Search

We assessed a subset of behavioral indicators from the American Heart Association Life's Essential 8 cardiovascular health (CVH) construct--diet, physical activity, sleep, and nicotine exposure--and quantified associations in scores between members of 12 grandparent-grandchild dyads (grandparents, 52-70 years old; children, 7-12 years old). We also assessed the number of adverse childhood experiences from the dyads. Using the Life's Essential 8 scoring algorithm (0-100, with 100 as optimal), we calculated averages and used Spearman's' correlation to quantify associations. Mean score was 67.5 (±12.4) for grandparents and 63.0 (±11.2) for grandchildren. Mean scores for the dyad members were significantly correlated (r = 0.66, P < .05). The mean numbers of adverse childhood experiences were 7.0 and 5.8 for the grandparents and grandchildren, respectively. The results indicate that CVH in these dyadswas suboptimal and interrelated. Adverse childhood experiences in this analysis surpass levels reported as high risk for poor CVH. Our findings suggest that dyadic-based interventions to improve CVH are warranted. [ABSTRACT FROM AUTHOR]

Cardiovascular disease risk factors are highly prevalent among youth in the United States and Canada. Pediatric preventive cardiology programs have independently developed and proliferated to address cardiovascular risk factors in youth, but there is a general lack of clarity on best practices to optimize and sustain desired outcomes. We conducted surveys of pediatric cardiology division directors and pediatric preventive cardiology clinicians across the United States and Canada to describe the current landscape and perspectives on future directions for the field. We summarize the data and conclude with a call to action for various audiences who seek to improve cardiovascular health in youth, reduce the burden of premature cardiovascular disease, and increase healthy longevity. We call on heart centers, hospitals, payers, and policymakers to invest resources in the important work of pediatric preventive cardiology programs. We urge professional societies to advocate for pediatric preventive cardiology and provide opportunities for training and cross-pollination across programs. We encourage researchers to close evidence gaps. Last, we invite pediatric preventive cardiology clinicians to collaborate and innovate to advance the practice of pediatric preventive cardiology. [ABSTRACT FROM AUTHOR]

Background: Although many studies have been conducted to examine predictors of quality of life (QoL), little information exists on the real-world application of Rector's conceptual model for QoL related to heart failure (HF). Objectives: In this study, we aimed to examine a hypothetical model of QoL based on Rector's conceptual model for QoL in relation to HF and the existing literature on patients with HF. Methods: Using a cross-sectional survey, 165 patients with HF were recruited from an outpatient clinic in Korea. Data were collected based on Rector's model constructs, such as cardiac function, symptoms, functional limitation, depression, distress, and QoL. Left ventricular ejection fraction for cardiac function was measured using echocardiography. Results: Functional limitation, depression, and distress, but not symptoms, had a direct effect on QoL (all P s <.001). Cardiac function and symptoms directly affected functional limitation (β = 0.186, P =.004, and β = −0.488, P = <.001, respectively), whereas cardiac function, symptoms, and depression affected QoL through functional limitation and distress. Conclusions: These results confirm that the Rector's model is suitable for predicting QoL in patients with HF. These findings have potential to guide and inform intervention programs designed to alleviate symptoms in patients with HF, enhance their physical functioning, and moderate their psychological distress with the ultimate goal of improving their QoL. [ABSTRACT FROM AUTHOR]

Experts suggest how 6 research articles can be used in nursing practice. [ABSTRACT FROM AUTHOR]

Use of ambulatory blood pressure monitoring in children and adolescents has markedly increased since publication of the last American Heart Association scientific statement on pediatric ambulatory blood pressure monitoring in 2014. In addition, there has also been significant expansion of the evidence base for use of ambulatory blood pressure monitoring in the pediatric population, including new data linking ambulatory blood pressure levels with the development of blood pressure–related target organ damage. Last, additional data have recently been published that enable simplification of the classification of pediatric ambulatory monitoring studies. This scientific statement presents a succinct review of this new evidence, guidance on optimal application of ambulatory blood pressure monitoring in the clinical setting, and an updated classification scheme for the interpretation of ambulatory blood pressure monitoring in children and adolescents. We also highlight areas of uncertainty where additional research is needed. [ABSTRACT FROM AUTHOR]

In 1997, Soergel et al1 published the first set of normative values for ambulatory blood pressure monitoring (ABPM) in children. Since then, the clinical utility of ABPM has increased dramatically, and now, ABPM is accepted as the standard method to confirm the diagnosis of hypertension in children. Despite significant progress in the field of pediatric ABPM, many important questions remain unanswered. One of the most controversial issues is how to define ambulatory hypertension in children. The purpose of this review is to discuss the limitations of the current pediatric ABPM classification scheme and to provide the justification and rationale for a new classification. [ABSTRACT FROM AUTHOR]

Cardiovascular-related adverse childbirth outcomes have been increasing in the United States, with widening racial and ethnic disparities. Objective: We examined the association between maternal cardiovascular health (CVH) and childbirth outcomes among US births. Methods: We analyzed data from the Pregnancy Risk Assessment Monitoring System. Ideal CVH was defined as a composite of 4 cardiovascular disease (CVD) risk factors: absence of a medical diagnosis of diabetes, hypertension, history of cigarette smoking before or during pregnancy, and a pre-pregnancy body mass index of 18.5 to 24.9 kg/m2. Childbirth outcomes examined were preterm birth, low birthweight, andmode of birth. Survey logistic regression was used formultivariate analyses. Results: A total of 34 918 women were included in our study, and most (61%) had more than 1 CVD risk factor. Clustering of CVD risk factors was more likely among women with an annual income of less than $40 000 and not college educated and found among non-Hispanic Black, Hispanic, and American Indian/Alaska Natives (P < .001). The odds of an adverse childbirth outcome increased with each additional CVD risk factor. Hypertension was highest among non-Hispanic Black women (20%) and the strongest predictor of having a low-birth-weight infant (odds ratio [OR], 3.16; 95%confidence interval [CI], 2.86--3.48), preterm birth (OR, 2.72; 95% CI, 2.40--3.07), and cesarean birth (OR, 1.68; 95% CI, 1.52--1.87). Conclusion: Clustering of maternal CVD risk factors was significantly associated with adverse childbirth outcomes. Unfavorable CVH and its association with adverse childbirth outcomes were most common in women of color, calling for special attention to this group. [ABSTRACT FROM AUTHOR]

Background: Disability-adjusted life years (DALYs) are used to evaluate the relative burden of diseases in populations to help set prevention or treatment priorities. The impact of parental cardiovascular health (CVH) on healthy life years lost from cardiovascular disease (CVD) in adult offspring is unknown. We compared parent-offspring CVD DALYs trends over the life course and examined the association of parental CVH with offspring CVD DALYs. Methods: Using data from the Framingham Heart Study, 4814 offspring-mother-father trios were matched for age at selected baseline exams. CVH score was computed from the number of CVH metrics attained at recommended levels: poor (0–2), intermediate (3–4), and ideal (5–7). CVD DALYs were defined as the sum of years of life lost and years lived with CVD. Age-sex-standardized life expectancy and disability weights were derived from the actuarial life tables and Global Burden of Disease study, respectively. Multivariable-adjusted linear regression was used to investigate the association of parental CVH with offspring CVD DALYs. Results: Over an equal 47-year follow-up, parents lost nearly twice the number of CVD DALYs compared to their offspring (23 234 versus 12 217). However, age-adjusted CVD DALYs were higher at younger ages and similar along the life course for parents and offspring. One-unit increase in parental CVH was associated with 5 healthy life months saved in offspring. Offspring of mothers with ideal versus poor CVH had 3 healthy life years saved (β=−3.0 DALYs [95% CI, −5.6 to −0.3]). No statistically significant association was found between paternal CVH categories and offspring CVD DALYs. Conclusions: Higher maternal and paternal CVH were associated with increased healthy life years in offspring; however, the association was strongest between mothers and offspring. Investment in CVH promotion along the life course has the potential to reduce the burden of CVD in the current and future generation of adults. [ABSTRACT FROM AUTHOR]

The global epidemic of cardiovascular disease (CVD) calls for multidisciplinary and multiprofessional approaches to the management of this condition, with strategic emphasis on prevention, treatment, and control. In addition, there is increasing recognition that effective prevention and management of CVD requires a diverse workforce skilled in the social, environmental, and policy determinants of health. Nowhere are these approaches and strategies brought together and more closely aligned than in the field of preventive cardiovascular nursing. This executive summary of "Global Cardiovascular Prevention: A Call to Action for Nursing" includes key points from the 6 papers written by the Preventive Cardiovascular Nurses Association and published in July-August 2011 as a supplement to the Journal of Cardiovascular Nursing and the European Journal of Cardiovascular Nursing. This supplement addresses innovative efforts to stem the current global epidemic of CVD and emphasizes the need for effective team-based interventions for lifestyle and behavior changes across the life span. Social solutions, strategies for working with key players to develop interactive models, as well as coordinated multilevel policies, partnerships, and programs that are culturally relevant and context specific are examined. Such approaches are urgently needed to reduce death and disability from CVD in the United States and globally. Nurse leaders and other members of the healthcare team are well positioned internationally to meet these challenges. [ABSTRACT FROM AUTHOR]