Most Americans found to have suboptimal cardiovascular health

1. Most Americans found to have suboptimal cardiovascular health
Black-white disparities still exist, but the gap has narrowed due to worsening health among whites
Abstract: http://annals.org/aim/article/doi/10.7326/M17-0996
Editorial: http://annals.org/aim/article/doi/10.7326/M18-0349
URLs go live when the embargo lifts

A study of data from the National Health and Nutrition Examination Survey (NHANES) from 1988 to 2014 found that most Americans have suboptimal cardiovascular health. While racial disparities still exist, the black-white divide has narrowed due to worsening health among whites rather than health gains among blacks. The findings are published in Annals of Internal Medicine.

Researchers from UCLA and the University of Washington studied NHANES data to examine U.S. trends in cardiovascular health disparities by race, ethnicity, and nativity (foreign-born vs U.S.-born) for adults aged 25 years or older who had not previously reported cardiovascular disease. The researchers explored differences in the Life's Simple 7 (LS7) health factors and behaviors (blood pressure, cholesterol, hemoglobin A1c, body mass index, physical activity, diet, and smoking) and a composite score for optimal cardiovascular health. The study was limited to whites, African Americans and Mexican Americans.

The researchers found that rates of optimal cardiovascular health remain below 40 percent for whites, 25 percent for Mexican Americans, and 15 percent for African Americans. Health disparities between whites and blacks have persisted but decreased over time due to reductions in optimal cardiovascular health among whites of all ages.

In an accompanying editorial, George A. Mensah, MD, from the National Institutes of Health (NIH), points out that the narrowing of disparities is no cause for celebration. However, LS7 factors and behaviors are simple to understand and provide the opportunity for all stakeholders and patients to take action. Dr. Mensah suggests that cardiovascular health and prevention and control of related risk factors be a key focus of the NIH's Healthy People 2030.

Media contact: For an embargoed PDF, please contact Lauren Evans at laevans@acponline.org or Angela Collom at acollom@acponline.org. To interview with the lead author, Arleen F. Brown, MD, PhD, please contact Enrique Rivero at ERivero@mednet.ucla.edu or 310-267-7120.

2. HIV incidence has decreased overall, but remains higher among minority men who have sex with men
Many younger men who have sex with men do not know they are infected with HIV
Abstract: http://annals.org/aim/article/doi/10.7326/M17-2082
URLs go live when the embargo lifts

A study of data from the National HIV Surveillance System (NHSS) found that HIV incidence has decreased overall and for all risk groups except for men who have sex with men (MSM), and the incidence remains highest among black/African American and Hispanic/Latino MSM. Among younger MSM with HIV, many do not know they are infected. The findings are published in Annals of Internal Medicine.

HIV infection is a persistent health concern in the United States, and MSM continue to be the most affected population. Using data from the NHSS of the Centers for Disease Control and Prevention (CDC) on the first CD4 value after diagnosis, researchers from the CDC modeled HIV incidence and prevalence and the percentage of undiagnosed HIV infections from 2008 through 2015 for persons aged 13 years and older. They used information on persons living with diagnosed HIV infection by the end of 2007 to estimate prevalence and the percentage of undiagnosed infections.

The researchers found that HIV incidence decreased by nearly 15 percent overall between 2008 and 2015, and declined among all risk groups except MSM, who had the highest incidence, prevalence, and percentage of undiagnosed HIV infections. Among MSM, incidence among black/African Americans remained the same and increased among Hispanic/Latino MSM. The data also showed that among younger MSM, many did not know they were infected with HIV.

According to the researchers, the overall reduction in incidence is promising, but the lack of progress in reducing the incidence among MSM, especially black/African American and Hispanic/Latino MSM, must be urgently addressed. They suggest that routine HIV screening in health care settings, targeted testing, and linkage to care should occur so that persons with HIV can access treatment early and achieve viral suppression. It is also important to identify those who have not been linked to care to help them get the treatment they need.

Media contacts: For an embargoed PDF, please contact Lauren Evans at laevans@acponline.org or Angela Collom at acollom@acponline.org. To interview lead author, Sonia Singh, PhD, please contact CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at NCHHSTPMediaTeam@cdc.gov or 404-639-8895.

3. Top docs say it's time to end the funding freeze for gun violence research
Annals editors call for more papers on the health consequences of firearms
FREE content: http://annals.org/aim/article/doi/10.7326/M18-0579
FREE content: http://annals.org/aim/article/doi/10.7326/M18-0636
URLs go live when the embargo lifts

According to Victor J. Dzau, MD, president of the National Academy of Medicine, it's time to end the funding freeze on research related to gun violence, a "defining public health challenge of our time." Dr. Dzau and his co-author, Alan I. Leshner, PhD, CEO, emeritus of the American Association for the Advancement of Science, think that gun violence should be treated as any other public health threat. They call for researchers from different disciplines, including public health, social and behavioral sciences, mental health, and law enforcement to work together to tackle the problem. Their editorial is published in Annals of Internal Medicine.

In 2013 following the Sandy Hook tragedy, President Obama directed federal agencies to mount research programs to better understand gun violence and how to reduce it. The Centers for Disease Control and Prevention (CDC) and the CDC Foundation asked the Institute of Medicine (IOM) and National Research Council (NRC) to define a research agenda for gun violence. Before the initiative was dismantled, five key research domains were identified: 1) characteristics of firearm violence; 2) risk and protective factors; 3) interventions and strategies; 4) impact of gun safety technology; and 5) influence of video games and other media. The authors say it's time to restore research funding so that the goals of the IOM/NRC agenda can be realized.

The editors of Annals of Internal Medicine agree. In the same issue, the editors are calling for authors of papers on firearm-related harm to submit their work to Annals. The editors say that peer-review will be expedited and published papers will be added to Annals' publicly available collection of gun-related articles at http://annals.org/aim/pages/firearm-related-content.

Media contacts: For an embargoed PDF or an interview with the authors or editors, please contact Lauren Evans at laevans@acponline.org or Angela Collom at acollom@acponline.org.

Also new in this issue:

Patient Experience as a Health Care Value Domain in Hospitals
Patrick P. Kneeland, MD, and Marisha Burden, MD
Annals for Hospitalists
Abstract: http://annals.org/aim/article/doi/10.7326/M18-0231

Lost in Translation: Linking Biomedical Research and Clinical Practice at the National Institutes of Health, 1977 to 2013
Todd M. Olszewski, PhD
History of Medicine
Abstract: http://annals.org/aim/article/doi/10.7326/M17-2418

Cautions as Regulators Move to End Exclusive Reliance on Intention to Treat
Miguel A. Hernán, MD, DrPH; Daniel Scharfstein, ScD
Ideas and Opinions
Abstract: http://annals.org/aim/article/doi/10.7326/M17-3354

An Innovative Program to Support Gender Equity and Success in Academic Medicine: Early Experiences From the Doris Duke Charitable Foundation's Fund to Retain Clinical Scientists
Reshma Jagsi, MD, DPhil; Rochelle D. Jones, MS; Kent A. Griffith, MS; Kathleen T. Brady, MD, PhD; Ann J. Brown, MD, MHS; Randal D. Davis, MBA; Amelia F. Drake, MD; Daniel Ford, MD, MPH; Victoria J. Fraser, MD; Katherine E. Hartmann, MD, PhD; Judith S. Hochman, MD; Susan Girdler, PhD; Anne M. Libby, PhD; Christina Mangurian, MD, MAS; Judith G. Regensteiner, PhD; Kimberly Yonkers, MD; Sindy Escobar-Alvarez, PhD; Elizabeth R. Myers, PhD
Brief Research Report
Abstract: http://annals.org/aim/article/doi/10.7326/M17-2676

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