Category Archives: Heart disease
David S. Jones, MD, PhD, is the A. Bernard Ackerman Professor of the Culture of Medicine at Harvard Medical School's Department of Global Health & Social Medicine. He is a 2007 recipient of a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research, and the author of Broken Hearts: The Tangled History of Cardiac Care.
Every day, all over America, people visit their doctors with chest pain and other symptoms of coronary artery disease. Each year, more than a million of them choose to undergo bypass surgery or angioplasty. Are these decisions good ones? Even though modern medicine has committed itself to an ideal of evidence-based medicine, with its clinical trials, meta-analyses, and practice guidelines, the answer is not always clear. By looking closely at the history of these procedures, it is possible to understand some of the reasons why this is the case. With support from a RWJF Investigator Award in Health Policy Research, I looked at three specific questions: the role of evidence and intuition in medical decisions, the reasons why it can be so difficult to determine the risks of medical interventions, and the problem of “unwarranted variation” in medical practice.
Aneesah Gilbert participated in the "Change My Steps Challenge,” organized by Robert Wood Johnson Foundation Clinical Scholar Chileshe Nkonde-Price, MD, to address the fact that heart disease rates are increasing among Black women.
At age 26, I came to the realization that I wasn’t getting any younger. With this being so obvious, you’re probably sarcastically wondering: How did she figure that out? Well, I will tell you the story. One winter morning I awakened to my left arm so numb I thought it was not my own. My arm was numb because I’d slept on it all night (I had slept this way from birth up until this point).
I visited my doctor and discussed this tragedy, he laughed as he does normally to all my hypochondriac symptoms. After he had a good chuckle he told me that because of my weight (all 210 lbs. of me), the blood flow was being cut off in my arm and caused it to go numb. He then told me that my weight could cause a number of issues I did not want to experience at 26 years of age. I went home, grabbed my computer, typed in the search bar ‘DIET’ and began my stretch of unsuccessful attempts at losing weight. I came up with this personal fact: There is no diet or exercise that will work for me if I am not willing to work for it.
Health Care Providers Shouldn’t Hit the Snooze Button When It Comes to Asking Their Patients About Sleep
Aric A. Prather, PhD, is an assistant professor of psychiatry at the University of California, San Francisco and an alumnus of the Robert Wood Johnson Foundation Health & Society Scholars program.
Heart disease accounts for one in every four deaths in the United States—600,000 deaths per year. Prevention and treatment regimens for heart disease include important changes in lifestyle, centering primarily on alterations to diet and physical activity. Interestingly, sleep is rarely part of this discussion.
This is alarming given the growing evidence from large-scale population studies and laboratory-based experiments that demonstrate that sleep plays a larger role in heart health than originally appreciated by the medical community. For example, in a 2003 study, women with established coronary heart disease who reported poor sleep quality were more than 2.5 times more likely to go on to experience a cardiac event than good quality sleepers. Nevertheless, when it comes to asking patients about their sleep, health care providers routinely hit the snooze button.
In an effort to raise the profile of sleep as a risk factor for cardiovascular disease (CVD), my work has focused on investigating the links between sleep and the biological pathways implicated in CVD development and progression. Said another way, much of my research focuses on how sleep disturbance gets under the skin.