- Cardiovascular disease remains the leading cause of death in women,1 but mechanisms of sex-related differences that affect many facets of cardiovascular disease remain underrecognized and poorly understood. Men historically have been disproportionately represented in clinical studies, and consequently, guidelines have been built on data that are predominantly applicable to men.1 There has recently been an increasing commitment to better understand sex-related differences that affect the epidemiology, presentation, diagnosis, treatment, and outcomes of cardiovascular disease.
- Worsening renal function (WRF) in patients hospitalized with acute heart failure (AHF) presents a frequent clinical dilemma that is compounded by the inconsistent results of studies seeking to determine whether WRF in AHF is associated with worse clinical outcomes, such as death or readmission. More recent studies suggest that when serum creatinine concentration rises from a hemodynamic process such as appropriate blood pressure lowering or decongestion, WRF is no longer associated with adverse outcomes.
- Mayo Clinic is committed to eliminating racism and reducing health care disparities. Without systemic change, these inequities compound and detract from the very patients and communities we serve. Racism limits the ability of learners, staff, and faculty to do their job and to be their full authentic self in clinical and learning environments. An effective path toward equity requires elimination of systemic barriers for both patients and staff. To do so, we must embrace opportunities to learn what is actually needed to improve their experience.
- Tricuspid regurgitation (TR) occurs in 65% to 85% of the population in the United States.1,2 Although mild TR in the setting of a structurally normal tricuspid valve apparatus can be considered a normal variant, progression to moderate-severe TR increases with age and is estimated to affect nearly 1.6 million adults in the United States.3 Echocardiographic data from the Framingham Heart Study reported an overall prevalence of moderate or higher TR of 0.8%, with a majority due to functional TR and only 10% due to an organic cause.
- Until the early 1990s, it was presumed that dietary calcium intake should be limited for preventing the onset and recurrence of calcium kidney stone formation, assuming that frequent consumption of milk and dairy products could unfavorably influence urinary calcium excretion. However, a prospective investigation conducted on 45,619 men without baseline history of kidney stones, published in 1993, showed an inverse relationship between baseline dietary calcium intake, assessed by a semiquantitative food frequency questionnaire, and the risk of incident symptomatic kidney stone disease after a 4-year follow-up period.
- In the process of aligning treatment options to fit each individual patient, the clinician must carefully evaluate how each decision affects the overarching goals of care. In the management of coronary artery disease, however, these tradeoffs are often confounded by a bias toward less invasive strategies in the elderly. Given that women outnumber men by 54% beyond the age of 80 years,1 this predisposition can also contribute to an insidious form of gender discrimination. Older patients are often excluded from major clinical trials,2 contributing to a lack of awareness surrounding the efficacy of aggressive treatments in this demographic.
- Currently in clinical cardiovascular medicine, prospective randomized controlled trials are considered the “gold standard.” The larger, the better. Such studies are considered to have high internal validity. In recent years, such studies are often subsequently compared with “real-world” data from individual institutions and registries to augment their external validity. This approach has been the foundation for the enormous progress in understanding the pathobiology and treatment of cardiovascular disease during the past half-century.
- Atherosclerotic cardiovascular disease (ASCVD) risk prediction is the cornerstone of decision-making strategies for the prevention of ASCVD.1,2 Whereas guideline recommendations for ASCVD risk prediction are still largely based on the measurement of traditional ASCVD risk factors, there are well-established limitations to this approach, and other predictors of ASCVD risk are needed to better personalize ASCVD risk prediction. Accordingly, the most recent American College of Cardiology/American Heart Association guidelines place added emphasis on refining risk beyond traditional ASCVD risk factors.