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Group 3 Assignment Week 7 -Michael Jantaworn, Sheircreasir Jensen, Raymonda Johnson, Karen Matthew, Fatema Ramadan
Coronary Artery Risk Development in Young Adults (CARDIA) study (U.S.; Cardiovascular and Metabolic Factors; 18-30)
Present the selected cohort study (purpose, design, methods, analysis, and results).
Purpose – Originally The Coronary Artery Risk Development in Young Adults (CARDIA) study purpose was to examine how cardiovascular disease (CVD) RFs in young adults was distributed, identify associated lifestyle, psychosocial, and other factors; and to assess early adulthood longitudinal risk factors (RF) evolution in early adulthood (Lloyd-Jones et al.,2021).
Design/Methods – A cohort included 5,115 African American and Caucasian men and women. The recruitment strategy involved selecting participants from diverse geographical regions and were contacted with random-digit dialing and in person contacts from different census tracts. Attempts occurred to achieve an equal number of age, sex, race, and educational status. A follow up at two, five, seven, ten, twenty, twenty-five, and thirty years was then conducted via in person examinations (Lloyd-Jones et al.,2021).
Analysis – (Fatema) The progression from a healthy young adult to middle age across various states of health and preclinical and clinical disease has been defined by CARDIA. Phenotypic evaluations of participating CARDIA participants have gone beyond the usual anthropometric and laboratory measurements and the collection of biospecimen samples for storage. These measures include:
Physical fitness at Years 0, 7, and 20
Diet at Years 0, 7, and 20
Pulmonary function at Years 0, 2, 5, 10, 20, and 30
Coronary artery calcium at Years 10, 15, 20, and 25
Carotid intima-media thickness at Year 20
Echocardiography at Years 5, 10, 25, and 30
Cognitive function at Years 25 and 30
Brain magnetic resonance at Years 25 and 30
Body composition including dual-energy X-ray absorptiometry at Year 20
Abdominal computed tomography at Year 25
Repeated assessment of genetic, psychosocial, neighborhood, environmental, lifestyle and behavioral factors; prescription, recreational, and illicit drug use
(Lloyd-Jones et al.,2021)
Results – CARDIA was able to define the modern epidemiology of CVH/CVD in the first half of adulthood in a cohort that had already been affected by obesity and diabetes. The neighborhood environment and the life course evolution of lifestyle behaviors with biological risk factors, subclinical illness, and early clinical CVD events from early adulthood onward have been established by CARDIA. The nature and key factors that differ between African Americans and Caucasians in the loss of cardiovascular health and the development of CVD risk have also been identified by CARDIA (Lloyd-Jones et al.,2021).
Examine the strengths and limitations of the selected cohort study.
Today there is an increased number of cases of young adults presenting with coronary artery disease and an even larger number at risk of developing CAD. Healthcare professionals are encountering patients with symptoms of cardiovascular disease risk factors in children and young adults. Literature has identified a broad range of psychological and social factors that are relevant for predicting cardiovascular disease risk factors (CVDRF) such as hypertension and diabetes (Vargas et al., 2022), Individuals diagnosed with high level depression symptoms and specific personality traits, like anxiety or certain social factors (ie. Discrimination, poverty, etc.) are more likely to develop hypertension or diabetes which can lead to the development of cardiovascular illness (Vargas et al., 2022). Healthcare professionals must collaborate with mental health and community health to improve the outcomes for this population.
List and defend your opinions of the study.
As mentioned in the CARDIA study, an individualâ€s risk of CVD is significantly contributed to by their neighborhood environment, the evolution of their lifestyle behaviors with biological risk factors, any subclinical disease, and early clinical events (Lloyd-Jones et al.,2021). The study was inclusive to African American men and women along with Caucusian men and women between the ages of 18 to 30 years. Out of these four specific demographics, African American men have the highest risk of falling ill to CVD events (Forrester et al., 2022). By focusing on their neighborhood environment alone, it is evident that a system was set in place to keep the African American male in a negative space, holistically. It is no secret that underprivileged peoples have never been ethically represented in the healthcare system, but when it comes to the African American male, a whole lot more goes unnoticed. It would be in our best interest to treat those that come to us for medical treatment as if they were a loved one (Nurmeksela et al., 2020). Malice and spite are two of many reasons as to why this demographic does not trust healthcare professionals. Being underdiagnosed and prescribed medications that do not treat the underlying problem is part of the bigger reason as to why their risk of CVD is so high (Wysocki & Seiber, 2018).
Discuss major contributions to a specific area of nursing practice
Heart disease is very common worldwide. Studies such as the CARDIA study have provided significant contributions into the identification of key areas like risk factors, such as race, and lifestyle (Lloyd-Jones et al., 2021). As with any disease state, nurses have a unique role in patient management. Their contribution is key in preventive efforts, and management. Their role includes patient education and motivation towards adherence (Nurmeksela et al., 2020). The findings from the CARDIA study will be helpful to cardiac nurses and nurse educators as they will allow for more tailored education based on risk factors such as family history and comorbidities. Additionally, education efforts can be targeted to the populations most impacted.
References
Forrester, S. N., Zmora, R., Schreiner, P. J., Jacobs Jr., D. R., Roger, V. L., Thorpe Jr., R. J., & Kiefe, C. I. (2022). Racial differences in the association of accelerated aging with future cardiovascular events and all-cause mortality: the coronary artery risk development in young adults study, 2007–2018. Ethnicity & Health, 27(5), 997–1009. https://doi-org.ezproxylocal.library.nova.edu/10.1080/13557858.2020.1839021
Lloyd-Jones, D. M., Lewis, C. E., Schreiner, P. J., Shikany, J. M., Sidney, S., & Reis, J. P. (2021). The Coronary Artery Risk Development In Young Adults (CARDIA) Study: JACC Focus Seminar 8/8. Journal of the American College of Cardiology, 78(3), 260–277. https://doi.org/10.1016/j.jacc.2021.05.022
Nurmeksela, A., Pihlainen, V., Kettunen, T., Laukkanen, J., & Peltokoski, J. (2021). Nurse-led counseling for coronary artery disease patients: A 1-year follow-up study. Nursing & Health Sciences, 23( 3), 678– 687. https://doi.org/10.1111/nhs.12852
Wysocki, K., & Seibert, D. (2018). Should genomic testing be considered in hyperlipidemia?. Journal of the American Association of Nurse Practitioners, 30(8), 427–429. https://doi.org/10.1097/JXX.0000000000000094
Vargas, E. A., Chirinos, D. A., Wong, M., Carnethon, M. R., Carroll, A. J., Kiefe, C. I., Carson, A. P., & Kershaw, K. N. (2022). Psychosocial profiles and longitudinal achievement of optimal cardiovascular risk factor levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Journal of Behavioral Medicine, 45(2), 172–185. https://doi-org/10.1007/s10865-021-00259-1
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