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Ciccarone Center Research
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Diet & Weight
Published in: Journal of the American College of CardiologyRead on Pubmed
To facilitate the guideline-based implementation of treatment recommendations in the ambulatory setting and to encourage participation in the multiple preventive health efforts that exist, we have organized several recent guideline updates into a simple ABCDEF approach. We would remind clinicians that evidence-based medicine is meant to inform recommendations but that synthesis of patient-specific data and use of appropriate clinical judgment in each individual situation is ultimately preferred.Published in: Journal of the American Heart AssociationRead on Pubmed
Unhealthy lifestyle habits are a major contributor to coronary artery disease (CAD). The purpose of the study was to investigate the associations of smoking, weight maintenance, physical activity, and Mediterranean-style diet with coronary calcium, cardiovascular events, and mortality. We discovered that, over the course of nearly 8 years, a combination of regular exercise, healthy diet, smoking avoidance, and weight maintenance contributed to lower coronary calcium incidence, slower calcium progression, and lower all-cause mortality.Published in: American Journal of EpidemiologyRead on Pubmed
Hepatic steatosis, obesity, and the metabolic syndrome are independently and additively associated with increased systemic inflammation.
The goal of this study was to assess the independent and collective associations of hepatic steatosis, obesity, and the metabolic syndrome with elevated hsCRP levels. We evaluated 2,388 individuals without clinical cardiovascular disease between December 2004 and December 2006. Hepatic steatosis was diagnosed by ultrasound, and the metabolic syndrome was defined using National Heart, Lung, and Blood Institute criteria. We concluded that hepatic steatosis, obesity, and the metabolic syndrome are independently and additively associated with increased odds of high hsCRP levels.Published in: Arteriosclerosis, Thrombosis & Vascular BiologyRead on Pubmed
Association between obesity, high-sensitivity C-reactive protein greater than or equal to 2 mg/L, and subclinical atherosclerosis: implications of JUPITER from the Multi-Ethnic Study of Atherosclerosis.
Levels of hsCRP are closely associated with abdominal obesity, metabolic syndrome, and atherosclerotic cardiovascular disease. The JUPITER trial has encouraged using hsCRP greater than or equal to 2 mg/L to guide statin therapy; however, the association of hsCRP and atherosclerosis, independent of obesity, remains unknown. We concluded that high hsCRP, as defined by JUPITER, was not associated with CAC and was mildly associated with carotid intima-media thickness (cIMT) in the absence of obesity. In contrast, obesity was associated with both measures of subclinical atherosclerosis independently of hsCRP status.Published in: Arteriosclerosis, Thrombosis & Vascular BiologyRead on Pubmed
Focused update on the 2013-2014 cardiovascular disease prevention guidelines.
Determinants of intrathoracic adipose tissue volume and associations with cardiovascular disease risk factors in Amish.
These data do not provide support for a significant role for intrathoracic fat in the development of CAC.Read on Pubmed
A systematic review of internet-based worksite wellness approaches for cardiovascular disease risk management: outcomes, challenges and opportunities.
Internet-based programs hold promise for improving the cardiovascular wellness among employees. However, much work is required to fully understand its utility and long-term impact, especially in special/at-risk populations.
Beyond BMI: the "metabolically healthy obese" phenotype and its association with clinical/subclinical cardiovascular disease and all-cause mortality: a systematic review.
This review analyzed the literature that has examined the burden of CVD and all-cause mortality in the metabolically healthy obese population.
Statin use is not associated with presence of and severity of nonalcoholic fatty liver disease.
These results favor statin use in subjects with nonalcoholic fatty liver disease, since its use is not associated with the presence of the disease or increased fibrosis.
Association of depressive symptoms and anti-depressants with body mass index and waist circumference in elderly men and women: The ARIC Carotid MRI Study.
Depressive symptoms are associated with obesity, a precursor to type 2 diabetes and cardiovascular disease, and might in part explain the association of depressive symptoms with adverse metabolic outcomes. We determined the cross-sectional association between depressive symptoms and body mass index (BMI) and waist circumference (WC) in 1,314 elderly men and women age 60 to 83 years in the Atherosclerosis Risk in Communities (ARIC) Carotid MRI Study.
Vegetarian diets in cardiovascular prevention.
There is growing evidence that consumption of a vegetarian diet as well as specific components of a vegetarian diet lower the incidence of cardiovascular disease (CVD) and death. Vegetarian diets lower the probability of developing CVD, are effective in altering serum lipids, are beneficial in reducing blood pressure, improve glycemic control and insulin sensitivity, reduce weight, and lower mortality. Vascular effects of a vegetarian diet include a thinner carotid IMT and lower brachial artery resistance. Health care providers should be aware of the types of vegetarian diets and their risks and benefits in order to guide patients' dietary habits with the ultimate goal of reducing their CVD risk. While a patient does not have to become a complete vegetarian to reduce their CVD risk, they can make simple changes in their diet that are effective in risk reduction.
Relation of hepatic steatosis to atherogenic dyslipidemia.
Hepatic steatosis may play a direct metabolic role in conferring increased cardiovascular risk.