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Sonia Anand

Publications and source records attributed to Sonia Anand.

10 recordsLinked to original sources
PubMed2005

Canadian Cardiovascular Society Consensus Conference: peripheral arterial disease - executive summary.

This Consensus Conference has been supported by the Canadian Cardiovascular Society. The process is dynamic, with intentional structure that requires peer review and feedback from cardiovascular specialists across Canada. The writing and review panel encompassed a broad range of specialists caring for the patient with peripheral arterial disease (PAD). PAD is an often asymptomatic, underdiagnosed, under-recognized and undertreated condition. It is associated with significant morbidity and cardiac mortality. Until recently, little attention has focused on the evaluation and treatment of the disease process itself. The goal of the present paper is to ensure better treatment, to reduce both morbidity and mortality in the patient with vascular disease and, importantly, to serve as a guide to the busy clinician. Although the focus is PAD, there are chapters on thoracic and abdominal aortic disease, renal arterial disease and the evidence supporting management. Screening and diagnostic techniques including history and physical examination as well as noninvasive imaging techniques are reviewed. Medical management for patients with vascular disease including prevention and risk reduction is graded based on evidence, including both pharmacological and nonpharmacological management strategies, followed by an introduction to newer percutaneous techniques. Finally, surgical treatment for claudication including new concepts on the perioperative risk assessment for patients undergoing major vascular surgery is discussed.

Aortic Aneurysm↗
PubMed2004

Prevalence of mitral valve prolapse in ethnic groups.

Mitral valve prolapse (MVP) was reported to be a common disorder occurring in 5% to 15% of the general population and to be frequently associated with serious complications. The reported high prevalence and complication rates of MVP have been challenged recently by the findings of the Framingham Heart Study, which was conducted in a Caucasian population; the findings in other ethnic groups remain uncertain. The prevalence of MVP was studied in a true population sample comprising 972 Canadians of South Asian (n=336), European (n=322) and Chinese (n=314) descent. MVP was diagnosed by two-dimensional echocardiography. The prevalence of MVP for the entire study cohort was 2.7% and did not differ significantly between the three ethnic groups evaluated (2.7% in South Asian, 3.1% in European and 2.2% in Chinese [P=0.79]). Age, sex, history of cardiac risk factors, blood pressure, abnormalities on electrocardiography, left atrial size, left ventricular end-diastolic and end-systolic diameters and volumes, and left ventricular ejection fraction were similar in subjects with and without MVP. There was a trend toward lower body mass index in subjects with MVP compared to those without MVP (24.5+/-5.5 kg/m(2) versus 26.0+/-4.3 kg/m(2), respectively, P=0.10). The prevalence of cardiovascular diseases, including history of angina, previous myocardial infarction, previous cardiac surgery and previous stroke, was similar in subjects with MVP (7.7%) and in those without MVP (6.7%) (P=0.84). The authors concluded that MVP has a much lower prevalence than previously estimated and the prevalence of MVP is similar among different ethnic groups. From a population perspective, the prevalence of serious cardiovascular complications associated with MVP is low.

Adult↗
PubMed2003

Antiplatelet agents in acute coronary syndromes.

Plaque disruption, platelet activation, and intracoronary artery thrombus formation are the key events in the pathogenesis of acute coronary syndromes. Antiplatelet therapies significantly reduce the risk of ischemic complications both during the acute phase and in the long term in patients with acute coronary syndromes. Aspirin remains the cornerstone of antiplatelet therapy, but there is incremental benefit when clopidogrel or ticlopidine is added to aspirin. Dual antiplatelet therapy with the combination of clopidogrel and aspirin is becoming the new standard of care for the management of patients with non-ST-segment elevation acute coronary syndrome and undergoing percutaneous coronary intervention and is currently being further evaluated in ST-segment elevation acute coronary syndrome.

Acute Disease↗
PubMed2003

The relationship between dysglycemia and atherosclerosis in South Asian, Chinese, and European individuals in Canada: a randomly sampled cross-sectional study.

OBJECTIVE: Raised glucose levels extending from normal into the diabetic range (dysglycemia) are an emerging risk factor for clinical cardiovascular events. The relationship between dysglycemia and atherosclerosis (AS) in the general population and in different ethnic groups remains controversial. RESEARCH DESIGN AND METHODS: Glucose tolerance, HbA1c, other metabolic risk factors for AS, and carotid mean maximal intimal media thickness were assessed in a random sample of 979 Canadians of South Asian, Chinese, and European descent. RESULTS: The age and sex-adjusted intimal medial thickness increased 0.026 mm for every 0.9% increase in HbA1c in all participants (P < 0.0001) and in those of South Asian (P = 0.018), Chinese (P = 0.002), and European (P < 0.0001) descent. This progressive curvilinear relationship was most apparent at HbA1c levels >5.7%. The HbA1c-AS relationship persisted after adjustment for ethnicity, age, sex, diabetes status, abdominal obesity, insulin resistance, insulin secretion, fasting free fatty acids, blood pressure, and/or dyslipidemia (P < 0.004). Both diabetes (P = 0.002) and HbA1c (P < 0.0001) were determinants of the intimal medial thickness when included in separate statistical models. When included together in a single model, HbA1c (P < 0.0001) but not diabetes (P = 0.6) was a significant determinant. CONCLUSIONS: The degree of AS is related to the level of HbA1c irrespective of diabetes status and independent of abdominal obesity and other markers of the metabolic syndrome. This progressive relationship between HbA1c and AS was observed within different ethnic groups.

Adult↗
PubMed2002

The global epidemic of atherosclerotic cardiovascular disease.

Of the 50 million deaths that occur in the world, 40 million occur in developing countries. Already a substantial proportion of these deaths are due to cardiovascular diseases. It is projected that by the year 2025 well over 80-90% of all the cardiovascular diseases in the world will be occurring in low income and middle income countries. This increase in cardiovascular disease is due to a number of causes which include the following: (1) conquest of deaths in childhood and infancy from nutritional deficiencies and infection; (2) urbanization with increasing levels of obesity; (3) increasing longevity of the population so that a higher proportion of individuals reach the age when they are subject to chronic diseases, and (4) increasing use of tobacco worldwide. In most countries in the world other than those in the West, the burden of disease is still due to a combination of infections and nutritional disorders as well as those due to chronic diseases. This double burden of disease poses a challenge that is not only medical and epidemiological, but also social and political. Tackling this projected global epidemic of cardiovascular disease therefore needs policies that combine sound knowledge of prevention, good clinical care, but also deals with the allocation of resources for both individual level and community level preventive strategies. The former involves dealing with high-risk individuals through appropriate medical and therapeutic interventions. The latter involves societal level changes including laws that curb the use of tobacco, and strategies that promote physical activities, and appropriate nutrition.

Arteriosclerosis↗