Assessing the Association between Heart Attack, High Blood Pressure, and Heart Disease Mortality Rates and Particulate Matter and Socioeconomic Status Using Multivariate Geostatistical Model

This study addresses the public concerns of potential adverse health effects from ambient fine particulate matter as well as socioeconomic factors. Heart attack, high blood pressure, and heart disease mortality rates were investigated against fine particulate matter and socioeconomic status, for all counties in the United States in 2013. Multivariate multiple regressions as well as multivariate geostatistical predictions show that these are significant factors towards assessing the causal inferences between exposure to air pollution and socioeconomic status and the three mortality rates.

State level correlations between high heart attack and stroke symptomology knowledge scores and CVD risk factors and mortality rates

Introduction: In 2008, cardiovascular disease (CVD) accounted for one in three deaths in the United States. Epidemiological analyses suggest that two or more risk factors are the indicator of high risk and/or poor CVD outcomes. Knowledge of heart attack and stroke symptomology has been the focus of much research based on the assumption that accurate identification of an event is critical to reducing time to treatment. There is a paucity of research showing a clear association between knowledge of heart attack and stroke symptomology, risk factors, and mortality rates. In this study, we hypothesized that high stroke and heart attack symptomology knowledge scores would correspond to lower stroke or CVD mortality rankings as well as to a lower prevalence of two or more CVD risk factors. Methods: State was the unit of analysis used to examine data from two different sources and combined into a customized database. The first source was a multiyear Behavioral Risk Factor Surveillance Survey (BRFSS) heart attack and stroke symptom knowledge module database. CVD and stroke mortality data used came from the American Heart Association’s (AHA) 2012 Heart Disease and Stroke Statistics Update. Spearman’s Rho was the test statistic. Results: A moderate negative correlation was found between high heart attack and stroke symptom knowledge scores and the percentage of adults with two or more CVD or stroke risk factors. Likewise, a similar correlation resulted from the two variables, high heart attack and stroke symptoms knowledge score and CVD mortality rank. Conclusions: This study demonstrated a significant relationship between high heart attack and stroke symptom knowledge and lower CVD mortality rates and lower prevalence of two or more CVD risk factors at the state level. Our findings suggest that it is important to continue education efforts regarding heart attack and stroke symptom knowledge. Pharmacists are one group of health care providers who could enhance the needed public health education efforts.

Public knowledge of heart attack symptoms in Beijing residents

Background Definitive treatment for heart attack is early reperfusion with either angioplasty or thrombolytic therapy, and the benefit is strictly time-dependent. Patient outcomes are improved with either therapy when initiated as soon as possible. Recognition of heart attack symptoms is logically tied to taking action to receive prompt emergency care. Inadequate knowledge of heart attack symptoms may prolong delay. The purpose of this study was to document knowledge about heart attack symptoms in Beijing residents and to identify the characteristics associated with increased knowledge of heart attack. Methods A structured survey was conducted in 18 communities in Beijing from March 1 through June 10 in 2006. Addresses and participants were selected randomly following a stratification. The survey was designed to collect knowledge of heart attack symptoms from sampled adults in each community. Results A total of 4627 respondents completed the questionnaires correctly, and 50.29% of them were female. Totally 64.15% of the respondents reported chest pain or discomfort （common symptoms） as a symptom of heart attack; 75.38% reported at least one of the following eight symptoms as a symptom of heart attack： back pain, shortness of breath, arm pain or numbness, nausea or vomiting, neck, jaw or shoulder pain, epigastric pain, sweating, weakness （less common symptoms）; 20.36% correctly reported four or more heart attack symptoms, only 7.4% knew all the correct heart attack symptoms, and 28.94% knew about reperfusion therapy for heart attack; 31.7% reported to call 120 or 999 while having a heart attack themselves; however 89.6% reported to call 120 or 999 when someone else is suffering from a heart attack. Very old persons and those with health insurance coverage, high education level, high household income, longer living in Beijing and previous experience with heart disease had greater knowledge of heart attack symptoms. Conclusions Public knowledge of common heart attack symptoms as well as less common heart attack symptoms is deficient in Beijing residents. But their knowledge of calling emergency medical services when someone is having a heart attack is relatively adequate. Public health efforts are needed to increase the recognition of the major heart attack symptoms in both the general public and groups at high risk for an acute cardiac event, especially in socioeconomically disadvantaged subgroups, including persons with low education level, low household income, and no health insurance coverage.

Heart attack pervasiveness along with associated risk factors in District Headquarter Hospital in Karak,Khyber Pakhtunkhwa,Pakistan

Objective:To investigate the possible risk factors among heart patients of Karak District.Methods:Different questions were asked from the respondents regarding their educational level,stress taking,smoking,mode of medication and diabetic history.A total of 72 heart patients were included in this study with the confirmed medical history of myocardial disorder/heart attack either once or twice.Results:It was revealed in this study that a high prevalence of heart attack was observed in respondents at secondary level of education i.e.73.33%.This was followed by the respondents at primary level of education having 63.64%heart patients and then respondents at postgraduate educational level having 61.11%heart patients.Least number of heart patients were found at graduate group i.e.27.78%heart patients.This study revealed that stress takers were at a higher risk of heart attack,while nonstress takers were comparatively healthier than stress takers.About 83.33%stress taker respondents were heart patients,while 76.67%healthy respondents were nonstress takers.Current study also revealed that smoking was a leading cause of cardiovascular diseases as 88.10%heart patients were either occasional smokers or chain smokers,while 66.67%nonsmokers were healthy with no symptoms of heart disease.Self-medication was found an elevated cause of heart diseases as 76.19%heart patients had a history of self-medication.Conclusions:This practice was found low in healthy respondents where only 23.81%respondents had self-medication in their past history.Diabetes was found the associated disease with the heart patients.

Posture Detection of Heart Disease Using Multi-Head Attention Vision Hybrid(MHAVH)Model

Cardiovascular disease is the leading cause of death globally.This disease causes loss of heart muscles and is also responsible for the death of heart cells,sometimes damaging their functionality.A person’s life may depend on receiving timely assistance as soon as possible.Thus,minimizing the death ratio can be achieved by early detection of heart attack(HA)symptoms.In the United States alone,an estimated 610,000 people die fromheart attacks each year,accounting for one in every four fatalities.However,by identifying and reporting heart attack symptoms early on,it is possible to reduce damage and save many lives significantly.Our objective is to devise an algorithm aimed at helping individuals,particularly elderly individuals living independently,to safeguard their lives.To address these challenges,we employ deep learning techniques.We have utilized a vision transformer(ViT)to address this problem.However,it has a significant overhead cost due to its memory consumption and computational complexity because of scaling dot-product attention.Also,since transformer performance typically relies on large-scale or adequate data,adapting ViT for smaller datasets is more challenging.In response,we propose a three-in-one steam model,theMulti-Head Attention Vision Hybrid(MHAVH).Thismodel integrates a real-time posture recognition framework to identify chest pain postures indicative of heart attacks using transfer learning techniques,such as ResNet-50 and VGG-16,renowned for their robust feature extraction capabilities.By incorporatingmultiple heads into the vision transformer to generate additional metrics and enhance heart-detection capabilities,we leverage a 2019 posture-based dataset comprising RGB images,a novel creation by the author that marks the first dataset tailored for posture-based heart attack detection.Given the limited online data availability,we segmented this dataset into gender categories(male and female)and conducted testing on both segmented and original datasets.The training accuracy of our model reached an impressive 99.77%.Upon testing,the accuracy for male and female datasets was recorded at 92.87%and 75.47%,respectively.The combined dataset accuracy is 93.96%,showcasing a commendable performance overall.Our proposed approach demonstrates versatility in accommodating small and large datasets,offering promising prospects for real-world applications.

Aspirin Helped Reduce Heart Attack Death Rate

本刊曾经多次刊登文章盛赞百年老药阿斯匹林。去年第10期就载文称阿斯匹林能抗前列腺癌,今又消息文称,阿斯匹林能减少心脏病人的死亡率。百年老药.青春犹在,至今仍能让人们不断发现其新的功效！本文除了传递了有关阿斯匹林的新信息之外,以下观点,也让我们耳目一新: Even as we live and practice medicine in an era of high technology,we mustalways remember that widespread application of relatively low technology,efficacious(有效的;灵验的),and cost-effective(有成本效益的,值得花费的)therapies is often the way we help most of our patients and provide the greatestaggregate(集合的;聚合的)benefit for the broader population. 上句是否可以这样译: 即使我们生活、就医在一个高科技的时代,但是,我们仍必须一直牢记:科技含量相对较低却又广为应用的东西,其灵验而又具有成本效益的治疗常常是我们帮助大多数患者,为广大群众提供最大利益的途径。 上句的难点在于:如何理解provide the greatest aggregate benefit for thebroader population的主语。

Alcohol Cuts Heart Attack Risk in Men

选注者言:本文的主题句开门见山地告诉读者:frequent tippling(少喝常饮,常饮少量烈酒)of beer,wine or even spirits lowers a man’s risk of heart attack(心脏病发作)。但是,让我们感到不解的是文中的另一句话:alcohol affects womendifferently than men and that it would be"premature and unwise"to extrapolate(推断)the results beyond men。现代科技尚不能揭开这个谜:男性每日少量饮酒能降低心脏病的风险,而女性经常喝酒,却会增加得乳腺癌的机会。此句中的premature and unwise可以学用,而extrapolate一词则用得太文绉绉了。

郑东海医案:心脏神经官能症治疗病例

心脏神经官能症又称神经性血管综合征、功能性心脏不适等,属于神经官能症的一种特殊类型,目前病因尚不明确,西医对其无特异性的治疗方法,多以稳定心率、防止瘀血、阻断靶点与受体结合为主,引发的情志性后遗症较多,临床疗效不理想。中医对于心脏神经官能症独特的认知和辨治方法为临床治疗提供了新的方向。传统认知上,结合患者体质辨证论治,多从肝郁、肺虚、阴虚等方面入手,可取得良好疗效。而郑东海教授认为因气机逆乱、阳虚水泛为先,水饮之邪上泛和阴阳不相顺接而形成心脏神经官能症,需秉承易水学派“怡情志,调升降”的理论,采用舒畅患者情志,调理气机,温化水饮,交通阴阳的基本方法治疗。临证时,郑教授使用四逆散合真武汤,不仅可以调畅一身气机,使阴阳之气相互顺接,升降相接,还可以防止因阳气亏虚无以温化水液,导致水饮之邪随逆乱之气机上凌于心。从临床效果来看,中医药治疗心脏神经官能症不仅可以较迅速地缓解症状,更可以恢复人体的正常功能,保障患者正常的生活,疗效显著。文章中介绍郑东海教授治疗心脏神经官能症的学术思想,并附病案一则。

真武汤与葶苈大枣泻肺汤在肺心病急性发作期中的应用效果

目的研究在肺心病急性发作期中使用真武汤与葶苈大枣泻肺汤的效果。方法选取2022年1—12月本院收治的70例肺心病急性发作期患者进行研究,并按照随机分组法分为对照组和研究组,每组35例。其中,对照组在治疗中使用常规西药治疗,研究组在常规治疗的基础上加用真武汤与葶苈大枣泻肺汤,治疗后,对比两组治疗效果。结果研究组治疗效果明显更高,血气分析结果均明显更优,组间差异有统计学意义(P<0.05)。结论在肺心病急性发作期,应用真武汤与葶苈大枣泻肺汤联合治疗,疗效显著。

川芎嗪联合阿托伐他汀治疗冠心病心绞痛患者的效果

目的:探讨川芎嗪联合阿托伐他汀治疗冠心病心绞痛的效果。方法:选取2020年12月—2022年12月贵州省人民医院邮电医院收治的86例冠心病心绞痛患者作为研究对象,按照随机数表法分为两组,各43例。对照组给予阿托伐他汀钙片口服治疗,观察组在对照组基础上给予磷酸川芎嗪注射液治疗,两组均连续治10 d。比较两组治疗前后心绞痛发作情况、心功能指标、脂代谢指标、生活质量变化情况,并记录两组不良反应发生情况。结果:治疗前,两组心绞痛发作持续时间、心绞痛发作频率、视觉模拟评分法(VAS)、全血高切黏度、血浆黏度、全血低切黏度、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)、脑钠肽(BNP)、C反应蛋白(CRP)及健康状况调查问卷(SF-36)评分比较,差异无统计学意义(P>0.05);治疗10 d后,观察组心绞痛发作持续时间短于对照组,心绞痛发作频率、VAS评分、全血高切黏度、血浆黏度、全血低切黏度、LDL-C、TG、TC、BNP、CRP均低于对照组,HDL-C及SF-36中各项评分均高于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:川芎嗪联合阿托伐他汀治疗冠心病心绞痛的效果显著,能够有效改善患者心绞痛情况,改善血液流变学,调节脂代谢水平,提高生活质量,且安全性高。

丹参注射液辅助治疗对冠心病心绞痛患者心绞痛发作情况及血管内皮功能的影响

目的 探讨丹参注射液辅助治疗对冠心病心绞痛患者心绞痛发作情况及血管内皮功能的影响。方法 择取2021年5月至2023年5月于上饶市中心医院接受治疗的93例冠心病心绞痛患者,用随机数字表法分成对照组(n=46)、试验组(n=47)。对照组予常规西药治疗,在其基础上,试验组予丹参注射液辅助治疗,对比两组临床疗效、心绞痛发作情况、心功能、血管内皮功能、炎症因子水平和不良反应情况。结果 试验组临床有效率较对照组高(P<0.05)。治疗后,两组心绞痛持续时间均缩短,心绞痛发作频次均减少,且试验组较对照组改善更优(P<0.05);两组心输出量(CO)、每博输出量(SV)、左心室射血分数(LVEF)均增加,且试验组较对照组高(P<0.05);两组内皮素-1(ET-1)均降低,一氧化氮(NO)均增加,且试验组较对照组改善更优(P<0.05);两组CRP与IL-6均降低,且试验组较对照组低(P<0.05)。治疗期间两组均未出现明显不良反应。结论 丹参注射液辅助治疗冠心病心绞痛疗效确切,可改善血管内皮功能,拮抗炎性反应,减少心绞痛发作情况,改善心功能,且安全性较高。

他汀类药物联合曲美他嗪对冠心病心绞痛患者血管内皮功能及心绞痛发作的影响

目的探究他汀类药物联合曲美他嗪对冠心病心绞痛患者血管内皮功能及心绞痛发作的影响.方法选择2022年3月—2023年3月寿光市人民医院收治的90例冠心病心绞痛患者为研究对象,按随机数字表法分为对照组和观察组.对照组(n=45)采用阿托伐他汀片联合常规治疗,观察组(n=45)采用常规治疗、盐酸曲美他嗪缓释片联合阿托伐他汀片治疗.对比两组患者的心功能、血管内皮功能、心绞痛发作情况及不良反应发生情况.结果治疗后,观察组的血清一氧化氮水平高于对照组,血清内皮素-1及外周血循环内皮微颗粒水平均低于对照组,组间差异有统计学意义(P<0.05).治疗后,观察组的心绞痛发作次数少于对照组,心绞痛持续时间短于对照组,组间差异有统计学意义(P<0.05).治疗后,观察组的左室射血分数高于对照组,左室舒张末期内径短于对照组,心肌耗氧量低于对照组,组间差异有统计学意义(P<0.05).两组的不良反应发生率比较,差异无统计学意义(P>0.05).结论采用他汀类药物联合曲美他嗪治疗冠心病心绞痛患者,能提升其血管内皮功能及心功能,改善心绞痛症状,安全性较佳.

曲美他嗪联合氯吡格雷治疗冠心病心绞痛患者的效果

目的:观察曲美他嗪联合氯吡格雷治疗冠心病心绞痛患者的效果。方法:选取2020年1月至2023年1月该院收治的100例冠心病心绞痛患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各50例。对照组采用氯吡格雷治疗,研究组在对照组基础上联合盐酸曲美他嗪治疗,比较两组临床疗效,治疗前后心绞痛发作指标(心绞痛发作持续时间、心绞痛发作次数)水平、心功能指标[左心室射血分数(LVEF)、左心室收缩期末内径(LVESD)、左心室舒张期末内径(LVEDD)]水平、心肌损伤标志物[肌酸激酶同工酶(CK-MB)、生长分化因子-15(GDF-15)、和肽素(CPP)、N-末端脑钠肽前体(NT-proBNP)]水平和不良反应发生率。结果:研究组治疗总有效率为96.00%(48/50),高于对照组的84.00%(42/50),差异有统计学意义(P<0.05);治疗后,两组心绞痛发作持续时间均短于治疗前,且研究组短于对照组,两组心绞痛发作次数均少于治疗前,且研究组少于对照组,差异有统计学意义(P<0.05);治疗后,两组LVEF水平均高于治疗前,且研究组高于对照组,两组LVESD、LVEDD水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组CPP、GDF-15、CK-MB、NT-proBNP水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:曲美他嗪联合氯吡格雷治疗冠心病心绞痛患者可提高治疗总有效率,改善心功能指标水平,降低心肌损伤标志物和心绞痛发作指标水平,其效果优于单纯氯吡格雷治疗。

托伐普坦与托拉塞米治疗慢性心衰急性发作的疗效比较

目的比较分析托伐普坦与托拉塞米治疗慢性心衰急性发作的疗效。方法选取医院收治的慢性心衰急性发作患者78例,按入院先后顺序编号,采用奇偶法分为托拉塞米组及托伐普坦组,各39例。两组均给予常规抗心衰治疗,在此基础上,托拉塞米组静脉滴注托拉塞米治疗,托伐普坦组口服托伐普坦。对比两组治疗前后各项生化指标及24 h尿量变化。结果治疗后,两组肌酐值均有所下降,但托拉塞米组仍略高于正常值,而托伐普坦组已恢复至正常范围(P<0.05);托拉塞米组血钠呈下降趋势,而托伐普坦组的血钠较平稳,始终维持在正常范围内(P<0.05);两组血钾、血氯均恢复到正常范围(P>0.05)。治疗后,两组24 h尿量均呈上升趋势,且治疗后第7 d时,托伐普坦组24 h尿量明显高于托拉塞米组(P<0.05)。结论与静脉滴注托拉塞米治疗比较,服用托伐普坦治疗慢性心衰急性发作的效果更好,也可有效去除患者体液储留。

真武汤合苏葶丸治疗肺源性心脏病急性发作期合并左心衰竭的效果探讨

目的:探讨真武汤合苏葶丸治疗肺源性心脏病急性发作期(AECPHD)合并左心衰竭的效果。方法:选取2016年3月至2017年12月湖北省中医院收治的AECPHD合并左心衰竭患者91例作为研究对象,将其按照抽签法分为对照组(n=45)和观察组(n=46),对照组采用常规西医治疗,观察组在此基础上用真武汤合苏葶丸治疗,比较2组的临床疗效。结果:观察组总有效率为95.7%,对照组为80.0%,2组比较差异有统计学意义(P<0.05);治疗前2组患者中医证候积分、心肺功能及血管功能比较,差异均无统计学意义(P>0.05),治疗后2组上述指标均明显改善(P<0.05),其中观察组改善程度明显优于对照组(P<0.05)。结论:真武汤合苏葶丸治疗AECPHD合并左心衰竭效果显著,能够有效改善心肺功能,值得临床推广。

Unbalance of the Physiological System May Cause Trouble —The Other Side of the Story from the Very Successful Drug, VIOXX

Selective cyclo-oxygenase-2 (CQX-2) inhibitor, VIOXX (rofecoxib), wasvoluntarily withdrawn worldwide from drugstores by its maker Merck & Co., Inc. on September 30,2004, for its potential lethal side effects of heart attack or stroke, The Merck' s decision wasbased on new, three-year data from a prospective, multi-center, randomized, placebo-controlled,double-blind clinical trial of VIOXX with an unrelated study, the APPROVe (Adenomatous PolypPrevention on VIOXX) trial. The trial has been enrolling 2 600 patients and comparing 156 weeks(three years) of treatment with VIOXX 25 mg to placebo since 2000.

血压控制对慢性心力衰竭急性加重患者近期临床疗效的影响

目的：探讨血压控制水平对慢性心力衰竭（CHF）急性加重患者临床疗效的影响。方法：在规范治疗的基础上，根据收缩压控制水平将192例CHF患者分为低血压水平组（80～100mmHg）、中血压水平组（101～120mmHg）和高血压水平组（121～140mmHg），观察不同血压水平CHF患者的临床疗效。结果：显效、有效和无效／恶化率在低血压水平组分别为46．8％（29／62）、45．2％（28／62）和8．1％（5／62），中血压水平组为27．3％（18／66）、54．5％（36／66）和18．2％（12／66），高血压水平组为12．5％（8／64）、50．0％（32／64）和37．5％（24／64）。结论：CHF患者急性加重时血压水平在一定范围内控制越低，临床症状改善越快，近期疗效越好。

血清降钙素原对慢性心力衰竭急性发作患者的临床评估价值

目的评估血清降钙素原(PCT)升高与尚无明确细菌感染证据的慢性心力衰竭急性发作患者临床基础特征及预后的关系。方法对2015年2月—2017年12月于邯郸市中心医院住院的慢性心力衰竭急性发作患者进行前瞻性研究。根据PCT水平分为PCT升高组及PCT正常组,对比两组患者入院后的临床基础特征,应用logistic回归分析PCT升高的原因;比较入院后规范治疗48 h后的效果、30 d内全因死亡/再住院发生率。结果共纳入593例慢性心力衰竭急性发作患者,其中PCT正常组521例,PCT升高组72例。logistic回归分析表明,心率增快、肺水肿、白细胞计数、血尿素氮(BUN)与PCT升高呈正相关,白细胞计数相关性最大[OR=2. 19(95%CI:1. 76～2. 73),P <0. 001];而血红蛋白及血清蛋白与PCT的升高呈负相关。标准化治疗48 h后,PCT正常组有67. 9%的患者症状明显改善,高于PCT升高组的55. 6%,差异有统计学意义(P=0. 037)。PCT升高组患者30 d全因死亡/再住院率(30. 6%)高于PCT正常组(18. 8%),差异有统计学意义(P=0. 02)。结论尽管心力衰竭程度一致,但血清PCT水平升高的慢性心力衰竭急性发作患者治疗效果差、预后不佳,提示可能存在未诊断或者潜在的细菌感染。

Anterior myocardial pseudoinfarction in a patient with diabetic ketoacidosis

Diabetic ketoacidosis remains one of the most serious complications of diabetes mellitus. Among its precipitating factors is myocardial ischemia, responsible for 1% of the cases of diabetic ketoacidosis.Ell Diabetic ketoacidosis both with and without hyperkalemia has been reported to mimic a myocardial infarction pattem on ECG with ST segment elevation, described as pseudoinfarction pattern. Thus, it is important to raise awareness among physicians, as subjecting patients to invasive medical management can be avoided. We present a case of a 47-year-old female with diabetic ketoacidosis and hyperkalemia with initial ECG findings of ST segment elevation, but an urgent left heart catheterization revealed non-obstructive coronary disease.

Acute lymphocytic myocarditis

Myocarditis is an inflammatory disease of the myocardium. The clinical presentation of myocarditis may range from subclinical to sudden death. The incidence of fatal myocarditis, which often presents with sudden or rapid death, has been estimated at 0.15/100.000 in the general population and is highest in infants and young adults （but may affect any age group）. However, diffuse myocarditis in autopsies of sudden death is 〈 2% in adult.