Preventive Cardiovascular Nurses Association's 23rd Annual Cardiovascular Nursing Symposium: Leading the Way in Cardiovascular Disease Prevention and Management
Registration is now open for the Preventive Cardiovascular Nurses Association's (PCNA's) 23rd Annual Cardiovascular Nursing Symposium, happening April 6 to 9 at the Denver Marriott Tech Center in Denver, Colorado. This year's conference will continue the tradition of hosting star-quality faculty who deliver the most critical "need-to-knows." Take a look at our 2017 sessions.
Pharmacology Preconference-Thursday, April 6
* Cardio-metabolic Risk Reduction in Patients With Pre-diabetes and DM2
* It's a Balancing Act: Medication Management in Patients With Chronic Kidney and Cardiovascular Disease
* Pharmacological Management of the Cardiac Patient With Depression and/or Anxiety
* Complex Cases and Panel Discussion
General Sessions-Friday, April 7 through Sunday, April 9
* A Call to Action: Population Health and CVD Prevention
* CVD Risk Assessment and Health in Women Across the Lifespan
* Obesity and Health Behaviors: Success Stories From the National Weight Control Registry
* Pharmacological and Surgical Management for Weight Loss
* Million Hearts in 2017: The 5-Year Challenge to Prevent Heart Attack and Stroke
* Physical Activity: The Magic Bullet
* Making the Head Heart and Vascular Link: CVD Risk Factors and Dementia
* Cardio-metabolic Risk Management: Promoting Health and Preventing Disease
* Healthy Aging: Improving Quality of Life in Older Adults With Diabetes and Chronic Disease. A Joint Session of the AHA CV Nursing Council and PCNA
* Prevention and Management of Stroke Across the Continuum of Care
* Technology and Cardiovascular Health: Harvesting the Power of Innovation
* Skill-building sessions
[white circle] Effective Strategies for Engaging Patients in Health Behavior Change
[white circle] Chest pain! How to Perform a Comprehensive Evaluation for Ischemia
* Breakout sessions
[white circle] Interpreting and Translating Research Into Practice
[white circle] Structural Heart Interventions: Valves, Clips and Plugs, Oh My!
[white circle] Health Effects of Marijuana, E-Cigarettes and Vaping
Should We Be Concerned About Dietary Sugar and Cardiovascular Disease?
A recent article in the Journal of the American Medical Association1 found studies as far back as the 1960s suggesting that sugar may contribute to the development of cardiovascular disease (CVD). Many studies were epidemiologic, suggesting that risk factors for CVD include a diet with a high intake of added sugar. A prospective study in 2014 involving the National Health and Nutrition Examination Survey (1988-1994, 1999-2004, and 2005-2010) for the time trend analysis and National Health and Nutrition Examination Survey III Linked Mortality cohort (1988-2006) showed a significant relationship between added sugar consumption and increased risk for CVD mortality. The findings were independent of other risk factors such as blood pressure and lipid values and were consistent across age groups, sex, race, educational levels, physical activity, and body mass index.2 The pathophysiologic mechanism is not completely understood. Some studies have observed an association between high sugar intake and hypertension, lipogenesis, hepatic triglyceride synthesis, and increased triglycerides. Other studies have shown that an elevation in inflammatory markers was associated with intake of sugar-sweetened beverages.2
The American Heart Association's (AHA) recommendation is to limit the amount of added sugar. For most women, this is no more than 100 calories or 6 teaspoons, and for men, 150 calories or 9 teaspoons.3
So, how can we help our patients?
Personal
1. Read food labels for sugar content and choose foods with the lowest sugar grams.
2. Incremental sugar reduction.
3. Limit eating out at restaurants, but if patients do eat out, choose a restaurant that prepares fresh, unprocessed foods and shows nutritional information for their food.
4. Reduce the amount of prepared, "ready-to-eat" foods that are purchased in the grocery store or food marts.
5. Buy fresh or unsweetened frozen fruit or canned fruit in water.
6. Reduce the amount of sugar called for in recipes.
7. Avoid consumption of sugar-added beverages such as soft drinks, sports drinks, fruit drinks and juices, and ready-to-drink tea and coffee beverages.
Advocacy
1. Encourage patients and other professionals to get involved with their local AHA to influence the state government to encourage the food industry to reduce added sugars in food and drinks.
2. Promote the adoption of food policies that create healthier diets in schools, workplaces, sports clubs, faith centers, and community organizations.
3. Reduce the availability of sugar-sweetened beverages in schools.
4. Place restrictions on marketing sugar-sweetened drinks to children.
5. Work through the AHA locally or on the state level to adopt a tax on sugar-sweetened beverages.
In addition to working with the food industry to reduce the amount of sugars in foods and drinks, further prospective studies are needed to look at pathophysiologic effects and to more closely determine an amount of dietary sugar that may be safe to consume.
Cardiovascular Consequences of Childhood Secondhand Tobacco Smoke Exposure
A recent scientific statement from the AHA concludes that the epidemiological, observational, and experimental evidence accumulated to date demonstrates the detrimental cardiovascular consequences of secondhand smoke exposure in children.
The statement recognizes that, despite the success of public health programs in decreasing the prevalence of tobacco smoking, the adverse health effects of tobacco smoke exposure still exists. In the United States, 4 of 10 school-aged children and 1 of 3 adolescents are involuntarily exposed to secondhand tobacco smoke. Children who are disproportionately affected include ethnic minority children (68%) and those in low-socioeconomic-status households (43%). Children have little or no control over their home and social environments, which makes them particularly vulnerable. The smoke that emanates from the burning end of a cigarette is known as sidestream smoke and is the main source of secondhand smoke. It contains higher concentrations of some toxins than the smoke inhaled directly by the smoker, which is known as mainstream smoke. Secondhand smoke is potentially as dangerous, if not more dangerous, than direct smoking. Animal and human studies show that secondhand smoke exposure during childhood is detrimental to arterial function and structure, resulting in premature atherosclerosis and cardiovascular consequences. Childhood secondhand smoke exposure is also related to impaired cardiac autonomic function and changes in heart rate variability. In addition, childhood secondhand smoke exposure is associated with cardiometabolic risk factors such as obesity, dyslipidemia, and insulin resistance.
Individualized interventions to reduce childhood exposure to secondhand smoke and broader-based policy initiatives such as community smoking bans and increased taxation are shown to be effective. Increased awareness of the adverse lifetime cardiovascular consequences of childhood secondhand smoke may facilitate the development of innovative individual family-centered and community health interventions to reduce, and ideally eliminate, secondhand smoke exposure in the vulnerable pediatric population. This evidence indicates that a robust public health policy that promotes zero tolerance for childhood secondhand smoke exposure is needed.
As healthcare providers focused on cardiovascular prevention, we can impact this problem in several ways. Advocate in your community for public policy changes. Using this evidence, appeal to your patients who are smokers to quit for the sake of their children, grandchildren, or other young family members. Participate in community health forums that provide education and raise awareness of the detriments of secondhand smoke exposure for children. Look for every opportunity to spread information that could decrease the exposure and risks of secondhand smoke on our most vulnerable population.
Nurse's Health Study, 40 Years and Counting
The Nurse's Health Study (NHS) began in 1976 when a cohort of 121 700 nurses aged 30 to 55 years was assembled, by investigators from Harvard University, to improve our understanding of women's health and the prevention of chronic diseases. The study design consisted of contacting the nurses every 2 years to complete questionnaires and undergo clinical examinations. Although comparative epidemiological studies suffer from rapid depopulation, the NHS retained more than 94% of its original population. Better said, the nurses were incredibly committed to the purpose of the study and had the skills to sample their own blood, saliva, hair, and nails and complete health-related surveys.
To celebrate the 40th anniversary of the NHS, a compendium of findings was published in the September 2016 issue of the American Journal of Public Health (AJPH). The reviews assembled provide unique perspective on the effects on women's health of lifestyle, social and mental health determinants, biomarkers, genes, and proteins on most chronic diseases, including skin disorders, mental health occupational health, eye health, cardiovascular, and renal disease as well as reproductive health, neurodegenerative disorders, and life course exposures.
Members of PCNA will take great interest in the findings related to diet, lifestyle, biomarkers, genetic factors, and risk of CVDs in the NHS. Although there may have been no surprise that the study demonstrated increased CVD risk among those who smoked and were sedentary and overweight, an additional lifestyle survey demonstrated increased risk of CVD associated with shift work, poor sleep, phobic anxiety, depression, caregiving, and job insecurity. Oral contraceptive use was found to increase the risk of CVD, whereas postmenopausal hormone use was found to lower the risk of coronary heart disease and raise the risk of stroke in all age groups. Very detailed nutritional surveys highlighted the importance of a heart-healthy diet, including a variety of fruits, vegetables, nuts, legumes, and whole grains while limiting the intake of red meats, saturated fat, sugar-sweetened beverages, and refined grains.
Women in the original National Health Study continue to be followed via biennial questionnaires, with many of the participants now in their 80s and 90s. The range of lifestyle, health outcome, and chronic disease data has greatly expanded over time, as have the data base and biorepository. Additional arms of the NHS have grown as well. In 1989, the NHS II was started, enrolling nurses aged 25 to 42 years, with the goal of better understanding the effects of oral contraceptives on women's health. In 2010, the NHS 3 was started and is still enrolling nurses aged 1949 years in the United States and Canada. This new study has increased diversity, with 14% of participants identifying themselves as from a racial or ethnic minority. In 2015, the enrollment expanded to include male nurses.
Our gratitude and congratulations go to those nurses who have participated in the NHS for any or all of its 40 years! Thanks to you and the many researchers involved in helping to expand the breadth of knowledge on risk factors and ways to prevent the major chronic diseases of our time, including CVD, cancer, diabetes, cognitive decline, reproductive disorders, depression, and anxiety[horizontal ellipsis]just to mention just a few!
To learn more about the NHS or to join NHS 3, visit http://www.nurseshealthstudy.org.
Special Congratulations
Sandra Dunbar RN, PhD, FAAN, FAHA, FPCNA
Congratulations to PCNA board member Sandra B. Dunbar on her selection as the Florida State University 2016 Distinguished Graduate in the Educator Category.
Dr Sandra B. Dunbar is the associate dean of academic advancement and the Charles Howard Candler Professor of Cardiovascular Nursing at the Emory University's Nell Hodgson Woodruff School of Nursing in Atlanta, Georgia. She has focused her program of research on improving outcomes for complex cardiovascular patients and their families and has conducted NIH and other funded clinical trials that developed and tested intervention focused on improving self-care and quality of life and reducing cardiovascular risk, psychosocial distress, and health resource use.
The award was celebrated during the school's Homecoming Awards Dinner on October 14, 2016. Congratulations, Dr Dunbar!
Kim Newlin, MSN, ANP, FPCNA
Congratulations to PCNA board member Kim Newlin on her selection as a Fellow of the AHA with the Council on Cardiovascular and Stroke Nursing.
Kim is the clinical manager of Cardiac and Pulmonary Rehab as well as the Heart Health Clinic and Cardiology Care Transitions program, while continuing to see patients in the Heart Health clinic, which she established in 2011. She developed the first heart failure specific class in Cardiac Rehab and the first Care Transitions Program in the Sutter Sacramento region, both of which have significantly improved the patient experience during the transition home and reduced readmission back to the hospital. She also continues to have the opportunity to teach a variety of classes to the nursing staff, mentor new and seasoned nurses, and work on process improvement and research programs within the hospital and the region.
The newly elected Fellows will be recognized at the Annual Council on Cardiovascular and Stroke Nursing Awards Dinner held during the AHA Scientific Sessions 2016 in New Orleans, Louisiana.
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