American journal of preventive cardiology最新文献

{"title":"Representation is Prevention: Closing the Sex Gap in Novel Cardiovascular Clinical Trials","authors":"Nishant P. Shah , Martha Gulati","doi":"10.1016/j.ajpc.2026.101420","DOIUrl":"10.1016/j.ajpc.2026.101420","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"25 ","pages":"Article 101420"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of peripheral artery disease (PAD) on risk of major adverse cardiovascular events (MACE) in patients with type 2 diabetes","authors":"James Amamoo ,&nbsp;Lin Xie ,&nbsp;Andrea Steffens ,&nbsp;Erin Buysman ,&nbsp;Caroline Swift ,&nbsp;Sherif Mehanna ,&nbsp;Noelle N. Gronroos ,&nbsp;Marc P. Bonaca","doi":"10.1016/j.ajpc.2025.101397","DOIUrl":"10.1016/j.ajpc.2025.101397","url":null,"abstract":"<div><h3>Background</h3><div>As of 2021, global estimates show that 536.6 million adults aged 20 to 79 years are living with type 2 diabetes (T2D), and the prevalence of T2D is projected to increase to about 783 million individuals by 2045. Peripheral artery disease (PAD), which is caused by atherosclerosis of the extremities (most commonly lower limbs) leading to the narrowing of blood vessels, is a major risk factor for lower extremity amputation and is a common comorbidity of diabetes. Patients with both T2D and PAD often have advanced systemic vascular disease, which may involve other vascular territories, such as the coronary and cerebral arteries. However, PAD is underdiagnosed and underrecognized, particularly at earlier stages of the disease.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used real-world data to characterize the vascular risk profile of patients with T2D with PAD and those with T2D without other evidence of atherosclerotic cardiovascular disease, including irreversible harm events of the heart, limbs, and brain.</div></div><div><h3>Results</h3><div>Patients with T2D and PAD had a higher risk of major adverse cardiovascular events (MACE) and major adverse limb events (MALE) compared with those without PAD. Ankle-brachial index and duplex ultrasound were the most commonly used assessments during diagnostic evaluation for PAD.</div></div><div><h3>Conclusions</h3><div>Among patients with T2D, presence of PAD was associated with an increased risk of all evaluated outcomes. These findings highlight the significant vascular burden of PAD among patients with T2D.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"25 ","pages":"Article 101397"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The subclinical atherosclerosis clinic: Operationalizing opportunistic detection into cardiovascular preventive care","authors":"Michael J. Blaha","doi":"10.1016/j.ajpc.2026.101446","DOIUrl":"10.1016/j.ajpc.2026.101446","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"25 ","pages":"Article 101446"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of the 2025 AHA/ACC high blood pressure guidelines on the initiation and intensification of blood pressure-lowering medications among US adults","authors":"Ahmed Sayed ,&nbsp;Eric D. Peterson ,&nbsp;Ann Marie Navar","doi":"10.1016/j.ajpc.2025.101400","DOIUrl":"10.1016/j.ajpc.2025.101400","url":null,"abstract":"<div><h3>Background</h3><div>Recent updates to the American College of Cardiology (ACC) and American Heart Association (AHA) guidelines for high blood pressure (BP) changed the risk calculator recommended, lowered the preferred treatment target, and expanded treatment recommendations for lower risk adults. We sought to quantify the clinical implications of these change among US adults.</div></div><div><h3>Methods</h3><div>Using data from the 2015–2020 National Health and Nutrition Examination Survey (NHANES), we estimated the proportion and number of US adults aged 20 years or older who were eligible for initiation or intensification of pharmacological anti-hypertensive medications under the 2017 vs the 2025 guidelines.</div></div><div><h3>Results</h3><div>Among US adults ≥20 years not being currently treated for hypertension (<em>N</em> = 180.0 million), using the 2017 Guideline, 18.7 % (33.6 million) were eligible for initiation of pharmacological anti-hypertensive therapy. In contrast, the 2025 Guideline would treat 18.4 % (33.2 million) with upfront medication while an additional 10.8 % (19.4 million) would be considered for medications if lifestyle modification proves insufficient. Increases in treatment eligibility were most pronounced among younger adults age 30–60 and those with obesity. Among adults currently being treated for hypertension (<em>N</em> = 58.0 million), most (59.8 %; 34.6 million) did not meet the recommended goal of a BP &lt;130/80. An additional 17.6 % (5.6 million) are newly eligible for treatment intensification if pursuing the preferred BP target of &lt;120/80.</div></div><div><h3>Conclusion</h3><div>The new 2025 AHA/ACC Hypertension Guidelines potentially expands the number of adults eligible for initiation of antihypertensives, particularly in persons who are young and/or obese, and markedly expands number eligible for intensification.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"25 ","pages":"Article 101400"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lp(a) across the spectrum of disease in a Spanish population: A watchword for more answers and access","authors":"Jared A. Spitz ,&nbsp;Mahmoud Al Rifai","doi":"10.1016/j.ajpc.2026.101441","DOIUrl":"10.1016/j.ajpc.2026.101441","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"25 ","pages":"Article 101441"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real world utilization of coronary artery calcium scoring in a large academic health system","authors":"Peter A. Glynn ,&nbsp;Reniell Iniguez ,&nbsp;Samuel Luebbe ,&nbsp;Philip Greenland","doi":"10.1016/j.ajpc.2026.101459","DOIUrl":"10.1016/j.ajpc.2026.101459","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"25 ","pages":"Article 101459"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing existing test results to improve primary prevention in patients with subclinical coronary atherosclerosis: The USE-IT study","authors":"Mateo Iwanowski ,&nbsp;Carolina C. Pappalettere ,&nbsp;Joan Vime-Jubany ,&nbsp;Alina Velescu ,&nbsp;Lidia Marcos ,&nbsp;Roberto Chalela ,&nbsp;Flavio Zuccarino ,&nbsp;Jose Maria Maiques ,&nbsp;Helena Tizon-Marcos ,&nbsp;Beatriz Vaquerizo-Montilla ,&nbsp;Sonia Ruiz-Bustillo ,&nbsp;Benjamin Casteigt ,&nbsp;Nuria Rodriguez ,&nbsp;Diego Rodriguez-Chiaradia ,&nbsp;Jaume Marrugat ,&nbsp;Miguel Cainzos-Achirica","doi":"10.1016/j.ajpc.2025.101396","DOIUrl":"10.1016/j.ajpc.2025.101396","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;The systematic referral of patients with incidentally detected subclinical coronary atherosclerosis to a specialized prevention clinic is an innovative strategy in Europe. The USE-IT study aims to assess its impact in terms of 12-month change in low-density lipoprotein cholesterol (LDL-C) levels.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Prospective, non-randomized study (&lt;em&gt;N&lt;/em&gt; = 291). Patients were referred after incidental detection of subclinical coronary atherosclerosis through a clinically indicated cardiac/coronary computed tomography (CT) (29%), invasive coronary angiography (24%), or chest CT (44%). Cardiovascular risk-reduction interventions were implemented following relevant guidelines.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Mean age was 66 years, 43% women. The prevalence of traditional risk factors was high, 38% of the patients had atherosclerosis in ≥3 coronary arteries, 33% had at least one stenosis ≥50% and 60% had an elevated CAC score (≥300 UA). Mean baseline LDL-C levels were 108 mg/dL (SD 37), 16% had LDL-C &lt;70mg/dL, and 6% had LDL-C &lt;55mg/dL. At 12 months there were marked increases in the use of high-intensity statins (28% vs 78%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001) and ezetimibe (7% vs 69%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001). At the end of follow-up, mean LDL-C levels were 61 mg/dL (&lt;em&gt;p&lt;/em&gt; &lt; 0.001), 76% participants had LDL-C &lt;70mg/dL (&lt;em&gt;p&lt;/em&gt; &lt; 0.001), and 49% &lt;55mg/dL (&lt;em&gt;p&lt;/em&gt; &lt; 0.001). Among smokers, 15% of them successfully quit tobacco during follow-up, and obesity prevalence went from 34% to 29% (&lt;em&gt;p&lt;/em&gt; = 0.002).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Systematic referral of patients with incidentally detected subclinical coronary atherosclerosis to a specialized prevention clinic and subsequent guideline-based risk management provides an innovative opportunity to achieve large, guideline-recommended reductions in LDL-C and enhance the management of other risk factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Lay Summary&lt;/h3&gt;&lt;div&gt;This research study was performed to assess whether a specialized, dedicated cardiovascular prevention clinic could help lower the levels of “bad” cholesterol (LDL-C) and improve the management of other cardiovascular risk factors in people who, despite feeling well, already have fatty plaques building up in their heart’s arteries. Such men and women are at increased risk of heart attacks and strokes, however, so far they had received very limited attention in prevention clinics and primary care settings, particularly when those plaques are identified incidentally. Reducing their levels of bad cholesterol can be very helpful reducing their risk of a subsequent heart attack. Specifically, at twelve months, we observed:&lt;/div&gt;&lt;div&gt;• Large reductions in the levels of bad cholesterol compared to the levels that those same patients had at the beginning of follow-up (i.e., before being referred to the prevention clinic), paired with enhanced use of guideline-recommended lipid-lowering pha","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"25 ","pages":"Article 101396"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in lipoprotein(a) testing and impact on clinical care: A contemporary systemwide analysis","authors":"Mahima Mangla ,&nbsp;Tia Bimal ,&nbsp;Ehimare Akhabue ,&nbsp;Xueqi Huang ,&nbsp;Marlys Koschinsky ,&nbsp;Georgeta Vaidean ,&nbsp;James Donnelly ,&nbsp;Tanesh Ayyalu ,&nbsp;Guy Mintz ,&nbsp;Eugenia Gianos","doi":"10.1016/j.ajpc.2025.101402","DOIUrl":"10.1016/j.ajpc.2025.101402","url":null,"abstract":"<div><h3>Aims</h3><div>Elevated lipoprotein(a) [Lp(a)] is an independent, causal risk factor for atherosclerotic cardiovascular disease (ASCVD), yet testing remains low. As our health system has expanded its efforts to increase Lp(a) awareness, we evaluated testing rates and their impact on care.</div></div><div><h3>Methods</h3><div>Lp(a) testing rates were collected through electronic health record queries between 1/1/2022 to 12/31/2024. Baseline demographics, ASCVD status, Lp(a) testing rates by specialty, lipid lowering therapy (LLT) prescriptions and number of cardiology referrals were collected.</div></div><div><h3>Results</h3><div>450,412 outpatients had ≥1 lipid panel order and 3.7 % (<em>N</em> = 16,476) had Lp(a) tested. Of those who had Lp(a) measured, 50.5 % were female and 61.8 % identified as White. Most Lp(a) orders were for patients without established ASCVD (68.9 %). Between 2022–2024, Lp(a) orders increased from 3052 to 8425. Most orders were placed by cardiologists, although their proportion decreased (75.5 % in 2022 vs. 62.9 % in 2024) as orders from other specialties increased. We found 67.0 % of patients with normal Lp(a) (&lt;75 nmol/L) levels, 12.2 % with intermediate risk (75 ≥ Lp(a) &lt; 125 nmol/L), 11.3 % with high risk (125 ≥ Lp(a) &lt; 200 nmol/L) and 9.4 % with very high-risk values (≥200 nmol/L). Across the same Lp(a) categories, LLT initiation/escalation rates were 12.8 %, 17.5 %, 20.2 % and 22.1 %. There was a positive association between LLT initiation/escalation and Lp(a) range (<em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>While Lp(a) testing was low, it increased substantially over time. High risk Lp(a) levels were found irrespective of ASCVD status and were associated with more aggressive treatment. Systematic strategies to increase Lp(a) awareness and testing are warranted to mitigate cardiovascular risk.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"25 ","pages":"Article 101402"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying population-level antihypertensive treatment eligibility under the 2025 AHA/ACC hypertension guideline: What has changed — And where the greatest opportunity remains","authors":"Huanhuan Yang ,&nbsp;Yuan Lu","doi":"10.1016/j.ajpc.2026.101428","DOIUrl":"10.1016/j.ajpc.2026.101428","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"25 ","pages":"Article 101428"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population estimates, trends, characteristics and prognostic outcomes of cardiovascular-kidney-liver-metabolic health: A population-based study","authors":"Yiming Chen ,&nbsp;Haryo Raden Himan ,&nbsp;Yalkin Yazicioglu ,&nbsp;Rachel Goh ,&nbsp;Yip Han Chin ,&nbsp;Bryan Chong ,&nbsp;Srinithy Nagarajan ,&nbsp;Martin Tze Wah Kueh ,&nbsp;Jiong-Wei Wang ,&nbsp;Mark M Muthiah ,&nbsp;Xin Zhou ,&nbsp;Mark Y Chan ,&nbsp;Anurag Mehta ,&nbsp;Mamas A Mamas ,&nbsp;Muhammad Shahzeb Khan ,&nbsp;Nicholas WS Chew","doi":"10.1016/j.ajpc.2025.101405","DOIUrl":"10.1016/j.ajpc.2025.101405","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular-kidney-liver-metabolic (CKLM) diseases constitute the presence of MASLD, T2D, CKD, obesity and/or CVD, that often co-exist and synergistically increase cardiovascular risk. However, the prevalence, extent and outcomes of the CKLM burden remain poorly understood.</div></div><div><h3>Methods</h3><div>This population-based study utilised National Health and Nutrition Examination Survey (NHANES) 2007–2018 database, examining individuals’ number (0–4) and permutations of CKLM diseases, namely: type 2 diabetes (T2D), obesity, metabolic dysfunction-associated steatotic liver disease (MASLD), chronic kidney disease (CKD). The primary outcome was all-cause mortality. Cox regression models were constructed to evaluate the relationship between CKLM phenotypes and all-cause mortality, adjusting for age, sex, race, socioeconomic status, and physical activity.</div></div><div><h3>Results</h3><div>The weighted cohort represented 97.8 million US adults (mean age 47.7 ± 16.7 years). 54.16% of the cohort had ≥1 CKLM diseases. From 2007 to 2018, the proportion of individuals with ≥2 CKLM diseases increased from 32.4% to 55.6% of the population, with the largest increase in proportion of individuals with 4 diseases. The most common CKLM phenotype was MASLD-obesity (23.0%), followed by MASLD-obesity-T2D (5.1%). The highest mortality rates were observed in individuals with 4 CKLM diseases (21.4%), followed by 3 diseases (12.2%). Cox regression revealed that 4 diseases predicted the highest mortality risk (aHR 2.24, 95%CI: 1.66–3.02, <em>p</em> &lt; 0.001), followed by 3 diseases (aHR 1.52, 95%CI: 1.25–1.85, <em>p</em> &lt; 0.001). The MASLD-T2D-CKD phenotype (aHR 3.13, 95%CI: 1.80–5.42, <em>p</em> &lt; 0.001) and T2D-CKD phenotype (aHR 3.26, 95%CI: 2.33–4.55, <em>p</em> &lt; 0.001) predicted the highest mortality risk.</div></div><div><h3>Conclusions</h3><div>The CKLM multimorbidity burden is rising in the US population. Higher CKLM burden (≥3 CKLM diseases) and CKD-centric phenotypes (MASLD-T2D-CKD or T2D-CKD) independently predict the highest mortality risk.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"25 ","pages":"Article 101405"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}