalent. Such eating styles can have various effects on cardiometabolic health markers, namely obesity, lipid profile, insulin resistance, and blood pressure. In this statement, we review the cardiometabolic health effects of specific eating patterns: skipping breakfast, intermittent fasting, meal frequency (number of daily eating occasions), and timing of eating occasions. Furthermore, we propose definitions for meals, snacks, and eating occasions for use in research. Finally, data suggest that irregular eating patterns appear less favorable for achieving a healthy cardiometabolic profile. Intentional eating with mindful attention to the timing and frequency of eating occasions could lead to healthier lifestyle and cardiometabolic risk factor management.
Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association
and On behalf of the American Heart Association Nutrition Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Epidemiology and Prevention; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology

Circulation Volume 135, Issue 1511 April 2017

Abstract Export Citations PDF/EPUB

Abstract
Multiple randomized controlled trials (RCTs) have assessed the effects of supplementation with eicosapentaenoic acid plus docosahexaenoic acid (omega-3 polyunsaturated fatty acids, commonly called fish oils) on the occurrence of clinical cardiovascular diseases. Although the effects of supplementation for the primary prevention of clinical cardiovascular events in the general population have not been examined, RCTs have assessed the role of supplementation in secondary prevention among patients with diabetes mellitus and prediabetes, patients at high risk of cardiovascular disease, and those with prevalent coronary heart disease. In this scientific advisory, we take a clinical approach and focus on common indications for omega-3 polyunsaturated fatty acid supplements related to the prevention of clinical cardiovascular events. We limited the scope of our review to large RCTs of supplementation with major clinical cardiovascular disease end points; meta-analyses were considered secondarily. We discuss the features of available RCTs and provide the rationale for our recommendations. We then use existing American Heart Association criteria to assess the strength of the recommendation and the level of evidence. On the basis of our review of the cumulative evidence from RCTs designed to assess the effect of omega-3 polyunsaturated fatty acid supplementation on clinical cardiovascular events, we update prior recommendations for patients with prevalent coronary heart disease, and we offer recommendations, when data are available, for patients with other clinical indications, including patients with diabetes mellitus and prediabetes and those with high risk of cardiovascular disease, stroke, heart failure, and atrial fibrillation.
Methodological Standards for Meta-Analyses and Qualitative Systematic Reviews of Cardiac Prevention and Treatment Studies: A Scientific Statement From the American Heart Association
- Goutham Rao,
- Francisco Lopez-Jimenez,
- Jack Boyd,
- Frank D’Amico,
- Nefertiti H. Durant,
- Mark A. Hlatky,
- George Howard,
- Katherine Kirley,
- Christopher Masi,
- Tiffany M. Powell-Wiley,
- Anthony E. Solomonides,
- Colin P. West and
- Jennifer Wessel
and On behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; Council on Clinical Cardiology; Council on Functional Genomics and Translational Biology; and Stroke Council

Circulation Volume 136, Issue 105 September 2017

Abstract Export Citations PDF/EPUB

Abstract
Meta-analyses are becoming increasingly popular, especially in the fields of cardiovascular disease prevention and treatment. They are often considered to be a reliable source of evidence for making healthcare decisions. Unfortunately, problems among meta-analyses such as the misapplication and misinterpretation of statistical methods and tests are long-standing and widespread. The purposes of this statement are to review key steps in the development of a meta-analysis and to provide recommendations that will be useful for carrying out meta-analyses and for readers and journal editors, who must interpret the findings and gauge methodological quality. To make the statement practical and accessible, detailed descriptions of statistical methods have been omitted. Based on a survey of cardiovascular meta-analyses, published literature on methodology, expert consultation, and consensus among the writing group, key recommendations are provided. Recommendations reinforce several current practices, including protocol registration; comprehensive search strategies; methods for data extraction and abstraction; methods for identifying, measuring, and dealing with heterogeneity; and statistical methods for pooling results. Other practices should be discontinued, including the use of levels of evidence and evidence hierarchies to gauge the value and impact of different study designs (including meta-analyses) and the use of structured tools to assess the quality of studies to be included in a meta-analysis. We also recommend choosing a pooling model for conventional meta-analyses (fixed effect or random effects) on the basis of clinical and methodological similarities among studies to be included, rather than the results of a test for statistical heterogeneity.
Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association
- Mercedes R. Carnethon,
- Jia Pu,
- George Howard,
- Michelle A. Albert,
- Cheryl A.M. Anderson,
- Alain G. Bertoni,
- Mahasin S. Mujahid,
- Latha Palaniappan,
- Herman A. Taylor,
- Monte Willis and
- Clyde W. Yancy
and On behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Functional Genomics and Translational Biology; and Stroke Council

Circulation Volume 136, Issue 2121 November 2017

Abstract Export Citations PDF/EPUB

Abstract
Background and Purpose:Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management.Method:The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention.Results:The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment.Conclusions:The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines.
Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association
- George K. Lui,
- Arwa Saidi,
- Ami B. Bhatt,
- Luke J. Burchill,
- Jason F. Deen,
- Michael G. Earing,
- Michael Gewitz,
- Jonathan Ginns,
- Joseph D. Kay,
- Yuli Y. Kim,
- Adrienne H. Kovacs,
- Eric V. Krieger,
- Fred M. Wu and
- Shi-Joon Yoo
and On behalf of the American Heart Association Adult Congenital Heart Disease Committee of the Council on Clinical Cardiology and Council on Cardiovascular Disease in the Young; Council on Cardiovascular Radiology and Intervention; and Council on Quality of Care and Outcomes Research

Circulation Volume 136, Issue 2014 November 2017

Abstract Export Citations PDF/EPUB

Abstract
Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention.
Routine Assessment and Promotion of Physical Activity in Healthcare Settings: A Scientific Statement From the American Heart Association
- Felipe Lobelo,
- Deborah Rohm Young,
- Robert Sallis,
- Michael D. Garber,
- Sandra A. Billinger,
- John Duperly,
- Adrian Hutber,
- Russell R. Pate,
- Randal J. Thomas,
- Michael E. Widlansky,
- Michael V. McConnell and
- Elizabeth A. Joy
and On behalf of the American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Epidemiology and Prevention; Council on Clinical Cardiology; Council on Genomic and Precision Medicine; Council on Cardiovascular Surgery and Anesthesia; and Stroke Council

Circulation Volume 137, Issue 181 May 2018

Abstract Export Citations PDF/EPUB

Abstract
Physical inactivity is one of the most prevalent major health risk factors, with 8 in 10 US adults not meeting aerobic and muscle-strengthening guidelines, and is associated with a high burden of cardiovascular disease. Improving and maintaining recommended levels of physical activity leads to reductions in metabolic, hemodynamic, functional, body composition, and epigenetic risk factors for noncommunicable chronic diseases. Physical activity also has a significant role, in many cases comparable or superior to drug interventions, in the prevention and management of >40 conditions such as diabetes mellitus, cancer, cardiovascular disease, obesity, depression, Alzheimer disease, and arthritis. Whereas most of the modifiable cardiovascular disease risk factors included in the American Heart Association’s My Life Check - Life’s Simple 7 are evaluated routinely in clinical practice (glucose and lipid profiles, blood pressure, obesity, and smoking), physical activity is typically not assessed. The purpose of this statement is to provide a comprehensive review of the evidence on the feasibility, validity, and effectiveness of assessing and promoting physical activity in healthcare settings for adult patients. It also adds concrete recommendations for healthcare systems, clinical and community care providers, fitness professionals, the technology industry, and other stakeholders in order to catalyze increased adoption of physical activity assessment and promotion in healthcare settings and to contribute to meeting the American Heart Association’s 2020 Impact Goals.
Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association
- Jared W. Magnani,
- Mahasin S. Mujahid,
- Herbert D. Aronow,
- Crystal W. Cené,
- Victoria Vaughan Dickson,
- Edward Havranek,
- Lewis B. Morgenstern,
- Michael K. Paasche-Orlow,
- Amy Pollak,
- Joshua Z. Willey and
Circulation Volume 138, Issue 210 July 2018

Abstract Export Citations PDF/EPUB

Abstract
Health literacy is the degree to which individuals are able to access and process basic health information and services and thereby participate in health-related decisions. Limited health literacy is highly prevalent in the United States and is strongly associated with patient morbidity, mortality, healthcare use, and costs. The objectives of this American Heart Association scientific statement are (1) to summarize the relevance of health literacy to cardiovascular health; (2) to present the adverse associations of health literacy with cardiovascular risk factors, conditions, and treatments; (3) to suggest strategies that address barriers imposed by limited health literacy on the management and prevention of cardiovascular disease; (4) to demonstrate the contributions of health literacy to health disparities, given its association with social determinants of health; and (5) to propose future directions for how health literacy can be integrated into the American Heart Association’s mandate to advance cardiovascular treatment and research, thereby improving patient care and public health. Inadequate health literacy is a barrier to the American Heart Association meeting its 2020 Impact Goals, and this statement articulates the rationale to anticipate and address the adverse cardiovascular effects associated with health literacy.
Sedentary Behaviors in Today’s Youth: Approaches to the Prevention and Management of Childhood Obesity: A Scientific Statement From the American Heart Association
- Tracie A. Barnett,
- Aaron S. Kelly,
- Deborah Rohm Young,
- Cynthia K. Perry,
- Charlotte A. Pratt,
- Nicholas M. Edwards,
- Goutham Rao,
- Miriam B. Vos and
Circulation Volume 138, Issue 1111 September 2018

Abstract Export Citations PDF/EPUB

Abstract
This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health. This American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth and their impact on cardiometabolic health and obesity. As we reflect on implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices. Further evidence is required to better inform public health interventions and to establish detailed quantitative guidelines on specific sedentary behaviors in youth. In the meantime, we suggest that televisions and other recreational screen-based devices be removed from bedrooms and absent during meal times. Daily device-free social interactions and outdoor play should be encouraged. In addition, parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.
Dietary Diversity: Implications for Obesity Prevention in Adult Populations: A Science Advisory From the American Heart Association
- Marcia C. de Oliveira Otto,
- Cheryl A.M. Anderson,
- Jennifer L. Dearborn,
- Erin P. Ferranti,
- Dariush Mozaffarian,
- Goutham Rao,
- Judith Wylie-Rosett,
- Alice H. Lichtenstein and
Circulation Volume 138, Issue 1111 September 2018

Abstract Export Citations PDF/EPUB

Abstract
“Eat a variety of foods,” or dietary diversity, is a widely accepted recommendation to promote a healthy, nutritionally adequate diet and to reduce the risk of major chronic diseases. However, recent evidence from observational studies suggests that greater dietary diversity is associated with suboptimal eating patterns, that is, higher intakes of processed foods, refined grains, and sugar-sweetened beverages and lower intakes of minimally processed foods, such as fish, fruits, and vegetables, and may be associated with weight gain and obesity in adult populations. This American Heart Association science advisory summarizes definitions for dietary diversity and reviews current evidence on its relationship with obesity outcomes, eating behavior, and food-based diet quality measures. Current data do not support greater dietary diversity as an effective strategy to promote healthy eating patterns and healthy body weight. Given the current state of the science on dietary diversity and the insufficient data to inform recommendations on specific aspects of dietary diversity that may be beneficial or detrimental to healthy weight, it is appropriate to promote a healthy eating pattern that emphasizes adequate intake of plant foods, protein sources, low-fat dairy products, vegetable oils, and nuts and limits consumption of sweets, sugar-sweetened beverages, and red meats.
New and Emerging Tobacco Products and the Nicotine Endgame: The Role of Robust Regulation and Comprehensive Tobacco Control and Prevention: A Presidential Advisory From the American Heart Association
- Aruni Bhatnagar,
- Laurie P. Whitsel,
- Michael J. Blaha,
- Mark D. Huffman,
- Suchitra Krishan-Sarin,
- John Maa,
- Nancy Rigotti,
- Rose Marie Robertson,
- John J. Warner
Circulation Volume 139, Issue 197 May 2019

Abstract Export Citations PDF/EPUB

Abstract
The advent of new tobacco products such as electronic cigarettes and the dramatic rise in their use, especially by adolescents and young adults, are significant public health concerns. Electronic cigarettes have become the most popular tobacco products for youth and adolescents in the United States and are attracting youth to new avenues for nicotine addiction. Although these products may have benefit by helping some smokers quit or to move to a less harmful product, the long-term health effects of these products and the net public health effect associated with their use remain unclear and widely debated. There is increasing concern that the use of newer tobacco products may catalyze transition to the use of other tobacco products or recreational drugs, particularly in young adults. Therefore, there is urgent need for robust US Food and Drug Administration regulation of all tobacco products to avoid the significant economic and population health consequences of continued tobacco use. Although the American Heart Association acknowledges that the ultimate endgame would be an end to all tobacco and nicotine addiction in the United States, it supports first minimizing the use of all combustible tobacco products while ensuring that other products do not addict the next generation of youth and adolescents. The endgame strategy needs to be coordinated with the long-standing, evidence-based tobacco control strategies that have significantly reduced tobacco use and initiation in the United States.
The American Heart Association 2030 Impact Goal: A Presidential Advisory From the American Heart Association
- Sonia Y. Angell,
- Michael V. McConnell,
- Cheryl A.M. Anderson,
- Kirsten Bibbins-Domingo,
- Douglas S. Boyle,
- Simon Capewell,
- Majid Ezzati,
- Sarah de Ferranti,
- Darrell J. Gaskin,
- Ron Z. Goetzel,
- Mark D. Huffman,
- Marsha Jones,
- Yosef M. Khan,
- Sonia Kim,
- Shiriki K. Kumanyika,
- Alexa T. McCray,
- Robert K. Merritt,
- Bobby Milstein,
- Dariush Mozaffarian,
- Tyler Norris,
- Gregory A. Roth,
- Ralph L. Sacco,
- Jorge F. Saucedo,
- Christina M. Shay,
- David Siedzik,
- Somava Saha and
- John J. Warner
Circulation Volume 141, Issue 93 March 2020

Abstract Export Citations PDF/EPUB

Abstract
Each decade, the American Heart Association (AHA) develops an Impact Goal to guide its overall strategic direction and investments in its research, quality improvement, advocacy, and public health programs. Guided by the AHA’s new Mission Statement, to be a relentless force for a world of longer, healthier lives, the 2030 Impact Goal is anchored in an understanding that to achieve cardiovascular health for all, the AHA must include a broader vision of health and well-being and emphasize health equity. In the next decade, by 2030, the AHA will strive to equitably increase healthy life expectancy beyond current projections, with global and local collaborators, from 66 years of age to at least 68 years of age across the United States and from 64 years of age to at least 67 years of age worldwide. The AHA commits to developing additional targets for equity and well-being to accompany this overarching Impact Goal. To attain the 2030 Impact Goal, we recommend a thoughtful evaluation of interventions available to the public, patients, providers, healthcare delivery systems, communities, policy makers, and legislators. This presidential advisory summarizes the task force’s main considerations in determining the 2030 Impact Goal and the metrics to monitor progress. It describes the aspiration that these goals will be achieved by working with a diverse community of volunteers, patients, scientists, healthcare professionals, and partner organizations needed to ensure success.
Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical Association
- Daichi Shimbo,
- Nancy T. Artinian,
- Jan N. Basile,
- Lawrence R. Krakoff,
- Karen L. Margolis,
- Michael K. Rakotz,
- Gregory Wozniak and
Circulation Volume 142, Issue 428 July 2020

Abstract Export Citations PDF/EPUB

Abstract
The diagnosis and management of hypertension, a common cardiovascular risk factor among the general population, have been based primarily on the measurement of blood pressure (BP) in the office. BP may differ considerably when measured in the office and when measured outside of the office setting, and higher out-of-office BP is associated with increased cardiovascular risk independent of office BP. Self-measured BP monitoring, the measurement of BP by an individual outside of the office at home, is a validated approach for out-of-office BP measurement. Several national and international hypertension guidelines endorse self-measured BP monitoring. Indications include the diagnosis of white-coat hypertension and masked hypertension and the identification of white-coat effect and masked uncontrolled hypertension. Other indications include confirming the diagnosis of resistant hypertension and detecting morning hypertension. Validated self-measured BP monitoring devices that use the oscillometric method are preferred, and a standardized BP measurement and monitoring protocol should be followed. Evidence from meta-analyses of randomized trials indicates that self-measured BP monitoring is associated with a reduction in BP and improved BP control, and the benefits of self-measured BP monitoring are greatest when done along with cointerventions. The addition of self-measured BP monitoring to office BP monitoring is cost-effective compared with office BP monitoring alone or usual care among individuals with high office BP. The use of self-measured BP monitoring is commonly reported by both individuals and providers. Therefore, self-measured BP monitoring has high potential for improving the diagnosis and management of hypertension in the United States. Randomized controlled trials examining the impact of self-measured BP monitoring on cardiovascular outcomes are needed. To adequately address barriers to the implementation of self-measured BP monitoring, financial investment is needed in the following areas: improving education and training of individuals and providers, building health information technology capacity, incorporating self-measured BP readings into clinical performance measures, supporting cointerventions, and enhancing reimbursement.
Fifteen-Year Trends in Awareness of Heart Disease in Women: Results of a 2012 American Heart Association National Survey
- Lori Mosca,
- Gmerice Hammond,
- Heidi Mochari-Greenberger,
- Amytis Towfighi and
- Michelle A. Albert
and on behalf of the American Heart Association Cardiovascular Disease and Stroke in Women and Special Populations Committee of the Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council on Cardiovascular Nursing, Council on High Blood Pressure Research, and Council on Nutrition, Physical Activity and Metabolism

Circulation Volume 127, Issue 1119 March 2013

Abstract Export Citations PDF/EPUB

Abstract
Background—The purpose of this study was to evaluate trends in awareness of cardiovascular disease (CVD) risk among women between 1997 and 2012 by racial/ethnic and age groups, as well as knowledge of CVD symptoms and preventive behaviors/barriers.Methods and Results—A study of awareness of CVD was conducted by the American Heart Association in 2012 among US women >25 years of age identified through random-digit dialing (n=1205) and Harris Poll Online (n=1227), similar to prior American Heart Association national surveys. Standardized questions on awareness were given to all women; additional questions about preventive behaviors/barriers were given online. Data were weighted, and results were compared with triennial surveys since 1997. Between 1997 and 2012, the rate of awareness of CVD as the leading cause of death nearly doubled (56% versus 30%; P<0.001). The rate of awareness among black and Hispanic women in 2012 (36% and 34%, respectively) was similar to that of white women in 1997 (33%). In 1997, women were more likely to cite cancer than CVD as the leading killer (35% versus 30%), but in 2012, the trend reversed (24% versus 56%). Awareness of atypical symptoms of CVD has improved since 1997 but remains low. The most common reasons why women took preventive action were to improve health and to feel better, not to live longer.Conclusions—Awareness of CVD among women has improved in the past 15 years, but a significant racial/ethnic minority gap persists. Continued effort is needed to reach at-risk populations. These data should inform public health campaigns to focus on evidenced-based strategies to prevent CVD and to help target messages that resonate and motivate women to take action.

Search

Narrow Results

Applied FiltersReset all

Journal Title

Article Type

Subject

Date Range

Author

Export Citation

Advanced

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Export Citation