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Coronary heart disease remains the leading cause of death in both men and women in most industrialized countries. Yet it is largely preventable, and health care providers can acquire the skills to help their patients reduce their risks substantially. Traditional risk factors such as cigarette smoking, hypercholesterolimia, hypertension, sedentary lifestyle, obesity and glucose intolerance explain a major proportion of coronary events. Recent evidence also suggests important adjunctive roles for hormone replacement therapy in postmenopausal women, and aspirin prophlaxis in individuals at high risk of a first myocardial infarction. Emerging evidence indicates an important role for diet in the prevention of heart disease. Although the importance of lifestyle and behavioral modifications may well be known among physicians and other health-care providers, the implementation of this knowledge has been limited. One reason is that the information supporting the value, feasibility and cost-effectiveness of risk-reduction strategies has not been previously synthesized and made widely available to health-care providers in office and community settings. Prevention of Myocardial Infarction fills these critical gaps by providing a state-of-the-art compendium of the scientific evidence on the efficacy of coronary disease prevention, while focusing on helping clinicians develop intervention skills to utilize available knowledge. Chapters by leading authorities in cardiovascular epidemiology, clinical cardiology, cost-effectiveness analysis, and public health translate the theory of preventive cardiology into feasible implementation. The counseling and other intervention strategies described in this textbook have documented clinical efficacy and cost-effectiveness, and they require little time to learn or implement. The book is written mainly for primary care providers, including general internists and family physicians, but will also be of interest to medical subspecialties such as cardiologists and endocrinologists, as well as medical students, dietitians, psychologists, epidemiologists, and students, practitioners, and researchers in public health.
This is a compendium of the scientific evidence on the efficacy of coronary disease prevention that will help clinicians develop intervention skills to utilize available knowledge. The counselling and strategies described in this textbook have documented clinical efficacy and cost-effectiveness, and they require little time to learn or implement.
The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.
Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs.
Chronic diseases are common and costly, yet they are also among the most preventable health problems. Comprehensive and accurate disease surveillance systems are needed to implement successful efforts which will reduce the burden of chronic diseases on the U.S. population. A number of sources of surveillance data-including population surveys, cohort studies, disease registries, administrative health data, and vital statistics-contribute critical information about chronic disease. But no central surveillance system provides the information needed to analyze how chronic disease impacts the U.S. population, to identify public health priorities, or to track the progress of preventive efforts. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases outlines a conceptual framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung diseases. This system should be capable of providing data on disparities in incidence and prevalence of the diseases by race, ethnicity, socioeconomic status, and geographic region, along with data on disease risk factors, clinical care delivery, and functional health outcomes. This coordinated surveillance system is needed to integrate and expand existing information across the multiple levels of decision making in order to generate actionable, timely knowledge for a range of stakeholders at the local, state or regional, and national levels. The recommendations presented in A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases focus on data collection, resource allocation, monitoring activities, and implementation. The report also recommends that systems evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease. This report will inform decision-making among federal health agencies, especially the Department of Health and Human Services; public health and clinical practitioners; non-governmental organizations; and policy makers, among others.
The Pathophysiology and Pharmacotherapy of Myocardial Infarction deals with the advances in the pathophysiology and pharmacotherapy of acute myocardial infarction and related complications. This book covers two major consequences—cardiac muscle dysfunction and cardiac electrical dysfunction. This text begins by reviewing the controversy surrounding the pathogenetic mechanisms of atheroma formation and its potential reversibility, including the status of coronary risk factors and benefits of primary prevention. The pathophysiologic mechanisms of pump failure and the current approach to its management are then deliberated, followed by a discussion on the rational use of vasodilators in post-infarction heart failure and pharmacotherapy of cardiogenic shock. The rationale for the interest in the role of coronary vasospasm and thrombolytic therapy for acute myocardial infarction is also covered. This publication concludes by reviewing the approaches for the management of post-infarction ventricular tachyarrhythmias and concept of secondary prevention of sudden cardiac death. This compilation is valuable to medical students, primary care physicians, and cardiovascular specialists.
"EACPR, European Association for Cardiovascular Prevention and Rehabilitation -- European Society of Cardiology."
This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
In the network of cardiologists within the European Society of Cardiology Working Group on Cardiac Rehabilitation and Exercise Physiology there is a strong view that the time indeed is right to publish definitively on the methods involved in cardiovascular prevention and rehabilitation. We are facing a transition from conventional cardiac rehabilitation to a phase of combined preventive and rehabilitative efforts, as witnessed in the recent Joint Task Force Guidelines on Preventive Cardiology. For this revision of our clinical routines we lack a practical textbook, based upon the conditions and resources of European health care. This textbook is designed to fill that gap.
The authoritative clinical handbook promoting excellence and best practice Cardiovascular Prevention and Rehabilitation in Practice is a comprehensive, practitioner-focused clinical handbook which provides internationally applicable evidence-based standards of good practice. Edited and written by a multidisciplinary team of experts from the British Association for Cardiovascular Prevention and Rehabilitation (BACPR), this book is invaluable for practitioners helping people with heart disease return to health. The text provides an overview of research findings, examines the core components of cardiac rehabilitation, and discusses how to support healthier lifestyles and reduce the risks of recurrence. Now in its second edition, this textbook has been fully revised to incorporate recent clinical evidence and align with current national and international guidelines. Increased emphasis is placed on an integrated approach to cardiac rehabilitation programmes, whilst six specified standards and six core components are presented to promote sustainable health outcomes. Describes how cardiovascular prevention and rehabilitation programmes can be delivered to meet standards of good practice Covers a broad range of topics including: promoting health behaviour change to improve lifestyle risk factors, supporting psycho-social health, managing medical risk factors, and how to develop long-term health strategies Emphasises the importance of early programme commencement with assessment and reassessment of patient goals and outcomes, and gives examples of strategies to achieve these Discusses the role of programme audit and certification of meeting minimum standards of practice Looks to the future and how delivery of cardiovascular prevention and rehabilitation programmes internationally will need to meet common challenges Cardiovascular Prevention and Rehabilitation in Practice is an indispensable resource for all health professionals involved in cardiac rehabilitation and cardiovascular disease prevention.