Publications by authors named "Jill Belch"

Background: Age-related macular degeneration (AMD) is a major cause of vision loss worldwide. This study aimed to assess risk factors for wet AMD by two methods: assessing risk factors measured in the Scottish Heart Health Extended Cohort (SHHEC), and to systematically review the literature.

Methods: Eighteen thousand one hundred seven volunteers were recruited to SHHEC between 1984-1995, with risk factor data collected on recruitment.

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Background: Research suggests that although men have a higher cardiovascular disease (CVD) rate, women with CVD are more likely to experience a poorer prognosis, possibly owing to incorrect diagnosis and poorer treatment. A question not yet addressed is whether some of this inequality could be due to sex bias when selecting patients for operation.

Method: The participants were from the Scottish Heart Health Extended Cohort who had been admitted to hospital with a cardiovascular diagnosis over the study period.

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Background: The aim of this work was to determine whether the ASSIGN cardiovascular disease (CVD) score, a 10-year CVD risk score used in primary care in Scotland, could additionally detect cancer risk.

Methods: 18,107 participants were recruited to the Scottish Heart Health Extended Cohort (SHHEC) study between 1982 and 1995. Information on health and lifestyle were collected, along with blood and urine, and participants were followed up via record linkage to 2017.

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Article Synopsis
  • Left ventricular mass (LVM) is a key marker for cardiovascular risk, but long-term studies in low-to-intermediate risk individuals are limited; this study evaluated LVM's association with cardiovascular outcomes using cardiac MRI in a cohort of adults over 40.
  • In a sample of 1495 participants, LVM was found to be linked to cardiovascular events differently for sexes: increased LVM was a significant predictor for men, while the LVM-to-volume ratio was more relevant for women.
  • The findings suggest that risk factors for cardiovascular events may differ by sex, indicating the need for tailored approaches in assessing cardiovascular health in low-risk populations.
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Endovascular interventions and diagnostic examinations using iodinated contrast media (ICM) are standard of care in current vascular medicine. Although ICM use is generally considered safe, it may be associated with adverse reactions, vary from minor disturbances to rare, but severe life-threatening complications. This position paper of European Society of Vascular Medicine integrates current knowledge and summarizes the key information related to the use of intravascular ICM, serving as recommendation on prevention and management of acute, late, and very late adverse reactions.

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  • Guidelines worldwide endorse exercise as a key treatment for patients with lower extremity peripheral artery disease (PAD).
  • Structured exercise programs yield the best outcomes, and this paper aims to help establish these programs for patients with chronic PAD.
  • It discusses specific exercise protocols, assesses patient outcomes based on evidence, and addresses disparities in access to supervised programs across Europe, pointing out areas needing further research.
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  • Exercise is highly recommended globally as an essential part of managing lower extremity peripheral artery disease (PAD) to improve patient outcomes.
  • This paper aims to help clinicians create effective structured exercise programs tailored for patients with symptomatic chronic PAD, detailing various training protocols and assessment methods.
  • It also addresses the unequal access to supervised exercise programs across Europe and points out the need for more research in this area.
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Article Synopsis
  • Exercise is essential for managing lower extremity peripheral artery disease (PAD), and guidelines worldwide strongly support its use.
  • A structured exercise program is crucial for achieving the best results in patients with symptomatic chronic PAD, with various training protocols outlined.
  • The document also addresses disparities in access to supervised exercise programs in Europe and identifies areas where more research is needed.
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Tobacco consumption is one of the most important risk factors for cardiovascular disease. Despite all efforts to curb any form of smoking, the number of e-cigarette users is still rising more than tabacco smoking decreases. E-cigarettes are often advertised as less harmful than regular cigarettes and helpful for smoking cessation.

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Coronavirus disease 2019 (COVID-19) has been shown to be strongly associated with increased risk for venous thromboembolism events (VTE) mainly in the inpatient but also in the outpatient setting. Pharmacologic thromboprophylaxis has been shown to offer significant benefits in terms of reducing not only VTE events but also mortality, especially in acutely ill patients with COVID-19. Although the main source of evidence is derived from observational studies with several limitations, thromboprophylaxis is currently recommended for all hospitalized patients with acceptable bleeding risk by all national and international guidelines.

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Purpose: Risk factor-based models struggle to accurately predict the development of cardiovascular disease (CVD) at the level of the individual. Ways of identifying people with low predicted risk who will develop CVD would allow stratified advice and support informed treatment decisions about the initiation or adjustment of preventive medication, and this is the aim of this prospective cohort study.

Participants: The Tayside Screening for Cardiac Events (TASCFORCE) study recruited men and women aged≥40 years, free from known CVD, with a predicted 10-year risk of coronary heart disease<20%.

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Aims: Chronic limb-threatening ischaemia (CLTI) entails dismal outcomes and is an absolute indication to lower extremity revascularization (LER) whenever possible. Antithrombotic therapy is here crucial, but available evidence on best strategies (choice of drugs, combinations, duration) is scarce. We conducted a European internet-based survey on physicians' use of antithrombotic therapy after revascularization for CLTI, under the aegis of the ESC Working Group on Aorta and Peripheral Vascular Disease in collaboration with other European scientific societies involved in CLTI management and agreeing to send the survey to their affiliates.

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Atherosclerotic cardiovascular disease remains the leading cause of morbidity and mortality globally. the integrated care pathways (ICPs) are tools through which evidence-based guidelines (GLs) on a specific disease or clinical topic can be implemented in a clinical process. This study aims to facilitate decision making for health professionals in their daily practice.

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The optimal first line management of patients with symptomatic chronic lower extremity peripheral artery disease (PAD) includes secondary prevention of cardiovascular risk factors, pharmacological treatment, and supervised exercise therapy (SET). SET programs have shown to be effective in improving walking performance, functional performance, and quality of life. However, despite a large body of evidence, and despite national and international guidelines recommending SET as first line therapy, SET remains largely underused in patients with chronic PAD.

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The factors that influence the atherosclerotic disease process in high-risk individuals remain poorly understood. Here, we used a combination of vascular imaging, risk factor assessment, and biomarkers to identify factors associated with 3-year change in carotid disease severity in a cohort of high-risk subjects treated with preventive therapy (n = 865). The results show that changes in intima-media thickness (IMT) are most pronounced in the carotid bulb.

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Cancer and COVID-19 are both well-established risk factors predisposing to thrombosis. Both disease entities are correlated with increased incidence of venous thrombotic events through multifaceted pathogenic mechanisms involving the interaction of cancer cells or SARS-CoV2 on the one hand and the coagulation system and endothelial cells on the other hand. Thromboprophylaxis is recommended for hospitalized patients with active cancer and high-risk outpatients with cancer receiving anticancer treatment.

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With an increasing global burden of patients with chronic peripheral artery disease (PAD) the safe and effective provision of lower limb revascularisation is a growing medical need. Endovascular procedures for the treatment of PAD have become a crucial cornerstone of modern vascular medicine, and the first line revascularisation approach if technically feasible and taking patient choice into consideration. With the increasing age of patients with PAD and the increasing number of comorbidities open vascular surgery is also often not feasible.

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Patients with peripheral arterial disease (PAD) are at very high risk of cardiovascular events, but risk factor management is usually suboptimal. This Joint Task Force from the European Atherosclerosis Society and the European Society of Vascular Medicine has updated evidence on the management on dyslipidaemia and thrombotic factors in patients with PAD. Guidelines recommend a low-density lipoprotein cholesterol (LDLC) goal of more than 50% reduction from baseline and <1.

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Article Synopsis
  • Limited research exists on how air pollutants like nitrogen oxides and particulate matter impact acute limb ischaemia (ALI), a serious peripheral arterial disease with poor outcomes.
  • An 18-year study at Ninewells Hospital and Perth Royal Infirmary analyzed healthcare records alongside daily pollutant levels from 2000 to 2017 to investigate this relationship.
  • The findings indicated that higher levels of nitrogen oxides on pollution days correlated with increased ALI hospital admissions, while particulate matter showed a cumulative effect over time, but there was no link to increased ALI mortality.
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Patients with peripheral arterial disease (PAD) are at very high risk of cardiovascular events, but risk factor management is usually suboptimal. This Joint Task Force from the European Atherosclerosis Society and the European Society of Vascular Medicine has updated evidence on the management on dyslipidaemia and thrombotic factors in patients with PAD. Guidelines recommend a low-density lipoprotein cholesterol (LDLC) goal of more than 50% reduction from baseline and <1.

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