3 research outputs found
Mortality Trends Associated With Acute Myocardial Infarction and Psychoactive Substance Use in Older Adults: A US Nationwide Analysis (1999-2020).
No full textThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2025 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC.Background: Acute myocardial infarction (AMI) remains a leading cause of mortality in the USA, particularly among individuals aged 65 and older. There is limited research about the association between psychoactive substance use and cardiovascular death due to AMI. This study aims to analyze trends in AMI-related mortality among older adults (aged ≥ 65) associated with psychoactive substance use in the USA from 1999 to 2020, with a focus on demographic and geographic variations.
Methods: We conducted a descriptive analysis using death certificates from the CDC's WONDER database. Data were extracted for age, sex, race/ethnicity, urban-rural status, and geographic region. Crude mortality rates and AAMR were calculated, and temporal trends were assessed using Joinpoint regression.
Results: Between 1999 and 2020, there were 231 359 AMI-related deaths among older adults with substance use disorders. Men (39.2) had a markedly higher mortality rate than women (15.0). Mortality rates increased across all age groups, with the most pronounced rise in those aged 85 and older (33.9). Metropolitan areas (22.3) experienced lower mortality rates than nonmetropolitan areas (37.9). The Midwest (32.3) consistently recorded the highest mortality rates, followed by the Northeast (25.0), South (24.5), and West (18.7).
Conclusion: The study reveals notable temporal trends in AMI mortality among older adults with psychoactive substance use, highlighting significant demographic and regional disparities. These findings underscore the need for targeted interventions to address this growing public health issue
Efficacy and Safety of Aldosterone Synthase Inhibitors in Hypertension: A Systematic Review and Meta-Analysis.
No full textThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium,
provided the original work is properly cited.
© 2025 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.Background: Hypertension remains a major contributor to global cardiovascular morbidity and mortality. Aldosterone, a key hormone in blood pressure regulation, plays a significant role in hypertension pathophysiology. This has led to growing interest in aldosterone synthase inhibitors (ASIs) as a potential treatment. This meta-analysis aims to evaluate the efficacy and safety of ASIs in managing hypertension.
Methods: A systematic search of PubMed, Google Scholar and Cochrane Central was conducted up to 13 July 2025, to identify randomised controlled trials (RCTs) evaluating ASIs in hypertensive adults. Data were analysed using RevMan version 5.4, employing random-effects models with significance set at p < 0.05.
Results: A total of 8 RCTs were included, with a total of 2003 participants in the ASI group and 650 participants in the placebo group. ASIs significantly reduced systolic blood pressure (SBP) compared to placebo (MD: -6.01 mmHg; 95% confidence interval [CI]: -9.31 to -2.71; I2 = 85%; p = 0.0004); diastolic blood pressure (DBP) was found to be comparable between the two groups (MD: -2.20 mmHg; 95% CI: -4.46 to 0.06; I2 = 69%; p = 0.06). There was a significant reduction in serum aldosterone levels favouring ASI use (MD: -1.46; 95% CI: -2.76 to -0.16; I2 = 99%; p < 0.00001). The risk of serious (RD: 0.00; 95% CI: -0.01 to 0.02; I2 = 30%; p = 0.75) and non-serious adverse events (RD: 0.05; 95% CI: -0.02 to 0.12; I2 = 64%; p = 0.20) did not differ significantly between ASI and placebo groups. However, ASI use was associated with a significantly higher risk of hyperkalemia (RD: 0.04; 95% CI: 0.02 to 0.06; I2 = 70%; p = 0.002).
Conclusion: ASIs effectively lower SBP and serum aldosterone in adults with hypertension. They appear safe overall but may increase the risk of hyperkalemia
The Paradox of Informal Settlements Revealed in an ATLAS of Informality: Findings from Mapping Growth in the Most Common Yet Unmapped Forms of Urbanization
No full textInformal settlements are the most common form of urbanization on the planet, accounting for one-third of the total urban form. It is expected that by the mid twenty-first century, up to three billion people will live in informal urban environments. However, we lack a consistent mapping method to pinpoint where that informality is located or how it expands. This paper presents the findings from a collection of standardized measurements of 260 informal settlements across the world. The main research goal is to identify a standard global sample of informal neighborhoods. It then focuses on mapping urban growth with remote sensing and direct mapping tools. The third stage classifies settlements based on how adjacency features such as development, topography, or bodies of water relate to their growth. The survey of growth corroborates the idea of informality as expanding geography, although at different rates than previously cited in the literature. We found peri-urban location to be a suitable estimator of informal settlement growth. This finding validates the comparison of multiple settlements to understand rates of change of urban informality worldwide. The findings here are vital to resolve important questions about the role of informal urban development in the context of accelerated global population growth
