Leadership & Motivation

Transcription

1 PROMOTING HEALTH CHILDREN, FAMILY & COMMUNITY Leadership & Motivation ACC-New York, Dec. 11, 2015 No Disclosures

2 Documents on Global CV Health Follow-up? Promoting Cardiovascular Health in the Developing World; A Critical Challenge to Achieve Global Health. Ed. V Fuster and B Kelly. IOM of the Natl. Academies. Natl. Academies Press. Washington DC.2010.

3 Institute of Medicine Experience A Critical Challenge to Achieve Global Health 2011 June Circ. 2011;123: RECOMMEDATIONS

4 FUNDING THE FIGHT AGAINST CHRONIC NCD Sense of Need - Local, National and International Government, Non-Profit Private, For-Profit Private, Partnerships

5 EDUCATION & LOCAL DATA Census-Based, Survey-Based, Study-Based - Great Impact

6 PROMOTING HEALTH CHILDREN, FAMILY & COMMUNITY Leadership & Motivation ACC-New York, Dec. 11, 2015 No Disclosures

7 Health & Quality of Life (QoL) Aging (A) to Birth (B) B Present Health (QoL) Early Economic Late Expensive Policy Mandatory (?) Air Pollution & Noise A 0 B Prom. Health Subcl. Disease Science Future Stable-Unst. Disease A Environment V Fuster, JACC 2015 (October) B Window Behav. Young Change 0 Education Adherence Simplicity A

8 Child s Brain Development Less Networking Brings Atention 1B JN Giedd. Scientific American 2015;312:32

9 COLOMBIA CHILDREN S PROGRAM EDUCATIVE GOAL: HEALTHY HABITS FOR CHILDREN BETWEEN 3 & 5 YRS CHILDREN GENERAL PUBLIC

10 Score (mean) 1. In Children s KAH Mean Scores* p< p< p< p< p< Knowledge Attitudes Habits (physical activity) The Amer J of Med 2012; 126, 27 The Amer J of Med 2013;126:1122 Bogota 25,000

11 2. Changes In Anthropometric Variables At Each FU In Overweight Children Body Mass Index (BMI) Waist Circumference (WC) JL Peñalvo, V Fuster et. al. JACC 2015 (In Press). - 75,000,

12 PROMOTING HEALTH CHILDREN, FAMILY & COMMUNITY Leadership & Motivation ACC-New York, Dec. 11, 2015 No Disclosures

13 Health & Quality of Life (QoL) Aging (A) to Birth (B) B Present Health (QoL) Early Economic Late Expensive Policy Mandatory (?) Air Pollution & Noise A 0 B Prom. Health Subcl. Disease Science Future Stable-Unst. Disease A Environment V Fuster, JACC 2015 (October) B Window Behav. Young Change 0 Education Adherence Simplicity A

14 Subclinical Disease (N=10,000) Carotid 3D-US, Coronary Calcification U Baber, R Mehran, V Fuster, et al. J. Am. Coll. Card. 2015; 65: 1065 L Fernandez-Friera, A Fernandez-Ortiz, V Fuster et.al Circ 2015, 4/20

15 A Health Center In The Adult Brain (?) c 2B? To Stimulate / Motivate

16 1. AMPATH Centers In Kenya BP Control / Non MD / High Technology R Vedanthan, V Fuster, NHLBI / Kenya Model ( )

17 2a. CARDONA INTEGRAL FIFTY-FIFTY SMOKING OVERWEIGHT SEDENTARISM HYPERTENSION TOTAL HABIT SCORE 8 SIX MONTHS 95% of the people have improved in one or more of the habits or RF.

18 2b.The Seven Community Study N= E. Gomez, V Fuster et al 2015 (Subm) Approach 3: PESA Program, Madrid AHA 2015, Orlando

19 2c. Global Demonstration Project - GHP High Risk Factor Profile

20 2c. GHP-CHANGE Grenada Heart Project Community Health ActioN to EncouraGe Healthy BEhaviors. >1 CV Risk Frs N=402 R Monthly Group Meetings Self- Management 12 month GHP Outcomes Score 12 month GHP Outcomes Score Planning Baseline Assessment Group Meetings Midpoint Assessment Post-Interv. Assessment August/Sept 2014 Completed March 2015 Ongoing currently August/Sept 2015 March/April 2016

21 Health & Quality of Life (QoL) Aging (A) to Birth (B) B Present Health (QoL) Early Economic Late Expensive Policy Mandatory (7) Air Pollution & Noise A 0 B Prom. Health Subcl. Disease Science Future Stable-Unst. Disease A Environment V Fuster, JACC 2015 (October) B Window Behav. Young Change 0 Education Adherence Simplicity A

22 1. DBD/AD - CVRFs, Lacunar Les., < Cognitive MRI Perfusion Ischemia affects 60 to 90% of patients with Alzheimer s 1.V Novak, I Hajjar. Nat. Rev. Cardiol. 2010; 7:686(HMS) 2. HW Querfurth, FM LaFerla. NEJM 2010; 362:329 Autopsy (n=6000) 3B 3. JB Toledo et al. Brain July 10, 2013 CV Risk Factors, Cognitive Function, Imaging 4. CARDIA (K Yaffe et al) Circ (In Press) 5.JI Friedman, V Fuster et. al JACC CV Imag (In Press) Intervention 6. FINGER (T Ngandu et al)., The Lancet 2015; 385:2255

23 2. Aging / Frailty Oxidative Stress on Telomere B Niemann et. al. JACC 2011; 57: 577. R Madonna, R De Caterina et. al EHJ 2011;32:1190 (Houston &Chieti, Italy) JC Kovacic, EG Nabel, V Fuster Circ. 2011;123:1650

24 3. CV Drugs Underuse - Polypill, 2ary Prevention. FOCUS 1 & 2 Argentina Brazil Paraguay Italy Spain FREEDOM AETNA-DIABETES SECURE-EC 2015 BIO-EQUIVALENCE PHARMACODINAMIC INTERACTION WITH RAMIPRIL PHARMACODYNAMIC INTERACTION WITH SYMVASTATIN FOOD INTERACTION PHARMACOKINETIC INTERACTION WITH ASPIRIN ASA, Statin, ACE-Inhibitor PHARMACOKINETIC INTERACTION WITH SYMVASTATIN PHARMACOKINETIC INTERACTION WITH RAMIPRIL Am. H J 2011;162:811 Semin.Thor.Cardiov.Surg 2011;23:24 JACC, 2014; 64:2071 PHARMACODYNAMIC INTERACTION WITH ASPIRIN Approved in 26 Countries * Valentín Fuster (inventor)

25 Science, Health, Education(SHE) Colombia / Spain Behavior 2 Kenya/Spain/Grenada. Five Countries IIIP / PPPI Polypill Extended healthy lives in part due to medical research generates dramatic returns - Albert & Mary Lasker Found

26 American Heart Association, Focused Prevention Research Center Family-Based Approach Prevention of CVD in a Minority Community Integrating Systems-Biology Icahn School of Medicine at Mount Sinai

27 Head Start Organization

28 Start (1) Children 3 Groups Caregivers 3 Groups (2) Start KAH-BEA Mol. Genomics KAH-BEA S-KAH-BEA P P P P P P O I I (3) I O O Teachers O IP II BEWAT Point of Care. 3D-US Mol. Genomics O O O O IP II BEWAT Point of Care 3D-US Mol. Genomics O O O 1 st Yr 2 nd Yr 3 rd Yr 4 th Yr (3) O O O (1) Contr./Interv. Intervention. Intervention Control PPPI IIIP (2) S-BEWAT Point of Care KAH-BEA = Knowledge, Attitude, Habit -BMI, Exercise, Alimentation PPPI = Peer-to-Peer Program Interv; IIIP = Intensive Individual Intervention Program BEWAT = BP, Exercise, Weight, Alimentation, Tobacco

29 Wearable Tech

30 Interactive Circle of Health - App Actividades previstas Lanzamiento de la versión internacional THE CIRCLE OF HEALTH

31 Engaging Partners Mount Sinaí Heart FC Barcelona

32 PROMOTING HEALTH CHILDREN, FAMILY & COMMUNITY Leadership & Motivation ACC-New York, Dec. 11, 2015 No Disclosures

33 HEALTH ENVIRONMENT SCIENCE EDUCATION

34 Continuity EDUCATION CARDONA HARLEM GRENADA KENYA MADRID BOGOTA Community Family Adults Children

35 PROMOTING HEALTH A CHALLENGE FOR SCIENCE & EDUCATION Leadership & Motivation ACC-New York, Dec. 11, 2015 No Disclosures