Category Archives: Heart disease

Apr 23 2014
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Saving Limbs, Saving Lives: Harold Amos Alum Honored for Research into Peripheral Arterial Disease

Ayotunde Dokun, MD, PHD, is an assistant professor of medicine at the University of Virginia Health System in Charlottesville, VA. He is also an alumnus of the Harold Amos Medical Faculty Development program (2009-2013), an initiative funded by the Robert Wood Johnson Foundation (RWJF) that supports faculty in academic medicine and dentistry who are from historically disadvantaged backgrounds.

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Human Capital Blog: Congratulations on your recent award from the American Heart Association! What does it mean for your work and for your career?

Ayotunde Dokun: It is a great honor to be recognized by the Peripheral Vascular Council of the American Heart Association with an early stage investigator award. For my work, it means the society recognizes the significance of what I have contributed to the field thus far. For my career, it’s a stepping stone hopefully to a brighter future as physician scientist.

HCB: The award recognizes the research and background of outstanding early-career researchers in the field of peripheral vascular disease. Can you describe your current work in this area?

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Mar 28 2014
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Merging Social Media with Art to Improve Cardiovascular Health

Raina Merchant, MD, MSHP, is a Robert Wood Johnson Foundation (RWJF) Clinical Scholars program alumna and an assistant professor at the University of Pennsylvania Department of Emergency Medicine. She recently launched a venture that challenges citizen designers to make automated external defibrillators (AEDs) more visible.

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Human Capital Blog: Congratulations on the launch of your new research venture at the University of Pennsylvania. Can you describe it?

Raina Merchant: In June, 2013, we launched the Social Media and Health Innovation Lab. It’s a multidisciplinary group of physicians, computer scientists, demographers, communications specialists, policy scientists, designers, and more.

The group has expertise in crowdsourcing, app development, Twitter analyses, Facebook analyses, Foursquare engagement, Gigwalk analyses, Yelp analyses, and gaming. The Lab disseminates multidisciplinary research at the intersection of social media, mobile technology, and health—and uses digital tools to improve individual and population health behaviors and outcomes. One of the Lab’s recent projects merges social media with art to improve cardiovascular health.

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HCB: How does your current project build off of your previous one, which located and digitally mapped AEDs in Philadelphia?

Merchant: Our initial project, the MyHeartMap Challenge, used crowdsourcing and social media to locate life-saving AEDs in Philadelphia. Through this project we located and documented more than 1,400 AEDs in Philadelphia and created an AED map. Through this effort we learned how difficult it is for AEDs to be identified when they are suddenly needed. AEDs are often hidden in plain sight.

To explore ways to make AEDs more visible, we launched the Defibrillator Design Challenge. Specifically, it’s an online crowdsourcing contest for individuals to create designs around the space of AEDs so they are more noticeable. We’ve allotted more than $1,000 for the winner with the most votes and social media “shares.”

Through this work we hope to accomplish two things: First, we want to make AEDs more visible so that people will know where they are when needed; and second, we want to empower people to look for AEDs in public places and notice them.

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Feb 25 2014
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New Hope for Treatment of Rare Pediatric Disease

About 19 in every 100,000 American children under the age of five suffers from an inflammatory illness called Kawasaki Disease (KD) that can cause irreversible damage to the heart. If diagnosed early, it can usually be treated effectively, and children can be returned to health in just a few days. But between 10 and 20 percent of treated patients suffer from a persistent fever, or one that recurs after treatment, and they are at elevated risk of developing coronary artery aneurysms. A new study, led by Robert Wood Johnson Foundation (RWJF) Harold Amos Medical Faculty Development Program Scholar Adriana H. Tremoulet, MD, MAS, and published yesterday in The Lancet, offers new hope for patients with KD.

The symptoms of KD include prolonged fever associated with a rash, swollen neck glands, red eyes, swollen red lips, a condition physicians call strawberry tongue, and swollen hands and feet with peeling skin. Current treatment is infusion of intravenous immunoglobulin (IVIG) and aspirin. The IVIG carries the pooled antibodies from the blood plasma of more than 100,000 donors, and in the KD patient, it decreases the inflammation that causes heart damage. The treatment usually works, but some patients’ IVIG-resistance puts them at greater risk and in need of further treatment.

Tremoulet, a pediatric infectious disease specialist at Rady Children’s Hospital in San Diego, conducted a Phase III trial in which a synthetic antibody called infliximab was added to the standard IVIG and aspirin treatment. While the protocol did not affect the patients’ resistance, it had important positive results. “In our study,” Tremoulet said, “we demonstrated that a single dose of infliximab is safe in children with Kawasaki Disease and that this treatment reduced the inflammation in the body overall as well as in the arteries of the heart faster than just using standard treatment with intravenous immunoglobulin.”

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Feb 5 2014
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Be Heart Smart: Addressing the High Burden of Cardiovascular Disease Among African-American Women

Nadia Winston, MSPH, is a graduate student at the University of Illinois at Chicago, School of Nursing, pursuing dual nurse practitioner studies in family practice and occupational health. She has a master of science in public health degree from Meharry Medical College and is a former scholar with the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College. This post is part of the “Health Care in 2014” series.

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Cardiovascular disease is the number one killer of African American women. It has become imperative for the nation to take back the reins of its health status and educate the public about this threat. The statistics are alarming. Black women are twice as likely to suffer from cardiovascular disease as women of other ethnicities. And according to the American Heart Association, cardiovascular disease kills nearly 50,000 African-American women annually. The reason for this disparity can be attributed to a lack of health knowledge, being overweight or obese, and lack of physical activity. Early intervention and action has been identified as the key to reducing this population’s risk of mortality from cardiovascular disease and related diagnoses.

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Addressing and raising awareness of the health risks associated with cardiovascular diseases for African American women has been quite challenging. Recognizing this issue, Vanessa Jones Briscoe, PhD, MSN, then a Health Policy Associate at the Center for Health Policy at Meharry Medical College, developed and implemented a culturally appropriate health education program to educate minority populations about unhealthy lifestyles. It is called the “Be Heart Smart” program.

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Sep 20 2013
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A Closer Look at the Quality of Cardiac Care in the United States

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.

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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.

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Aug 6 2013
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How the 'Change My Steps Challenge' Changed Me

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.

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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).

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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.

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Jul 12 2013
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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.

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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. 

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