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Cardiovascular disease
|Cardiovascular disease
Micrograph of a heart with fibrosis (yellow) and amyloidosis (brown). Movat's stain.
|Classification and external resources
Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels.[1] Cardiovascular disease includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack).[1] Other CVDs are stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, heart arrhythmia, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, and venous thrombosis.[1][2]
The underlying mechanisms vary depending on the disease in question. Coronary artery disease, stroke, and peripheral artery disease involve atherosclerosis. This may be caused by high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol consumption, among others. High blood pressure results in 13% of CVD deaths, while tobacco results in 9%, diabetes 6%, lack of exercise 6% and obesity 5%. Rheumatic heart disease may follow untreated strep throat.[1]
It is estimated that 90% of CVD is preventable.[3] Prevention of atherosclerosis involves improving risk factors through: healthy eating, exercise, avoidance of tobacco smoke and limiting alcohol intake.[1] Treating high blood pressure, blood lipids and diabetes is also beneficial.[1] Treating people who have strep throat with antibiotics can decrease the risk of rheumatic heart disease.[4] The effect of the use of aspirin in people who are otherwise healthy is of unclear benefit.[5][6] The United States Preventive Services Task Force recommends against its use for prevention in women less than 55 and men less than 45 years old; however, in those who are older it is recommends in some individuals.[7] Treatment of those who have CVD improves outcomes.[1]
Cardiovascular diseases are the leading cause of death globally.[1] This is true in all areas of the world except Africa.[1] Together they resulted in 17.3 million deaths (31.5%) in 2013 up from 12.3 million (25.8%) in 1990.[2] Deaths, at a given age, from CVD are more common and have been increasing in much of the developing world, while rates have declined in most of the developed world since the 1970s.[8][9] Coronary artery disease and stroke account for 80% of CVD deaths in males and 75% of CVD deaths in females.[1] Most cardiovascular disease affects older adults. In the United States 11% of people between 20 and 40 have CVD, while 37% between 40 and 60, 71% of people between 60 and 80, and 85% of people over 80 have CVD.[10] The average age of death from coronary artery disease in the developed world is around 80 while it is around 68 in the developing world.[8] Disease onset is typically seven to ten years earlier in men as compared to women.[11]
There are many cardiovascular diseases involving the blood vessels. They are known as vascular diseases.
- Coronary artery disease (also known as coronary heart disease and ischemic heart disease)
- Peripheral arterial disease – disease of blood vessels that supply blood to the arms and legs
- Cerebrovascular disease – disease of blood vessels that supply blood to the brain (includes stroke)
- Renal artery stenosis
- Aortic aneurysm
There are also many cardiovascular diseases that involve the heart.
- Cardiomyopathy – diseases of cardiac muscle
- Hypertensive heart disease – diseases of the heart secondary to high blood pressure or hypertension
- Heart failure - a clinical syndrome caused by the inability of the heart to supply sufficient blood to the tissues to meet their metabolic requirements
- Pulmonary heart disease – a failure at the right side of the heart with respiratory system involvement
- Cardiac dysrhythmias – abnormalities of heart rhythm
- Inflammatory heart disease
- Endocarditis – inflammation of the inner layer of the heart, the endocardium. The structures most commonly involved are the heart valves.
- Inflammatory cardiomegaly
- Myocarditis – inflammation of the myocardium, the muscular part of the heart.
- Valvular heart disease
- Congenital heart disease – heart structure malformations existing at birth
- Rheumatic heart disease – heart muscles and valves damage due to rheumatic fever caused by Streptococcus pyogenes a group A streptococcal infection.
Risk factors
There are several risk factors for heart diseases: age, gender, tobacco use, physical inactivity, excessive alcohol consumption, unhealthy diet, obesity, family history of cardiovascular disease, raised blood pressure (hypertension), raised blood sugar (diabetes mellitus), raised blood cholesterol (hyperlipidemia), psychosocial factors, poverty and low educational status, and air pollution.[13][14][15][16][17] While the individual contribution of each risk factor varies between different communities or ethnic groups the overall contribution of these risk factors is very consistent.[18] Some of these risk factors, such as age, gender or family history, genetic, are immutable; however, many important cardiovascular risk factors are modifiable by lifestyle change, social change, drug treatment and prevention of hypertension, hyperlipidemia, and diabetes.
Cardiovascular disease in a person's parents increases their risk by 3 fold.[19]
Age is by far the most important risk factor in developing cardiovascular or heart diseases, with approximately a tripling of risk with each decade of life.[20] Coronary fatty streaks can begin to form in adolescence.[21] It is estimated that 82 percent of people who die of coronary heart disease are 65 and older.[22] At the same time, the risk of stroke doubles every decade after age 55.[23]
Multiple explanations have been proposed to explain why age increases the risk of cardiovascular/heart diseases. One of them is related to serum cholesterol level.[24] In most populations, the serum total cholesterol level increases as age increases. In men, this increase levels off around age 45 to 50 years. In women, the increase continues sharply until age 60 to 65 years.[24]
Aging is also associated with changes in the mechanical and structural properties of the vascular wall, which leads to the loss of arterial elasticity and reduced arterial compliance and may subsequently lead to coronary artery disease.[25]
Men are at greater risk of heart disease than pre-menopausal women.[20][26] Once past menopause, it has been argued that a woman's risk is similar to a man's[26] although more recent data from the WHO and UN disputes this.[20] If a female has diabetes, she is more likely to develop heart disease than a male with diabetes.[27]
Coronary heart diseases are 2 to 5 times more common among middle-aged men than women.[24] In a study done by the World Health Organization, sex contributes to approximately 40% of the variation in sex ratios of coronary heart disease mortality.[28] Another study reports similar results finding that gender differences explains nearly half the risk associated with cardiovascular diseases[24] One of the proposed explanations for gender differences in cardiovascular diseases is hormonal difference.[24] Among women, estrogen is the predominant sex hormone. Estrogen may have protective effects through glucose metabolism and hemostatic system, and may have direct effect in improving endothelial cell function.[24] The production of estrogen decreases after menopause, and this may change the female lipid metabolism toward a more atherogenic form by decreasing the HDL cholesterol level while increasing LDL and total cholesterol levels.[24]
Among men and women, there are notable differences in body weight, height, body fat distribution, heart rate, stroke volume, and arterial compliance.[25] In the very elderly, age-related large artery pulsatility and stiffness is more pronounced among women than men.[25] This may be caused by the women's smaller body size and arterial dimensions which are independent of menopause.[25]
Cigarettes are the major form of smoked tobacco.[1] Risks to health from tobacco use result not only from direct consumption of tobacco, but also from exposure to second-hand smoke.[1] Approximately 10% of cardiovascular disease is attributed to smoking;[1] however, people who quit smoking by age 30 have almost as low a risk of death as never smokers.[29]
Physical inactivity
Insufficient physical activity (defined as less than 5 x 30 minutes of moderate activity per week, or less than 3 x 20 minutes of vigorous activity per week) is currently the fourth leading risk factor for mortality worldwide.[1] In 2008, 31.3% of adults aged 15 or older (28.2% men and 34.4% women) were insufficiently physically active.[1] The risk of ischemic heart disease and diabetes mellitus is reduced by almost a third in adults who participate in 150 minutes of moderate physical activity each week (or equivalent).[30] In addition, physical activity assists weight loss and improves blood glucose control, blood pressure, lipid profile and insulin sensitivity. These effects may, at least in part, explain its cardiovascular benefits.[1]
High dietary intakes of saturated fat, trans-fats and salt, and low intake of fruits, vegetables and fish are linked to cardiovascular risk, although whether all these associations are a cause is disputed. The World Health Organization attributes approximately 1.7 million deaths worldwide to low fruit and vegetable consumption.[1] The amount of dietary salt consumed is also an important determinant of blood pressure levels and overall cardiovascular risk.[1] Frequent consumption of high-energy foods, such as processed foods that are high in fats and sugars, promotes obesity and may increase cardiovascular risk.[1] High trans-fat intake has adverse effects on blood lipids and circulating inflammatory markers,[31] and elimination of trans-fat from diets has been widely advocated.[32] There is evidence that higher consumption of sugar is associated with higher blood pressure and unfavorable blood lipids,[33] and sugar intake also increases the risk of diabetes mellitus.[34] High consumption of processed meats is associated with an increased risk of cardiovascular disease, possibly in part due to increased dietary salt intake.[35]
The relationship between alcohol consumption and cardiovascular disease is complex, and may depend on the amount of alcohol consumed. There is a direct relationship between high levels of alcohol consumption and risk of cardiovascular disease.[1] Drinking at low levels without episodes of heavy drinking may be associated with a reduced risk of cardiovascular disease.[36] Overall alcohol consumption at the population level is associated with multiple health risks that exceed any potential benefits.[1][37]
Socioeconomic disadvantage
Cardiovascular disease affects low- and middle-income countries even more than high-income countries.[38] There is relatively little information regarding social patterns of cardiovascular disease within low- and middle-income countries,[38] but within high-income countries low income and low educational status are consistently associated with greater risk of cardiovascular disease.[39] Policies that have resulted in increased socio-economic inequalities have been associated with greater subsequent socio-economic differences in cardiovascular disease[38] implying a cause and effect relationship. Psychosocial factors, environmental exposures, health behaviours, and health-care access and quality contribute to socio-economic differentials in cardiovascular disease. [40] The Commission on Social Determinants of Health recommended that more equal distributions of power, wealth, education, housing, environmental factors, nutrition, and health care were needed to address inequalities in cardiovascular disease and non-communicable diseases.[41]
Air pollution
Particulate matter has been studied for its short- and long-term exposure effects on cardiovascular disease. Currently, PM2.5 is the major focus, in which gradients are used to determine CVD risk. For every 10 μg/m3 of PM2.5 long-term exposure, there was an estimated 8–18% CVD mortality risk.[42] Women had a higher relative risk (RR) (1.42) for PM2.5 induced coronary artery disease than men (0.90) did.[42] Overall, long-term PM exposure increased rate of atherosclerosis and inflammation. In regards to short-term exposure (2 hours), every 25 μg/m3 of PM2.5 resulted in a 48% increase of CVD mortality risk.[43] In addition, after only 5 days of exposure, a rise in systolic (2.8 mmHg) and diastolic (2.7 mmHg) blood pressure occurred for every 10.5 μg/m3 of PM2.5.[43] Other research has implicated PM2.5 in irregular heart rhythm, reduced heart rate variability (decreased vagal tone), and most notably heart failure.[43][44] PM2.5 is also linked to carotid artery thickening and increased risk of acute myocardial infarction.[43][44]
Cardiovascular risk assessment
Existing cardiovascular disease or a previous cardiovascular event, such as a heart attack or stroke, is the strongest predictor of a future cardiovascular event.[45] Age, sex, smoking, blood pressure, blood lipids and diabetes are important predictors of future cardiovascular disease in people who are not known to have cardiovascular disease.[46] These measures, and sometimes others, may be combined into composite risk scores to estimate an individual's future risk of cardiovascular disease.[45] Numerous risk scores exist although their respective merits are debated.[47] Other diagnostic tests and biomarkers remain under evaluation but currently these lack clear-cut evidence to support their routine use. They include family history, coronary artery calcification score, high sensitivity C-reactive protein (hs-CRP), ankle brachial index, lipoprotein subclasses and particle concentration, lipoprotein(a), apolipoproteins A-I and B, fibrinogen, white blood cell count, homocysteine, N-terminal pro B-type natriuretic peptide (NT-proBNP), and markers of kidney function.[48][49]
Little is known about the relationship between work and cardiovascular disease, but links have been established between certain toxins, extreme heat and cold, exposure to tobacco smoke, and mental health concerns such as stress and depression.[50]
Population-based studies show that atherosclerosis, the major precursor of cardiovascular disease, begins in childhood. The Pathobiological Determinants of Atherosclerosis in Youth Study demonstrated that intimal lesions appear in all the aortas and more than half of the right coronary arteries of youths aged 7–9 years.[52]
This is extremely important considering that 1 in 3 people die from complications attributable to atherosclerosis. In order to stem the tide, education and awareness that cardiovascular disease poses the greatest threat, and measures to prevent or reverse this disease must be taken.
Obesity and diabetes mellitus are often linked to cardiovascular disease,[53] as are a history of chronic kidney disease and hypercholesterolaemia.[54] In fact, cardiovascular disease is the most life-threatening of the diabetic complications and diabetics are two- to four-fold more likely to die of cardiovascular-related causes than nondiabetics.[55][56][57]
Screening ECGs (either at rest or with exercise) are not recommended in those without symptoms who are at low risk.[58] This includes those who are young without risk factors.[59] In those at higher risk the evidence for screening with ECGs is inconclusive.[58]
Additionally echocardiography, myocardial perfusion imaging, and cardiac stress testing is not recommended in those at low risk who do not have symptoms.[60]
Some biomarkers may add to conventional cardiovascular risk factors in predicting the risk of future cardiovascular disease; however, the clinical value of some biomarkers is questionable.[61][62]
The NIH recommends lipid testing in children beginning at the age of 2 if there is a family history of heart disease or lipid problems.[63] It is hoped that early testing will improve lifestyle factors in those at risk such as diet and exercise.[64]
Up to 90% of cardiovascular disease may be preventable if established risk factors are avoided.[65][66] Currently practiced measures to prevent cardiovascular disease include:
- A low-fat, high-fiber diet including whole grains and fruit and vegetables.[67][68] Five portions a day reduces risk by about 25%.[69]
- Tobacco cessation and avoidance of second-hand smoke[67]
- Limit alcohol consumption to the recommended daily limits;[67] consumption of 1–2 standard alcoholic drinks per day may reduce risk by 30%.[70][71] However, excessive alcohol intake increases the risk of cardiovascular disease.[72]
- Lower blood pressures, if elevated
- Decrease non-HDL cholesterol.[73][74]
- Decrease body fat if overweight or obese[75]
- Increase daily activity to 30 minutes of vigorous exercise per day at least five times per week (multiply by three if horizontal);[67]
- Reduce sugar consumptions
- Decrease psychosocial stress.[76] This measure may be complicated by imprecise definitions of what constitute psychosocial interventions.[77] Mental stress–induced myocardial ischemia is associated with an increased risk of heart problems in those with previous heart disease.[78] Severe emotional and physical stress leads to a form of heart dysfunction known as Takotsubo syndrome in some people.[79] Stress, however, plays a relatively minor role in hypertension.[80] Specific relaxation therapies are of unclear benefit.[81][82]
For adults without a known diagnosis of hypertension, diabetes, hyperlipidemia, or cardiovascular disease, routine counseling to advise them to improve their diet and increase their physical activity has not been found to significantly alter behavior, and thus is not recommended.[83] It is unclear whether or not dental care in those with periodontitis affects the risk of cardiovascular disease.[84] Exercise in those who are at high risk of heart disease has not been well studied as of 2014.[85]
A diet high in fruits and vegetables decreases the risk of cardiovascular disease and death.[69] Evidence suggests that the Mediterranean diet may improve cardiovascular outcomes.[86] There is also evidence that a Mediterranean diet may be more effective than a low-fat diet in bringing about long-term changes to cardiovascular risk factors (e.g., lower cholesterol level and blood pressure).[87] The DASH diet (high in nuts, fish, fruits and vegetables, and low in sweets, red meat and fat) has been shown to reduce blood pressure,[88] lower total and low density lipoprotein cholesterol[89] and improve metabolic syndrome;[90] but the long-term benefits outside the context of a clinical trial have been questioned.[91] A high fiber diet appears to lower the risk.[92]
Total fat intake does not appear to be an important risk factor.[93][94] A diet high in trans fatty acids, however, does appear to increase rates of cardiovascular disease.[94][95] Worldwide, dietary guidelines recommend a reduction in saturated fat.[96] However, there are some questions around the effect of saturated fat on cardiovascular disease in the medical literature.[95][97] Reviews from 2014 and 2015 did not find evidence of harm from saturated fats.[95][97] A 2012 Cochrane review found suggestive evidence of a small benefit from replacing dietary saturated fat by unsaturated fat.[98] A 2013 meta analysis concludes that substitution with omega 6 linoleic acid (a type of unsaturated fat) may increase cardiovascular risk.[96] Replacement of saturated fats with carbohydrates does not change or may increase risk.[99][100] Benefits from replacement with polyunsaturated fat appears greatest;[94][101] however, supplementation with omega-3 fatty acids (a type of polysaturated fat) does not appear to have an effect.[102]
The effect of a low-salt diet is unclear. A Cochrane review concluded that any benefit in either hypertensive or normal-tensive people is small if present.[103] In addition, the review suggested that a low-salt diet may be harmful in those with congestive heart failure.[103] However, the review was criticized in particular for not excluding a trial in heart failure where people had low-salt and -water levels due to diuretics.[104] When this study is left out, the rest of the trials show a trend to benefit.[104][105] Another review of dietary salt concluded that there is strong evidence that high dietary salt intake increases blood pressure and worsens hypertension, and that it increases the number of cardiovascular disease events; the latter happen both through the increased blood pressure and, quite likely, through other mechanisms.[106][107] Moderate evidence was found that high salt intake increases cardiovascular mortality; and some evidence was found for an increase in overall mortality, strokes, and left ventricular hypertrophy.[106]
Aspirin has been found to be of only modest benefit in those at low risk of heart disease as the risk of serious bleeding is almost equal to the benefit with respect to cardiovascular problems.[108] In those at very low risk it is not recommended.[109]
Statins are effective in preventing further cardiovascular disease in people with a history of cardiovascular disease.[110] As the event rate is higher in men than in women, the decrease in events is more easily seen in men than women.[110] In those without cardiovascular disease but risk factors statins appear to also be beneficial with a decrease in the risk of death and further heart disease.[111] A United States guideline recommends statins in those who have a 12% or greater risk of cardiovascular disease over the next ten years.[112]
The time course over which statins provide prevention against death appears to be long, of the order of one year, which is much longer than the duration of their effect on lipids.[113] The medications niacin, fibrates and CETP Inhibitors, while they may increase HDL cholesterol do not affect the risk of cardiovascular disease in those who are already on statins.[114]
The use of vasoactive agents for people with pulmonary hypertension with left heart disease or hypoxemic lung diseases may cause harm and unnecessary expense.[115]
While a healthy diet is beneficial, in general the effect of antioxidant supplementation (vitamin E, vitamin C, etc.) or vitamins has not been shown to protection against cardiovascular disease and in some cases may possibly result in harm.[116][117] Mineral supplements have also not been found to be useful.[118] Niacin, a type of vitamin B3, may be an exception with a modest decrease in the risk of cardiovascular events in those at high risk.[119][120] Magnesium supplementation lowers high blood pressure in a dose dependent manner.[121] Magnesium therapy is recommended for patients with ventricular arrhythmia associated with torsades de pointes who present with long QT syndrome as well as for the treatment of patients with digoxin intoxication-induced arrhythmias.[122] Evidence to support omega-3 fatty acid supplementation is lacking.[123]
Cardiovascular disease is treatable with initial treatment primarily focused on diet and lifestyle interventions.[1]
Cardiovascular diseases are the leading cause of death. In 2008, 30% of all global death is attributed to cardiovascular diseases. Death caused by cardiovascular diseases are also higher in low- and middle-income countries as over 80% of all global death caused by cardiovascular diseases occurred in those countries. It is also estimated that by 2030, over 23 million people will die from cardiovascular diseases each year.
It is estimated that 60% of the world's cardiovascular disease burden will occur in the South Asian subcontinent despite only accounting for 20% of the world's population. This may be secondary to a combination of genetic predisposition and environmental factors. Organizations such as the Indian Heart Association are working with the World Heart Federation to raise awareness about this issue.[125]
The first studies on cardiovascular health were performed in year 1949 by Jerry Morris using occupational health data and were published in year 1958.[126] The causes, prevention, and/or treatment of all forms of cardiovascular disease remain active fields of biomedical research, with hundreds of scientific studies being published on a weekly basis.
A fairly recent emphasis is on the link between low-grade inflammation that hallmarks atherosclerosis and its possible interventions. C-reactive protein is a common inflammatory marker that has been found to be present in increased levels in patients who are at risk for cardiovascular disease.[127] Also osteoprotegerin, which is involved with regulation of a key inflammatory transcription factor called NF-κB, has been found to be a risk factor of cardiovascular disease and mortality.[128][129]
Some areas currently being researched include the possible links between infection with Chlamydophila pneumoniae (a major cause of pneumonia) and coronary artery disease. The Chlamydia link has become less plausible with the absence of improvement after antibiotic use.[130]
Several research also investigated the benefits of melatonin on cardiovascular diseases prevention and cure. Melatonin is a pineal gland secretion and it is shown to be able to lower total cholesterol, very-low-density and low-density lipoprotein cholesterol levels in the blood plasma of rats. Reduction of blood pressure is also observed when pharmacological doses are applied. Thus, it is deemed to be a plausible treatment for hypertension. However, further research needs to be conducted to investigate the side-effects, optimal dosage, etc. before it can be licensed for use.[131]
- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Shanthi Mendis; Pekka Puska; Bo Norrving; World Health Organization (2011). Global Atlas on Cardiovascular Disease Prevention and Control (PDF). World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization. pp. 3–18. ISBN 978-92-4-156437-3.
- 1 2 GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
- ↑ McGill HC, McMahan CA, Gidding SS (March 2008). "Preventing heart disease in the 21st century: implications of the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study". Circulation. 117 (9): 1216–27. doi:10.1161/CIRCULATIONAHA.107.717033. PMID 18316498.
- ↑ Spinks, A; Glasziou, PP; Del Mar, CB (5 November 2013). "Antibiotics for sore throat.". The Cochrane database of systematic reviews. 11: CD000023. doi:10.1002/14651858.CD000023.pub4. PMID 24190439.
- ↑ Sutcliffe, P; Connock, M; Gurung, T; Freeman, K; Johnson, S; Ngianga-Bakwin, K; Grove, A; Gurung, B; Morrow, S; Stranges, S; Clarke, A (2013). "Aspirin in primary prevention of cardiovascular disease and cancer: a systematic review of the balance of evidence from reviews of randomized trials.". PLOS ONE. 8 (12): e81970. doi:10.1371/journal.pone.0081970. PMC 3855368. PMID 24339983.
- ↑ Sutcliffe, P; Connock, M; Gurung, T; Freeman, K; Johnson, S; Kandala, NB; Grove, A; Gurung, B; Morrow, S; Clarke, A (September 2013). "Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer: a systematic review and overview of reviews.". Health technology assessment (Winchester, England). 17 (43): 1–253. doi:10.3310/hta17430. PMID 24074752.
- ↑ US Preventive Services Task, Force (17 March 2009). "Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement.". Annals of Internal Medicine. 150 (6): 396–404. doi:10.7326/0003-4819-150-6-200903170-00008. PMID 19293072.
- 1 2 Fuster, Board on Global Health; Valentin; Academies, Bridget B. Kelly (2010). Institute of Medicine of the National, eds. Promoting cardiovascular health in the developing world : a critical challenge to achieve global health. Washington, D.C.: National Academies Press. pp. Chapter 2. ISBN 978-0-309-14774-3.
- ↑ Moran, AE; Forouzanfar, MH; Roth, GA; Mensah, GA; Ezzati, M; Murray, CJ; Naghavi, M (8 April 2014). "Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: the Global Burden of Disease 2010 study.". Circulation. 129 (14): 1483–92. doi:10.1161/circulationaha.113.004042. PMID 24573352.
- ↑ Go, AS; Mozaffarian, D; Roger, VL; Benjamin, EJ; Berry, JD; Borden, WB; Bravata, DM; Dai, S; Ford, ES; Fox, CS; Franco, S; Fullerton, HJ; Gillespie, C; Hailpern, SM; Heit, JA; Howard, VJ; Huffman, MD; Kissela, BM; Kittner, SJ; Lackland, DT; Lichtman, JH; Lisabeth, LD; Magid, D; Marcus, GM; Marelli, A; Matchar, DB; McGuire, DK; Mohler, ER; Moy, CS; Mussolino, ME; Nichol, G; Paynter, NP; Schreiner, PJ; Sorlie, PD; Stein, J; Turan, TN; Virani, SS; Wong, ND; Woo, D; Turner, MB; American Heart Association Statistics Committee and Stroke Statistics, Subcommittee (1 January 2013). "Heart disease and stroke statistics--2013 update: a report from the American Heart Association.". Circulation. 127 (1): e6–e245. doi:10.1161/cir.0b013e31828124ad. PMID 23239837.
- ↑ Mendis, Shanthi; Puska,, Pekka; Norrving, Bo (2011). Global atlas on cardiovascular disease prevention and control (1 ed.). Geneva: World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization. p. 48. ISBN 9789241564373.
- ↑ "WHO Disease and injury country estimates". World Health Organization. 2009. Retrieved Nov 11, 2009.
- ↑ Bridget B. Kelly; Institute of Medicine; Fuster, Valentin (2010). Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health. Washington, D.C: National Academies Press. ISBN 0-309-14774-3.
- ↑ Howard, BV; Wylie-Rosett, J (Jul 23, 2002). "Sugar and cardiovascular disease: A statement for healthcare professionals from the Committee on Nutrition of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association.". Circulation. 106 (4): 523–7. doi:10.1161/01.cir.0000019552.77778.04. PMID 12135957.
- ↑ Finks, SW; Airee, A; Chow, SL; Macaulay, TE; Moranville, MP; Rogers, KC; Trujillo, TC (April 2012). "Key articles of dietary interventions that influence cardiovascular mortality.". Pharmacotherapy. 32 (4): e54–87. doi:10.1002/j.1875-9114.2011.01087.x. PMID 22392596.
- ↑ Micha, R; Michas, G; Mozaffarian, D (Dec 2012). "Unprocessed red and processed meats and risk of coronary artery disease and type 2 diabetes—an updated review of the evidence.". Current atherosclerosis reports. 14 (6): 515–24. doi:10.1007/s11883-012-0282-8. PMC 3483430. PMID 23001745.
- ↑ Shanthi Mendis; Pekka Puska; Bo Norrving (2011). Global Atlas on Cardiovascular Disease Prevention and Control. World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization. ISBN 978-92-4-156437-3.
- ↑ Yusuf S, Hawken S, Ounpuu S, et al. (2004). "Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study". Lancet. 364 (9438): 937–52. doi:10.1016/S0140-6736(04)17018-9. PMID 15364185.
- ↑ Kathiresan, S; Srivastava, D (16 March 2012). "Genetics of human cardiovascular disease.". Cell. 148 (6): 1242–57. doi:10.1016/j.cell.2012.03.001. PMC 3319439. PMID 22424232.
- 1 2 3 Finegold, JA; Asaria, P; Francis, DP (Dec 4, 2012). "Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations.". International Journal of Cardiology. 168 (2): 934–945. doi:10.1016/j.ijcard.2012.10.046. PMID 23218570.
- ↑ D'Adamo, E; Guardamagna, O; Chiarelli, F; Bartuli, A; Liccardo, D; Ferrari, F; Nobili, V (2015). "Atherogenic dyslipidemia and cardiovascular risk factors in obese children.". International journal of endocrinology. 2015: 912047. doi:10.1155/2015/912047. PMC 4309297. PMID 25663838.
- ↑ "Understand Your Risk of Heart Attack". American Heart Association.http://www.heart.org/HEARTORG/Conditions/HeartAttack/UnderstandYourRiskofHeartAttack/Understand-Your-Risk-of-Heart-Attack_UCM_002040_Article.jsp#
- ↑ Mackay, Mensah, Mendis, et al. The Atlas of Heart Disease and Stroke. World Health Organization. January 2004.
- 1 2 3 4 5 6 7 Jousilahti Vartiainen; Tuomilehto Puska (1999). "Sex, Age, Cardiovascular Risk Factors, and coronary heart disease". Circulation. 99 (9): 1165–1172. doi:10.1161/01.cir.99.9.1165.
- 1 2 3 4 Jani B, Rajkumar C (2006). "Ageing and vascular ageing". Postgrad Med J. 82 (968): 357–362. doi:10.1136/pgmj.2005.036053.
- 1 2 http://www.world-heart-federation.org/cardiovascular-health/cardiovascular-disease-risk-factors
- ↑ "Diabetes raises women's risk of heart disease more than for men". NPR.org. May 22, 2014. Retrieved May 23, 2014.
- ↑ Jackson R, Chambles L, Higgins M, Kuulasmaa K, Wijnberg L, Williams D (WHO MONICA Project, and ARIC Study.) Sex difference in ischaemic heart disease mortality and risk factors in 46 communities: an ecologic analysis. Cardiovasc Risk Factors. 1999; 7:43–54.
- ↑ Richard Doll; Richard Peto; Jillian Boreham & Isabelle Sutherland (June 2004). "Mortality in relation to smoking: 50 years' observations on male British doctors". BMJ (Clinical research ed.). 328 (7455): 1519. doi:10.1136/bmj.38142.554479.AE. PMC 437139. PMID 15213107.
- ↑ World Health Organization; UNAIDS (1 January 2007). Prevention of Cardiovascular Disease. World Health Organization. pp. 3–. ISBN 978-92-4-154726-0.
- ↑ Booker, C.S.; Mann, J.I. (2008). "Trans fatty acids and cardiovascular health: Translation of the evidence base". Nutrition, Metabolism and Cardiovascular Diseases. 18 (6): 448–456. doi:10.1016/j.numecd.2008.02.005. ISSN 0939-4753.
- ↑ Remig, Valentina; Franklin, Barry; Margolis, Simeon; Kostas, Georgia; Nece, Theresa; Street, James C. (2010). "Trans Fats in America: A Review of Their Use, Consumption, Health Implications, and Regulation". Journal of the American Dietetic Association. 110 (4): 585–592. doi:10.1016/j.jada.2009.12.024. ISSN 0002-8223.
- ↑ Te Morenga, L. A.; Howatson, A. J.; Jones, R. M.; Mann, J. (2014). "Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids". American Journal of Clinical Nutrition. 100 (1): 65–79. doi:10.3945/ajcn.113.081521. ISSN 0002-9165.
- ↑ "Wylie-Rosett2002"
- ↑ Micha, Renata; Michas, Georgios; Mozaffarian, Dariush (2012). "Unprocessed Red and Processed Meats and Risk of Coronary Artery Disease and Type 2 Diabetes – An Updated Review of the Evidence". Current Atherosclerosis Reports. 14 (6): 515–524. doi:10.1007/s11883-012-0282-8. ISSN 1523-3804. PMC 3483430. PMID 23001745.
- ↑ Mukamal, Kenneth J.; Chen, Chiung M.; Rao, Sowmya R.; Breslow, Rosalind A. (2010). "Alcohol Consumption and Cardiovascular Mortality Among U.S. Adults, 1987 to 2002". Journal of the American College of Cardiology. 55 (13): 1328–1335. doi:10.1016/j.jacc.2009.10.056. ISSN 0735-1097.
- ↑ World Health Organization (2011). Global Status Report on Alcohol and Health. World Health Organization. ISBN 978-92-4-156415-1.
- 1 2 3 Mariachiara Di Cesare; Young-Ho Khang; Perviz Asaria; Tony Blakely; Melanie J. Cowan; Farshad Farzadfar; Ramiro Guerrero; Nayu Ikeda; Catherine Kyobutungi; Kelias P. Msyamboza; Sophal Oum; John W. Lynch; Michael G. Marmot; Majid Ezzati (February 2013). "Inequalities in non-communicable diseases and effective responses". Lancet. 381 (9866): 585–597. doi:10.1016/S0140-6736(12)61851-0. PMID 23410608.
- ↑ J. P. Mackenbach; A. E. Cavelaars; A. E. Kunst; F. Groenhof (July 2000). "Socioeconomic inequalities in cardiovascular disease mortality; an international study". European Heart Journal. 21 (14): 1141–1151. doi:10.1053/euhj.1999.1990. PMID 10924297.
- ↑ Alexander M. Clark; Marie DesMeules; Wei Luo; Amanda S. Duncan; Andy Wielgosz (November 2009). "Socioeconomic status and cardiovascular disease: risks and implications for care". Nature reviews. Cardiology. 6 (11): 712–722. doi:10.1038/nrcardio.2009.163. PMID 19770848.
- ↑ World Health Organization (2008). Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health : Commission on Social Determinants of Health Final Report. World Health Organization. pp. 26–. ISBN 978-92-4-156370-3.
- 1 2 Khallaf, Mohamed (2011). The Impact of Air Pollution on Health, Economy, Environment and Agricultural Sources. InTech. pp. 69–92. ISBN 978-953-307-528-0.
- 1 2 3 4 Franchini M, Mannucci PM (2012). "Air pollution and cardiovascular disease". Thrombosis Research. 129 (3): 230–4. doi:10.1016/j.thromres.2011.10.030. PMID 22113148.
- 1 2 Sun Q, Hong X, Wold LE (2010). "Cardiovascular Effects of Ambient Particulate Air Pollution Exposure". Circulation. 121 (25): 2755–65. doi:10.1161/CIRCULATIONAHA.109.893461. PMC 2924678. PMID 20585020.
- 1 2 Tunstall-Pedoe, H. (2011). "Cardiovascular Risk and Risk Scores: ASSIGN, Framingham, QRISK and others: how to choose". Heart. 97 (6): 442–444. doi:10.1136/hrt.2010.214858. ISSN 1355-6037.
- ↑ World Health Organization (2007). Prevention of Cardiovascular Disease: Guidelines for Assessment and Management of Cardiovascular Risk. World Health Organization. ISBN 978-92-4-154717-8.
- ↑ Hernandez, Adrian V.; van Staa, Tjeerd-Pieter; Gulliford, Martin; Ng, Edmond S.-W.; Goldacre, Ben; Smeeth, Liam (2014). "Prediction of Cardiovascular Risk Using Framingham, ASSIGN and QRISK2: How Well Do They Predict Individual Rather than Population Risk?". PLoS ONE. 9 (10): e106455. doi:10.1371/journal.pone.0106455. ISSN 1932-6203.
- ↑ Hlatky, M. A.; Greenland, P.; Arnett, D. K.; Ballantyne, C. M.; Criqui, M. H.; Elkind, M. S.V.; Go, A. S.; Harrell, F. E.; Hong, Y.; Howard, B. V.; Howard, V. J.; Hsue, P. Y.; Kramer, C. M.; McConnell, J. P.; Normand, S.-L. T.; O'Donnell, C. J.; Smith, S. C.; Wilson, P. W.F. (2009). "Criteria for Evaluation of Novel Markers of Cardiovascular Risk: A Scientific Statement From the American Heart Association". Circulation. 119 (17): 2408–2416. doi:10.1161/CIRCULATIONAHA.109.192278. ISSN 0009-7322.
- ↑ Eckel, Robert H; Cornier, Marc-Andre (2014). "Update on the NCEP ATP-III emerging cardiometabolic risk factors". BMC Medicine. 12 (1): 115. doi:10.1186/1741-7015-12-115. ISSN 1741-7015.
- ↑ "CDC - NIOSH Program Portfolio : Cancer, Reproductive, and Cardiovascular Diseases : Program Description". www.cdc.gov. Retrieved 2016-06-07.
- ↑ Bertazzo, S. et al. Nano-analytical electron microscopy reveals fundamental insights into human cardiovascular tissue calcification. Nature Materials 12, 576–583 (2013).
- ↑ Vanhecke TE, Miller WM, Franklin BA, Weber JE, McCullough PA (Oct 2006). "Awareness, knowledge, and perception of heart disease among adolescents". Eur J Cardiovasc Prev Rehabil. 13 (5): 718–23. doi:10.1097/01.hjr.0000214611.91490.5e. PMID 17001210.
- ↑ Highlander P, Shaw GP (2010). "Current pharmacotherapeutic concepts for the treatment of cardiovascular disease in diabetics". Ther Adv Cardiovasc Dis. 4 (1): 43–54. doi:10.1177/1753944709354305.
- ↑ NPS Medicinewise (1 March 2011). "NPS Prescribing Practice Review 53: Managing lipids". Retrieved 1 August 2011.
- ↑ Kvan E.; Pettersen K.I.; Sandvik L.; Reikvam A. (2007). "High mortality in diabetic patient with acute myocardial infarction: cardiovascular co-morbidities contribute most to the high risk". Int J Cardiol. 121 (2): 184–188. doi:10.1016/j.ijcard.2006.11.003.
- ↑ Norhammar A.; Malmberg K.; Diderhol E.; Lagerqvist B.; Lindahl B., Ryde; et al. (2004). "Diabetes mellitus: the major risk factor in unstable coronary artery disease even after consideration of the extent of coronary artery disease and benefits of revascularization. J". Am Coll Cardiol. 43 (4): 585–591. doi:10.1016/j.jacc.2003.08.050.
- ↑ DECODE , European Diabetes Epidemiology Group (1999). "Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria". Lancet. 354 (9179): 617–621. doi:10.1016/S0140-6736(98)12131-1. PMID 10466661.
- 1 2 Moyer, VA; U.S. Preventive Services Task Force (Oct 2, 2012). "Screening for coronary heart disease with electrocardiography: U.S. Preventive Services Task Force recommendation statement.". Annals of Internal Medicine. 157 (7): 512–8. doi:10.7326/0003-4819-157-7-201210020-00514. PMID 22847227.
- ↑ Maron, B. J.; Friedman, R. A.; Kligfield, P.; Levine, B. D.; Viskin, S.; Chaitman, B. R.; Okin, P. M.; Saul, J. P.; Salberg, L.; Van Hare, G. F.; Soliman, E. Z.; Chen, J.; Matherne, G. P.; Bolling, S. F.; Mitten, M. J.; Caplan, A.; Balady, G. J.; Thompson, P. D. (15 September 2014). "Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardiovascular Disease in Healthy General Populations of Young People (12–25 Years of Age): A Scientific Statement From the American Heart Association and the American College of Cardiology". Circulation. 130 (15): 1303–1334. doi:10.1161/CIR.0000000000000025.
- ↑ Chou, Roger (17 March 2015). "Cardiac Screening With Electrocardiography, Stress Echocardiography, or Myocardial Perfusion Imaging: Advice for High-Value Care From the American College of Physicians". Annals of Internal Medicine. 162 (6): 438. doi:10.7326/M14-1225.
- ↑ Wang TJ, Gona P, Larson MG, Tofler GH, Levy D, Newton-Cheh C, Jacques PF, Rifai N, Selhub J, Robins SJ, Benjamin EJ, D'Agostino RB, Vasan RS (2006). "Multiple biomarkers for the prediction of first major cardiovascular events and death". N. Engl. J. Med. 355 (25): 2631–billy bob joe9. doi:10.1056/NEJMoa055373. PMID 17182988.
- ↑ Spence JD (2006). "Technology Insight: ultrasound measurement of carotid plaque—patient management, genetic research, and therapy evaluation". Nat Clin Pract Neurol. 2 (11): 611–9. doi:10.1038/ncpneuro0324. PMID 17057748.
- ↑ Adolescents, Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children And (2011-12-01). "Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report". Pediatrics. 128 (Supplement 5): S213–S256. doi:10.1542/peds.2009-2107C. ISSN 0031-4005. PMC 4536582. PMID 22084329.
- ↑ Saenger, Amy K. (2012-08-01). "Universal Lipid Screening in Children and Adolescents: A Baby Step toward Primordial Prevention?". Clinical Chemistry. 58 (8): 1179–1181. doi:10.1373/clinchem.2012.182287. ISSN 0009-9147. PMID 22510399.
- ↑ McGill, Henry C.; McMahan, C. Alex; Gidding, Samuel S. (2008-03-04). "Preventing Heart Disease in the 21st Century". Circulation. 117 (9): 1216–1227. doi:10.1161/CIRCULATIONAHA.107.717033. ISSN 0009-7322. PMID 18316498.
- ↑ McNeal, Catherine J.; Dajani, Tala; Wilson, Don; Cassidy-Bushrow, Andrea E.; Dickerson, Justin B.; Ory, Marcia (2010-01-01). "Hypercholesterolemia in youth: opportunities and obstacles to prevent premature atherosclerotic cardiovascular disease". Current Atherosclerosis Reports. 12 (1): 20–28. doi:10.1007/s11883-009-0072-0. ISSN 1534-6242. PMID 20425267.
- 1 2 3 4 NHS Direct
- ↑ Ignarro, LJ; Balestrieri, ML; Napoli, C (Jan 15, 2007). "Nutrition, physical activity, and cardiovascular disease: an update.". Cardiovascular research. 73 (2): 326–40. doi:10.1016/j.cardiores.2006.06.030. PMID 16945357.
- 1 2 Wang, X; Ouyang, Y; Liu, J; Zhu, M; Zhao, G; Bao, W; Hu, FB (Jul 29, 2014). "Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies.". BMJ (Clinical research ed.). 349: g4490. doi:10.1136/bmj.g4490. PMC 4115152. PMID 25073782.
- ↑ World Heart Federation (5 October 2011). "World Heart Federation: Cardiovascular disease risk factors". Retrieved 5 October 2011.
- ↑ The National Heart, Lung, and Blood Institute (NHLBI) (5 October 2011). "How To Prevent and Control Coronary Heart Disease Risk Factors – NHLBI, NIH". Retrieved 5 October 2011.
- ↑ Klatsky AL (May 2009). "Alcohol and cardiovascular diseases". Expert Rev Cardiovasc Ther. 7 (5): 499–506. doi:10.1586/erc.09.22. PMID 19419257.
- ↑ McMahan, C. Alex; Gidding, Samuel S.; Malcom, Gray T.; Tracy, Richard E.; Strong, Jack P.; McGill, Henry C. (2006-10-01). "Pathobiological determinants of atherosclerosis in youth risk scores are associated with early and advanced atherosclerosis". Pediatrics. 118 (4): 1447–1455. doi:10.1542/peds.2006-0970. ISSN 1098-4275. PMID 17015535.
- ↑ Raitakari, Olli T.; Rönnemaa, Tapani; Järvisalo, Mikko J.; Kaitosaari, Tuuli; Volanen, Iina; Kallio, Katariina; Lagström, Hanna; Jokinen, Eero; Niinikoski, Harri (2005-12-13). "Endothelial function in healthy 11-year-old children after dietary intervention with onset in infancy: the Special Turku Coronary Risk Factor Intervention Project for children (STRIP)". Circulation. 112 (24): 3786–3794. doi:10.1161/CIRCULATIONAHA.105.583195. ISSN 1524-4539. PMID 16330680.
- ↑ McTigue KM, Hess R, Ziouras J (September 2006). "Obesity in older adults: a systematic review of the evidence for diagnosis and treatment". Obesity (Silver Spring). 14 (9): 1485–97. doi:10.1038/oby.2006.171. PMID 17030958.
- ↑ Linden W, Stossel C, Maurice J (April 1996). "Psychosocial interventions for patients with coronary artery disease: a meta-analysis". Arch. Intern. Med. 156 (7): 745–52. doi:10.1001/archinte.1996.00440070065008. PMID 8615707.
- ↑ Thompson, D. R.; Ski, C. F. (2013). "Psychosocial interventions in cardiovascular disease - what are they?". European Journal of Preventive Cardiology. 20 (6): 916–917. doi:10.1177/2047487313494031. ISSN 2047-4873.
- ↑ Wei, J; Rooks, C; Ramadan, R; Shah, AJ; Bremner, JD; Quyyumi, AA; Kutner, M; Vaccarino, V (15 July 2014). "Meta-analysis of mental stress-induced myocardial ischemia and subsequent cardiac events in patients with coronary artery disease.". The American journal of cardiology. 114 (2): 187–92. doi:10.1016/j.amjcard.2014.04.022. PMID 24856319.
- ↑ Pelliccia, F; Greco, C; Vitale, C; Rosano, G; Gaudio, C; Kaski, JC (August 2014). "Takotsubo syndrome (stress cardiomyopathy): an intriguing clinical condition in search of its identity.". The American Journal of Medicine. 127 (8): 699–704. doi:10.1016/j.amjmed.2014.04.004. PMID 24754972.
- ↑ Marshall, IJ; Wolfe, CD; McKevitt, C (Jul 9, 2012). "Lay perspectives on hypertension and drug adherence: systematic review of qualitative research.". BMJ (Clinical research ed.). 345: e3953. doi:10.1136/bmj.e3953. PMC 3392078. PMID 22777025.
- ↑ Dickinson, HO; Mason, JM; Nicolson, DJ; Campbell, F; Beyer, FR; Cook, JV; Williams, B; Ford, GA (February 2006). "Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials.". Journal of Hypertension. 24 (2): 215–33. doi:10.1097/01.hjh.0000199800.72563.26. PMID 16508562.
- ↑ Abbott, RA; Whear, R; Rodgers, LR; Bethel, A; Thompson Coon, J; Kuyken, W; Stein, K; Dickens, C (May 2014). "Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: A systematic review and meta-analysis of randomised controlled trials.". Journal of psychosomatic research. 76 (5): 341–51. doi:10.1016/j.jpsychores.2014.02.012. PMID 24745774.
- ↑ Moyer, VA; U.S. Preventive Services Task Force (Sep 4, 2012). "Behavioral counseling interventions to promote a healthful diet and physical activity for cardiovascular disease prevention in adults: U.S. Preventive Services Task Force recommendation statement.". Annals of Internal Medicine. 157 (5): 367–71. doi:10.7326/0003-4819-157-5-201209040-00486. PMID 22733153.
- ↑ Li, C; Lv, Z; Shi, Z; Zhu, Y; Wu, Y; Li, L; Iheozor-Ejiofor, Z (Aug 15, 2014). "Periodontal therapy for the management of cardiovascular disease in patients with chronic periodontitis.". The Cochrane database of systematic reviews. 8: CD009197. doi:10.1002/14651858.CD009197.pub2. PMID 25123257.
- ↑ Seron, P; Lanas, F; Pardo Hernandez, H; Bonfill Cosp, X (Aug 13, 2014). "Exercise for people with high cardiovascular risk.". The Cochrane database of systematic reviews. 8: CD009387. doi:10.1002/14651858.CD009387.pub2. PMID 25120097.
- ↑ Walker C, Reamy BV (April 2009). "Diets for cardiovascular disease prevention: what is the evidence?". Am Fam Physician. 79 (7): 571–8. PMID 19378874.
- ↑ Nordmann, AJ; Suter-Zimmermann, K; Bucher, HC; Shai, I; Tuttle, KR; Estruch, R; Briel, M (September 2011). "Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors.". The American Journal of Medicine. 124 (9): 841–51.e2. doi:10.1016/j.amjmed.2011.04.024. PMID 21854893.
- ↑ Sacks FM, Svetkey LP, Vollmer WM, et al. (January 2001). "Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group". N. Engl. J. Med. 344 (1): 3–10. doi:10.1056/NEJM200101043440101. PMID 11136953.
- ↑ Obarzanek E, Sacks FM, Vollmer WM, et al. (July 2001). "Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial". Am. J. Clin. Nutr. 74 (1): 80–9. PMID 11451721.
- ↑ Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F (December 2005). "Beneficial effects of a Dietary Approaches to Stop Hypertension eating plan on features of the metabolic syndrome". Diabetes Care. 28 (12): 2823–31. doi:10.2337/diacare.28.12.2823. PMID 16306540.
- ↑ Logan AG (March 2007). "DASH Diet: time for a critical appraisal?". Am. J. Hypertens. 20 (3): 223–4. doi:10.1016/j.amjhyper.2006.10.006. PMID 17324730.
- ↑ Threapleton, D. E.; Greenwood, D. C.; Evans, C. E. L.; Cleghorn, C. L.; Nykjaer, C.; Woodhead, C.; Cade, J. E.; Gale, C. P.; Burley, V. J. (19 December 2013). "Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis". BMJ. 347 (dec19 2): f6879–f6879. doi:10.1136/bmj.f6879. PMC 3898422. PMID 24355537.
- ↑ "Fats and fatty acids in human nutrition Report of an expert consultation". World Health Organization. WHO/FAO. Retrieved 20 December 2014.
- 1 2 3 Willett, WC (July 2012). "Dietary fats and coronary heart disease.". Journal of internal medicine. 272 (1): 13–24. doi:10.1111/j.1365-2796.2012.02553.x. PMID 22583051.
- 1 2 3 Chowdhury, Rajiv; Warnakula, Samantha; Kunutsor, Setor; Crowe, Francesca; Ward, Heather A.; Johnson, Laura; Franco, Oscar H.; Butterworth, Adam S.; Forouhi, Nita G.; Thompson, Simon G.; Khaw, Kay-Tee; Mozaffarian, Dariush; Danesh, John; Di Angelantonio, Emanuele (18 March 2014). "Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk". Annals of Internal Medicine. 160 (6): 398–406. doi:10.7326/M13-1788. PMID 24723079.
- 1 2 Ramsden, CE; Zamora, D; Leelarthaepin, B; Majchrzak-Hong, SF; Faurot, KR; Suchindran, CM; Ringel, A; Davis, JM; Hibbeln, JR (Feb 4, 2013). "Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis.". BMJ (Clinical research ed.). 346: e8707. doi:10.1136/bmj.e8707. PMID 23386268.
- 1 2 de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS (Aug 12, 2015). "Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies". BMJ. 351 (h3978). doi:10.1136/bmj.h3978. PMC 4532752. PMID 26268692.
- ↑ Hooper, L; Summerbell, CD; Thompson, R; Sills, D; Roberts, FG; Moore, HJ; Davey Smith, G (May 16, 2012). "Reduced or modified dietary fat for preventing cardiovascular disease.". Cochrane database of systematic reviews (Online). 5: CD002137. doi:10.1002/14651858.CD002137.pub3. PMID 22592684.
- ↑ Siri-Tarino Patty W; Sun Qi; Hu Frank B; Krauss Ronald M (2010). "Saturated fat, carbohydrate, and cardiovascular disease". American Journal of Clinical Nutrition. 91 (3): 502–509. doi:10.3945/ajcn.2008.26285. PMC 2824150. PMID 20089734.
- ↑ Micha, R; Mozaffarian, D (October 2010). "Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence.". Lipids. 45 (10): 893–905. doi:10.1007/s11745-010-3393-4. PMC 2950931. PMID 20354806.
- ↑ Astrup, A; Dyerberg, J; Elwood, P; Hermansen, K; Hu, FB; Jakobsen, MU; Kok, FJ; Krauss, RM; Lecerf, JM; LeGrand, P; Nestel, P; Risérus, U; Sanders, T; Sinclair, A; Stender, S; Tholstrup, T; Willett, WC (April 2011). "The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010?". The American Journal of Clinical Nutrition. 93 (4): 684–8. doi:10.3945/ajcn.110.004622. PMC 3138219. PMID 21270379.
- ↑ Rizos, EC; Ntzani, EE; Bika, E; Kostapanos, MS; Elisaf, MS (Sep 12, 2012). "Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis.". JAMA: The Journal of the American Medical Association. 308 (10): 1024–33. doi:10.1001/2012.jama.11374. PMID 22968891.
- 1 2 Taylor, RS; Ashton, KE; Moxham, T; Hooper, L; Ebrahim, S (Jul 6, 2011). "Reduced dietary salt for the prevention of cardiovascular disease.". Cochrane database of systematic reviews (Online) (7): CD009217. doi:10.1002/14651858.CD009217. PMID 21735439.
- 1 2 He, F J; MacGregor G A (2011). "Salt reduction lowers cardiovascular risk: meta-analysis of outcome trials" (PDF). The Lancet. 378 (9789): 380–382. doi:10.1016/S0140-6736(11)61174-4. PMID 21803192.
- ↑ Paterna, S; Gaspare P; Fasullo S; Sarullo FM; Di Pasquale P (2008). "Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend?". Clin Sci (Lond). 114 (3): 221–230. doi:10.1042/CS20070193. PMID 17688420.
- 1 2 Bochud, M; Marques-Vidal, P; Burnier, M; Paccaud, F (2012). "Dietary Salt Intake and Cardiovascular Disease: Summarizing the Evidence". Public Health Reviews. 33: 530–552.
- ↑ Cook, N R; et al. (2007). "Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP)". BMJ. 334 (7599): 334. doi:10.1136/bmj.39147.604896.55. PMC 1857760. PMID 17449506.
- ↑ Berger, JS; Lala, A; Krantz, MJ; Baker, GS; Hiatt, WR (July 2011). "Aspirin for the prevention of cardiovascular events in patients without clinical cardiovascular disease: a meta-analysis of randomized trials.". American Heart Journal. 162 (1): 115–24.e2. doi:10.1016/j.ahj.2011.04.006. PMID 21742097.
- ↑ "Final Recommendation Statement Aspirin for the Prevention of Cardiovascular Disease: Preventive Medication". March 2009. Retrieved 15 January 2015.
- 1 2 Gutierrez, J; Ramirez, G; Rundek, T; Sacco, RL (Jun 25, 2012). "Statin Therapy in the Prevention of Recurrent Cardiovascular Events: A Sex-Based Meta-analysisStatin Therapy to Prevent Recurrent CV Events.". Archives of Internal Medicine. 172 (12): 909–19. doi:10.1001/archinternmed.2012.2145. PMID 22732744.
- ↑ Taylor, F; Huffman, MD; Macedo, AF; Moore, TH; Burke, M; Davey Smith, G; Ward, K; Ebrahim, S (Jan 31, 2013). "Statins for the primary prevention of cardiovascular disease.". Cochrane database of systematic reviews (Online). 1: CD004816. doi:10.1002/14651858.CD004816.pub5. PMID 23440795.
- ↑ Downs, JR; O'Malley, PG (18 August 2015). "Management of dyslipidemia for cardiovascular disease risk reduction: synopsis of the 2014 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline.". Annals of Internal Medicine. 163 (4): 291–7. doi:10.7326/m15-0840. PMID 26099117.
- ↑ Francis, DP (May 19, 2011). "Duration and magnitude of the effect of a single statin tablet in primary prevention of cardiovascular events.". International Journal of Cardiology. 149 (1): 102–7. doi:10.1016/j.ijcard.2010.11.013. PMID 21183232.
- ↑ Keene, D; Price, C; Shun-Shin, MJ; Francis, DP (Jul 18, 2014). "Effect on cardiovascular risk of high density lipoprotein targeted drug treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomised controlled trials including 117,411 patients.". BMJ (Clinical research ed.). 349: g4379. doi:10.1136/bmj.g4379. PMC 4103514. PMID 25038074.
- ↑ American College of Chest Physicians; American Thoracic Society (September 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American College of Chest Physicians and American Thoracic Society, retrieved 6 January 2013
- ↑ Bhupathiraju, SN; Tucker, KL (Aug 17, 2011). "Coronary heart disease prevention: nutrients, foods, and dietary patterns.". Clinica chimica acta; international journal of clinical chemistry. 412 (17–18): 1493–514. doi:10.1016/j.cca.2011.04.038. PMID 21575619.
- ↑ Myung, SK; Ju, W; Cho, B; Oh, SW; Park, SM; Koo, BK; Park, BJ; for the Korean Meta-Analysis (KORMA) Study, Group (Jan 18, 2013). "Efficacy of vitamin and antioxidant supplements in prevention of cardiovascular disease: systematic review and meta-analysis of randomised controlled trials.". BMJ (Clinical research ed.). 346: f10. doi:10.1136/bmj.f10. PMC 3548618. PMID 23335472.
- ↑ Fortmann, SP; Burda, BU; Senger, CA; Lin, JS; Whitlock, EP (Nov 12, 2013). "Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force.". Annals of Internal Medicine. 159 (12): 824–34. doi:10.7326/0003-4819-159-12-201312170-00729. PMID 24217421.
- ↑ Bruckert, E; Labreuche, J; Amarenco, P (June 2010). "Meta-analysis of the effect of nicotinic acid alone or in combination on cardiovascular events and atherosclerosis". Atherosclerosis. 210 (2): 353–61. doi:10.1016/j.atherosclerosis.2009.12.023. PMID 20079494.
- ↑ Lavigne, PM; Karas, RH (Jan 29, 2013). "The current state of niacin in cardiovascular disease prevention: a systematic review and meta-regression.". Journal of the American College of Cardiology. 61 (4): 440–6. doi:10.1016/j.jacc.2012.10.030. PMID 23265337.
- ↑ Jee SH, Miller ER, Guallar E, et al. (2002). "The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials". Am J Hypertens. 15 (8): 691–696. doi:10.1016/S0895-7061(02)02964-3. PMID 12160191.
- ↑ Zipes DP, Camm AJ, Borggrefe M, et al. (2012). "ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". Circulation. 114 (10): e385–e484. doi:10.1161/CIRCULATIONAHA.106.178233. PMID 16935995.
- ↑ Kwak, SM; Myung, SK; Lee, YJ; Seo, HG; for the Korean Meta-analysis Study, Group (Apr 9, 2012). "Efficacy of Omega-3 Fatty Acid Supplements (Eicosapentaenoic Acid and Docosahexaenoic Acid) in the Secondary Prevention of Cardiovascular Disease: A Meta-analysis of Randomized, Double-blind, Placebo-Controlled Trials.". Archives of Internal Medicine. 172 (9): 686. doi:10.1001/archinternmed.2012.262. PMID 22493407.
- ↑ "WHO Disease and injury country estimates". World Health Organization. 2009. Retrieved Nov 11, 2009.
- ↑ Indian Heart Association Why South Asians Facts Web. 29 April 2015. <http://indianheartassociation.org/why-indians-why-south-asians/overview/>
- ↑ Morris J. N.; Crawford Margaret D. (1958). "Coronary Heart Disease and Physical Activity of Work". British Medical Journal. 2 (5111): 1485–1496. doi:10.1136/bmj.2.5111.1485. PMC 2027542. PMID 13608027.
- ↑ Karakas M, Koenig W (December 2009). "CRP in cardiovascular disease". Herz. 34 (8): 607–13. doi:10.1007/s00059-009-3305-7. PMID 20024640.
- ↑ 20448212
- ↑ Venuraju SM, Yerramasu A, Corder R, Lahiri A (May 2010). "Osteoprotegerin as a predictor of coronary artery disease and cardiovascular mortality and morbidity". J. Am. Coll. Cardiol. 55 (19): 2049–61. doi:10.1016/j.jacc.2010.03.013. PMID 20447527.
- ↑ Andraws R, Berger JS, Brown DL (Jun 2005). "Effects of antibiotic therapy on outcomes of patients with coronary artery disease: a meta-analysis of randomized controlled trials". JAMA. 293 (21): 2641–7. doi:10.1001/jama.293.21.2641. PMID 15928286.
- ↑ Dominguez-Rodriguez, Alberto (January 2012). "Melatonin and Cardiovascular Disease: Myth or Reality?". Rev Esp Cardiol. 65: 215–218.
External links
- Cardiovascular disease at DMOZ
- European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
- Heart Disease MedicineNet Slides, photos, descriptions


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*previously posted in DigBoston
Recent LUPEC inductee Heather Mojer turned a year older Wednesday! We raise a glass to this lovely bartending lady and to her chosen cocktail moniker, a tipple that was until recently extinct: Swedish Punsch.
Not to be confused with "punch," the liqueur evolved from Batavia Arrack, a red rice-and-sugar cane based spirit native to Southeast Asia. The Swedish East India Company is responsible for importing the stuff, which eventually became beloved by Swedes far and wide. "To mollify the sailors on board the ships, they let them dive into the Batavia Arrack that they brought back from the East Indies," Eric Seed told theNew York Times last spring. "They would mix that with sugar and maybe a touch of the spice, and that grog they called their punch."
Swedish Punsch began to be bottled sometime in the 19th century and was classically enjoyed warm with pea soup as a Thursday night tradition. By the early 20th century Americans were putting it in—you guessed it—cocktails. As the story so often goes, Prohibition killed any momentum the category had and it was obsolete stateside until very recently.
Could selecting a nearly extinct tipple as her LUPEC name be more in keeping with our mission to breed, raise, and release endangered cocktails into the wild? We think not. For that we salute you, Heather—happy birthday!
Raise a glass and go pay Heather a visit at Hungry Mother, where she'll surely mix you up something fancy with the stuff.
1 oz fresh lemon juice
1/2 oz grenadine
2 oz Swedish Punsch
Shake in iced cocktail shaker and strain into a highball glass. Fill with ice & top with soda.


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|Jenny Cosgrave / CNBC:
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This is a Techmeme archive page. It shows how the site appeared at 10:35 AM ET, July 5, 2014.
The most current version of the site as always is available at our home page. To view an earlier snapshot click here and then modify the date indicated.
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This is the company that operates in Ottawa. Unfortunately, you have to be 23 years old to join. One more year to go!
I was really interested because it would be great for doing groceries a couple of times per week, and also when I want to go see my parents who aren't far at all, but public transportation doesn't get there.
I understand why they put an age restriction; but still, its a bit annoying.


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SeventeenStyle Council
Hailee SteinfeldSeventeenStyle Stars of 2011
readers! Lily from here. This outfit is inspired by from a very talented and stylish young actress by the name of . Not only is Hailee is one of 's , but she was one of the stars honored at Variety's 2011 Power Of Youth event on October 22 in Hollywood CA. The event celebrates top young talent and their dedication to philanthropic and humanitarian causes. Go Hailee! In addition to doing amazing philanthropy, Hailee is a fashion icon and is constantly wowing us with her youthful, fun, and ever-so-chic outfit choices. This one in particular has an effortless, fun, and edgy look. She wore a Chanel jacket and boots, J Brand shorts, and a cutetop by Jil Sander.
Now I'm
going to show you how I created a similar outfit without breaking the bank! I had a lot of
fun putting together the outfit and posing for my friend, San Francisco
photographer Yifei Gu. First I cut a pair of vintage jeans to make the shorts.
It's pretty easy to find a pair that you can cut off at your local thrift
store. Then I pulled a simple button up collared shirt from my closet. A
collared shirt is a staple for any wardrobe, so if you don't already have
one, you can get one here. I happened to have
something similar to Hailey's boxy wool jacket, but in a golden yellow color. I
found mine at the Goodwill (it's vintage - from the 1960s!), but you can find
one that's similar to her's here. As for the tall socks
you can get some at American Apparel, and for the
finishing touch.....the adorable bowler hat! Mine is a vintage fedora, which
can work too, but this cute bowlerwould be perfect!
There you have it. A super fun, chic outfit!
More From Seventeen
xoxo Lily
For more celeb inspired style, check out the Style Council blogs!


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British Airways Adds Nonstop Flight To Austin
NPR's business news starts with non-stop flights.
MONTAGNE: British Airways has announced a new non-stop service five days a week between London and Austin, Texas. The move comes as something of a surprise, considering the airline already serves Dallas and Houston.
From member station KUT, David Brown reports.
DAVID BROWN, BYLINE: The new Austin non-stops won't begin until next March - about the time some quarter-million visitors descend on the city for the annual music and film conference, South by Southwest.
Simon Brooks is a vice president with British Airways.
SIMON BROOKS: You seen through our plan and that's the reason we're starting the service in early March.
MICHAEL BOYD: This South by Southwest thing, forget that. You don't take an $80 million asset and throw it across the Atlantic on the basis of a two week hootenanny.
BROWN: Industry Analyst Michael Boyd says the real story is the new Boeing 787, the Dreamliner. Despite a series of highly publicized incidents, including in-flight electrical fires, the mid-sized Dreamliner makes a route like London to Austin viable for the first time.
BOYD: This would never happen without the 787. So, because the 787 is the right size and the right cost for this route. If that airplane had not come along, this would not be here.
BROWN: It also wouldn't have happened without city officials aggressively pitching Austin as a new high-tech hub. For that reason, Boyd doesn't expect a new British invasion at American airports anytime soon.
For NPR News, I'm David Brown in Austin, Texas. Transcript provided by NPR, Copyright NPR.


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Lydia McGrew argues that the problem of evil poses a substantial problem for natural theology. If we take, say, the famous trilemma of pseudo- Epicurus
If God is willing to stop evil but unable, how is he omnipotent?
If he is able but not willing, how benevolent?
If willing and able, how is there evil?
we can read it as showing that Christian and natural theology come to different conclusions about whether God is benevolent or indifferent with respect to the world. It seems that natural theologians are forced to conclude that God is indifferent, and that they must confess frankly that they stand in need of revelation in order to establish the crucial fact of Christian theology that God loves the world and desires to give good things to human beings. While she initially poses the problem with respect to the problem of evil, a more forceful way of putting McGrew's argument (which is implied in how she develops the point in the comments) is this:
In order to defend God's benevolence in the face of evil, one must be told God's plan to remedy evil, but
God's plan to remedy evil belongs to the history of salvation.
Salvation history is known only by revelation, therefore, etc.
The argument admits of more than one interpretation, and I need some groundwork in order to respond. The argument is a general argument about what reason can know purely by itself, and I think this question is usually understood poorly, and needs to be visualized in a better way.
St. Thomas argues that God needed to reveal even things that can be known by natural reason, since the truths which can be known about God were known only by few, after a long time, and with much error. It's crucial to notice that this state continues throughout all time. Natural theology or metaphysics are the most difficult of sciences. Almost no one can learn them at all, and of those who can, none can learn them quickly and all commit many errors. The sense we have that we can attain certainty early and easy is not entirely illusory, but this certitude depends on our practicing metaphysics in a safe environment that doesn't expose us to the full force of all possible objections from the beginning. Example: a flower kept in a greenhouse will really survive all the shocks and stresses it encounters, and in this sense it survives "by its own nature alone", but it is not exactly in its natural place, and it wouldn't survive at all if exposed to all possible stresses or strains we could inflict on it. The power of "pure reason" is like the survival power of a flower: it needs an environment that not only protects it not only from what it might encounter in it natural environment, but also from things that, while not part of it natural environment, might be introduced to kill it off (like pesticide). Institutions – normally churches and institutions affiliated with them – provide this environment. The proof of that the environment is the correct grows as the person nurtured in it finds himself able to assimilate more and more truth, and overcome more and more objections.
Even after metaphysics becomes strong enough to live on its own, there is another difficulty in that its truth is found only in the soul of the one studying it. There is no product that the metaphysician can produce to prove the truth of his efforts and no planes crash if he is wrong. The metaphysician is seeking just truth and knowledge, and both are interior perfections that no one experiences except the one who has them.
The question of what we can determine by pure reason is set against this backdrop. If we understand the question of what reason can know by itself to mean "what can a reasonable person expect to know about metaphysics if he tries real hard to figure it out for himself"? then the answer is "almost nothing". A person might present this "almost nothing" in a dogmatic or bull-headed way, or bully their way through objections, but this doesn't change that they know.
Taken in this way, what is proper to McGrew's question drops off and we see it in light of the general difficulty of all questions in metaphysics or natural theology. All natural theology is hard, it requires exterior help, and when pure reason finally succeeds fully, it is only within the soul of the one knowing, who is aware of how arbitrary his doctrine must look to anyone who has it presented to them in their natural habitat, or (what is quite common nowadays) from the pesticides that we introduce artificially to kill off even those plants that might have survived in the wild.


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Sleeping with the enemy
May 24, 2011 1 Comment
Ever wondered how your mobile manners rank? Read through the results of the latest iPass survey to see how your mobile etiquette compares to others.
iPass just published the latest edition of the Global Mobile Workforce Report. Along with the usual great insights on mobile device penetration (now 98%) and mobile applications usage this time the iPass survey reveals some more personal habits with regard to the use of mobile technology – including its use in the bedroom. Here are some nuggets from the report. Read through to see how your mobile etiquette compares to others.
Are you afraid to admit that you go to sleep with your iPhone? Well, don't feel bad because you are not alone. In fact almost one half (43%) of the mobile workers surveyed by iPass store their smartphones within arm's reach when they sleep at night. I have to admit I am one of those who carry not just the smartphone to bed but also the laptop – and more recently the iPad. Besides being my smartphone the only phone line I have – I closed my home landline long time ago when I realized only telemarketers would call me at that number, I like to end the day by watching movies or streaming videos on my laptop – YouTube and Hulu being my favorites of the moment. And hey, it comes handy to have the smartphone in reach when I wake up in the morning. If the last thing I do before falling asleep is to close the lid of my laptop and put it under the bed, the first thing I do in the morning when I open my eyes is to check the email on my iPhone. Sounds familiar? Well, according to iPass when mobile workers wake up in the morning, a good third of them (35%) check email before anything else including getting dressed or eating breakfast.
And here is where things get a little more controversial: the survey suggests that those who take their smartphones to bed are 60% more likely than average to wake during the night to check their smartphone. Albeit with some local variations, this seems to be a global reality. Those living in Asia Pacific are the least rested with 55% of mobile workers waking at least occasionally to check their smartphone or tablet, and 19% wake every night. Europeans are the most rested with only 27% waking at least occasionally, and 4% waking every night. I wonder whether these folks wake up because their phone is in reach or if they are actually taking the phones to bed because they already know they can't sleep all through the night anyway.
Not surprisingly, 29% of those who take the mobile devices to bed find that their mobile technology usage causes friction in their personal relationships, specifically with their significant other or spouse …
Leave a comment if you'd like to share how your mobile manners compare with those interviewed by iPass …


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I love milestones. It creates the little reasons for celebrations amidst a life of drudgery. It's the pat on the back that a job was well done. I especially love milestones when they are not mine, but belong to the people I love. Those who have followed my blog for a while know about year and a half ago, the quiet and solitary wanderer (and wonderer) Cao, was adopted by a rather loudly boisterous, rather large and kindly loving Italian "gypsy" family. In typical fashion they not only stole my quiet solitude, they stole my heart. I love each and every member of my gypsy family, they have taken my 8-bit colored Second Life and made it the entire technicolor visual feast that it is today.
But I digress, (as usual), early in December Mila silently had one of these milestones. My busily scurrying, always creating seamstress of dreams celebrated the 2nd anniversary of her passion, the *SoliDea FoliEs* line of apparel. One year in the cutthroat SL design industry is amazing in itself. Two years? That is a feat worthy of probably just a few dozen SL businesses. Congratulations my sister, my friend, my Mila. I am so proud of you!
Take froms? yep, there always is one. In true Mila's giving heart fashion, she wants to celebrate this day now, after the making of so many MVW dresses, after the week of 2lei, after the construction of a brand new mainstore at Salimar, after the confetti has been swept away by BOSL's Miss Virtual World contest. The birthday celebration is now. But whats a party unless it is a celebration surrounded by family and friends? Won't you please come celebrate this joyous occasion with us? Won't you come so we can thank you, our patrons, our friends, our family, for all of your support in these two wonderful years, because without you, there would be no true celebration. Come, be with us December 20th at noon (12:00PM SLT) for our grand-opening, runway show and party. I can't wait to see you there! Won't you stop by? See? I'm so nice, I even included the caravan for you: Taxi:


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Today, a growing number of stations are syndicating 'religious radio', or an emphasis where 'day time' radio focuses on Christianity, geared toward a conservative Christian audience.
Why is this? Are consumers more religious today? Is the base more proactive in its ability to listen and support this genre?
History of Religious Radio
If you listened to radio as a focal point of your entertainment growing up, many people did, you'd have heard at least one local radio hour based on the bible, the main book for Christianity. The life of religious radio and art of using the tool to draw more people to Christ began over 60 years ago.
Pastors like Billy Graham, who created "The Hour of Decision" show for the Los Angeles Area in 1949, set a precedent for other prominent pastors and clergy to follow suit; he saw the power of radio to develop his ministry.
Graham's media promoted his ministry, a crusade that converted many to Christianity and reignited tent ministries, a term started in the 19th/C where traveling ministers visited small American towns to preach the Gospel.
While many in the community discouraged media use and rejected popular entertainment, Graham showed the benefits through his increasingly popular radio ministry. The program eventually syndicated, reaching ministries in New York and other places on the east coast. His wit and foresight, along with keen understanding that radio was a powerful too to communicate Christian values, launched and set the foundation for religious radio as we know today.
Radio as a Conversion Tool
Not only did Graham have the wit to see how radio could benefit his followers, but the formula could be copied in many different genres. No longer was religious radio simply a lecture from the pulpit, it could be used in news and day time talk developed as a result.
Organizations sprung up from other denominations, even other religions saw the potential, where directors understood the power for those who could listen from afar and hear the message.
Billy Graham played a major role in the early history of religious radio. But today's leaders in the industry have found an even more powerful and succinct opportunity-through conservative news-to relay their message.
Religious Radio Today-Who's Behind it?
There is a spectrum of religious organizations who have developed religious radio to an art form. Organizations that have been around for three or more decades, like Pat Robertson's "The 700 Club", even "Trinity Broadcasting" started in the late 1970's primarily on small, local television and flourishing to include radio as part of its ministry. These producers understood the art of drama, offering those who listen human interest stories based in religious beliefs, missionary updates and talks on all subjects related to the 'good book', the Bible.
The movement took a dip in popularity, from Bill Graham's time, when many leaders in the industry were caught in scandal, decreasing public trust and creating the perception that the industry was fanatical.
In the late 1980s especially, the movement and listener-ship took an all-time low dip, propagating many AM and FM religious stations off air or to a lower wattage amount. This large decrease, from its hey day of over 1,300 stations between 1980-1987, was a wake up call for the industry.
They needed a positive re-invention, fast.
Enter Talk Radio
The conservative base, as well as Catholic base, though smaller in recent years, was still vital and active. Producers knew this and conservative news was becoming an increasingly sought after medium, with the rising popularity of secular cable news, like CNN.
The art of talk was important. They needed good pundits, who relayed the conservative message, in a way that would compel their base.
Pundits, like Sean Hannity, who got his start early in life, starting in 1989 climbing the ladder rungs of conservative radio (and television), and eventually hitting national syndication by 2001, were the answer.
People like Hannity, Glenn Beck, Rush Limbaugh and on the more incendiary end, people like Michael Savage, bolstered the conservative community, giving voice to an underlying sense of disenfranchisement and conviction in increasingly 'dangerous' secular spin on conservative beliefs.
The formula's taken off and it won't be declining any time soon.
Future of Religious Radio in the U.S.
To date, there are again more than 1,600 Christian broadcast. stations in the U.S. alone. There are many reasons, too, that point to the growth and stability of this format:
The ideological divide is never more prominent in the U.S. today, giving credence to the fact that religious radio is part of that equation.
The Catholic base has been refortified, with greater secular popularity for Pope Francis.
The formula works, but online presence increases exposure, too
Pope Francis is the most popular Pope since Pope John Paul II, in 30 years. Catholic ministry, also included in religious radio, is a grown subset of evangelical radio. And again, religious radio now includes online radio, with an ever growing number of pod casts and daily shows.
Religious radio is on the rise, with more online radio options, and more religious station broadcasting than ever before. Its rising because influential conservative talk show hosts, the most popular Pope in years, and better access in key, target markets — all are converging to help it grow.


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It seems inevitable that every fashion designer will foray into cosmetics or fragrance at some point in their career. And while some scents fall short in the vastness of the beauty industry, the excitement surrounding L'Wren Scott's collaboration with Barneys New York doesn't disappoint. The first of many designer collaborations, Scott worked hand-in-hand with perfumer Ralf Schwieger to create a scent that is sexy, mysterious, and daring. With notes of absinthe, tuberose, and leather (yes, leather) it seems fitting that the symphonic scent would be housed in a flask-like, heavy bottle of red glass.
ELLE.com sat down with the 6-foot-4-inch designer (and Mrs. Mick Jagger) to chat about her journey into beauty, her next steps (coyly hinted at), and her must-have beauty products. Dressed in head-to-toe L'Wren Scott Resort 2013, the designer was candid about her process with Schwieger, why all the men in her life will be sporting the fragrance, and how important the bottle design was to the overall experience.
More From ELLE
ELLE: How did you decide it was the right time to foray into fragrance?
L'Wren Scott: It was something I'd been planning for a while. I did this collaboration with Lancôme that was a color line, and it was very successful. It was exciting and fun for me, and it had such a great response. I really wanted to do my own perfume because I mix my own oils, so it just made sense.
ELLE: How did you decide on the final scent and the notes?
LS: I knew what I wanted the notes to be before we even started. I was very specific. When you're creating a fragrance, you're always thinking about what you want that first smell to be, that first reaction. It's a sensation, like a symphony with all of those layers and notes. I love the way it changes, and the way it dries down. The fun thing about scent is that it's unique to everyone; pheromones take on a new scent.
ELLE: Did you envision it being a unisex scent?
LS: Yes! All the men last night [at the launch dinner] were spritzing it on themselves and saying how much they love it, and they weren't just saying that to be nice to me [laughs]. I know these guys, they wouldn't say that if they didn't mean it. I didn't want it to be too feminine. It's quite sexy and mysterious, don't you think? And I love that the top note is absinthe!
ELLE: How important was the bottle design to you?
LS: The bottle was almost as important as the scent to me. Barneys and I chose this bottle together—they will continue to launch limited-edition fragrances with other designers. I wanted it to feel really solid in your hand and be very linear. It's almost like a flask, which I think is very fitting for the notes.
It was also really important to me that it was a colored bottle. I knew the notes that I wanted would be intense. And since perfumes change with age, I didn't want that discoloration to be part of the visual. I want it to always look perfect, so we went with a signature bordeaux bottle, and the box is clean white linen with a bordeaux interior.
ELLE: Do you have any future plans to create a beauty line?
LS: You mean, that we can disclose at this time? [She smiles coyly]
ELLE: You're such a glamorous woman, tell us what some of your favorite beauty products are.
LS: Oh my god, I love my Caudalie Beauty Elixir. I left it at home and I'm so upset, I need a spritz right now—this weather is drying me out. I also love oils. During the day I wear ColbertMD Illumino Face Oil. It's super light and makeup sits on it really well. At night and on flights I wear something a little heavier, usually the Rodin Olio Lusso.
I'm also really obsessed with my under eyes. I use the Clarisonic Opal, I call it my little eye bright. It really works! I never sleep, so this helps me fake it. I use the Natura Bisse Diamond Ice-Lift DNA Cryo Mask but just under my eyes. It's meant for the whole face but it really brightens under the eye.
Of course I love Laura Mercier Invisible Loose Setting Powder. It's her translucent powder but in HD. And for my face I use By Terry Hyaluronic Face Glow. It's a creamy coverup that isn't quite a foundation, almost more of a tinted moisturizer.
ELLE: And we can't forget about hair care.
LS: I have very dry hair, so I don't wash it every day. Instead, I use the Serge Normant Dry Shampoo. I'm a little obsessed with Serge [laughs]. I hate how when I have a bunch of events going on and I have to get my hair done so much, [then] I have to wash it more often. It's definitely better not to.


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- This event has passed.
Event Series: Passport to Leadville History
Passport to Leadville History
May 24, 2019 @ 9:00 am - 5:00 pm
Love history? Hit paydirt with the Passport to Leadville History! See eight museums for one low price.
This combination ticket is on sale mid-May and is good through Labor Day for one visit to each of these eight museums:
- Heritage Museum
- Healy House Museum and Dexter Cabin
- Matchless Mine
- National Mining Hall of Fame and Museum
- Tabor Home
- Tabor Opera House
- Temple Israel Synagogue and Museum
- The House with the Eye
The Museum Passport also offers 10% off scenic trips:
And discounts on stays:
- Sunday – Wednesday nights at the historic Delaware Hotel!
Additional Benefits:
In addition to saving money on admission, the Museum Passport offers these benefits:
- Convenience of purchasing only one admission ticket
- Ability to visit the museums at different times throughout the summer
- Ability to transfer to others
- Adults: $40
- Seniors: $35
- Children (ages 6-12): $10
Where to Buy:
- Healy House Museum and Dexter Cabin, 912 Harrison Ave.
- Leadville/Lake County Chamber of Commerce, 809 Harrison Ave.
- National Mining Hall of Fame and Museum, 120 W. 9th St.
- Tabor Opera House, 308 Harrison Ave.