Publications by authors named "Milla Arabadjian"

Background: Caregiving has been associated with high blood pressure in middle-aged and older women, but this relationship is understudied among younger Black women, a population at high risk for hypertension. We examined the associations of caregiving stress and caregiving for high-needs dependents with incident hypertension among reproductive-age women in the JHS (Jackson Heart Study), a cohort of community-dwelling Black adults.

Methods: We included 453 participants, aged 21 to 44 years, with blood pressure <140/90 mm Hg, and not taking antihypertensive medication at baseline (2000-2004).

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Background: Researchers have increasingly recognized the importance of structural and social determinants of health (SSDOH) as key drivers of a multitude of diseases and health outcomes. The Multi-Ethnic Study of Atherosclerosis (MESA) is an ongoing, longitudinal cohort study of subclinical cardiovascular disease (CVD) that has followed geographically and racially/ethnically diverse participants starting in 2000. Since its inception, MESA has incorporated numerous SSDOH assessments and instruments to study in relation to CVD and aging outcomes.

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Objective: To examine the pattern of health services access and utilization that may contribute to racial/ethnic disparities in receiving continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA).

Methods: This cross-sectional study used a national sample from the All of Us Research Program, which included over 80 % of participants from underrepresented populations in biomedical research. Study participants included adults aged 18 years and older diagnosed with OSA (N = 8518).

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Article Synopsis
  • Latent left ventricular outflow tract obstruction (LVOTO) is a significant issue for patients with hypertrophic cardiomyopathy (HCM), making it essential to find effective ways to diagnose it.
  • A study involving 252 HCM patients showed that postprandial echocardiography (after eating) revealed significantly higher LVOT gradients compared to routine assessments, indicating that eating can provoke these obstructions.
  • The findings suggest that using echocardiography after meals can help identify LVOTO in many patients and lead to effective treatment options, with symptom relief observed in a large percentage of those treated.
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Background: Medicare supplement insurance, or Medigap, covers 21% of Medicare beneficiaries. Despite offsetting some out-of-pocket (OOP) expenses, remaining OOP costs may pose a barrier to medication adherence. This study aims to evaluate how OOP costs and insurance plan types influence medication adherence among beneficiaries covered by Medicare supplement plans.

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Article Synopsis
  • Hypertension frequently co-occurs with hypertrophic cardiomyopathy (HCM) in about 50% of patients, yet its impact on clinical outcomes remains understudied in adults, complicating management due to potential negative effects of standard hypertension treatments on obstructive HCM.
  • A thorough review of literature published between 2011 and 2023 identified 11 articles, revealing that adults with both conditions tend to be older and have higher obesity and diabetes rates, while the relationship between their functional class and arrhythmias was unclear.
  • The study emphasizes the need for better-targeted management strategies, more research on quality of life, and an exploration of hypertension-related outcomes, such as renal disease and stroke, to enhance cardiovascular care
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Background: Women with myocardial infarction (MI) are more likely to have elevated stress levels and depression than men with MI.

Objectives: We investigated psychosocial factors in women with myocardial infarction with nonobstructive coronary arteries (MINOCA) and those with MI and obstructive coronary artery disease (CAD).

Methods: Women with MI enrolled in a multicenter study and completed measures of perceived stress (Perceived Stress Scale-4) and depressive symptoms (Patient Health Questionnaire-2) at the time of MI (baseline) and 2 months later.

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Introduction: Hypertension affects 40%-60% of adults with hypertrophic cardiomyopathy (HCM), the most common inherited cardiac condition. It can be a diagnostic confounder for HCM, contributing to delayed diagnosis. Clinically, treatment of co-occurring hypertension and HCM poses challenges as first-line and second-line antihypertensive medications are often contraindicated in HCM.

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Background: Black men in the United States have higher hypertension (HTN) prevalence than other groups, largely due to adverse social determinants of health, including poor healthcare access. The Community-to-Clinic Linkage Implementation Program (CLIP) is effective for HTN screening in Black-owned barbershops. However, its effect on HTN prevention among Black men is untested.

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Background Psychological well-being is important among individuals with myocardial infarction (MI) given the clear links between stress, depression, and adverse cardiovascular outcomes. Stress and depressive disorders are more prevalent in women than men after MI. Resilience may protect against stress and depressive disorders after a traumatic event.

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Article Synopsis
  • - Hypertrophic cardiomyopathy (HCM) is a genetic heart condition that affects quality of life (QOL) and physical functioning, but these aspects are rarely studied in diverse populations.
  • - A study compared QOL and physical functioning between Black and White adults with HCM, revealing that Black participants reported worse QOL scores, while both groups had similar exercise capacities overall.
  • - Findings highlight the need for further research into the health and well-being of Black individuals with HCM, especially since female gender negatively impacted QOL and functioning across both groups.
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Aims: Cardiovascular disease (CVD) is a leading cause of increased disability from work worldwide. Chronic stress including work-related stressors influences cardiovascular health. The purpose of this study was to assess stress levels amongst workers with CVD.

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Article Synopsis
  • * A study analyzed 70 adults with HCM who tested positive for COVID-19 over the course of a year, finding common symptoms like fever and cough, and revealing that most patients recovered without medical intervention.
  • * Key findings included a case fatality rate of 2.9% among the patients, with obesity and other existing health conditions appearing more significant in driving severe outcomes than HCM itself.
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Use of automated external defibrillators (AEDs) in out-of-hospital cardiac arrests (OHCAs) improve survival. Professional health organizations recommend that AEDs be available in crowded places, including schools but currently only 18 US states require them. Sudden cardiac arrest (SCA) research in the school-age population has largely focused on school sub-groups, leaving out the majority of US students and adults working in schools.

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Background There is limited research on hypertrophic cardiomyopathy (HCM), which is the most common inherited cardiac disorder, in diverse populations, including Black individuals. Current literature lacks comprehensive data on HCM disease expression, comorbidities, and outcomes in this historically disadvantaged group. The purpose of this study was to examine structural HCM characteristics, comorbidities, and outcomes in a Black and White cohort with HCM.

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Background: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disorder globally, affecting 0.2% to 0.5% of individuals.

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Clinical spectrum of hypertrophic cardiomyopathy (HC) has been expanded to include patients with mild or no thickening of the left ventricle (LV), who nevertheless have outflow tract obstruction at rest or after exercise, due to systolic anterior motion (SAM) and ventricular septal contact, with mitral valve elongation and papillary muscles anomalies. Apical ballooning mimicking a takotsubo syndrome (TS) wall motion pattern can occur in HC with mild septal thickening when latent obstruction becomes unrelenting. To define the prevalence of anatomic abnormalities characteristic of HC in patients diagnosed with TS, we analyzed echocardiograms of 44 unselected TS patients, age 67±12 years, 95% women including studies performed before the event (n = 11, median 515 days) and after recovery of left ventricular function (n = 33, median 92 days, interquartile range = 29 to 327) and compared the findings to 60 age and sexed matched controls.

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Background: Acute left ventricular (LV) apical ballooning with normal coronary angiography occurs rarely in obstructive hypertrophic cardiomyopathy (OHCM); it may be associated with severe hemodynamic instability.

Methods, Results: We searched for acute LV ballooning with apical hypokinesia/akinesia in databases of two HCM treatment programs. Diagnosis of OHCM was made by conventional criteria of LV hypertrophy in the absence of a clinical cause for hypertrophy and mitral-septal contact.

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Installation of automated external defibrillators (AEDs) in schools has been associated with increased survival after sudden cardiac arrest. An authoritative academic research database was interrogated to identify all current state statutes pertaining to AEDs in schools. As of February 2016, 17 of 50 U.

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Background: In patients with hypertrophic cardiomyopathy (HCM), akinetic apical aneurysms are associated with ventricular tachycardia, heart failure, apical thrombus, and mortality. The cause of apical aneurysms remains unresolved, and there is controversy about prevalence and significance of mid-left ventricular (LV) obstruction, often present in these patients. The aim of this study was to test the hypothesis that low velocities in patients with aneurysms are due to near complete cessation of mid-LV flow, characteristically marked by a Doppler signal void.

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Background: Anatomic features of obstructive hypertrophic cardiomyopathy are septal hypertrophy, elongated mitral leaflets, and anterior displacement of the papillary muscles. In addition to extended myectomy, the resect-plicate-release operation adds horizontal plication of the anterior mitral leaflet (AML) and release of the anterolateral papillary muscle (APM) in selected patients. The aim of this study was to test the hypotheses that (1) preoperative findings would be associated with procedures applied, (2) anatomic corrections would be observable postoperatively, and (3) there would be consistently good physiologic outcomes.

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