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Atherosclerotic cardiovascular disease (ASCVD) and chronic obstructive pulmonary disease (COPD) are among the leading causes of morbidity, mortality, and economic burden in the United States (US). While previous reports have shown that an optimal cardiovascular risk factor (CRF) profile is associated with improved outcomes among COPD patients, the impact of ASCVD and CRF on healthcare costs and resource utilization is not well described.

The Medical Expenditure Panel Survey (MEPS) database was used from 2011 to 2016 to study healthcare expenditure for COPD patients with and without ASCVD and across CRF profiles in a nationally representative population of adults in the United States.

The study population consisted of 14,807 adults with COPD, representing 28 million cases annually. Presence of ASCVD was associated with higher reported expenditure across the spectrum of CRF profiles among those with COPD. On average, after adjusting for confounders, presence of ASCVD represented a mean difference per capi ASCVD and a favorable CRF profile was associated with lower healthcare expenditure and resource utilization among patients with COPD. These results provide robust estimates for potential healthcare savings as preemptive strategies continue to become integrated into new healthcare delivery models, for increased awareness and the need for improvement of CRF profiles among high-risk patients.

The prevalence of atherosclerotic cardiovascular disease (ASCVD) in younger adults has increased over the past decade. However, it is less well established whether patient reported outcomes differ between younger and older adults with ASCVD. We sought to evaluate age-specific differences in patient reported outcomes among adults with ASCVD.

This was a retrospective cross-sectional survey study. We used data from the 2006-2015 Medical Expenditure Panel Survey (MEPS), a nationally representative sample of the United States population. Adults ≥18 years with a diagnosis of ASCVD, ascertained by ICD9 codes or self-reported data, were included. Logistic regression was used to compare self-reported patient-clinician communication, patient satisfaction, perception of health, emergency department (ED) visits, and use of preventive medications (aspirin and statins) by age category [Young 18-44, Middle 45-64, Older ≥65 years]. We used two-part econometric modeling to evaluate age-specific annual healthcare expenditu

Compared with older adults, younger adults with ASCVD were more likely to report poor patient experience and poor health status and less likely to be using preventive medications. More effort needs to be geared towards understanding the age-specific differences in healthcare quality and delivery to improve outcomes among high-risk young adults with ASCVD.

To identify the prevalence, treatment, and low-density lipoprotein cholesterol (LDL-C) control of individuals with LDL-C ≥190​mg/dL in contemporary clinical practice.

We included adults (age ≥18 years) with LDL-C ≥190​mg/dL, at least one LDL-C level drawn from 255 health systems participating in Cerner HealthFacts database (2000-2017, n​=​4,623,851), and a detailed examination within Duke University Health System (DUHS, 2015-2017, n​=​267,710). Factors associated with LDL-C control were evaluated using multivariable logistic regression modeling.

The cross-sectional prevalence of LDL-C ≥190​mg/dL was 3.0% in Cerner (n​=​139,539/4,623,851) and 2.9% at DUHS (n​=​7728/267,710); among these, rates of repeat LDL-C measurement within 13 months were low 27.9% (n​=​38,960) in Cerner, 54.5% (n​=​4211) at DUHS. Of patients with follow-up LDL-C levels, 23.6% in Cerner had a 50% of greater reduction in LDL-C, 18.3% achieved an LDL-C <100​mg/dL and 2.7%​<​70​mg/dL. At DUHS, 28.4% had a 50% or greater reduction tes of repeat measurement within one year were low; of those retested, only about one-fourth met guideline-recommended LDL-C treatment goals.

Approximately 3% of United States adults have LDL-C ≥190 mg/dL. Among those with very high LDL-C, rates of repeat measurement within one year were low; of those retested, only about one-fourth met guideline-recommended LDL-C treatment goals.

To describe the spatial distribution of acute myocardial infarction (AMI) mortality in France in association with the socio-economic characteristics of the patient's place of residence.

In this population-based study, we included patients hospitalized for AMI identified according to ICD-10 codes, using data from the national health insurance database from January 1, 2013 to December 31, 2014. In- and out-of-hospital deaths were identified over a period of 1 year following the first hospital stay for AMI.An exploratory analysis was performed to classify area profiles. The spatial analysis of AMI mortality was performed using a principal component analysis followed by an ascending hierarchical classification taking into account socio-economic data, access-time by road to coronary angiography, standardized in-hospital prevalence, and 1 year mortality.

Over the 2 years, 115,418 patients were hospitalized with a diagnosis of AMI. Patients were a mean of 68​±​15 years and most were men (68.5%). The overall moortality. The spatial distribution of lower healthcare indicators follows the distribution of social inequalities. This study highlights the importance of focusing national policies on universally accessible prevention programs such as the promotion cardiac rehabilitation and healthy lifestyles.

Despite advances in screening and prevention, rates of premature coronary artery disease (CAD) have been stagnant. The goals of this study were to investigate the barriers to early risk detection and preventive treatment in patients with premature CAD. In particular, we 1) assessed the performance of the latest versions of major international guidelines in detection of risk of premature CAD and eligibility for preventive treatment; and, 2) investigated real-life utilization of primary prevention with lipid-lowering therapies in these patients.

We included patients in the Study to Avoid cardioVascular Events in British Columbia (SAVE BC), an observational study of patients with premature (males​≤​50 years, females​≤​55 years) angiographically confirmed CAD. Eligibility for primary prevention and treatment received were assessed retrospectively based on information recorded prior to or at the index presentation with CAD.

Of 417 patients (28.1% females) who met the criteria, 94.3% had at least one major cas for premature CAD



The current versions of major guidelines fail to recognize many patients who develop premature CAD as being at risk. The vast majority of these patients, including patients who have guideline-directed indications, do not receive lipid-lowering therapy before presenting with CAD. Our findings highlight the need for more effective screening and prevention strategies for premature CAD.

To determine trends in ischemic heart disease (IHD) mortality and burden among women in India we performed a study.

Data were obtained from three publicly available resources. Cardiovascular disease (CVD) and IHD mortality were obtained from 2017 Global Burden of Diseases (GBD) Study. NX-2127 chemical structure Metabolic risk factor data (body-mass index, blood pressure and diabetes) were obtained from Non-Communicable Disease Risk Factor Collaboration (NCDRiSC) and lifestyle factors were obtained from National Family Health Surveys (NFHS). Descriptive statistics are reported.

GBD study reported that in year 2017 in India CVD caused 2.64 million deaths (women 1.18, men 1.45 million) and IHD 1.54 million (women 0.62, men 0.92 million). Burden of IHD related disability adjusted life years (DALYs) was 36.99 million (women 13.80, men 23.19 million). From 2000 to 2017 annual IHD mortality increased from 0.85 to 1.54 million (+81.1%) with greater increase in women 0.32 to 0.62 million (+93.7%) compared to men (0.53-0.92 million, +73.6%). Increase in age-adjusted IHD mortality rate/100,000 was also more in women (62.9-92.7, +47.4%) than men (97.5-129.5, +32.8%). Trends in cardiometabolic risk factors from 2000 to 2015 showed greater increase in body-mass index, diabetes, tobacco-use and periodontal infections among women than men.

IHD is increasing more rapidly among women than men in India and there is sex-associated convergence. This is associated with greater increase in overweight, diabetes, tobacco use and periodontal infections in women.

IHD is increasing more rapidly among women than men in India and there is sex-associated convergence. This is associated with greater increase in overweight, diabetes, tobacco use and periodontal infections in women.

While optimal cardiovascular risk factor (CRF) profile is associated with lower mortality, morbidity, and healthcare expenditures among individuals with atherosclerotic cardiovascular disease (ASCVD), less is known regarding its impact on financial hardship from medical bills. Therefore, we assessed whether an optimal CRF profile is associated with a lower burden of financial hardship from medical bills and a reduction in cost-related barriers to health.

We used a nationally representative sample of adults between 18 and 64 years from the National Health Interview Survey between 2013 and 2017. We assessed ASCVD status and the number of risk factors to categorize the study population into 4 mutually exclusive categories ASCVD (irrespective of CRF profile) and non-ASCVD with poor, average, and optimal CRF profile. Adjusted logistic regression model was used to determine the association of ASCVD/CRF profile with financial hardship from medical bills and cost-related barriers to health (cost-related medicatiors to health despite lower income and lack of insurance.

Optimal CRF profile is associated with a lower prevalence of financial hardship from medical bills and cost-related barriers to health despite lower income and lack of insurance.The extraordinary expansion of cardiometabolic risk factors, the impact they generate in the development of hypertension and its specific phenotypes, and its implications in cardiovascular risk and therapeutic decision-making deserve an extensive and careful reflection. The aim of this review is to analyze the available evidence and gaps in the relationship between cardiometabolic risk factors and hypertension phenotypes. Overweight or obese patients, dyslipidemic, carbohydrate intolerant and type 2 diabetic patients have a significantly higher probability of suffering from high blood pressure than subjects without metabolic disorders. Masked hypertension should be systematically suspected in subjects with type 2 diabetes or metabolic disorders and borderline hypertension independently of the debate on the reproducibility of blood pressure phenotypes diagnosis. Some minor difficulties emerge to understand the phenotypes of hypertension in diabetic individuals, since clinical practice guidelines are not homogeneous in their postulates regarding the blood pressure targets at office and ambulatory and home blood pressure monitoring. The small number of diabetic hypertensive patients included in epidemiological studies, and the presence of confounding factors, such as the duration of diabetes, the quantity and type of drugs indicated for the treatment of both hypertension and diabetes, or the level of diabetes control, undermine the possibilities to draw conclusions of value for the clinical practice.