{"markup":"\u003C?xml version=\u00221.0\u0022 encoding=\u0022UTF-8\u0022 ?\u003E\n    \u003Chtml version=\u0022HTML+RDFa+MathML 1.1\u0022\n    xmlns:content=\u0022http:\/\/purl.org\/rss\/1.0\/modules\/content\/\u0022\n    xmlns:dc=\u0022http:\/\/purl.org\/dc\/terms\/\u0022\n    xmlns:foaf=\u0022http:\/\/xmlns.com\/foaf\/0.1\/\u0022\n    xmlns:og=\u0022http:\/\/ogp.me\/ns#\u0022\n    xmlns:rdfs=\u0022http:\/\/www.w3.org\/2000\/01\/rdf-schema#\u0022\n    xmlns:sioc=\u0022http:\/\/rdfs.org\/sioc\/ns#\u0022\n    xmlns:sioct=\u0022http:\/\/rdfs.org\/sioc\/types#\u0022\n    xmlns:skos=\u0022http:\/\/www.w3.org\/2004\/02\/skos\/core#\u0022\n    xmlns:xsd=\u0022http:\/\/www.w3.org\/2001\/XMLSchema#\u0022\n    xmlns:mml=\u0022http:\/\/www.w3.org\/1998\/Math\/MathML\u0022\u003E\n  \u003Chead\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/js\/js_itu2PgFdrjV-docKmLK8Jn5oXe_05RgvQh73eOhI_mE.js\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_at_symbol.js?nzmuu2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_article_reference_popup.js?nzmuu2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/js\/js_I8yX6RYPZb7AtMcDUA3QKDZqVkvEn35ED11_1i7vVpc.js\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022\u003E\n\u003C!--\/\/--\u003E\u003C![CDATA[\/\/\u003E\u003C!--\n(function(i,s,o,g,r,a,m){i[\u0022GoogleAnalyticsObject\u0022]=r;i[r]=i[r]||function(){(i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)})(window,document,\u0022script\u0022,\u0022\/\/www.google-analytics.com\/analytics.js\u0022,\u0022ga\u0022);ga(\u0022create\u0022, \u0022UA-15605596-27\u0022, {\u0022cookieDomain\u0022:\u0022auto\u0022});ga(\u0022set\u0022, \u0022page\u0022, location.pathname + location.search + location.hash);ga(\u0022send\u0022, \u0022pageview\u0022);ga(\u0027create\u0027, \u0027UA-189672-26\u0027, \u0027auto\u0027, {\u0027name\u0027: \u0027hwTracker\u0027});\r\nga(\u0027hwTracker.send\u0027, \u0027pageview\u0027);\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022\u003E\n\u003C!--\/\/--\u003E\u003C![CDATA[\/\/\u003E\u003C!--\njQuery.extend(Drupal.settings, {\u0022basePath\u0022:\u0022\\\/\u0022,\u0022pathPrefix\u0022:\u0022\u0022,\u0022highwire\u0022:{\u0022markup\u0022:[{\u0022requested\u0022:\u0022full-text\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;9\\\/6\\\/12\u0022},{\u0022requested\u0022:\u0022long\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;9\\\/6\\\/12\u0022}],\u0022ac\u0022:{\u0022spmdc;9\\\/6\\\/12\u0022:{\u0022access\u0022:{\u0022reprint\u0022:true,\u0022full\u0022:true},\u0022pisa_id\u0022:\u0022spmdc;9\\\/6\\\/12\u0022,\u0022atom_uri\u0022:\u0022\u0022,\u0022jcode\u0022:\u0022spmdc\u0022}}},\u0022googleanalytics\u0022:{\u0022trackOutbound\u0022:1,\u0022trackMailto\u0022:1,\u0022trackDownload\u0022:1,\u0022trackDownloadExtensions\u0022:\u00227z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip\u0022,\u0022trackUrlFragments\u0022:1},\u0022ajaxPageState\u0022:{\u0022js\u0022:{\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/jquery.cluetip.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.hoverIntent.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.bgiframe.min.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_at_symbol.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_article_reference_popup.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/contrib\\\/google_analytics\\\/googleanalytics.js\u0022:1,\u00220\u0022:1}}});\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Clink type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EDespite advances in cardiovascular (CV) research, global disparities concerning life expectancy, health care resource allocation, and clinical implementation remain. In 2005, the global rate of death from CV causes was 3.3 times greater than AIDS, tuberculosis, and malaria combined. Additionally, four-fifths of all CV events occur in developing countries [Sanz G \u0026amp; Fuster V. \u003Cem\u003ENature Clin Practice Cardiovasc Med\u003C\/em\u003E 2009]. Due to the magnitude of the problem, biomedical research in developing countries is essential. This article discusses the global challenges of CV disease.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eprevention \u0026amp; screening\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EDespite advances in cardiovascular (CV) research, global disparities concerning life expectancy, health care resource allocation, and clinical implementation remain. In 2005, the global rate of death from CV causes was 3.3 times greater than AIDS, tuberculosis, and malaria combined. Additionally, four-fifths of all CV events occur in developing countries [Sanz G \u0026amp; Fuster V. \u003Cem\u003ENature Clin Practice Cardiovasc Med\u003C\/em\u003E 2009]. Due to the magnitude of the problem, biomedical research in developing countries is essential.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EMagdi Yacoub, FRS, Imperial College and Founder Patron of Chain of Hope, London, UK, discussed the Chain of Hope program, which has taken measures to promote research and health care in Africa and other regions in need. The objective is to develop local expertise and educate local providers while building a global network and generating region-specific solutions to health care issues, noted Prof. Yacoub. In early 2009, the first Heart Research Center was opened in Addis Ababa, Ethiopia. This new state-of-the-art facility will allow for advanced research in local \u201cneglected\u201d diseases at epidemiological, cellular, and molecular levels and will include continentwide databases, translational research studies, educational programs, and international collaborative efforts. These components are the key to sustainable solutions for global health care, added Prof. Yacoub. Similar projects are also underway in Kenya and Mozambique.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EValentin Fuster, MD, PhD, FACC, Mt. Sinai Medical Center, New York, NY, discussed the global challenges of cardiovascular disease (CVD) and what the future may hold. Conventional CVD risk factors, such as abnormal lipids, smoking, hypertension, diabetes, and abdominal obesity, will contribute to more than 90% of serious CV events (including coronary death, myocardial infarction, and stroke) worldwide in the next decade [Yusuf S et al. \u003Cem\u003ELancet\u003C\/em\u003E 2004; Vasan RS et al. \u003Cem\u003EAnn Intern Med\u003C\/em\u003E 2005; Pencina MJ et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2009]. Therefore, risk factors, early detection, and prevention must remain a focus moving forward.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EBioimaging is a critical component of early CVD detection. Dr. Fuster and colleagues (in collaboration with the Humana Health Plan) have launched a bioimaging study in the United States that consists of 7300 participants, 6000 of whom will be characterized with respect to their Framingham risk score and imaging features, including coronary calcification, carotid intima-media thickness, the presence of atherosclerotic plaques, and lower extremity arterial insufficiency, as determined by ankle brachial index. The remaining 1300 participants will be excluded from the imaging arm of the study.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EThe purpose of this study is to identify imaging and\/or circulating biomarkers that predict 3-year CV events, improve upon traditional risk assessment, and determine the predictive value of biological and\/or imaging markers for 1- to 3-year outcomes. Enrollment began in January 2008, and the study will continue through July 2012. Results from this study could impact CVD detection and prevention approaches worldwide.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EPharmacological therapy is another strategy for prevention that may help with the mounting global CVD crisis in the coming years. However, 50% of patients do not take the prescribed medication [Sanz G \u0026amp; Fuster V. \u003Cem\u003ENat Clin Pract Cardiovasc Med\u003C\/em\u003E 2009]. Dr. Fuster pointed out that several factors may impede adherence, including complexity of treatment, limited availability of medications, the financial burden of treatment, and inadequate prescription of medication. Therefore, a fixed-dose combination therapy (\u201cpolypill\u201d) approach may be a better solution for low-income countries.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EThe ongoing Centro Nacional de Investigaciones Cardiovasculares fixed-dose combination (CNIC-FDC) therapy project focuses on patients who have suffered an acute myocardial infarction (AMI) and will introduce a polypill that consists of aspirin, a statin, and an angiotensin-converting enzyme inhibitor along with behavioral modification strategies as part of a worldwide prevention program. Another CNIC program, the FOCUS study, will test the efficacy of the polypill post-AMI and assess the magnitude of inadequate prevention and factors that contribute to poor adherence in different socioeconomic environments.\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EThe first phase (n=4000) of the FOCUS study will evaluate economic and health care characteristics, such as the accessibility of care and treatment, out-of-pocket expenditure, food prices, and affordability of treatment. Adherence evaluations, clinical variables, demographics, and patient psychosocial factors will also be assessed during this phase of the study. The second phase (n=1340) of the study will evaluate the efficacy of the three drugs taken separately compared with the polypill. Participants will be seen at 1 month, 4 months, and 6 to 9 months for evaluation of clinical status, adverse effects, adherence and pill counting, lipid profile, and blood pressure.\u003C\/p\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EResults from The Indian Polycap Study (TIPS) indicated that tolerability of the fixed-dose combination pill was similar to that of individual treatments, with no evidence of increased intolerability that resulted from the consolidation of the medications into one pill. The polypill may reduce multiple risk factors and CV risk while offering a convenient adherence solution [TIPS. \u003Cem\u003ELancet\u003C\/em\u003E 2009]. Based on these data and preliminary findings from CNIC-FDC and FOCUS, Dr. Fuster noted that a polypill might improve secondary prevention worldwide due to its affordability and reduction in treatment complexity.\u003C\/p\u003E\n         \u003Cp id=\u0022p-11\u0022\u003EThe polypill has the potential to impact CVD on a global scale, particularly in developing countries, where resources are scarce and adherence is more problematic. Further outreach initiatives and biomedical research programs are needed in order to manage the growing CVD challenges. Identifying biomarkers and sustainable treatment solutions are the first steps in decreasing the global prevalence of CVD and mortality.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/9\/6\/12.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmuu2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}