Pharmacotherapy of Weight-loss and Obesity with a Focus on GLP 1-Receptor Agonists.

Obesity is a disease of epidemic proportions in the United States and contributes to morbidity and mortality for a large part of the population. In addition, the financial costs of this disease to society are high. Lifestyle modifications are key to prevention and treatment but adherence and long-term success have been challenging.

Polycystic ovary syndrome: A review of diagnosis and management, with special focus on atherosclerotic cardiovascular disease prevention.

Polycystic ovary syndrome (PCOS) is a common endocrinopathy worldwide with a heterogeneous clinical presentation including reproductive, metabolic, and endocrine elements. However, the assessment and management of PCOS remains inconsistent, with many women undiagnosed and untreated. We now also understand that the management of PCOS should extend throughout a woman's lifespan as many elements of the syndrome persist after menopause.

Managing cardiometabolic risk factors across a woman's lifespan: A lipidologist's perspective.

A recent rise in atherosclerotic cardiovascular disease (ASCVD) mortality in women warrants a heightened focus on the cardiometabolic risk factors that are closely tied to increasing trends in obesity and suboptimal lifestyle. Polycystic ovarian syndrome (PCOS), adverse pregnancy outcomes (APOs) and nonalcoholic fatty liver disease (NAFLD) are often manifestations of cardiometabolic disease that convey cardiovascular risk requiring recognition foremost, as well as a targeted approach to treatment. Similarly, menopause is a time to reflect on a woman's cardiovascular risk as multiple cardiometabolic changes occur during this time.

Prolonged QTc in HIV-Infected Patients: A Need for Routine ECG Screening.

Background: With HIV-infected patients living longer, there is an increased burden of comorbidities related to aging, HIV itself, and polypharmacy. Cardiac morbidity is of particular importance.

Methods: This 2-group comparison study (156 HIV-positive and 105 HIV-negative patients) investigated the prevalence of abnormalities in and factors associated with an electrocardiogram (ECG) measure, corrected QT interval (QTc), where prolongation can lead to arrhythmia and sudden death.

JCL roundtable: Managing lipid disorders in patients with HIV.

The HIV-AIDS epidemic has provided one of the more challenging problems in treatment of infectious diseases. As antiretroviral drugs made a very marked improvement in controlling the immunodeficiency state and patients gained in their longevity, the concern with lipid abnormalities came to the fore. The initial drugs produced a form of metabolic syndrome accompanied by very elevated plasma triglyceride concentrations.

Tricuspid Valve Replacement in an HIV-Infected Patient with Severe Tricuspid Regurgitation Secondary to Remote Endocarditis.

Surgical intervention for severe tricuspid regurgitation secondary to remote infective endocarditis has been infrequent, especially in patients also infected with the human immunodeficiency virus (HIV). We describe the case of a 62-year-old HIV-positive man, with a 24-year history of endocarditis caused by intravenous heroin use, who presented with severe tricuspid regurgitation. The patient was initially asymptomatic, was taking antiretroviral medications, and had a satisfactory CD4 count and an undetectable viral load, so we decided to manage the regurgitation conservatively.

Lipid Management in Human Immunodeficiency Virus.

The development and use of antiretroviral medications to treat patients infected with human immunodeficiency virus (HIV) has dramatically changed the course of this disease from one that was fatal to a chronic and more manageable condition. Recommendations and guidelines for the general population are presented in this review with suggestions as to how they may be applied to this patient population. Issues for which there is little or no information available are noted to highlight the many gaps in our knowledge regarding diagnosis and management of dyslipidemia for patients living with HIV.

Lipid management in human immunodeficiency virus.

The development and use of antiretroviral medications to treat patients infected with human immunodeficiency virus (HIV) has dramatically changed the course of this disease from one that was fatal to a chronic and more manageable condition. Recommendations and guidelines for the general population are presented in this review with suggestions as to how they may be applied to this patient population. Issues for which there is little or no information available are noted to highlight the many gaps in our knowledge regarding diagnosis and management of dyslipidemia for patients living with HIV.

Management of lipid disorders in patients living with HIV.

Since the discovery and development of antiretroviral therapy (ART), HIV has become a chronic disease with patients living longer lives and to ages where co-morbidities, such as cardiovascular disease (CVD) are prevalent. Diagnosis and management of risk factors for CVD, in particular dyslipidemia, have become an important part of the overall care for patients living with HIV infection. Existing guidelines and recommendations for the management of dyslipidemia for persons with HIV infection are largely based on guidelines for the general population.

Efficacy of Resistance Training as an Aid to Smoking Cessation: Rationale and Design of the Strength To Quit Study.

Despite recent declines in the rates of cigarette smoking, smoking remains prevalent among individuals with lower income, less education, and those with mental illness or HIV. Exercise is promoted as an aid to smoking cessation; however, the evidence for this recommendation is equivocal. To date, the majority of studies have only examined aerobic exercise; there is a poor understanding of the mechanisms of action; and there is an under-representation of male smokers.

Prevalence, treatment, and control of dyslipidemia and hypertension in 4278 HIV outpatients.

Objective: Patients with HIV may have an increased risk of cardiovascular disease (CVD). The objective of this study was to determine the prevalence, treatment, and control of low-density lipoprotein cholesterol (LDL-C) dyslipidemia and hypertension in a population of HIV-infected patients at an HIV/AIDS clinic in New York City.

Methods: Review of electronic medical records of 4278 HIV-infected patients aged 20 years or older in a racially and ethnically diverse urban HIV/AIDS clinic based in a large tertiary hospital and designated New York State AIDS Center that provides comprehensive care.

No relation between coronary artery disease or electrocardiographic markers of disease in middle age and prenatal exposure to the Dutch famine of 1944-5.

Objective And Setting: Associations between prenatal famine and coronary artery disease (CAD) have been examined before with inconsistent results. For further evaluation, we examined multiple cardiac risk markers in adult men and women with prenatal exposure to the Dutch famine of 1944-5.

Design: Birth cohort study of 407 men and women with prenatal famine exposure, 344 born before or after the famine as time controls, and 324 unexposed siblings as family controls.

Preparticipation athletic screening for genetic heart disease.

Sudden cardiac death (SCD) in young athletes is relatively uncommon but tragic when it occurs. Many of these deaths can be prevented by pre-exercise screening to identify cardiac abnormalities and those at high risk. Although recent research has provided much needed information on SCD in athletes, there remain significant gaps in the knowledge needed to determine an optimal screening protocol.

Sudden cardiac death in young competitive athletes due to genetic cardiac abnormalities.

Sudden cardiac death (SCD) in young athletes is generally caused by inherited cardiac disorders. While these events are relatively few compared to other cardiac deaths, they are tragic in that death occurs in a young, otherwise healthy person. The genetic abnormalities most associated with SCD are hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia.

Declining severity of myocardial infarction from 1987 to 2002: the Atherosclerosis Risk in Communities (ARIC) Study.

Background: Death rates for coronary heart disease have been declining in the United States, but the reasons for this decline are not clear. One factor that could contribute to this decline is a reduction in the severity of acute myocardial infarction (MI). We hypothesized that for those patients hospitalized in the Atherosclerosis Risk in Communities (ARIC) Study with acute incident MI, there was a decline in MI severity from 1987 to 2002.

Variation and temporal trends in the use of diagnostic testing during hospitalization for acute myocardial infarction by age, gender, race, and geography (the Atherosclerosis Risk In Communities Study).

The use of cardiovascular procedures has become routine in the management of acute myocardial infarction (MI). However, diagnostic testing beyond coronary revascularization procedures and use over time has not been well characterized. Records of 35- to 74-year-old adults hospitalized with MI in 4 US communities from 1987 to 2001 were abstracted using standardized data collection methods.

Left ventricular geometric patterns in the Jackson cohort of the Atherosclerotic Risk in Communities (ARIC) Study: clinical correlates and influences on systolic and diastolic dysfunction.

Background: The distribution and determinants of left ventricular (LV) geometric patterns and their relation to LV function in African Americans is not well described despite higher rates of LV hypertrophy and cardiovascular mortality reported in this group.

Purpose: This study investigates the distribution and clinical correlates of LV geometric patterns and how these patterns relate to function in a population-based African American cohort.

Methods: The study population included participants in the Jackson cohort of ARIC, who underwent echocardiograms between 1993 and 1995.

Report of the National Heart, Lung, and Blood Institute Working Group on research in adult congenital heart disease.

The Working Group on research in adult congenital heart disease (ACHD) was convened in September 2004 under the sponsorship of National Heart, Lung, and Blood Institute (NHLBI) and the Office of Rare Diseases, National Institutes of Health, Department of Health and Human Services, to make recommendations on research needs. The purpose of the Working Group was to advise the NHLBI on the current state of the science in ACHD and barriers to optimal clinical care, and to make specific recommendations for overcoming those barriers. The members of the Working Group were chosen to provide expert input on a broad range of research issues from both scientific and lay perspectives.

Lipoprotein-associated phospholipase A2, high-sensitivity C-reactive protein, and risk for incident ischemic stroke in middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) study.

Background: Measurement of inflammatory markers has been reported to identify individuals at increased risk for ischemic stroke. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a proinflammatory enzyme secreted by macrophages. We assessed Lp-PLA2 and C-reactive protein (CRP) levels along with traditional risk factors to examine their relation to ischemic stroke.