User:Ddoherty31/sandbox

Brainstorming:

Chest pain

HEARTScore

Myocardial infarction

Decision Aid

Food Security

Cook County Hospital

Stroke

Walking

Lifestyle Modification

Cardiovascular Prevention

Atrial Fibrillation

Alcoholism

JNK

Chosen Article: Cardiovascular Disease

Dan:

• Screening
  • Doesn't go into great depth about screening methods other than listing test names
  • Doesn't mention screening for those with moderate to high risk other than lipid testing of children

Management

• Very short: two sentences
• Only references influenza effects on cardiovascular disease
• Does not break down by individual subsets of cardiovascular disease (MI, stroke, angina, etc), but those individual articles already fully complete/thorough, don't want to double cover material

Management:

Proper CVD management necessitates a focus on MI and stroke cases due to their combined high mortality rate, keeping in mind the cost-effectiveness of any intervention, especially in developing countries with low or middle income levels. Regarding MI, strategies using aspirin, atenolol, streptokinase, and/or tissue plasminogen activator have been compared for quality-adjusted life-year (QALY) in regions of low and middle income. The costs for a single QALY for aspirin & atenolol, streptokinase, and t-PA were $25, $630-$730, and $16,000, respectively. Aspirin, ACE inhibitors, beta blockers, and statins used together for secondary CVD prevention in the same regions showed single QALY costs of $300-400.

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Wendy:

Since a healthy nutritious diet is linked to decreased risk of cardiovascular disease, it is important to consider whether people have access to such a diet. Food security, or access by all people at all times to enough food for an active, healthy, life is one of several conditions necessary for a population to be healthy and well-nourished [1]. Food insecurity, on the other hand, represents a state of uncertainty as to whether enough food will be available to the household. Food insecurity has profound implications in terms of increasing socioeconomic disparities in the management of chronic conditions related to cardiovascular disease such as hypertension, hyperlipidemia, and diabetes [2].

In 2015, 12.7% of American households were food insecure at least some time during the year [1]. Thus, many families do not have the financial resources to afford healthy, balanced meals each day and thus are at higher risk for cardiovascular disease. These low-income families usually respond to this uncertain access to food by decreasing dietary variety and increasing the consumption of energy dense foods [3]. Energy-dense foods are often of poor nutritional quality with refined grains, added sugar, and added saturated/trans fats [4]. These types of foods are not only the least expensive, but also most resistant to inflation [5]. The more expensive cost of low-energy density foods suggests that economic factors may pose a barrier to the adoption of more healthful diets and limit the impact of dietary guidance. Thus, existing efforts to increase the supply of fresh fruits and vegetables in low income neighborhoods should be coupled with wider efforts to ensure the affordability of such foods.

1. Bickel G, Nord M, Price C, Hamilton W, Cook J. Guide to Measuring Household Food Security, Revised 2000. Alexandria, VA, U.S Department of Agriculture, 2000
2. Seligman HK, Schillinger D. Hunger and socioeconomic disparities in chronic disease. N Engl J Med. 2010; 363:6-9
3. Kendall A, Olson CM, Frongillo EA. Relationship of hunger and food insecurity to food availability and consumption. J Am Diet Assoc. 1996; 96:1019-24
4. Drewnowski A, Darmon N. Food choices and diet costs: an economic analysis. J Nutr. 2005; 135:900-4
5. Monsivais P, Drewnowski A. The rising cost of low energy-density foods. J Am Diet Assoc. 2007; 107:2071-6

Kelsey:

This should be inserted in the paragraph discussing alcohol under diet:

A risk factor for atrial fibrillation is binge drinking. In a study by Djousee et al., they showed that consuming more than 36g/day of alcohol increased the risk of getting AF by 34% (1).  It has also been shown that abstinence is the one optimal management for alcohol induced atrial fibrillation (3).  This phenomenon was recognized in 1978 when Ettinger examined the correlation between binge drinking on the holidays and the onset of heart arrhythmias (2).  This concept became known as the holiday heart (2).  

Sources:

1.      Djousse L, Levy D, Benjamin EJ, Blease SJ, Russ A, Larson MG, Massaro JM, D'Agostino RB, Wolf PA and Ellison RC. Long-term alcohol consumption and the risk of atrial fibrillation in the Framingham Study. Am J Cardiol. 2004;93:710-3.

2.      Samokhvalov AV, Irving HM and Rehm J. Alcohol consumption as a risk factor for atrial fibrillation: a systematic review and meta-analysis. European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology. 2010;17:706-12.

3.      Pogwizd SM and Bers DM. Cellular basis of triggered arrhythmias in heart failure. Trends in cardiovascular medicine. 2004;14:61-6.