Search

IMPORTANCE: The burden of atherosclerotic cardiovascular disease (ASCVD) in the US is higher among Black and Hispanic vs White adults. Inclusion of race in guidance for statin indication may lead to decreased disparities in statin use. OBJECTIVE: To evaluate prevalence of primary prevention statin use by race and ethnicity according to 10-year ASCVD risk. DESIGN, SETTING, AND PARTICIPANTS: This serial, cross-sectional analysis performed in May 2022 used data from the National Health and Nutrition Examination Survey, a nationally representative sample of health status in the US, from 2013 to March 2020 (limited cycle due to the COVID-19 pandemic), to evaluate statin use for primary prevention of ASCVD and to estimate 10-year ASCVD risk. Participants aged 40 to 75 years without ASCVD, diabetes, low-density lipoprotein cholesterol levels 190 mg/dL or greater, and with data on medication use were included. EXPOSURES: Self-identified race and ethnicity (Asian, Black, Hispanic, and White) and 10-year ASCVD risk category (5%-<7.5%, 7.5%-<20%, ≥20%). MAIN OUTCOMES AND MEASURES: Prevalence of statin use, defined as identification of statin use on pill bottle review. RESULTS: A total of 3417 participants representing 39.4 million US adults after applying sampling weights (mean [SD] age, 61.8 [8.0] years; 1289 women [weighted percentage, 37.8%] and 2128 men [weighted percentage, 62.2%]; 329 Asian [weighted percentage, 4.2%], 1032 Black [weighted percentage, 12.7%], 786 Hispanic [weighted percentage, 10.1%], and 1270 White [weighted percentage, 73.0%]) were included. Compared with White participants, statin use was lower in Black and Hispanic participants and comparable among Asian participants in the overall cohort (Asian, 25.5%; Black, 20.0%; Hispanic, 15.4%; White, 27.9%) and within ASCVD risk strata. Within each race and ethnicity group, a graded increase in statin use was observed across increasing ASCVD risk strata. Statin use was low in the highest risk stratum overall with significantly lower rates of use among Black (23.8%; prevalence ratio [PR], 0.90; 95% CI, 0.82-0.98 vs White) and Hispanic participants (23.9%; PR, 0.90; 95% CI, 0.81-0.99 vs White). Among other factors, routine health care access and health insurance were significantly associated with higher statin use in Black, Hispanic, and White adults. Prevalence of statin use did not meaningfully change over time by race and ethnicity or by ASCVD risk stratum. CONCLUSIONS AND RELEVANCE: In this study, statin use for primary prevention of ASCVD was low among all race and ethnicity groups regardless of ASCVD risk, with the lowest use occurring among Black and Hispanic adults. Improvements in access to care may promote equitable use of primary prevention statins in Black and Hispanic adults.

IMPORTANCE: High blood pressure (BP) during sleep (asleep blood pressure) is associated with an increased risk of cardiovascular disease, but a national prevalence estimate of masked asleep hypertension (high BP while sleeping but without high BP measured in the clinic [clinic BP]) for the United States is lacking. OBJECTIVES: To estimate the prevalence of masked asleep hypertension among US adults by using BP thresholds from the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) and the 2017 American College of Cardiology–American Heart Association (ACC-AHA) BP guidelines. DESIGN, SETTING, AND PARTICIPANTS: This cohort analysis pooled data from 3000 participants in 4 US population-based studies that conducted 24-hour ambulatory BP monitoring (ABPM) and 17 969 participants in the 2011-2016 National Health and Nutrition Examination Survey (NHANES) without ABPM. Masked asleep hypertension status in NHANES was imputed using a 2-stage multiple imputation process. Data were collected from 2000 to 2016 and analyzed from March 4, 2019, to June 29, 2020. MAIN OUTCOMES AND MEASURES: High clinic BP was defined as clinic systolic BP (SBP)/diastolic BP (DBP) of at least 140/90 mm Hg using JNC7 and at least 130/80 mm Hg using 2017 ACC-AHA guidelines. High asleep BP was defined as mean asleep SBP/DBP of at least 120/70 mm Hg for JNC7 and at least 110/65 mm Hg for the 2017 ACC-AHA guidelines. Masked asleep hypertension was defined as high asleep BP without high clinic BP. RESULTS: For the 3000 pooled cohort participants, the mean (SD) age was 52.0 (12.0) years, and 62.6% were women. For the 17 969 NHANES participants, the mean (SD) age was 46.7 (17.5) years, and 51.8% (weighted) were women. The estimated prevalence of masked asleep hypertension among US adults was 18.8% (95% CI, 16.7%-20.8%; 44.4 million US adults) using the JNC7 guideline and 22.7% (95% CI, 20.6%-24.8%; 53.7 million US adults) using the 2017 ACC-AHA guideline criteria. The prevalence of masked asleep hypertension was higher among older adults (aged ≥65 years, 24.4% [95% CI, 20.7%-28.0%]), men (27.0% [95% CI, 24.1%-29.9%]), non-Hispanic Black individuals (28.7% [95% CI, 25.4%-32.0%]), those who were taking antihypertensives (24.4% [95% CI, 21.1%-27.8%]), those who had masked daytime hypertension (44.7% [95% CI, 40.1%-49.3%]), and those with diabetes (27.6% [95% CI, 23.5%-31.8%]), obesity (24.3% [95% CI, 21.8%-26.9%]), or chronic kidney disease (21.5% [95% CI, 17.3%-25.6%]) using the 2017 ACC-AHA guideline. An estimated 11.9% of US adults (28.2 million) had isolated masked asleep hypertension (masked asleep hypertension but without high awake BP) using JNC7 guideline criteria, as did an estimated 13.3% (31.5 million) using 2017 ACC-AHA guideline criteria. CONCLUSIONS AND RELEVANCE: These findings suggest that the prevalence of masked asleep hypertension is high among US adults. Data are needed on the cardiovascular risk reduction benefits of treating asleep hypertension.

We evaluate the accuracy of point-of-care ultrasonography compared with computed tomographic (CT) scan and assess the potential time-saving effect of point-of-care ultrasonography in diagnosing small bowel obstruction.

•GLP1-RAs and SGLT2Is lower the risk of adverse cardiac-kidney events in diabetes.•Only 10 % used GLP1-RAs or SGLT2Is, regardless of level of cardiac-kidney risk.•Few people who would benefit most from GLP1-RAs or SGLT2Is, were receiving them from 2015 to 2020.

While legislators have been getting an earful on the pros and cons of 'Common Core,' bureaucrats and businessmen are trying to determine whether Arkansas has the infrastructure to implement the [...]

The four Arkansas airports that saw the biggest rise in passenger boardings in 2011 had one thing in common: government-subsidized air service offered through SeaPort Airlines Inc. Boone County Regional [...]

Several clinical trials have shown the efficacy of continuous infusion beta-lactam (BL) antibiotics in patients with cystic fibrosis (CF); however, little is known about pharmacokinetic changes during the treatment of an acute pulmonary exacerbation (APE). Identifying and understanding these changes may assist in optimizing antibiotic dosing during APE treatment.

It was late August 2012. My daughter was 2 years, 8 months old. I had worked tirelessly every day since she was born to cultivate her communication skills--from cooing all [...]

We aimed to predict volume responsiveness and to assess the diagnostic accuracy of carotid flow time (FTc) with the change in hydration status before and after a passive leg raise (PLR) maneuver.

Originally published July 1, 2013. Sources: the companies. Arkansas Economic Development Commission 1 Dassault Aviation revenue for fiscal year ended Dec. 31 and converted from euros at that date's exchange [...]

Florence & Hutchenson Inc., a regional engineering services firm with an office in Little Rock, will now be known as Infrastructure Corp. of America Engineering Inc., marking the final step [...]

Shane Young of North Little Rock has recently launched Service Ninjas Inc., a general contractor service that maintains telecommunications equipment in Arkansas, Mississippi, Louisiana and Tennessee. Service Ninjas' operations revolve [...]

A number of Arkansas Tech University students returning to Russellville for classes this month will move into the newly completed five-story M Street Residence Hall, which represents the most recent [...]

Designer Jamie Davidson has recently announced the debut of Strong Suit, a collection of men's suits and sport coats that will appear in 20 stores this September. Strong Suit represents [...]

Coffee.org, a family-owned coffee retailer based in Fort Smith, has recently launched its own line of single-serve coffees that can be brewed with nearly any Keurig coffee maker. Bill McClure, [...]

Donovan Marine Inc. of Harahan, La., recently acquired Southern Marine Inc. of Little Rock. Donovan and Southern are wholesale distributors of marine supplies for recreational boating dealers and marinas. The [...]

Anthony Forest Products of El Dorado launched a lumber span calculator on its website to help craftsmen adjust to a recent industrywide change in design values for Southern pine dimension [...]

Fayettechill Clothing Co., a producer of outdoor apparel and accessories, has moved the bulk of its operations to a repur-posed three-story smokehouse at the foot of Mount Kessler in Fayetteville. [...]

The University of Central Arkansas is purchasing $345,000 worth of lighting equipment and installation services from Techline Sports Lighting LLC of Austin, Texas, for three of the university's sports fields [...]

Jo-Ann Fabric & Craft Stores has announced that it will open a store in the Shackleford Crossing Shopping Center in Little Rock on Aug. 30. Beth Shivak, Jo-Ann's manager of [...]

Jason International Inc. of North Little Rock has announced the debut of a new free-standing, seamless bath. Remo Jacuzzi, Jason International chairman and founder, called the product a fusion of [...]

Arkansas natives Michele McCutcheon and Lindsey Newton have recently opened a Little Rock franchise of Pure Barre, an exercise dance studio, at the Pleasant Ridge Town Center at 11525 Cantrell [...]

Delta Trust & Bank and The Purple Cow have announced that they will open locations in the newly constructed Market Square South building in Conway. Market Square, which is scheduled [...]

The Arkansas Foodbank has announced the reopening of the Dumas Community Food Pantry at a new location in Desha County. The pantry has moved to the former Arkansas National Guard [...]

Husband-and-wife team Jeff and Kayla Stephens of Cabot have recently launched First Choice Senior Care Inc., a private-pay, nonmedical senior care company serving Pulaski and Lonoke counties. First Choice offers [...]

Financial adviser Donnie Dietz recently announced that he has joined Stratos Wealth Partners to open an office in Conway, the firm's first Arkansas office. Stratos, which is headquartered in Solon, [...]

Conway Corp., the provider of Conway's city-owned utility services, hopes to have completed designs for a new 'headend' facility by September, according to Chief Technology Officer Jason Hansen. Hansen described [...]

Ballet Arkansas announced Tuesday that it's raising $200,000 to secure rehearsal and office space in Little Rock's emerging Main Street Creative Corridor. Standing in what might become a 1,500-SF rehearsal [...]

The Arkansas Foodbank recently announced the opening of a community food pantry in Arkansas City (Desha County), the first of its kind in the area. The pantry is the result [...]

Rock City Running recently celebrated its grand opening at 10300 N. Rodney Parham in Little Rock. Owner and avid runner Bill Torrey said that opening a store catering to runners [...]

Destruction is giving way to innovation for Arkansas' storm shelter manufacturers and retailers, who are reporting increased interest in their products in the aftermath of recent tornadoes. The devastating tornadoes [...]

Downtown Properties Group LLC has purchased the 29,634-SF building at 1023 Main St. in Conway that was solely occupied by Regions Bank. Brent Salter, vice president of Salter Properties, said [...]

The Cellular Connection has announced the opening of a new location in Little Rock. The store, at 2608 S. Shackleford Road in the Shackleford Crossing Shopping Center, is the cellular [...]

The Conway City Council recently signaled its interest in buying the 1.23-acre site of the Conway Scrap Metal Yard at 1110 Spencer St., despite a number of environmental concerns. In [...]

This study hypothesized that left atrial structural remodeling (LA-TR) correlates with exercise capacity (EC) in a cohort of patients with atrial fibrillation (AF).

The objective of this study was to determine the cost-effectiveness and cost per quality-adjusted life year (QALY) gained of sacubitril-valsartan relative to enalapril for treatment of heart failure with reduced ejection fraction (HFrEF).

Introduction:The burden of ASCVD is higher among non-Hispanic Black (NHB) and Hispanic vs. non-Hispanic White (NHW) US adults, potentially due to differences in use of preventive medications such as statins. We evaluated patterns in statin use for primary prevention by self-identified race/ethnicity (NHB, NHW, and Hispanic) according to 10-year ASCVD risk using the Pooled Cohort Equations.Methods:This serial, cross-sectional analysis included NHANES participants from 2013-2020 age 40-75 years without ASCVD, diabetes, LDL ≥190 mg/dL, or missing data for estimation of 10-year ASCVD risk. Statin use was determined by interviewer pill bottle review. Poisson regression estimated adjusted prevalence ratios for statin use associated with race/ethnicity and ASCVD risk categories (5-<7.5%, 7.5-<20%, and ≥20%); all analyses incorporated NHANES survey weights.Results:A total of 3,088 participants representing 37.8 million US adults (mean age 62 y, 38% women, 13% NHB, 11% Hispanic, 76% NHW) were included. Overall, statin use was lower in NHB (20.0%) and Hispanic (15.4%) than NHW adults (27.9%). Within all ASCVD risk categories, the odds of statin use were significantly lower among NHB and Hispanic vs. NHW adults (Figure). Within each race/ethnicity group, the use of statins increased across increasing ASCVD risk strata, with a significantly greater utilization among those with ASCVD risk ≥20% (vs. ASCVD risk 5-<7.5%) (Figure). Statin use was stable over time and within race/ethnicity and risk strata (p>0.05 for all NHANES cycles).Conclusions:Overall statin use for primary prevention based on 10-year ASCVD risk was low in all race/ethnicity groups regardless of predicted ASCVD risk, though undertreatment was most severe in NHB and Hispanic adults. Improvements in equitable utilization of statins for primary prevention in Black and Hispanic adults are needed to address disparities in ASCVD.

Presents letters to the editor referencing articles and topics discussed in previous issues. "Orewa II: Did it Work?," which focused on the treatment to unemployed people; "Teacher Teacher Learning Right?," which highlighted the need of a training for teachers; "Disappearing ACT," which discussed the political system in Australian Capital Territory.

Abstract: Since LTR retrotransposons and retroviruses are especially prone to regional duplications and recombination events, these viral-like systems may be especially conducive to the evolution of closely spaced combinatorial regulatory motifs. Using the Drosophila copia LTR retrotransposon as a model, we show that a regulatory region contained within the element's untranslated leader region (ULR) consists of multiple copies of an 8 bp motif (TTGTGAAA) with similarity to the core sequence of the SV40 enhancer. Naturally occurring variation in the number of these motifs is correlated with the enhancer strength of the ULR. Our results indicate that inter-element selection may favor the evolution of more active enhancers within permissive genetic backgrounds. We propose that LTR retroelements and perhaps other retrotransposons constitute drive mechanisms for the evolution of eukaryotic enhancers which can be subsequently distributed throughout host genomes to play a role in regulatory evolution.

Background:Individual social vulnerabilities to health disparities increase the risk of developing hypertension and lower life expectancy, but their cumulative effect on these outcomes is unknown.Methods:Using the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, we included participants aged 45 years or older without hypertension at baseline (i.e., systolic/diastolic blood pressure <130/80 mm Hg and no antihypertensive medication use). The exposure was count of vulnerabilities at baseline which were defined across economic, education, health and health care, neighborhood and built environment, and social and community context domains. The primary outcome took on three levels: 1) alive at follow-up without hypertension (reference group), 2) alive at follow-up with hypertension, or 3) deceased prior to follow-up 10-year risk of hypertension or death. Multinomial logistic regression was used to determine associations of the count of vulnerabilities with hypertension and survival status at the second in-home visit, expressed as adjusted relative risk ratios (aRRR). Analyses were stratified by race.Results:Among 5425 participants (mean±SD age of 63±10 years, 24% black, and 54% female), 1785 (33%) participants developed hypertension and 1135 (21%) participants died. A greater proportion of black participants developed hypertension and died than did white participants (hypertension, 38% vs 31%; death, 25% vs 20%). The associations between vulnerability count and both hypertension and death were stronger in white participants than black participants (p-value for vulnerability count*race interaction: hypertension = 0.042, death =0.021; Figure 1).Conclusions:The relative effect of multiple social vulnerabilities on hypertension development may be stronger in white adults than black adults. Nonetheless, black adults experience the highest absolute rates of hypertension in all subpopulations.

Supplemental Digital Content is available in the text.

Supplemental Digital Content is available in the text.

A personal narrative is presented which explores the author's experience of designing a trailer that can handle heavy loads behind the all terrain vehicle (ATV).