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Cardiovascular disease refers to conditions that affect the heart or blood vessels. It describes conditions ranging from peripheral artery disease and high blood pressure to heart attacks and strokes. It is the number-one killer of Americans and the leading cause of hospitalization in the VA health care system. It is also a major cause of disability. Although there are many different forms of cardiovascular disease, one of the most common forms is a narrowing or a blocking of the blood vessels that supply blood to the heart. This is called coronary artery disease (CAD) and is the main reason people have heart attacks.

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Heart procedures in VA versus community hospitals

Performing coronary revascularization procedures at community care hospitals that partner with VA, rather than at VA hospitals, has benefits and downsides, according to a study in several VA health care systems. Coronary revascularization refers to procedures to treat artery narrowing or blockage near the heart. The procedures studied were percutaneous coronary intervention and coronary artery bypass graft. One in five elective coronary revascularizations for VA patients was performed at community care sites that were part of the VA Community Care Program. Patients who had percutaneous coronary interventions at community-based medical centers had shorter travel distances than their peers who had the procedure at VA hospitals. However, community care patients had higher mortality and higher costs to the health care system than VA hospital patients. Coronary artery bypass grafts performed at community care hospitals had shorter travel distance, similar mortality, and lower costs than those performed at VA hospitals. The results show that patients should be provided with information to help them pick the health care professionals best for them regardless of location, say the researchers. (JAMA Cardiology, Jan. 3, 2018)

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Effect of testosterone on cardiovascular risk remain unclear

Results were mixed on whether treatment for low testosterone in older men improves cardiovascular risk factors, in a study that included several VA researchers. The researchers looked at how testosterone treatment affects cardiovascular risk factors in 788 men age 65 or older. The study was part of a larger series of trials looking at how testosterone therapy affects a number of health outcomes. Testosterone was linked to small reductions in cholesterol and fasting insulin. But testosterone therapy did not affect other cardiovascular risk factors, such as glucose markers, inflammation, or clotting. More large studies are needed to figure out what effect testosterone has on cardiovascular risk, say the researchers. (Journal of Clinical Endocrinology and Metabolism, Dec. 14, 2017)

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Self-monitoring can lower blood pressure when used with other treatments

Self-monitoring leads to lower blood pressure when combined with other treatments, found a large international review including several VA researchers. The researchers analyzed 36 relevant articles on high blood pressure. They found that having patients monitor their own blood pressure on a regular basis at home resulted in reductions in pressure when combined with treatments such as medication, education, and lifestyle counseling. Self-monitoring by itself, however, did not lower blood pressure. The American Heart Association recommends self-monitoring at home for all those with high blood pressure, as the regular and frequent readings help providers track whether treatments are working. Based on the new study results, the researchers recommend including self-monitoring with other methods to treat high blood pressure. (PLoS Medicine, Sept. 19, 2017)

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PTSD and heart disease can go hand in hand

When most people think of posttraumatic stress disorder (PTSD) the first thing that comes to mind is stress. But mental health isn't the only body system that can suffer from the effects of PTSD. Researchers have known for quite some time that prolonged stress can affect multiple organ systems, for example, the cardiovascular system—which consists of the heart and blood vessels. (Spring 2017)

MVP data leads to new finding on 'resistant hypertension'

Using data from the Million Veteran Program, VA researchers found that a blood pressure condition called resistant hypertension can increase the risk of cardiovascular problems and kidney failure. (11/28/2017)

VA scientist mentors pair of former Marines in biomedicine, with goal of creating artificial heart

Dr. Ngan Huang, a biomedical engineer at the VA Palo Alto Health Care System, currently has two former Marines interning in her lab, and plans to expand the opportunity to other Veterans. (08/31/2017)

• Major VA trial helps answer question of which heart bypass method is better
• New app will target Veterans in cardiac rehab