Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-13 (of 13 Records) |
Query Trace: Angell S[original query] |
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The American Heart Association 2030 Impact Goal: A Presidential Advisory From the American Heart Association
Angell SY , McConnell MV , Anderson CAM , Bibbins-Domingo K , Boyle DS , Capewell S , Ezzati M , de Ferranti S , Gaskin DJ , Goetzel RZ , Huffman MD , Jones M , Khan YM , Kim S , Kumanyika SK , McCray AT , Merritt RK , Milstein B , Mozaffarian D , Norris T , Roth GA , Sacco RL , Saucedo JF , Shay CM , Siedzik D , Saha S , Warner JJ . Circulation 2020 141 (9) e120-e138 Each decade, the American Heart Association (AHA) develops an Impact Goal to guide its overall strategic direction and investments in its research, quality improvement, advocacy, and public health programs. Guided by the AHA's new Mission Statement, to be a relentless force for a world of longer, healthier lives, the 2030 Impact Goal is anchored in an understanding that to achieve cardiovascular health for all, the AHA must include a broader vision of health and well-being and emphasize health equity. In the next decade, by 2030, the AHA will strive to equitably increase healthy life expectancy beyond current projections, with global and local collaborators, from 66 years of age to at least 68 years of age across the United States and from 64 years of age to at least 67 years of age worldwide. The AHA commits to developing additional targets for equity and well-being to accompany this overarching Impact Goal. To attain the 2030 Impact Goal, we recommend a thoughtful evaluation of interventions available to the public, patients, providers, healthcare delivery systems, communities, policy makers, and legislators. This presidential advisory summarizes the task force's main considerations in determining the 2030 Impact Goal and the metrics to monitor progress. It describes the aspiration that these goals will be achieved by working with a diverse community of volunteers, patients, scientists, healthcare professionals, and partner organizations needed to ensure success. |
Risk Factors for SARS-CoV-2 Infection Among US Healthcare Personnel, May-December 2020.
Chea N , Brown CJ , Eure T , Ramirez RA , Blazek G , Penna AR , Li R , Czaja CA , Johnston H , Barter D , Miller BF , Angell K , Marshall KE , Fell A , Lovett S , Lim S , Lynfield R , Davis SS , Phipps EC , Sievers M , Dumyati G , Concannon C , McCullough K , Woods A , Seshadri S , Myers C , Pierce R , Ocampo VLS , Guzman-Cottrill JA , Escutia G , Samper M , Thompson ND , Magill SS , Grigg CT . Emerg Infect Dis 2022 28 (1) 95-103 To determine risk factors for coronavirus disease (COVID-19) among US healthcare personnel (HCP), we conducted a case-control analysis. We collected data about activities outside the workplace and COVID-19 patient care activities from HCP with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test results (cases) and from HCP with negative test results (controls) in healthcare facilities in 5 US states. We used conditional logistic regression to calculate adjusted matched odds ratios and 95% CIs for exposures. Among 345 cases and 622 controls, factors associated with risk were having close contact with persons with COVID-19 outside the workplace, having close contact with COVID-19 patients in the workplace, and assisting COVID-19 patients with activities of daily living. Protecting HCP from COVID-19 may require interventions that reduce their exposures outside the workplace and improve their ability to more safely assist COVID-19 patients with activities of daily living. |
Practices and activities among healthcare personnel with severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection working in different healthcare settings-ten Emerging Infections Program sites, April-November 2020.
Chea N , Eure T , Penna AR , Brown CJ , Nadle J , Godine D , Frank L , Czaja CA , Johnston H , Barter D , Miller BF , Angell K , Marshall K , Meek J , Brackney M , Carswell S , Thomas S , Wilson LE , Perlmutter R , Marceaux-Galli K , Fell A , Lim S , Lynfield R , Davis SS , Phipps EC , Sievers M , Dumyati G , Concannon C , McCullough K , Woods A , Seshadri S , Myers C , Pierce R , Ocampo VLS , Guzman-Cottrill JA , Escutia G , Samper M , Pena SA , Adre C , Groenewold M , Thompson ND , Magill SS . Infect Control Hosp Epidemiol 2021 43 (8) 1-17 Healthcare personnel with SARS-CoV-2 infection were interviewed to describe activities and practices in and outside the workplace. Among 2,625 healthcare personnel, workplace-related factors that may increase infection risk were more common among nursing home personnel than hospital personnel, whereas selected factors outside the workplace were more common among hospital personnel. |
Mapping stages, barriers and facilitators to the implementation of HEARTS in the Americas initiative in 12 countries: A qualitative study
Giraldo GP , Joseph KT , Angell SY , Campbell NRC , Connell K , DiPette DJ , Escobar MC , Valdés-Gonzalez Y , Jaffe MG , Malcolm T , Maldonado J , Lopez-Jaramillo P , Olsen MH , Ordunez P . J Clin Hypertens (Greenwich) 2021 23 (4) 755-765 The World Health Organization (WHO) Global Hearts Initiative offers technical packages to reduce the burden of cardiovascular diseases through population-wide and targeted health services interventions. The Pan American Health Organization (PAHO) has led implementation of the HEARTS in the Americas Initiative since 2016. The authors mapped the developmental stages, barriers, and facilitators to implementation among the 371 primary health care centers in the participating 12 countries. The authors used the qualitative method of document review to examine cumulative country reports, technical meeting notes, and reports to regional stakeholders. Common implementation barriers include segmentation of health systems, overcoming health care professionals' scope of practice legal restrictions, and lack of health information systems limiting operational evaluation and quality improvement mechanisms. Main implementation facilitators include political support from ministries of health and leading scientific societies, PAHO's role as a regional catalyst to implementation, stakeholder endorsement demonstrated by incorporating HEARTS into official documents, and having a health system oriented to primary health care. Key lessons include the need for political commitment and cultivating on-the-ground leadership to initiate a shift in hypertension care delivery, accompanied by specific progress in the development of standardized treatment protocols and a set of high-quality medicines. By systematizing an implementation strategy to ease integration of interventions into delivery processes, the program strengthened technical leadership and ensured sustainability. These study findings will aid the regional approach by providing a staged planning model that incorporates lessons learned. A systematic approach to implementation will enhance equity, efficiency, scale-up, and sustainability, and ultimately improve population hypertension control. |
Impact of a municipal policy restricting trans fatty acid use in New York City restaurants on serum trans fatty acid levels in adults
Wright M , McKelvey W , Curtis CJ , Thorpe LE , Vesper HW , Kuiper HC , Angell SY . Am J Public Health 2019 109 (4) e1-e3 OBJECTIVES: To estimate the impact of the 2006 policy restricting use of trans fatty acids (TFAs) in New York City restaurants on change in serum TFA concentrations in New York City adults. METHODS: Two cross-sectional population-based New York City Health and Nutrition Examination Surveys conducted in 2004 (n = 212) and 2013-2014 (n = 247) provided estimates of serum TFA exposure and average frequency of weekly restaurant meals. We estimated the geometric mean of the sum of serum TFAs by year and restaurant meal frequency by using linear regression. RESULTS: Among those who ate less than 1 restaurant meal per week, geometric mean of the sum of serum TFAs declined 51.1% (95% confidence interval [CI] = 42.7, 58.3)-from 44.6 (95% CI = 39.7, 50.1) to 21.8 (95% CI = 19.3, 24.5) micromoles per liter. The decline in the geometric mean was greater (P for interaction = .04) among those who ate 4 or more restaurant meals per week: 61.6% (95% CI = 55.8, 66.7) or from 54.6 (95% CI = 49.3, 60.5) to 21.0 (95% CI = 18.9, 23.3) micromoles per liter. CONCLUSIONS: New York City adult serum TFA concentrations declined between 2004 and 2014. The indication of greater decline in serum TFAs among those eating restaurant meals more frequently suggests that the municipal restriction on TFA use was effective in reducing TFA exposure. Public Health Implications. Local policies focused on restaurants can promote nutritional improvements. (Am J Public Health. Published online ahead of print February 21, 2019: e1-e3. doi:10.2105/AJPH.2018.304930). |
A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet Commission on hypertension
Olsen MH , Angell SY , Asma S , Boutouyrie P , Burger D , Chirinos JA , Damasceno A , Delles C , Gimenez-Roqueplo AP , Hering D , Lopez-Jaramillo P , Martinez F , Perkovic V , Rietzschel ER , Schillaci G , Schutte AE , Scuteri A , Sharman JE , Wachtell K , Wang JG . Lancet 2016 388 (10060) 2665-2712 Elevated blood pressure is the strongest modifi able risk | factor for cardiovascular disease worldwide. Despite | extensive knowledge about ways to prevent as well as to | treat hypertension, the global incidence and prevalence | of hypertension and, more importantly, its cardiovascular | complications are not reduced—partly because of | inadequacies in prevention, diagnosis, and control of the | disorder in an ageing world. | The aim of the Lancet Commission on hypertension | is to identify key actions to improve the management of | blood pressure both at the population and the individual | level, and to generate a campaign to adopt the suggested | actions at national levels to reduce the impact of | elevated blood pressure globally. The fi rst task of the | Commission is this report, which briefl y reviews the | available evidence for prevention, identifi cation, and | treatment of elevated blood pressure, hypertension, | and its cardiovascular complications. The report | focuses on how as-yet unsolved issues might be tackled | using approaches with population-wide impact and | new methods for patient evaluation and education in | the broadest sense (some of which are not always | strictly evidence based) to manage blood pressure | worldwide. |
Improved blood pressure control to reduce cardiovascular disease morbidity and mortality: The Standardized Hypertension Treatment and Prevention Project
Patel P , Ordunez P , DiPette D , Escobar MC , Hassell T , Wyss F , Hennis A , Asma S , Angell S . J Clin Hypertens (Greenwich) 2016 18 (12) 1284-1294 Hypertension is the leading remediable risk factor for cardiovascular disease, affecting more than 1 billion people worldwide, and is responsible for more than 10 million preventable deaths globally each year. While hypertension can be successfully diagnosed and treated, only one in seven persons with hypertension have controlled blood pressure. To meet the challenge of improving the control of hypertension, particularly in low- and middle-income countries, the authors developed the Standardized Hypertension Treatment and Prevention Project, which involves a health systems-strengthening approach that advocates for standardized hypertension management using evidence-based interventions. These interventions include the use of standardized treatment protocols, a core set of medications along with improved procurement mechanisms to increase the availability and affordability of these medications, registries for cohort monitoring and evaluation, patient empowerment, team-based care (task shifting), and community engagement. With political will and strong partnerships, this approach provides the groundwork to reduce high blood pressure and cardiovascular disease-related morbidity and mortality. |
Relationships between blood pressure and 24-hour urinary excretion of sodium and potassium by body mass index status in Chinese adults
Yan L , Bi Z , Tang J , Wang L , Yang Q , Guo X , Cogswell ME , Zhang X , Hong Y , Engelgau M , Zhang J , Elliott P , Angell SY , Ma J . J Clin Hypertens (Greenwich) 2015 17 (12) 916-25 This study examined the impact of overweight/obesity on sodium, potassium, and blood pressure associations using the Shandong-Ministry of Health Action on Salt Reduction and Hypertension (SMASH) project baseline survey data. Twenty-four-hour urine samples were collected in 1948 Chinese adults aged 18 to 69 years. The observed associations of sodium, potassium, sodium-potassium ratio, and systolic blood pressure (SBP) were stronger in the overweight/obese population than among those of normal weight. Among overweight/obese respondents, each additional standard deviation (SD) higher of urinary sodium excretion (SD=85 mmol) and potassium excretion (SD=19 mmol) was associated with a 1.31 mm Hg (95% confidence interval, 0.37-2.26) and -1.43 mm Hg (95% confidence interval, -2.23 to -0.63) difference in SBP, and each higher unit in sodium-potassium ratio was associated with a 0.54 mm Hg (95% confidence interval, 0.34-0.75) increase in SBP. The association between sodium, potassium, sodium-potassium ratio, and prevalence of hypertension among overweight/obese patients was similar to that of SBP. Our study indicated that the relationships between BP and both urinary sodium and potassium might be modified by BMI status in Chinese adults. |
A public health approach to global management of hypertension
Angell SY , De Cock KM , Frieden TR . Lancet 2015 385 (9970) 825-7 Non-communicable diseases are responsible for two-thirds of deaths worldwide, with 80% occurring in low-income and middle-income countries (LMICs).1 Cardiovascular disease causes more deaths than any other non-communicable disease, and hypertension is the leading remediable risk factor for cardiovascular disease.2 Hypertension kills an estimated 9·4 million people annually worldwide—about as many as all infectious diseases combined.3 | Hypertension is probably the easiest chronic non-communicable disease to treat, since blood pressure measurement for diagnosis and monitoring is simple, drug regimens can be once daily and inexpensive, and treatments exist that do not need laboratory monitoring. However, hypertension is adequately controlled in only about 13% of people with the disorder worldwide.4 | Although there is some scepticism about the ability of LMICs to implement programmes to treat chronic disorders, antiretroviral treatment for HIV, which is substantially more complex and expensive than treatment for hypertension, has been successfully scaled up to reach at least 37% of HIV-infected people who are eligible for treatment. Most of these patients live in LMICs.5 This experience suggests that rapid expansion of treatment and control of hypertension in LMICs should be achievable. |
The World Health Organization recognizes noncommunicable diseases and raised blood pressure as global health priority for 2025
Cohen DL , Townsend RR , Angell SY , DiPette DJ . J Clin Hypertens (Greenwich) 2014 16 (9) 624 The World Health Organization (WHO) Global Monitoring Framework includes a set of nine voluntary noncommunicable disease goals for 2025.1 It was endorsed by the World Health Assembly in 2013 and includes for the first time a shared target to reduce the prevalence of raised blood pressure (BP; ≥140/90 mm Hg) globally by 25% by 2025. Other related priorities include reducing salt intake by 30% and physical inactivity by 10%. | | Hypertension affects 1 billion people worldwide and one third of adults have the condition. In addition to a significant increase in morbidity and mortality, the economic impact of suboptimal BP control is substantial. Reasons for poor BP control are many, ranging from poor medication adherence as a result of drug cost and complex medication regimens, to an inability to deliver effective treatment because of inadequate patient medical care, initial access, and follow‐up, to complicated treatment algorithms for providers to follow. | | To address these issues, the Centers for Disease Control and Prevention (CDC), Pan American Health Organization, and other major stakeholder organizations are collaborating on the Global Standardized Hypertension Treatment Project.2 The Project aims to standardize and simplify the treatment of hypertension through the development of a framework that is flexible and has worldwide applicability. In Latin America and the Caribbean, regional workshop participants developed a primary core set of medications appropriate for the treatment of most adults with the condition. They include a diuretic (chlorthalidone), angiotensin‐converting enzyme inhibitor (lisinopril), angiotensin receptor blocker (losartan), calcium channel blocker (amlodipine), β‐blocker (bisoprolol), and a mineralocorticoid antagonist (spironolactone). Additional combination pharmacologic regimens were developed as well. Mechanisms to increase the availability and affordability of these medications in the region are also being pursued. |
Deaths ascribed to non-communicable diseases among rural Kenyan adults are proportionately increasing: evidence from a health and demographic surveillance system, 2003-2010
Phillips-Howard PA , Laserson KF , Amek N , Beynon CM , Angell SY , Khagayi S , Byass P , Hamel MJ , van Eijk AM , Zielinski-Gutierrez E , Slutsker L , De Cock KM , Vulule J , Odhiambo FO . PLoS One 2014 9 (11) e114010 BACKGROUND: Non-communicable diseases (NCDs) result in more deaths globally than other causes. Monitoring systems require strengthening to attribute the NCD burden and deaths in low and middle-income countries (LMICs). Data from health and demographic surveillance systems (HDSS) can contribute towards this goal. METHODS AND FINDINGS: Between 2003 and 2010, 15,228 deaths in adults aged 15 years (y) and older were identified retrospectively using the HDSS census and verbal autopsy in rural western Kenya, attributed into broad categories using InterVA-4 computer algorithms; 37% were ascribed to NCDs, 60% to communicable diseases (CDs), 3% to injuries, and <1% maternal causes. Median age at death for NCDs was 66y and 71y for females and males, respectively, with 43% (39% male, 48% female) of NCD deaths occurring prematurely among adults aged below 65y. NCD deaths were mainly attributed to cancers (35%) and cardio-vascular diseases (CVDs; 29%). The proportionate mortality from NCDs rose from 35% in 2003 to 45% in 2010 (chi2 linear trend 93.4; p<0.001). While overall annual mortality rates (MRs) for NCDs fell, cancer-specific MRs rose from 200 to 262 per 100,000 population, mainly due to increasing deaths in adults aged 65y and older, and to respiratory neoplasms in all age groups. The substantial fall in CD MRs resulted in similar MRs for CDs and NCDs among all adult females by 2010. NCD MRs for adults aged 15y to <65y fell from 409 to 183 per 100,000 among females and from 517 to 283 per 100,000 population among males. NCD MRs were higher among males than females aged both below, and at or above, 65y. CONCLUSIONS: NCDs constitute a significant proportion of deaths in rural western Kenya. Evidence of the increasing contribution of NCDs to overall mortality supports international recommendations to introduce or enhance prevention, screening, diagnosis and treatment programmes in LMICs. |
Global health. Global indicators and targets for noncommunicable diseases
Angell SY , Danel I , DeCock KM . Science 2012 337 (6101) 1456-7 In September 2011, the United Nations (UN) convened a High Level Meeting (HLM) of member states to address a largely neglected, global reality: Noncommunicable diseases (NCDs)—including heart disease, stroke, cancer, diabetes, and chronic lung diseases—kill more people than other causes, health and non–health related, and the world is ill-prepared to respond. This was only the second such UN meeting of heads of state focused on a health issue, the first having been on HIV/AIDS in 2001. Without more effective and focused action, the growing burden of NCDs threatens to undermine increasingly interdependent development and economic agendas (1–3). The 2011 meeting ushered in the potential for an orchestrated response, facilitated by a mandate that the World Health Organization (WHO), in consultation with member states, develop a global monitoring framework with key indicators and targets to be achieved by 2025. | The task is to be completed by the end of 2012 (1). Only one global voluntary indicator with a target has received formal member-state endorsement thus far: reduce the probability of premature mortality from NCDs by 25% by 2025. Another 10 indicators with targets, and 9 indicators without targets, are proposed and under development (2), with the deadline just months away. |
Cholesterol control beyond the clinic: New York City's trans fat restriction
Angell SY , Silver LD , Goldstein GP , Johnson CM , Deitcher DR , Frieden TR , Bassett MT . Ann Intern Med 2009 151 (2) 129-34 Decades after key modifiable risk factors were identified, cardiovascular disease remains the leading cause of preventable death, and only one quarter of persons with high cholesterol levels have attained recommended levels of control. Cholesterol control efforts have focused on consumer education and medical treatment. A powerful, complementary approach is to change the makeup of food, a route the New York City Department of Health and Mental Hygiene took when it restricted artificial trans fat--a contributor to coronary heart disease--in restaurants. The Department first undertook a voluntary campaign, but this effort did not decrease the proportion of restaurants that used artificial trans fat. In December 2006, the Board of Health required that artificial trans fat be phased out of restaurant food. To support implementation, the Department provided technical assistance to restaurants. By November 2008, the restriction was in full effect in all New York City restaurants and estimated restaurant use of artificial trans fat for frying, baking, or cooking or in spreads had decreased from 50% to less than 2%. Preliminary analyses suggest that replacement of artificial trans fat has resulted in products with more healthful fatty acid profiles. For example, in major restaurant chains, total saturated fat plus trans fat in French fries decreased by more than 50%. At 2 years, dozens of national chains had removed artificial trans fat, and 13 jurisdictions, including California, had adopted similar laws. Public health efforts that change food content to make default choices healthier enable consumers to more successfully meet dietary recommendations and reduce their cardiovascular risk. |
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