One of the most common health complications related to diabetes is the development of cardiovascular disease (CVD). Studies addressing the association between adherence to diabetes management regimens and the risk of CVD among minority populations are limited. This cross-sectional study was conducted to examine the association between diabetes management regimens and risk of CVD among African American men. The health belief model was used to frame the study. Data were collected from the Behavioral Risk Factor Surveillance System database for the states of Missouri and Ohio. Multiple logistic regression analysis was used to assess the association between adherence to diabetes management regimens and the risk of CVD in diabetic African American men in the 2 states. Results indicated that adherence to recommended checkup frequencies and insulin therapies were not significantly associated with the risk of CVD. Participants who attended college or technical school had a lower risk of diagnosis of CVD compared to those who did not attend. Participants in the top income bracket had a lower risk of diagnosis of CVD compared to those in the bottom income bracket. Social change implications include consideration of socioeconomic factors such as educational status and income when planning and implementing diabetes management regimens to reduce the risk of CVD among diabetic African American men.

When the Minority Health Improvement and Health Disparity Elimination Act of 2007 went into effect, there was a corresponding increase in research focused on cardiovascular disease (CVD) in underrepresented groups, except for 1: culturally Deaf Americans. Guided by the health belief model, the purpose of this study was to determine if there were significant differences in the level of knowledge, perceived barriers, and preventive behaviors associated with CVD among Deaf and hearing employees at Gallaudet University, Washington D.C. This cross-sectional quantitative research study used a survey with questions derived from 2 existing national surveys. One hundred eighty-six subjects were recruited on the campus of Gallaudet University. Chi-square analysis was conducted to seek any association between respondents and cardiovascular knowledge. A t test assessed for association between respondent characteristics and knowledge of CVD. A multivariate linear regression model was used to discover if differences in CVD knowledge score were predicted by socioeconomic factors. Deaf (28%) and hearing (43%) participants differed significantly in identifying all 6 correct signs/symptoms of heart attack (p = 0.04). Hearing females (80%) managed their blood pressure at healthy levels which is twice more than their Deaf female counterparts (61%, p = 0.01). Hearing Blacks (78%) had a discussion of their high blood pressure with their doctor more than Deaf Black counterparts (28%, p = 0.05). Gaining a better understanding of the Deaf health trends on CVD could inspire positive social change that ultimately could improve health for Deaf individuals in the United States.

Both posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are related to an increased risk for cardiovascular disease (CVD), with links to ischemic heart disease, myocardial infarction, cardiac mortality, and other cardiac conditions. Given that these disorders are associated with increased medical costs, disability, and employer burden, research has investigated which factors increase the likelihood that one will develop CVD. While one hypothesis suggests that individuals who exhibit exaggerated responses to stress are at greater risk of developing CVD, individuals with PTSD/depression have been shown to exhibit both exaggerated and blunted stress responses. The purpose of the present study was to examine whether differing PTSD symptomatology, depressive presentation, dissociation, or cognitive appraisals of stressful events can predict the nature of one’s cardiovascular response to stress. It was hypothesized that: (1) PTSD arousal would be positively related to cardiac reactivity and PTSD avoidance negatively related to cardiac reactivity; (2) depressive activation would be positively related to cardiovascular reactivity and depressive withdrawal negatively related to cardiovascular reactivity; (3) dissociative symptoms would be negatively related to cardiovascular reactivity; and (4) challenge appraisals would be related to greater cardiac reactivity and threat appraisals to greater peripheral resistance. Female participants (N = 57) were administered the Clinician-Administered PTSD Scale (CAPS) and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) by graduate research assistants. Participants subsequently completed a demographic questionnaire and the Traumatic Life Events Questionnaire (TLEQ), Beck Depression Inventory-II (BDI-II), Dissociative Experiences Scale II (DES II), and Stress Appraisal Measure (SAM) to assess traumatic life events, depression, dissociation, and cognitive appraisals, respectively. Participants’ cardiovascular reactivity (HR, CO, SBP, DBP, and TPR) in response to two stress tasks‒mental arithmetic and public speaking‒were assessed via impedance cardiography and an automated blood pressure cuff. Multivariate regression revealed support for some hypotheses as significant relationships were found between reactivity and PTSD avoidance, PTSD arousal, and depressive withdrawal. No significant relationships were found between reactivity and dissociation, depressive activation, or threat appraisals. This study provides preliminary support for the idea that differing psychological presentations can predict the type of cardiovascular response one exhibits in response to stress.

The effects of occupational stress on public servants who seek to protect and maintain security for the general public have begun to receive more attention in recent years. Most of this research has focused on police officers. Much less attention has been directed towards other first responders (i.e., firefighters, paramedics) except in comparisons with police samples or inclusion in mixed first responder groups. Investigative efforts that specifically target firefighters and their unique responses to occupational stress, the vulnerabilities of negative responses to stress, and the variables that enhance and maintain resiliency in these first responders is limited. Moreover, cardiovascular risk has been recognized in firefighters. However research has been focused on examining physical variables related to this risk with little attention to psychological contributions, particularly the role of posttraumatic stress disorder (PTSD) on cardiovascular disease (CVD). The goals of the current investigation were to (1) review research that has been conducted on stress in firefighters, (2) examine the effects of job stress, length of service, and critical incidents on developing PTSD and CVD risk (3) evaluate the relationship between PTSD and CVD risk in firefighters (4) increase our understanding of the manifestations of stress in this population, and (5) provide organizations and treatment providers potentially useful information for developing and improving assessment and intervention strategies. Firefighters from the Broward Sheriff's Office special operations teams (N=87) were the participants. Self-report measures and annual physical examination data provided information regarding CVD risk (weight, height, blood pressure, cholesterol, smoking, physical exercise), job stress, trauma exposure, service length, and posttraumatic stress symptoms. Results indicated statistically significant relationships between PTSD symptomatology and current smoking status, triglycerides levels, and the number of CVD risk factors. Neither the number of experienced critical incidents, nor the number of service years was associated with PTSD symptomatology. Organizational job stress variables were associated with PTSD symptoms, but not directly with CVD risk. Collectively these findings suggest the reaction to traumatic experiences may be a better indicator of PTSD symptom development, than the actual number of traumatic events experienced. Moreover, the presence of PTSD symptoms may negatively influence overall CVD risk.

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Människor med hjärt- och kärlrelaterade åkommor är den främst förekommande patientgruppen att utredas och behandlas inom akutsjukvården. Behandlingsresultatet för dessa patienter har ett starkt samband med ett skyndsamt och korrekt omhändertagande, blir patienten inte korrekt prioriterad kan det leda till allvarliga vårdskador. Forskning visar att sjuksköterskor brister i att urskilja patienter med akuta hjärt- och kärlhändelser ur de stora patientflödena som akutsjukvården idag har. Syftet med studien var att belysa faktorer som påverkar identifiering av patienter med akut hjärt- och kärlsjukdom. Metoden som arbetet grundar sig på är en litteraturöversikt med systematiska artikelsökningar. Datainsamlingen har utförts i databaserna PubMed och CINAHL Complete. Femton vetenskapliga artiklar har granskats, sammanställts, analyserats och kritiskt utvärderats. Resultatet lyfter ett antal faktorer hos sjuksköterskan och patienten som påverkar sjuksköterskans möjligheter att identifiera de patienter som drabbats av en akut hjärt- och kärlhändelse. Sjuksköterskans kunskap, erfarenhet och individuella mål samt patientens demografi, symtombild och tidigare medicinska historia är alla faktorer som redovisas i resultatet. Även betydelsen av fortbildning och beslutsstöd för sjuksköterskan framhålls. Slutsatsen som baseras på studiens resultat understryker sjuksköterskans betydelse i det akuta omhändertagandet av de hjärt- och kärlsjuka patienterna. Sjuksköterskans förmåga att identifiera korrekt vårdbehov för enstaka patient leder till ökad vårdkvalitet för vårdtagarna och en minskad risk för vårdskador. Det är viktigt att ytterligare studera dessa faktorer så att adekvat och korrekt vård upprätthålls vid patientomhändertagande i det akuta skedet. / People suffering from cardiovascular diseases are the most common patient group that is examined and treated in emergency care. Treatment outcome for these patients has a strong connection with prompt and correct choice of therapy, if the patient is not prioritized correctly it can lead to serious healthcare injuries. Research shows that nurses fail to distinguish patients with acute cardiovascular events from the large patient flows in emergency care units. The aim of the study was to clarify factors that influence the nurse's ability to identify patients with acute cardiovascular disease. The method used in this study is a literature review where article searches and data collection have been carried out using the databases PubMed and CINAHL. Fifteen scientific articles have been reviewed, compiled, analysed and critically evaluated. The result highlights several factors in nurse and patient characteristics that affect the nurse's ability to identify patients suffering from an acute cardiovascular event. The nurse's knowledge, experience and individual goals as well as patient's demographics, symptom picture and previous medical history are all factors that are reported in the result. The importance of continuing education and decision support for the nurse is also emphasized. Conclusion based on the results of the study underlines the importance of the nurse’s role in urgent care of patients suffering from cardiovascular diseases. The ability to identify correct treatment for each individual patient leads to an increased quality of care and reduced risk of healthcare injury (for the patient). Further studies of these factors are needed in order to maintain adequate and correct patient care during the acute phase of cardiovascular events.

Atherosclerosis and symptoms of metabolic syndrome such as obesity, high cholesterol, and insulin resistance often coincide and exacerbate one another, but the cellular and molecular events in common with these conditions have not yet been fully elucidated. Low density lipoprotein receptor adaptor protein 1 (LDLRAP1) is an adaptor protein which interacts with the cytoplasmic tail of the LDL receptor, internalizing the receptor when it engages with LDL. Mutations in this gene lead to LDLR malfunction and cause Autosomal Recessive Hypercholesterolemia (ARH) in humans; however, direct causality on atherogenesis or metabolism in a defined pre-clinical model has not been reported. The aim of this study was to test the hypothesis that deletion of LDLRAP1 would lead to hypercholesterolemia and atherosclerosis. LDLRAP1-/- mice fed a high fat, western diet (HFD) for 16 weeks had significantly increased plasma cholesterol and triglyceride concentrations, accompanied with significantly increased plaque burden compared with wild-type controls. Unexpectedly, LDLRAP1-/- mice gained significantly more weight compared to the wild-type, LDLRAP1-/- mice were insulin resistant, and calorimetric studies suggested an altered metabolic profile. We determined that LDLRAP1 is highly expressed in white adipose tissue (WAT), and LDLRAP1-/- adipocytes are significantly larger and have reduced glucose uptake and AKT phosphorylation, but increased CD36 expression. WAT from LDLRAP1-/- mice is hypoxic, and has gene expression signatures of dysregulated lipid storage and energy homeostasis. These data indicate that lack of LDLRAP1 directly leads to atherosclerosis in mice, and also are the first to suggest that LDLRAP1 plays an unanticipated metabolic regulatory role in adipose tissue. LDLRAP1 deletion leads to systemic effects, and may act as a molecular link which regulates dyslipidemia, atherosclerosis, insulin resistance, and obesity. / Biomedical Sciences

Paraoxonase-1 (PON1) is a high density lipoprotein (HDL)-associated enzyme displaying esterase and lactonase activity. PON1 hydrolyzes the oxons of several organophosphorous insecticides (e.g. paraoxon, diazoxon and chlorpyrifos-oxon) and metabolizes lipid peroxides of low density lipoproteins (LDL) and HDL. As such, PON1 plays a relevant role in determining susceptibility of organophosphate toxicity and cardiovascular disease. The objective of this study was to determine associations of PON1 status (i.e. genotype and activity levels) with atherosclerosis (ATH) in individuals from the Southeastern United States. An additional objective was to determine whether PON1 genotype and/or PON1 activity levels influence the capacity of PON1 to metabolize chlorpyrifos-oxon (CPO) at a relatively low concentration. Data indicated increasing PON1 activity assessed by hydrolysis of phenyl acetate is associated with decreased odds of ATH. Furthermore, neither PON1 genotype nor PON1 activity levels influence capacity of PON1 to metabolize CPO at a relatively low concentration.

Chronic kidney disease greatly raises cardiovascular disease risk. Heart disease and death risk grow proportionately with renal disease progression. Investigate the link between cardiovascular disease prevalence and chronic renal disease severity and mortality using meta-analysis. In this study, 155 publications were found after searching several databases (including PubMed and Google Scholar). 48 studies that matched the inclusion criteria were included in the literature review, however, only 20 were included in the meta-analysis. 17101 people had CKD, while 8883 had CVD or non-CVD. Using the R programming language, a meta-analysis was performed to get a pooled impact of the influence of CVD on the severity of CKD (odds ratio OR), and a funnel plot was also generated to check for publication bias. The outcomes of the meta-analysis indicate that cardiovascular disease has a moderate impact on the severity of chronic kidney disease (OR=2.28, 95% CI, 1.90-2.73). All data will give essential insights into the epidemiology of the cardiovascular disease in chronic kidney disease (CKD), disclose the influence of individual risk variables on bad outcomes, and serve as the platform for future interventional research. Further investigation of the particular (non-traditional) risk factors associated with the renal illness that contribute to accelerated atherosclerosis in this population is necessary to improve the efficacy of cardiovascular treatments for patients with CKD. The purpose of this research is to determine whether and how these variables affect the development of CKD. / <p>Utbytesstudent.</p>