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Sickle cell disease (SCD) predominantly affects African-Americans (AAs) in the United States (US). Due to increasing life expectancy in developed countries, SCD-associated cardiomyopathy is typically seen in adults. The aim of this study was to distinguish hospitalization for this phenotype from traditional heart failure (HF) in AAs. We used the National Inpatient Sample (NIS) database to identify HF hospitalizations in AAs between 2005 and 2014 and stratified them according to SCD status. We compared the characteristics and outcomes before and after matching in a 1:3 ratio for age, gender, insurance, smoking status and admission year. Amongst the 1,195,718 HF admissions in AAs, SCD accounted for 7835. The age (mean ± SD) in the SCD cohort was significantly younger (45.66 ± 13.2) vs non-SCD (64.8 ± 15.2), p

Introduction: Hypertension is a significant risk factor for cardiovascular morbidity and mortality. According to the recent guideline, the criteria for diagnosing hypertension is now 130/80mmhg. This study seeks to gain a better understanding of the prevalence of hypertension, its awareness, and control in the United States population over the last 10 years using the new criteria for hypertension. Methods: NHANES is a stratified multistage probability sampling of the civilian noninstitutionalized population of the United States. We used the last five cycles available (2007-2016) to conduct a prevalence study applying statistical methods to account for the survey technique and non-response. Result: The mean age was 47.33 years (95%CI, 46.82-29.09), females constituted 51.9% of the population(n=28147), non-Hispanic white 66.63%, non-Hispanic black, 11.40%, Mexican American 8.55%. About 39% of the population studied were obese (BMI greater than or equal to 30). The crude ten years prevalence of hypertension was 38.85%, there was an increasing trend from 37.58% in the 2007-2008 cycle to 41.12% in the 2015-2016 cycle; this increase is statistically significant Conclusion: We were able to demonstrate the significant increase in hypertension prevalence with an increasing trend based on the new guidelines. Also, there is a downward trend in awareness and control; we have demonstrated again, the significant racial disparities in hypertension with about half of the black population being hypertensive. Our study showed that there is a need to intensify effort to combat this epidemic.

Mesoamerican nephropathy (MeN), formerly called chronic kidney disease of unknown cause (CKDu), refers to chronic kidney disease (CKD) that presents in young and middle-aged Central Americans in the absence of any clear etiology. MeN is a relatively new diagnosis with rapidly rising prevalence in specific regions of El Salvador and Nicaragua, Guatemala, and Costa Rica. It is seldom associated with hyperuricemia. We present a case of a patient with gouty arthritis and hyperuricemia with associated CKD due to MeN. We also provide a review of literature of this disease.

Dual antiplatelet agents and high-intensity statins are frequently used in combination after myocardial infarction. Ticagrelor has the potential of causing acute kidney injury. Rosuvastatin is excreted through the kidneys and dose adjustment is needed in patients with kidney disease. When used in combination, they can potentiate the toxic effects of each other. We report a case of drug interaction between rosuvastatin and ticagrelor resulting in rhabdomyolysis and acute renal failure necessitating dialysis. This case stresses the importance of monitoring renal function and adjusting the dose of rosuvastatin accordingly in patients with kidney disease.

Introduction: Anemia has been implicated in heart failure. Existing literatures, involving predominantly African-Americans, suggests that Sickle Cell Disease (SCD) maybe linked to various cardiovascular complications including pulmonary hypertension and left venticular dysfunction. Peculiarly, our study involves exclusively Sub-Saharan population. Method: We conducted a cross sectional observational study of 208 hydroxyurea-naive consecutive SCD patients aged 10-52 years at steady state and 94 healthy non-matched controls who were studied in an out patient clinic in Sub-Saharan Africa. SCD patients were required to have electrophoretic or liquid chromatography documentation of major sickling phenotypes. Control group was required to have non-sickling phenotypes. Cardiac measurements were performed with TransThoracic Echo according to American Society of Echocardiography guidelines. Hemoglobin level was also obtained. Results: Hemoglobin level in SCD group (8.5+/- 1.5) was significant (P Conclusions: We were unable to demonstrate existence of anemia-associated left ventricular dysfunction in Sub-Saharan African with SCD. Further studies is required to highlight the reason behind this finding.

Introduction There is some evidence concerning the role of testosterone in cardiovascular diseases including heart failure. Some evidence favors reduced risk of cardiovascular events with higher levels while others have found no association. Hypothesis We hypothesized that lower testosterone level is associated with a lower hospital stay and admission rates in those with heart failure. Methods We used the NHANES database to identify males with a reported diagnosis of heart failure. The outcomes were inpatient admission in the past year and the number of days spent in the hospital in the past year. Results We identified 284 males with a reported a diagnosis of heart failure in 2011-2016 NHANES, mean age was 66.5 years, and there was no statistically significant difference in age between the group with serum testosterone less than 250 ng/ml and the group with serum testosterone more than 250 ng/ml(p=0.21). In the monovariate analysis, the group with lower testosterone levels are less likely to be admitted when compared to the group with higher testosterone, but this association was not statistically significant (25.6% vs. 40.0%,P=0.05). After multivariate analysis using logistic regression adjusting for comorbid conditions, the odds of being admitted is less in those with normal testosterone, but this was not statistically significant (OR 0.54, 95CI 0.25-1.57,p=0.11). In the linear regression model, we didn't find any significant effect of serum testosterone in the overall number of days spent in the hospital. Conclusions There was no evidence of an association between testosterone and increased admission and also no evidence of an association between serum testosterone and the overall length of stay. Some studies have shown possible benefits of testosterone supplementation in heart failure, but our study revealed that there is likely no effect on the risk of admission or length of stay.

Heart failure (HF) and atrial fibrillation (AF) share several risk factors including coronary artery disease, hypertension, smoking, obesity, diabetes, and renal disease, as well as common pathophysiologic pathway involving activation of the renin-angiotensin-aldosterone system, maladaptive atrial

There is paucity of data on outcomes of Human Immunodeficiency Virus (HIV) patients that are hospitalized and had percutaneous coronary intervention (PCI). Our study describes the characteristics and outcomes of HIV patients that were hospitalized and had PCI in the United States over a period of 16