Items in AFP with MESH term: Coronary Disease
ABSTRACT: Menopause is the permanent cessation of menstruation resulting from the loss of ovarian and follicular activity. It usually occurs when women reach their early 50s. Vasomotor symptoms and vaginal dryness are frequently reported during menopause. Estrogen is the most effective treatment for management of hot flashes and night sweats. Local estrogen is preferred for vulvovaginal symptoms because of its excellent therapeutic response. Bone mineral density screening should be performed in all women older than 65 years, and should begin sooner in women with additional risk factors for osteoporotic fractures. Adequate intake of calcium and vitamin D should be encouraged for all postmenopausal women to reduce bone loss. Coronary artery disease is the leading cause of death in women. Postmenopausal women should be counseled regarding lifestyle modification, including smoking cessation and regular physical activity. All women should receive periodic measurement of blood pressure and lipids. Appropriate pharmacotherapy should be initiated when indicated. Women should receive breast cancer screening every one to two years beginning at age 40, as well as colorectal cancer screening beginning at age 50. Women younger than 65 years who are sexually active and have a cervix should receive routine cervical cancer screening with Papanicolaou smear. Recommended immunizations for menopausal women include an annual influenza vaccine, a tetanus and diphtheria toxoid booster every 10 years, and a one-time pneumococcal vaccine after age 65 years.
Dietary Fatty Acids - Article
ABSTRACT: Fatty acids can be divided into four general categories: saturated, monounsaturated, polyunsaturated, and trans fats. Saturated fatty acids and trans fats are associated with an increased risk of coronary heart disease. Monounsaturated fatty acids and polyunsaturated fatty acids are associated with a decreased risk of coronary heart disease, although these associations are not uniformly supported in the literature. Omega-3 fatty acids, which are a type of polyunsaturated fatty acid, have been studied as potential therapy for a variety of medical conditions because of their suspected anti-inflammatory properties. Omega-3 fatty acids have also been shown to provide some benefit to patients with cystic fibrosis, and may have a protective effect against dementia. Physicians should counsel patients about the importance of avoiding hydrogenated oils and foods containing trans fats because of their association with coronary heart disease in observational studies.
Cardiac Rehabilitation - Article
ABSTRACT: An estimated 80 million (nearly one in three) Americans have cardiovascular disease, which is the leading cause of morbidity and mortality worldwide. In the United States alone, more than 850,000 deaths are attributed annually to cardiovascular disease, and more than 8 million Americans have had a heart attack. Nearly 7 million cardiovascular procedures are performed annually in U.S. hospitals. Cardiac rehabilitation is a comprehensive program of patient evaluation, risk factor reduction (e.g., lipid control, weight management), physical activity, and longitudinal care designed to reduce the effects of cardiovascular disease, and is an effective means of mitigating disease and disability. Family physicians incorporate many of the fundamental principles of comprehensive cardiac rehabilitation into their daily practices. However, the use of dedicated cardiac rehabilitation programs serves to further reinforce the principles of nutrition, physical activity, risk factor reduction, and wellness. Cardiac rehabilitation services are underused in the United States, even though there is evidence that structured programs improve quality of life and reduce mortality for patients with coronary artery disease and other select forms of cardiovascular disease.
Dietary Fat: Quantity and Quality - Editorials
ABSTRACT: Few older adults in the United States achieve the minimum recommended amount of physical activity. Lack of physical activity contributes to many chronic diseases that occur in older adults, including heart disease, stroke, diabetes mellitus, lung disease, Alzheimer disease, hypertension, and cancer. Lack of physical activity, combined with poor dietary habits, has also contributed to increased obesity in older persons. Regular exercise and increased aerobic fitness are associated with a decrease in all-cause mortality and morbidity, and are proven to reduce disease and disability, and improve quality of life in older persons. In 2008, The U.S. Department of Health and Human Services released guidelines to provide information and guidance on the amount of physical activity recommended to maintain health and fitness. For substantial health benefits, the guidelines recommend that most older adults participate in at least 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalent combination of each per week. Older adults should also engage in strengthening activities that involve all major muscle groups at least two days a week. Those at risk of falling should add exercises that help maintain or improve balance. Generally healthy adults without chronic health conditions do not need to consult with a physician before starting an exercise regimen.
Screening for Lipid Disorders in Adults: Recommendations and Rationale - U.S. Preventive Services Task Force
Improvment in Current Approaches to Lipid Lowering - Editorials
Should We Use Multiple Risk Factor Interventions for the Primary Prevention of Coronary Heart Disease? - Cochrane for Clinicians
A Common Sense Approach to Perioperative Evaluation - Editorials
AHA Releases Scientific Statement on Cardiovascular Health in Childhood - Practice Guidelines