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Bouchard K, Liu PP, Dautenhahn K, Fiedorowicz JG, Afrin J, Dans M, McGuinty C, Tulloch H. Cardiology professionals' views of social robots in augmenting heart failure patient care. Eur Heart J Digit Health 2024; 5:69-76. [PMID: 38264699 PMCID: PMC10802821 DOI: 10.1093/ehjdh/ztad067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/14/2023] [Accepted: 10/11/2023] [Indexed: 01/25/2024]
Abstract
Aims Social robots are arriving to the modern healthcare system. Whether patients with heart failure, a prevalent chronic disease with high health and human costs would derive benefit from a social robot intervention has not been investigated empirically. Diverse healthcare provider's perspectives are needed to develop an acceptable and feasible social robot intervention to be adopted for the clinical benefit of patients with heart failure. Using a qualitative research design, this study investigated healthcare providers' perspectives of social robot use in heart failure patient care. Methods and results Interdisciplinary healthcare providers from a tertiary care cardiac hospital completed a structured individual interview and a supplemental questionnaire. The framework method was used to analyse the qualitative data. Respondents (n = 22; saturation was reached with this sample; 77% female; 52% physicians) were open to using social robots to augment their practice, particularly with collecting pertinent data and providing patient and family education and self-management prompts, but with limited responsibility for direct patient care. Prior to implementation, providers required robust evidence of: value-added beyond current remote patient monitoring devices, patient and healthcare provider partnerships, streamlined integration into existing practice, and capability of supporting precision medicine goals. Respondents were concerned that social robots did not address and masked broader systemic issues of healthcare access and equity. Conclusion The adoption of social robots is a viable option to assist in the care of patients with heart failure, albeit in a restricted capacity. The results inform the development of a social robotic intervention for patients with heart failure, including improving social robot efficiencies and increasing their uptake, while protecting patients' and providers' best interest.
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Affiliation(s)
- Karen Bouchard
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7 ON, Canada
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
| | - Peter P Liu
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7 ON, Canada
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
| | - Kerstin Dautenhahn
- Faculty of Engineering, University of Waterloo, 200 University Ave W., Waterloo, N2L 3G1 ON, Canada
| | - Jess G Fiedorowicz
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
- Department of Mental Health, The Ottawa Hospital/Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, K1H 8L6 ON, Canada
| | - Jenifar Afrin
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
| | - Michael Dans
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7 ON, Canada
| | - Caroline McGuinty
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7 ON, Canada
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
| | - Heather Tulloch
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7 ON, Canada
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
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Shen NN, Lin JH, Liu PP. [EBF1 Promotes the Sensitivity of Cervical Cancer Cells to Cisplatin via Activating FBN1 Transcription]. Mol Biol (Mosk) 2023; 57:503-504. [PMID: 37326054 DOI: 10.31857/s0026898423030102, edn: chkzxj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/05/2022] [Indexed: 06/17/2023]
Abstract
Cisplatin (DDP) is widely used in the chemotherapy of cervical cancer (CC), the fourth most common female malignancy worldwide. However, some patients progress to chemotherapy resistance, which leads to chemotherapy failure, tumor recurrence, and poor prognosis. Therefore, strategies to identify the regulatory mechanisms underlying CC development and increase tumor sensitivity to DDP will help improve patient survival. This research was designed to ascertain the mechanism of EBF1-dependent regulation of FBN1 which promotes chemosensitivity of CC cells. The expression of EBF1 and FBN1 was measured in CC tissues resistant or sensitive to chemotherapy and in DDP-sensitive or -resistant cells (SiHa and SiHa-DDP cells). SiHa-DDP cells were transduced with lentiviruses encoding EBF1 or FBN1 to evaluate the influence of these two proteins on cell viability, expression of MDR1 and MRP1, and cell aggressiveness. Moreover, the interaction between EBF1 and FBN1 was predicted and demonstrated. Finally, to further verify the EBF1/FB1-dependent mechanism of DDP sensitivity regulation in CC cells a xenograft mouse model of CC was established using SiHa-DDP cells transduced with lentiviruses carrying EBF1 gene and shRNA directed to FBN1 EBF1 and FBN1 showed decreased expression in CC tissues and cells, particularly in those resistant to chemotherapy. Transduction of SiHa-DDP cells with lentiviruses encoding EBF1 or FBN1 lead to decreased viability, IC50, proliferation capacity, colony formation ability, aggressiveness, and increased cell apoptosis. We have shown that EBF1 activates FBN1 transcription by binding to FBN1 promoter region. Additionally, it was revealed that FBN1 silencing reversed the promoting effect of EBF1 overexpression on chemosensitivity of CC cells in vivo. EBF1 facilitated chemosensitivity in CC cells by activating FBN1 transcription.
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Affiliation(s)
- N N Shen
- Department of Pharmacy, Ganzhou Women and Children's Health Care Hospital, Ganzhou, Jiangxi, 341000 P.R. China
| | - J H Lin
- Department of Pharmacy, the First Affiliated Hospital of Gannan Medical University, Ganzhou Jiangxi, 341000 P.R. China
| | - P P Liu
- Department of Pharmacy, the First Affiliated Hospital of Gannan Medical University, Ganzhou Jiangxi, 341000 P.R. China
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Jankowska EA, Liu PP, Cowie MR, Groenhart M, Cobey KD, Howlett J, Komajda M, Lund LH, Serrano JAM, Mourilhe-Rocha R, Rosano GMC, Saldarriaga C, Schwartzmann PV, Zannad F, Zhang J, Zhang Y, Coats AJS. Personalised care of patients with heart failure - are we ready for a REWOLUTION? Insights from two international surveys on healthcare professionals' needs and patients' perceptions. Eur J Heart Fail 2023; 25:364-372. [PMID: 36823770 DOI: 10.1002/ejhf.2798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023] Open
Abstract
AIMS Guidelines for the management of heart failure (HF) are evolving, and increasing emphasis is placed on patient-centred care. As part of the REWOLUTION HF (REal WOrLd EdUcaTION in HF) programme, we conducted two international surveys aimed at assessing healthcare professionals (HCPs)' educational needs and patients' perspectives on the care of HF. METHODS AND RESULTS Anonymous online questionnaires co-developed by HF experts and patients assessed HCPs' educational needs (520 respondents, mostly cardiologists, in 68 countries) and patients' perceptions on HF impact and management (98 respondents in 18 countries). Among HCPs, 62.7% prioritised rapid initiation of all guideline-mandated medications over uptitration of some medications, and 87.7% always or frequently discussed treatment goals with patients. There was good agreement between HCPs and patients on key treatment goals, except for a greater emphasis on reducing hospitalisations among HCPs. The most frequently cited barriers to the provision of guideline-recommended pharmacological therapy were treatment side effects/intolerance, complex treatment regimens, low blood pressure, cost/reimbursement issues, and low eGFR. Most patients (81.6%) reported no difficulties taking medications as prescribed, although 21.4% felt they were taking too many pills. Patients wanted more information about HF and its consequences, prognosis, and treatments (70.4%, 74.5% and 76.6%, respectively). Cardiologists were the preferred source of information about HF, followed by general practitioners and HF nurses. CONCLUSIONS These surveys provide valuable insights into HCPs' needs about personalised care for patients with HF, as well as patients' perceptions, expectations and preferences. These findings will be helpful to develop patient-centred, needs-driven quality improvement programmes. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ewa A Jankowska
- Institute of Heart Diseases, Wrocław Medical University, Wrocław, Poland.,Institute of Heart Diseases, University Hospital, Wrocław, Poland
| | - Peter P Liu
- University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Martin R Cowie
- Royal Brompton Hospital & School of Cardiovascular Medicine, Faculty of Lifesciences & Medicine, King's College London, London, UK
| | | | - Kelly D Cobey
- University of Ottawa Heart Institute, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jonathan Howlett
- Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
| | - Michel Komajda
- Saint Joseph Hospital, Paris-Sorbonne University, Paris, France
| | | | | | - Ricardo Mourilhe-Rocha
- Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.,Complexo Hospitalar Américas, Vitória e Samaritano Barra, Rio de Janeiro, RJ, Brazil
| | - Giuseppe M C Rosano
- Centre for Clinical & Basic Research, IRCCS San Raffaele Pisana, Rome, Italy
| | - Clara Saldarriaga
- Department of Cardiology, Pontifical Bolivarian University and University of Antioquia, Medellín, Colombia
| | - Pedro V Schwartzmann
- Unimed Hospital Ribeirão Preto and Advanced Center for Research, Teaching and Diagnosis, Ribeirão Preto, SP, Brazil
| | | | - Jian Zhang
- Peking Union Medical College, Beijing, China
| | - Yuhui Zhang
- Peking Union Medical College, Beijing, China
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Jain R, Stone JA, Agarwal G, Andrade JG, Bacon SL, Bajaj HS, Baker B, Cheng G, Dannenbaum D, Gelfer M, Habert J, Hickey J, Keshavjee K, Kitty D, Lindsay P, L'Abbé MR, Lau DCW, Macle L, McDonald M, Nerenberg K, Pearson GJ, Pham T, Poppe AY, Rabi DM, Sherifali D, Selby P, Smith E, Stern S, Thanassoulis G, Terenzi K, Tu K, Udell J, Virani SA, Ward RA, Warburton DER, Wharton S, Zymantas J, Hua-Stewart D, Liu PP, Tobe SW. Ligne directrice C-CHANGE pour l’harmonisation des lignes directrices nationales de prévention et de prise en charge des maladies cardiovasculaires en contexte de soins primaires au Canada: mise à jour 2022. CMAJ 2023; 195:E21-E42. [PMID: 36623864 PMCID: PMC9829070 DOI: 10.1503/cmaj.220138-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Rahul Jain
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - James A Stone
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Gina Agarwal
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Jason G Andrade
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Simon L Bacon
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Harpreet S Bajaj
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Brian Baker
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Gemma Cheng
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - David Dannenbaum
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Mark Gelfer
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Jeffrey Habert
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - John Hickey
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Karim Keshavjee
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Darlene Kitty
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Patrice Lindsay
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Mary R L'Abbé
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - David C W Lau
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Laurent Macle
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Michael McDonald
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Kara Nerenberg
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Glen J Pearson
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Thuy Pham
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Alexandre Y Poppe
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Doreen M Rabi
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Diana Sherifali
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Peter Selby
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Eric Smith
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Sol Stern
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - George Thanassoulis
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Kristin Terenzi
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Karen Tu
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Jacob Udell
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Sean A Virani
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Richard A Ward
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Darren E R Warburton
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Sean Wharton
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Jennifer Zymantas
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Diane Hua-Stewart
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Peter P Liu
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont.
| | - Sheldon W Tobe
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
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Jain R, Stone JA, Agarwal G, Andrade JG, Bacon SL, Bajaj HS, Baker B, Cheng G, Dannenbaum D, Gelfer M, Habert J, Hickey J, Keshavjee K, Kitty D, Lindsay P, L'Abbé MR, Lau DCW, Macle L, McDonald M, Nerenberg K, Pearson GJ, Pham T, Poppe AY, Rabi DM, Sherifali D, Selby P, Smith E, Stern S, Thanassoulis G, Terenzi K, Tu K, Udell J, Virani SA, Ward RA, Warburton DER, Wharton S, Zymantas J, Hua-Stewart D, Liu PP, Tobe SW. Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2022 update. CMAJ 2022; 194:E1460-E1480. [PMID: 36343954 PMCID: PMC9828999 DOI: 10.1503/cmaj.220138] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Rahul Jain
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - James A Stone
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Gina Agarwal
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Jason G Andrade
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Simon L Bacon
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Harpreet S Bajaj
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Brian Baker
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Gemma Cheng
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - David Dannenbaum
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Mark Gelfer
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Jeffrey Habert
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - John Hickey
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Karim Keshavjee
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Darlene Kitty
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Patrice Lindsay
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Mary R L'Abbé
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - David C W Lau
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Laurent Macle
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Michael McDonald
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Kara Nerenberg
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Glen J Pearson
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Thuy Pham
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Alexandre Y Poppe
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Doreen M Rabi
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Diana Sherifali
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Peter Selby
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont.
| | - Eric Smith
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sol Stern
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - George Thanassoulis
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Kristin Terenzi
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Karen Tu
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Jacob Udell
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sean A Virani
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Richard A Ward
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Darren E R Warburton
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sean Wharton
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Jennifer Zymantas
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Diane Hua-Stewart
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Peter P Liu
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sheldon W Tobe
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
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6
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Sun LY, Zghebi SS, Eddeen AB, Liu PP, Lee DS, Tu K, Tobe SW, Kontopantelis E, Mamas MA. Derivation and External Validation of a Clinical Model to Predict Heart Failure Onset in Patients With Incident Diabetes. Diabetes Care 2022; 45:2737-2745. [PMID: 36107673 PMCID: PMC9862443 DOI: 10.2337/dc22-0894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/20/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Heart failure (HF) often develops in patients with diabetes and is recognized for its role in increased cardiovascular morbidity and mortality in this population. Most existing models predict risk in patients with prevalent rather than incident diabetes and fail to account for sex differences in HF risk factors. We derived sex-specific models in Ontario, Canada to predict HF at diabetes onset and externally validated these models in the U.K. RESEARCH DESIGN AND METHODS Retrospective cohort study using international population-based data. Our derivation cohort comprised all Ontario residents aged ≥18 years who were diagnosed with diabetes between 2009 and 2018. Our validation cohort comprised U.K. patients aged ≥35 years who were diagnosed with diabetes between 2007 and 2017. Primary outcome was incident HF. Sex-stratified multivariable Fine and Gray subdistribution hazard models were constructed, with death as a competing event. RESULTS A total of 348,027 Ontarians (45% women) and 54,483 U.K. residents (45% women) were included. At 1, 5, and 9 years, respectively, in the external validation cohort, the C-statistics were 0.81 (95% CI 0.79-0.84), 0.79 (0.77-0.80), and 0.78 (0.76-0.79) for the female-specific model; and 0.78 (0.75-0.80), 0.77 (0.76-0.79), and 0.77 (0.75-0.79) for the male-specific model. The models were well-calibrated. Age, rurality, hypertension duration, hemoglobin, HbA1c, and cardiovascular diseases were common predictors in both sexes. Additionally, mood disorder and alcoholism (heavy drinker) were female-specific predictors, while income and liver disease were male-specific predictors. CONCLUSIONS Our findings highlight the importance of developing sex-specific models and represent an important step toward personalized lifestyle and pharmacologic prevention of future HF development.
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Affiliation(s)
- Louise Y. Sun
- Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - Salwa S. Zghebi
- NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, U.K
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, U.K
| | - Anan Bader Eddeen
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
| | - Peter P. Liu
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Douglas S. Lee
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
- Ted Rodgers Cardiac Centre, University Health Network, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Karen Tu
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
- Ted Rodgers Cardiac Centre, University Health Network, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- North York General Hospital, Toronto, Ontario, Canada
| | - Sheldon W. Tobe
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Nephrology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Evangelos Kontopantelis
- NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, U.K
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, U.K
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, U.K
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institutes of Applied Clinical Science and Primary Care and Health Sciences, Keele University, Staffordshire, U.K
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, U.K
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7
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Affiliation(s)
- Peter P Liu
- University of Ottawa Heart Institute, University of Ottawa, Canada (P.P.L.)
| | - Malcolm King
- Department of Community Health and Epidemiology (M.K.), University of Saskatchewan, Saskatoon, Canada
| | - Alexandra King
- Cameco Chair in Indigenous Health and Wellness (A.K.), University of Saskatchewan, Saskatoon, Canada
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8
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Chu JY, Kaliwal Y, Koh M, Chen R, Chow CM, Ko DT, Liu PP, Moe GW. COVID-19 and its Cardiac and Neurological Complications among Ontario Visible Minorities. Can J Neurol Sci 2022; 49:504-513. [PMID: 34162448 PMCID: PMC8365110 DOI: 10.1017/cjn.2021.148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/19/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Due to lack of data on the epidemiology, cardiac, and neurological complications among Ontario visible minorities (Chinese and South Asians) affected by coronavirus disease (COVID-19), this population-based retrospective study was undertaken to study them systematically. METHODS From January 1, 2020 to September 30, 2020 using the last name algorithm to identify Ontario Chinese and South Asians who were tested positive by PCR for COVID-19, their demographics, cardiac, and neurological complications including hospitalization and emergency visit rates were analyzed compared to the general population. RESULTS Chinese (N = 1,186) with COVID-19 were found to be older (mean age 50.7 years) compared to the general population (N = 42,547) (mean age 47.6 years) (p < 0.001), while South Asians (N = 3,459) were younger (age of 42.1 years) (p < 0.001). The 30-day crude rate for cardiac complications among Chinese was 169/10,000 (p = 0.069), while for South Asians, it was 64/10,000 (p = 0.008) and, for the general population, it was 112/10,000. For neurological complications, the 30-day crude rate for Chinese was 160/10,000 (p < 0.001); South Asians was 40/10,000 (p = 0.526), and general population was 48/10,000. The 30-day all-cause mortality rate was significantly higher for Chinese at 8.1% vs 5.0% for the general population (p < 0.001), while it was lower in South Asians at 2.1% (p < 0.001). CONCLUSIONS Chinese and South Asians in Ontario affected by COVID-19 during the first wave of the pandemic were found to have a significant difference in their demographics, cardiac, and neurological outcomes.
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Affiliation(s)
- Joseph Y. Chu
- Division of Neurology, Department of Medicine, Toronto Western Hospital-University Health Network and William Osler Health System, University of Toronto, Toronto, Canada
| | | | | | - Robert Chen
- Krembil Research Institute, University Health Network and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Chi-Ming Chow
- Division of Cardiology, Department of Medicine, St. Michael’s Hospital, University of Toronto, Toronto, Canada
| | - Dennis T. Ko
- ICES, Toronto, Canada
- Schulich Heart Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Peter P. Liu
- University of Ottawa Heart Institute and Department of Medicine and Cellular & Molecular Medicine, University of Ottawa and Division of Cardiology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Gordon W. Moe
- Division of Cardiology, Department of Medicine, St. Michael’s Hospital, University of Toronto, Toronto, Canada
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9
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Chu A, Shah BR, Rashid M, Booth GL, Fazli GS, Tu K, Sun LY, Abdel-Qadir H, Yu CH, Shin S, Connelly KA, Tobe S, Liu PP, Lee DS. Trends in glucose testing among individuals without diabetes in Ontario between 2010 and 2017: a population-based cohort study. CMAJ Open 2022; 10:E772-E780. [PMID: 35998927 PMCID: PMC9402266 DOI: 10.9778/cmajo.20210195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Early identification of people with diabetes or prediabetes enables greater opportunities for glycemic control and management strategies to prevent related complications. To identify gaps in screening for these conditions, we examined population trends in receipt of timely glucose testing overall and in specific clinical subgroups. METHODS Using linked administrative databases, we conducted a retrospective cohort study of people aged 40 years and older without diabetes at baseline. Our primary outcome was up-to-date glucose testing, defined as having received testing at least once in the 3 years before each index year from 2010 to 2017, using linked administrative databases of people residing in Ontario, Canada. We calculated rates of up-to-date testing by age group, sex, ethnicity (South Asian, Chinese, general population) and comorbidities (hypertension, hyperlipidemia, cardiovascular disease). RESULTS Over the 8-year study period, up-to-date glucose testing rates were stable at 67% for men and 77% for women (both relative risk 1.00 per year; 95% confidence interval 1.00-1.00). Testing rates were significantly lower in men than in women (all age groups p < 0.001) and lower in younger than older age groups (except those aged ≥ 80 yr). South Asian people had the highest testing rates, although among people aged 70 years or older, testing was highest in the general population (p < 0.001). Among people with hypertension, hyperlipidemia and cardiovascular disease, annual testing rates were also stable, but only 58% overall among people with hypertension. INTERPRETATION We found lower glucose testing rates in younger men and people with hypertension. Our findings reinforce the need for initiatives to increase awareness of glycemic testing.
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Affiliation(s)
- Anna Chu
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Baiju R Shah
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Mohammed Rashid
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Gillian L Booth
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Ghazal S Fazli
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Karen Tu
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Louise Y Sun
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Husam Abdel-Qadir
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Catherine H Yu
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sheojung Shin
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Kim A Connelly
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sheldon Tobe
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Peter P Liu
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Douglas S Lee
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont.
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10
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Affiliation(s)
- Karen Bouchard
- University of Ottawa Heart Institute, Canada (K.B., P.P.L., H.T.).,University of Ottawa, Canada (K.B., P.P.L., H.T.)
| | - Peter P Liu
- University of Ottawa Heart Institute, Canada (K.B., P.P.L., H.T.).,University of Ottawa, Canada (K.B., P.P.L., H.T.)
| | - Heather Tulloch
- University of Ottawa Heart Institute, Canada (K.B., P.P.L., H.T.).,University of Ottawa, Canada (K.B., P.P.L., H.T.)
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11
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Chouchana L, Blet A, Al‐Khalaf M, Kafil TS, Nair G, Robblee J, Drici M, Valnet‐Rabier M, Micallef J, Salvo F, Treluyer J, Liu PP. Features of Inflammatory Heart Reactions Following mRNA COVID-19 Vaccination at a Global Level. Clin Pharmacol Ther 2022; 111:605-613. [PMID: 34860360 PMCID: PMC9015432 DOI: 10.1002/cpt.2499] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/25/2021] [Indexed: 12/19/2022]
Abstract
Myocarditis and pericarditis may constitute adverse reactions of mRNA coronavirus disease 2019 (COVID-19) vaccines. This study aimed to document these reactions and to assess the association with patient sex and age. This is as an observational retrospective study using a case-non-case design (also called disproportionality study) on inflammatory heart reactions reported with mRNA COVID-19 vaccines within the World Health Organization (WHO) global safety database (VigiBase), up to June 30, 2021. Results are expressed using reporting odds ratios (RORs) and their 95% confidence interval (95% CI). Of 716,576 reports related to mRNA COVID-19 vaccines, 2,277 were cases of inflammatory heart reactions, including 1241 (55%) myocarditis and 851 (37%) pericarditis. The main age group was 18-29 years (704, 31%), and mostly male patients (1,555, 68%). Pericarditis onset was delayed compared with myocarditis with a median time to onset of 8 (3-21) vs. 3 (2-6) days, respectively (P = 0.001). Regarding myocarditis, an important disproportionate reporting was observed in adolescents (ROR, 22.3, 95% CI 19.2-25.9) and in 18-29 years old (ROR, 6.6, 95% CI 5.9-7.5) compared with older patients, as well as in male patients (ROR, 9.4, 95% CI 8.3-10.6). Reporting rate of myocarditis was increased in young adults and adolescents. Inflammatory heart reactions may rarely occur shortly following mRNA COVID-19 vaccination. Although an important disproportionate reporting of myocarditis was observed among adolescents and young adults, particularly in male patients, reporting rates support a very rare risk, that does not seem to compromise the largely positive benefit-risk balance of these vaccines. Furthermore, this study confirmed the value of disproportionality analyses for estimation of relative risks among subgroups of patients.
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Affiliation(s)
- Laurent Chouchana
- Regional Center of PharmacovigilanceDepartment of PharmacologyCochin HospitalAP‐HP.Centre – Université de ParisParisFrance
| | - Alice Blet
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
- Department of AnesthesiologyCritical Care and Burn CenterLariboisière – Saint‐Louis HospitalsDMU ParabolAP–HP NordUniversity of ParisParisFrance
- Inserm UMR‐S 942Cardiovascular Markers in Stress Conditions (MASCOT)University of ParisParisFrance
| | - Mohammad Al‐Khalaf
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
| | - Tahir S. Kafil
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
| | - Girish Nair
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
| | - James Robblee
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
| | - Milou‐Daniel Drici
- Regional Center of PharmacovigilanceDepartment of PharmacologyNice University HospitalNiceFrance
| | | | - Joëlle Micallef
- UMR 1106InsermInstitute of Neurosciences SystemAix‐Marseille UniversityMarseilleFrance
- Regional Center of PharmacovigilanceDepartment of Clinical Pharmacology and PharmacovigilanceUniversity Hospitals of MarseilleMarseilleFrance
| | - Francesco Salvo
- INSERMBPHUniversity of BordeauxBordeauxFrance
- CHU de BordeauxPôle de Santé PubliqueService de Pharmacologie MédicaleCentre Régional de PharmacovigilanceBordeauxFrance
| | - Jean‐Marc Treluyer
- Regional Center of PharmacovigilanceDepartment of PharmacologyCochin HospitalAP‐HP.Centre – Université de ParisParisFrance
- University of ParisParisFrance
| | - Peter P. Liu
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
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12
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Jing XP, Wang WJ, Degen AA, Guo YM, Kang JP, Liu PP, Ding LM, Shang ZH, Zhou JW, Long RJ. Small intestinal morphology and sugar transporters expression when consuming diets of different energy levels: comparison between Tibetan and small-tailed Han sheep. Animal 2022; 16:100463. [PMID: 35193064 DOI: 10.1016/j.animal.2022.100463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/28/2022] Open
Abstract
Some non-structural carbohydrates, especially starch, escape ruminal fermentation, are converted into glucose, and are absorbed from the small intestine. This glucose provides an important source of energy, and its usage is more efficient than glucose from carbohydrates which are fermented as short chain fatty acids in the rumen and, subsequently, undergo hepatic gluconeogenesis. Tibetan sheep graze on the harsh Qinghai-Tibetan Plateau (QTP) all year round and their carbohydrate and energy intakes fluctuate greatly with seasonal forage availability. Consequently, a high capacity to absorb glucose from the small intestine would be particularly beneficial for Tibetan sheep to allow them to cope with the inconsistent dietary intakes. This study examined how the small intestinal morphology and sugar transporters' expression of Tibetan and Small-tailed Han (Han) sheep respond to fluctuating energy intakes under the harsh conditions of the QTP. Han sheep graze on the QTP only in summer and are generally raised in feedlots. Twenty-four Tibetan sheep and 24 Han sheep, all wethers, were assigned randomly to four groups (n = 6 per breed/group), with each group offered a diet differing in digestible energy content: 8.21, 9.33, 10.45 and 11.57 MJ/kg DM. After 49 d, all sheep were slaughtered, tissues of the small intestine were collected, and measurements were made of the morphology and glucose transporters and the related regulation gene expressions. At intakes of low energy levels, Tibetan sheep had a greater villus surface area in the duodenum, jejunum and ileum and higher mRNA expression of sodium-dependent glucose transporter 1 in the duodenum and ileum (P < 0.05) than Han sheep. In the glucose transporter 2 (GLUT2) mediated glucose absorption pathway, Tibetan sheep had higher GLUT2 and taste receptor family 1 member 2 and 3 mRNA expressions than Han sheep in the duodenum, jejunum and ileum (P < 0.05). We concluded that the differences between breeds indicated a greater glucose absorption capacity in the small intestine of Tibetan than Han sheep, which would confer an advantage to Tibetan over Han sheep to an inconsistent energy intake on the harsh QTP. These findings suggested that ruminants raised under harsh environmental conditions with highly fluctuating dietary intakes, as is often the case in grazing ruminants worldwide, are able to absorb glucose from the small intestine to a greater extent than ruminants raised under more moderate conditions.
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Affiliation(s)
- X P Jing
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China; State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China; Laboratory for Animal Nutrition and Animal Product Quality, Department of Animal Sciences and Aquatic Ecology, Faculty of Bioscience Engineering, Ghent University, Ghent 9000, Belgium
| | - W J Wang
- State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - A A Degen
- Desert Animal Adaptations and Husbandry, Wyler Department of Dryland Agriculture, Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Beer Sheva 8410500, Israel
| | - Y M Guo
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China
| | - J P Kang
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China
| | - P P Liu
- State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - L M Ding
- State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - Z H Shang
- State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - J W Zhou
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China.
| | - R J Long
- State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
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13
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Liu PP, Si RJ, Yang X, Zhang ZR, Han J, Wang AM, Zhang J. Tazarotene gel promotes healing of deep tissue injury in mice. Biotech Histochem 2022; 97:99-106. [PMID: 33827340 DOI: 10.1080/10520295.2021.1905181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
We investigated the efficacy and molecular mechanisms of tazarotene gel for healing deep tissue injury (DTI). We used male C57BL/6J mice to establish a DTI model. Animals were divided randomly into control, tazarotene gel and purilon gel groups. We injected 100 ul tazarotene gel, purilon gel or saline every 48 h for 20 days. Hematoxylin and eosin staining was used to observe pathological changes on days 14 and 21. The mRNA and protein expression of VEGF-α, TGF-β1 and HIF-1α were detected by qRT-PCR and western blot, respectively. Wound sites exhibited accelerated healing by 20 days in the tazarotene gel group. Fewer inflammatory cells and more granulation tissue were found in both experimental groups compared to controls. The mRNA and protein expression of VEGF-α and TGF-β1 in the experimental groups were increased compared to the control group by day 14. Expression of HIF-1α in the experimental groups was significantly less than in the controls. Tazarotene gel promoted wound healing independent of the HIF-1α/VEGF signalling pathway during tissue repair of DTI. Tazarotene and purilon gels exhibited similar macroscopic healing of wounds and expression of genes and proteins.
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Affiliation(s)
- P P Liu
- Shandong Qingdao No.2 Health School Province, Qingdao, China
| | - R J Si
- School of Nursing, Qingdao University, Qingdao, China
| | - X Yang
- School of Nursing, Qingdao University, Qingdao, China
| | - Z R Zhang
- School of Nursing, Qingdao University, Qingdao, China
| | - J Han
- School of Nursing, Qingdao University, Qingdao, China
| | - A M Wang
- School of Nursing, Qingdao University, Qingdao, China
| | - J Zhang
- School of Nursing, Qingdao University, Qingdao, China
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14
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Affiliation(s)
| | - Peter P Liu
- University of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine and Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
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15
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Zhang XJ, Ji YX, Cheng X, Cheng Y, Yang H, Wang J, Zhao LP, Huang YP, Sun D, Xiang H, Shen LJ, Li PL, Ma JP, Tian RF, Yang J, Yao X, Xu H, Liao R, Xiao L, Zhang P, Zhang X, Zhao GN, Wang X, Hu ML, Tian S, Wan J, Cai J, Ma X, Xu Q, Wang Y, Touyz RM, Liu PP, Loomba R, She ZG, Li H. A small molecule targeting ALOX12-ACC1 ameliorates nonalcoholic steatohepatitis in mice and macaques. Sci Transl Med 2021; 13:eabg8116. [PMID: 34910548 DOI: 10.1126/scitranslmed.abg8116] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Xiao-Jing Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Yan-Xiao Ji
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Xu Cheng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Yanjie Cheng
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Hailong Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Junyong Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Ling-Ping Zhao
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Yong-Ping Huang
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Dating Sun
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Hui Xiang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Li-Jun Shen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Peng-Long Li
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Jun-Peng Ma
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Rui-Feng Tian
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Juan Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Xinxin Yao
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Rufang Liao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Li Xiao
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Peng Zhang
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Xin Zhang
- Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Guang-Nian Zhao
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Xi Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Man-Li Hu
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Song Tian
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Juan Wan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Jingjing Cai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Xinliang Ma
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA 19004, USA
| | - Qingbo Xu
- Centre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, London SE5 9NU, UK
| | - Yibin Wang
- Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Rhian M Touyz
- British Heart Foundation Chair in Cardiovascular Medicine, and Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Peter P Liu
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario K1Y 4W7, Canada
| | - Rohit Loomba
- NAFLD Research Center, Division of Gastroenterology and Epidemiology, University of California, San Diego, San Diego, CA 92093, USA
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
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16
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Zhang XJ, She ZG, Wang J, Sun D, Shen LJ, Xiang H, Cheng X, Ji YX, Huang YP, Li PL, Yang X, Cheng Y, Ma JP, Wang HP, Hu Y, Hu F, Tian S, Tian H, Zhang P, Zhao GN, Wang L, Hu ML, Yang Q, Zhu LH, Cai J, Yang J, Zhang X, Ma X, Xu Q, Touyz RM, Liu PP, Loomba R, Wang Y, Li H. Multiple omics study identifies an interspecies conserved driver for nonalcoholic steatohepatitis. Sci Transl Med 2021; 13:eabg8117. [PMID: 34910546 DOI: 10.1126/scitranslmed.abg8117] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Xiao-Jing Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Junyong Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Dating Sun
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Li-Jun Shen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Hui Xiang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Xu Cheng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Yan-Xiao Ji
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Yong-Ping Huang
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Peng-Long Li
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Xia Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Yanjie Cheng
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Jun-Peng Ma
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Hai-Ping Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Yufeng Hu
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Fengjiao Hu
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Song Tian
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Han Tian
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Peng Zhang
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Guang-Nian Zhao
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Lin Wang
- Department of Hepatic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Man-Li Hu
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Qin Yang
- Institute of Model Animal of Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Li-Hua Zhu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Jingjing Cai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Juan Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Xin Zhang
- Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Xinliang Ma
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA 19004, USA
| | - Qingbo Xu
- Centre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, London SE5 9NU, UK
| | - Rhian M Touyz
- British Heart Foundation Chair in Cardiovascular Medicine, and Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Peter P Liu
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario K1Y 4W7, Canada
| | - Rohit Loomba
- NAFLD Research Center, Division of Gastroenterology and Epidemiology, University of California, San Diego, San Diego, CA 92093, USA
| | - Yibin Wang
- Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Institute of Model Animal of Wuhan University, Wuhan 430071, China.,School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
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17
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Zhang XJ, Liu X, Hu M, Zhao GJ, Sun D, Cheng X, Xiang H, Huang YP, Tian RF, Shen LJ, Ma JP, Wang HP, Tian S, Gan S, Xu H, Liao R, Zou T, Ji YX, Zhang P, Cai J, Wang ZV, Meng G, Xu Q, Wang Y, Ma XL, Liu PP, Huang Z, Zhu L, She ZG, Zhang X, Bai L, Yang H, Lu Z, Li H. Pharmacological inhibition of arachidonate 12-lipoxygenase ameliorates myocardial ischemia-reperfusion injury in multiple species. Cell Metab 2021; 33:2059-2075.e10. [PMID: 34536344 DOI: 10.1016/j.cmet.2021.08.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 04/01/2020] [Accepted: 08/25/2021] [Indexed: 12/18/2022]
Abstract
Myocardial ischemia-reperfusion (MIR) injury is a major cause of adverse outcomes of revascularization after myocardial infarction. To identify the fundamental regulator of reperfusion injury, we performed metabolomics profiling in plasma of individuals before and after revascularization and identified a marked accumulation of arachidonate 12-lipoxygenase (ALOX12)-dependent 12-HETE following revascularization. The potent induction of 12-HETE proceeded by reperfusion was conserved in post-MIR in mice, pigs, and monkeys. While genetic inhibition of Alox12 protected mouse hearts from reperfusion injury and remodeling, Alox12 overexpression exacerbated MIR injury. Remarkably, pharmacological inhibition of ALOX12 significantly reduced cardiac injury in mice, pigs, and monkeys. Unexpectedly, ALOX12 promotes cardiomyocyte injury beyond its enzymatic activity and production of 12-HETE but also by its suppression of AMPK activity via a direct interaction with its upstream kinase TAK1. Taken together, our study demonstrates that ALOX12 is a novel AMPK upstream regulator in the post-MIR heart and that it represents a conserved therapeutic target for the treatment of myocardial reperfusion injury.
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Affiliation(s)
- Xiao-Jing Zhang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Xiaolan Liu
- Institute of Model Animal of Wuhan University, Wuhan 430071, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Manli Hu
- Institute of Model Animal of Wuhan University, Wuhan 430071, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Guo-Jun Zhao
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Dating Sun
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Xu Cheng
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Hui Xiang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Yong-Ping Huang
- Institute of Model Animal of Wuhan University, Wuhan 430071, China; College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Rui-Feng Tian
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Li-Jun Shen
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Jun-Peng Ma
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Hai-Ping Wang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Song Tian
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Shanyu Gan
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Rufang Liao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Toujun Zou
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Yan-Xiao Ji
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Peng Zhang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Jingjing Cai
- Department of Cardiology, Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Zhao V Wang
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Guannan Meng
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China
| | - Qingbo Xu
- Centre for Clinic Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Yibin Wang
- Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Xin-Liang Ma
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA 19004, USA
| | - Peter P Liu
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
| | - Zan Huang
- College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Lihua Zhu
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China
| | - Xin Zhang
- Gannan Institute of Translational Medicine, Ganzhou 341000, China
| | - Lan Bai
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China.
| | - Hailong Yang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China.
| | - Zhibing Lu
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan 430060, China.
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan 430071, China; Institute of Model Animal of Wuhan University, Wuhan 430071, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
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18
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Al-Khalaf MH, Smyth D, Akolkar G, Williams J, Zhang L, Yip K, Li RK, Liu FF, Liu PP. Abstract MP233: Investigating Genotoxic-induced Innate Immune Pathways Leading To Heart Failure With Preserved Ejection Fraction For Developing Effective Treatments. Circ Res 2021. [DOI: 10.1161/res.129.suppl_1.mp233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
A hallmark of heart failure pathologies is excessive and cumulative DNA damage, leading to an increased and accelerated cardiac cellular senescence. We aimed to investigate the role of DNA breaks in inducing inflammation leading to adverse remodeling, premature senescence, and cardiac dysfunction leading to onset of Heart Failure with preserved Ejection Fraction (HFpEF), a specific type of disease prevalent in the aging population.
Results:
We use heart-focused ionizing radiation, a novel in vivo technique to induce aging related DNA damage and onset of diastolic dysfunction and HFpEF (n= 4-5 per group & per species; animals used: Rattus norvegicus and Mus musculus). We performed functional analysis, histological tissue assessment and molecular investigations to evaluate and validate this novel animal model technique. DNA damage response is upregulated in aging-related Heart Failure, and here demonstrated in our novel heart-focused radiation technique. Using in vitro ionizing radiation exposure alters cardiomyocyte morphology and activates inflammation, leading to upregulation of fibrosis and senescence markers. Finally using experimental inhibitor compounds targeting the cGAS-STING axis of innate immunity, we show effective attenuation of this relevant pathway, leading to decreased systemic inflammation, cardiomyocyte remodeling, and senescence associated with DNA damage injury.
Conclusions:
We present a novel technique to induce genotoxic outcomes and inflammation of the heart, leading to HFpEF pathology. We elucidate novel connections from the onset and accumulation of unresolved DNA damage, to activation of specialized innate immune cellular responses, and ultimately upregulation of cardiac tissue specific inflammation, fibrosis and senescence. Finally we demonstrate that antagonizing the cGAS-STING pathway could allow a precision medicine approach to treating genotoxic and inflammatory HFpEF.
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Affiliation(s)
| | | | | | | | | | | | - Ren-Ke Li
- Univ Health Network, Toronto, Canada
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19
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Niu Y, Li DM, Liu PP, Zhang HL, Zhong DR. [Eosinophilic solid and cystic renal cell carcinoma with tumor-induced osteomalacia: report of a case]. Zhonghua Bing Li Xue Za Zhi 2021; 50:829-831. [PMID: 34405628 DOI: 10.3760/cma.j.cn112151-20201225-00966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Y Niu
- Department of Pathology, the China-Japan Friendship Hospital, Beijing 100029, China
| | - D M Li
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - P P Liu
- Department of Pathology, the China-Japan Friendship Hospital, Beijing 100029, China
| | - H L Zhang
- Department of Pathology, the China-Japan Friendship Hospital, Beijing 100029, China
| | - D R Zhong
- Department of Pathology, the China-Japan Friendship Hospital, Beijing 100029, China
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20
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Bayes-Genis A, Liu PP, Lanfear DE, de Boer RA, González A, Thum T, Emdin M, Januzzi JL. Omics phenotyping in heart failure: the next frontier. Eur Heart J 2021; 41:3477-3484. [PMID: 32337540 DOI: 10.1093/eurheartj/ehaa270] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/23/2020] [Accepted: 03/30/2020] [Indexed: 12/16/2022] Open
Abstract
This state-of-the-art review aims to provide an up-to-date look at breakthrough omic technologies that are helping to unravel heart failure (HF) disease mechanisms and heterogeneity. Genomics, transcriptomics, proteomics, and metabolomics in HF are reviewed in depth. In addition, there is a thorough, expert discussion regarding the value of omics in identifying novel disease pathways, advancing understanding of disease mechanisms, differentiating HF phenotypes, yielding biomarkers for diagnosis or prognosis, or identifying new therapeutic targets in HF. The combination of multiple omics technologies may create a more comprehensive picture of the factors and physiology involved in HF than achieved by either one alone and provides a rich resource for predictive phenotype modelling. However, the successful translation of omics tools as solutions to clinical HF requires that the observations are robust and reproducible and can be validated across multiple independent populations to ensure confidence in clinical decision-making.
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Affiliation(s)
- Antoni Bayes-Genis
- Heart Institute (iCor), University Hospital Germans Trias i Pujol, Badalona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Medicine, Universitat Autònoma Barcelona
| | - Peter P Liu
- University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - David E Lanfear
- Henry Ford Heart and Vascular Institute, Center for Individualized and Genomic Medicine Research, Henry Ford Hospital, Detroit, MI, USA
| | - Rudolf A de Boer
- Department of Cardiology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Arantxa González
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Michele Emdin
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.,Fondazione Toscana G. Monasterio, Pisa, Italy
| | - James L Januzzi
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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21
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Wang J, He S, Zhu JQ, Xue LY, An L, Zhang YM, Dou LZ, Liu Y, Ke Y, Liu XD, Liu YM, Wu HR, Liu PP, Xun HY, Zhang X, Jia XZ, Wang GQ. [Efficacy and safety of endoscopic papillectomy of major duodenal papilla neoplasms]. Zhonghua Zhong Liu Za Zhi 2021; 43:329-334. [PMID: 33752314 DOI: 10.3760/cma.j.cn112152-20200619-00580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To discuss the efficacy and safety of endoscopic papillectomy of major duodenal papilla neoplasms. Methods: The clinical-pathological data of 21 patients who were admitted to the Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and underwent endoscopic papillectomy of major duodenal papilla neoplasms from January 2014 to January 2020 were retrospectively studied, their postoperative outcomes and complication were also analyzed. Results: Tweenty-one patients were successfully performed endoscopic papillectomy of major duodenal papilla neoplasms. The resected lesions varied between 0.5-2.8 cm. Completed lesion was resected in 19 cases and lesion blocks in 2 cases. The incidence of postoperative complication was 52.4% (11/21), including 8 cases of postoperative bleeding (38.1%). Five patients stopped bleeding after endoscopic hemostasis and 3 patients stopped after interventional embolization. Two patients experienced perforation (9.5%) and recovered after conservative treatment including anti-inflammatory treatment and abdominal drainage. Five patients had pancreatitis (23.8%) and recovered after treatment with pre-somatostatin and anti-inflammatory rectal suppository. Preoperative pathological results of 21 patients suggested that 11 were high-grade intraepithelial neoplasia and 8 were low-grade intraepithelial neoplasia, and 2 were chronic inflammation. Postoperative pathological results suggested that 4 were adenocarcinoma, and the rest 17 were adenoma. The coincidence rate of preoperative biopsy results and postoperative pathology was 38.1%(8/21), and underestimate of the pathological stage occurred in 11 patients (52.4%) during the preoperative biopsy, overestimate occurred in two patients (9.5%). Four cases had a positive incisal margin. All patients had good prognoses and no death event occurred during the follow-up period. Conclusions: Early-stage major duodenal papilla neoplasms should be treated with aggressive resection. Endoscopic papillectomy of duodenal papilla neoplasms is safe, effective, and can be recommended as the preferred procedure for major duodenal papilla neoplasms.
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Affiliation(s)
- J Wang
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - S He
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Q Zhu
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Y Xue
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L An
- Office of Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y M Zhang
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Z Dou
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Liu
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Ke
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X D Liu
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y M Liu
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H R Wu
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - P P Liu
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H Y Xun
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X Zhang
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X Z Jia
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - G Q Wang
- Department of Endoscope, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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22
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Liu PP, Al-Khalaf M, Blet A. Time to Reframe Ejection Fraction in Light of New Pathophysiological Insights Into Heart Failure. J Am Coll Cardiol 2021; 76:1995-1998. [PMID: 33092735 DOI: 10.1016/j.jacc.2020.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Peter P Liu
- University of Ottawa Heart Institute and University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine and Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - Mohammad Al-Khalaf
- University of Ottawa Heart Institute and University of Ottawa, Ottawa, Ontario, Canada. https://twitter.com/MoAlkhalafPhD
| | - Alice Blet
- University of Ottawa Heart Institute and University of Ottawa, Ottawa, Ontario, Canada; Department of Anesthesiology, Critical Care and Burn Center, Lariboisière-Saint Louis Hospitals, Département Médico-Universitaire Parabol, Assistance Publique des Hôpitaux de Paris Nord, University of Paris, Paris, France; INSERM Unité mixte de Recherche-S 942, Cardiovascular Markers in Stress Conditions, University of Paris, Paris, France. https://twitter.com/BletAlice
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23
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Jing XP, Wang WJ, Degen AA, Guo YM, Kang JP, Liu PP, Ding LM, Shang ZH, Zhou JW, Long RJ. Energy substrate metabolism in skeletal muscle and liver when consuming diets of different energy levels: comparison between Tibetan and Small-tailed Han sheep. Animal 2021; 15:100162. [PMID: 33485829 DOI: 10.1016/j.animal.2020.100162] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/21/2022] Open
Abstract
The energy intake of Tibetan sheep on the harsh Qinghai-Tibetan Plateau (QTP) varies greatly with seasonal forage fluctuations and is often below maintenance requirements, especially during the long, cold winter. The liver plays a crucial role in gluconeogenesis and skeletal muscle is the primary tissue of energy expenditure in mammals. Both play important roles in energy substrate metabolism and regulating energy metabolism homeostasis of the body. This study aimed to gain insight into how skeletal muscle and liver of Tibetan sheep regulate energy substrate metabolism to cope with low energy intake under the harsh environment of the QTP. Tibetan sheep (n = 24; 48.5 ± 1.89 kg BW) were compared with Small-tailed Han sheep (n = 24; 49.2 ± 2.21 kg BW), which were allocated randomly into one of four groups that differed in dietary digestible energy densities: 8.21, 9.33, 10.45 and 11.57 MJ /kg DM. The sheep were slaughtered after a 49-d feeding period, skeletal muscle and liver tissues were collected and measurements were made of the activities of the key enzymes of energy substrate metabolism and the expressions of genes related to energy homeostasis regulation. Compared with Small-tailed Han sheep, Tibetan sheep exhibited higher capacities of propionate to glucose conversion and fatty acid oxidation and ketogenesis in the liver, higher glucose utilization efficiency in both skeletal muscle and liver, but lower activities of fatty acid oxidation and protein mobilization in skeletal muscle, especially when in negative energy balance. However, the Small-tailed Han sheep exhibited higher capacities to convert amino acids and lactate to glucose and higher levels of glycolysis and lipogenesis in the liver than Tibetan sheep. These differences in gluconeogenesis and energy substrate metabolism conferred the Tibetan sheep an advantage over Small-tailed Han sheep to cope with low energy intake and regulate whole-body energy homeostasis under the harsh environment of the QTP.
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Affiliation(s)
- X P Jing
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China; International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China; Laboratory for Animal Nutrition and Animal Product Quality, Department of Animal Sciences and Aquatic Ecology, Faculty of Bioscience Engineering, Ghent University, Ghent 9000, Belgium
| | - W J Wang
- International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - A A Degen
- Desert Animal Adaptations and Husbandry, Wyler Department of Dryland Agriculture, Blaustein Institutes for Desert Research, Ben-Gurion University of Negev, Beer Sheva 8410500, Israel
| | - Y M Guo
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China
| | - J P Kang
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China
| | - P P Liu
- International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - L M Ding
- International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - Z H Shang
- International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - J W Zhou
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China.
| | - R J Long
- International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
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24
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Sun LY, Mielniczuk LM, Liu PP, Beanlands RS, Chih S, Davies R, Coutinho T, Lee DS, Austin PC, Bader Eddeen A, Tu JV. Sex-specific temporal trends in ambulatory heart failure incidence, mortality and hospitalisation in Ontario, Canada from 1994 to 2013: a population-based cohort study. BMJ Open 2020; 10:e044126. [PMID: 33243819 PMCID: PMC7692840 DOI: 10.1136/bmjopen-2020-044126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To examine the temporal trends in mortality and heart failure (HF) hospitalisation in ambulatory patients following a new diagnosis of HF. DESIGN Retrospective cohort study SETTING: Outpatient PARTICIPANTS: Ontario residents who were diagnosed with HF in an outpatient setting between 1994 and 2013. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was all-cause mortality within 1 year of diagnosis and the secondary outcome was HF hospitalisation within 1 year. Risks of mortality and hospitalisation were calculated using the Kaplan-Meier method and the relative hazard of death was assessed using multivariable Cox proportional hazard models. RESULTS A total of 352 329 patients were studied (50% female). During the study period, there was a greater decline in age standardised 1-year mortality rates (AMR) in men (33%) than in women (19%). Specifically, female AMR at 1 year was 10.4% (95% CI 9.1% to 12.0%) in 1994 and 8.5% (95% CI 7.5% to 9.5%) in 2013, and male AMR at 1 year was 12.3% (95% CI 11.1% to 13.7%) in 1994 and 8.3% (95% CI 7.5% to 9.1%) in 2013. Conversely, age standardised HF hospitalisation rates declined in men (11.4% (95% CI 10.1% to 12.9%) in 1994 and 9.1% (95% CI 8.2% to 10.1%) in 2013) but remained unchanged in women (9.7% (95% CI 8.3% to 11.3%) in 1994 and 9.8% (95% CI 8.6% to 11.0%) in 2013). CONCLUSION Among patients with HF over a 20-year period, there was a greater improvement in the prognosis of men compared with women. Further research should focus on the determinants of this disparity and ways to reduce this gap in outcomes.
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Affiliation(s)
- Louise Y Sun
- Division of Cardiac Anesthesiology, Department of Anesthesiology and Pain Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Cardiovasulcar Research Program, ICES (formerly the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Lisa M Mielniczuk
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Peter P Liu
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Rob S Beanlands
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sharon Chih
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Ross Davies
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Thais Coutinho
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Douglas S Lee
- Cardiovasulcar Research Program, ICES (formerly the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Peter C Austin
- Cardiovasulcar Research Program, ICES (formerly the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
| | - Anan Bader Eddeen
- Cardiovasulcar Research Program, ICES (formerly the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
| | - Jack V Tu
- Cardiovasulcar Research Program, ICES (formerly the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Sunnybrook Schulich Heart Centre, University of Toronto, Toronto, Ontario, Canada
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25
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Lee TMH, Tobe SW, Butt DA, Ivers NM, Gershon AS, Barnsley J, Liu PP, Jaakkimainen L, Walker KM, Tu K. Patient- and Physician-Level Factors Associated With Adherence to C-CHANGE Recommendations in Primary Care Settings in Ontario. CJC Open 2020; 2:563-576. [PMID: 33305217 PMCID: PMC7711016 DOI: 10.1016/j.cjco.2020.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/11/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND We previously found large variation among family physicians in adherence to the Canadian Cardiovascular Harmonization of National Guidelines Endeavour (C-CHANGE). We assessed the role of patient- and physician-level factors in the variation in adherence to recommendations for managing cardiovascular disease risk factors. METHODS We conducted a retrospective study using multilevel logistic regression analyses with the Electronic Medical Record Administrative data Linked Database (EMRALD) housed at ICES in Ontario. Five quality indicators based on C-CHANGE guidelines were modelled. Effects of clustering and between-group variation, patient-level (sociodemographics, comorbidities) and physician-level characteristics (demographic and practice information) were assessed to determine odds ratios of receiving C-CHANGE recommended care. RESULTS In all, 324 Ontario physicians practicing in 41 clinics who provided care to 227,999 adult patients were studied. We found significant variation in quality indicators, with 15% to 39% of the total variation attributable to nonpatient factors. The largest variation was in performing 2-hour plasma glucose testing in prediabetic patients. Patient-level factors most frequently associated with recommendation adherence included sex, age, and multi-comorbidities. Women were more likely than men to have their body mass index measured, and their blood pressure controlled, but less likely to receive antiplatelet medications and liver-enzyme testing if overweight or obese. CONCLUSIONS The majority of variations in adherence were attributable to patient attributes, but a substantial proportion of unexplained variation was due to differences among physicians and clinics. This finding may signal suboptimal processes or structures and warrant further investigation to improve the quality of primary care management of cardiovascular disease in Ontario.
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Affiliation(s)
- Theresa Min-Hyung Lee
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Sheldon W. Tobe
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Canadian Cardiovascular Harmonization of National Guidelines Endeavour, Ottawa, Ontario, Canada
| | - Debra A. Butt
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Scarborough Health Network, Toronto, Ontario, Canada
| | - Noah M. Ivers
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women’s College Hospital, Toronto, Ontario, Canada
| | - Andrea S. Gershon
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jan Barnsley
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Peter P. Liu
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Canadian Cardiovascular Harmonization of National Guidelines Endeavour, Ottawa, Ontario, Canada
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Liisa Jaakkimainen
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kimberly M. Walker
- Canadian Cardiovascular Harmonization of National Guidelines Endeavour, Ottawa, Ontario, Canada
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Karen Tu
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- North York General Hospital, Toronto, Ontario, Canada
- Toronto Western Hospital Family Health Team, University Health Network, Toronto, Ontario, Canada
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26
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Lin HB, Naito K, Oh Y, Farber G, Kanaan G, Valaperti A, Dawood F, Zhang L, Li GH, Smyth D, Moon M, Liu Y, Liang W, Rotstein B, Philpott DJ, Kim KH, Harper ME, Liu PP. Innate Immune Nod1/RIP2 Signaling Is Essential for Cardiac Hypertrophy but Requires Mitochondrial Antiviral Signaling Protein for Signal Transductions and Energy Balance. Circulation 2020; 142:2240-2258. [PMID: 33070627 DOI: 10.1161/circulationaha.119.041213] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cardiac hypertrophy is a key biological response to injurious stresses such as pressure overload and, when excessive, can lead to heart failure. Innate immune activation by danger signals, through intracellular pattern recognition receptors such as nucleotide-binding oligomerization domain 1 (Nod1) and its adaptor receptor-interacting protein 2 (RIP2), might play a major role in cardiac remodeling and progression to heart failure. We hypothesize that Nod1/RIP2 are major contributors to cardiac hypertrophy, but may not be sufficient to fully express the phenotype alone. METHODS To elucidate the contribution of Nod1/RIP2 signaling to cardiac hypertrophy, we randomized Nod1-/-, RIP2-/-, or wild-type mice to transverse aortic constriction or sham operations. Cardiac hypertrophy, fibrosis, and cardiac function were examined in these mice. RESULTS Nod1 and RIP2 proteins were upregulated in the heart after transverse aortic constriction, and this was paralleled by increased expression of mitochondrial proteins, including mitochondrial antiviral signaling protein (MAVS). Nod1-/- and RIP2-/- mice subjected to transverse aortic constriction exhibited better survival, improved cardiac function, and decreased cardiac hypertrophy. Downstream signal transduction pathways that regulate inflammation and fibrosis, including NF (nuclear factor) κB and MAPK (mitogen-activated protein kinase)-GATA4/p300, were reduced in both Nod1-/- and RIP2-/- mice after transverse aortic constriction compared with wild-type mice. Coimmunoprecipitation of extracted cardiac proteins and confocal immunofluorescence microscopy showed that Nod1/RIP2 interaction was robust and that this complex also included MAVS as an essential component. Suppression of MAVS expression attenuated the complex formation, NF κB signaling, and myocyte hypertrophy. Interrogation of mitochondrial function compared in the presence or ablation of MAVS revealed that MAVS serves to suppress mitochondrial energy output and mediate fission/fusion related dynamic changes. The latter is possibly linked to mitophagy during cardiomyocytes stress, which may provide an intriguing link between innate immune activation and mitochondrial energy balance under stress or injury conditions. CONCLUSIONS We have identified that innate immune Nod1/RIP2 signaling is a major contributor to cardiac remodeling after stress. This process is critically joined by and regulated through the mitochondrial danger signal adapter MAVS. This novel complex coordinates remodeling, inflammatory response, and mitochondrial energy metabolism in stressed cardiomyocytes. Thus, Nod1/RIP2/MAVS signaling complex may represent an attractive new therapeutic approach toward heart failure.
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Affiliation(s)
- Han-Bin Lin
- University of Ottawa Heart Institute (H.-B.L., Y.O., G.F., L.Z., G.H.L., D.S., W.L., B.R., K.-H.K., P.P.L.), University of Ottawa, Canada.,Departments of Medicine and Cellular and Molecular Medicine (H.-B.L., Y.O., L.Z., G.H.L., D.S., W.L., K.-H.K., P.P.L.), University of Ottawa, Canada
| | - Kotaro Naito
- Cardiology, Keiyu Hospital, Yokohama, Japan (K.N.).,University Health Network (K.N., A.V., F.D., M.M., Y.L., P.P.L.), University of Toronto, Canada
| | - Yena Oh
- University of Ottawa Heart Institute (H.-B.L., Y.O., G.F., L.Z., G.H.L., D.S., W.L., B.R., K.-H.K., P.P.L.), University of Ottawa, Canada.,Departments of Medicine and Cellular and Molecular Medicine (H.-B.L., Y.O., L.Z., G.H.L., D.S., W.L., K.-H.K., P.P.L.), University of Ottawa, Canada
| | - Gedaliah Farber
- University of Ottawa Heart Institute (H.-B.L., Y.O., G.F., L.Z., G.H.L., D.S., W.L., B.R., K.-H.K., P.P.L.), University of Ottawa, Canada
| | - Georges Kanaan
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine (G.K., B.R., M.-E.H.), University of Ottawa, Canada
| | - Alan Valaperti
- Department of Clinical Immunology of the University Hospital Zurich, Switzerland (A.V.).,University Health Network (K.N., A.V., F.D., M.M., Y.L., P.P.L.), University of Toronto, Canada
| | - Fayez Dawood
- University Health Network (K.N., A.V., F.D., M.M., Y.L., P.P.L.), University of Toronto, Canada
| | - Liyong Zhang
- University of Ottawa Heart Institute (H.-B.L., Y.O., G.F., L.Z., G.H.L., D.S., W.L., B.R., K.-H.K., P.P.L.), University of Ottawa, Canada.,Departments of Medicine and Cellular and Molecular Medicine (H.-B.L., Y.O., L.Z., G.H.L., D.S., W.L., K.-H.K., P.P.L.), University of Ottawa, Canada
| | - Guo Hua Li
- University of Ottawa Heart Institute (H.-B.L., Y.O., G.F., L.Z., G.H.L., D.S., W.L., B.R., K.-H.K., P.P.L.), University of Ottawa, Canada.,Departments of Medicine and Cellular and Molecular Medicine (H.-B.L., Y.O., L.Z., G.H.L., D.S., W.L., K.-H.K., P.P.L.), University of Ottawa, Canada
| | - David Smyth
- University of Ottawa Heart Institute (H.-B.L., Y.O., G.F., L.Z., G.H.L., D.S., W.L., B.R., K.-H.K., P.P.L.), University of Ottawa, Canada.,Departments of Medicine and Cellular and Molecular Medicine (H.-B.L., Y.O., L.Z., G.H.L., D.S., W.L., K.-H.K., P.P.L.), University of Ottawa, Canada
| | - Mark Moon
- Department of Physiology, Institute of Medical Science (M.M., P.P.L.), University of Toronto, Canada.,University Health Network (K.N., A.V., F.D., M.M., Y.L., P.P.L.), University of Toronto, Canada
| | - Youan Liu
- University Health Network (K.N., A.V., F.D., M.M., Y.L., P.P.L.), University of Toronto, Canada
| | - Wenbin Liang
- University of Ottawa Heart Institute (H.-B.L., Y.O., G.F., L.Z., G.H.L., D.S., W.L., B.R., K.-H.K., P.P.L.), University of Ottawa, Canada.,Departments of Medicine and Cellular and Molecular Medicine (H.-B.L., Y.O., L.Z., G.H.L., D.S., W.L., K.-H.K., P.P.L.), University of Ottawa, Canada
| | - Benjamin Rotstein
- University of Ottawa Heart Institute (H.-B.L., Y.O., G.F., L.Z., G.H.L., D.S., W.L., B.R., K.-H.K., P.P.L.), University of Ottawa, Canada.,Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine (G.K., B.R., M.-E.H.), University of Ottawa, Canada
| | | | - Kyoung-Han Kim
- University of Ottawa Heart Institute (H.-B.L., Y.O., G.F., L.Z., G.H.L., D.S., W.L., B.R., K.-H.K., P.P.L.), University of Ottawa, Canada.,Departments of Medicine and Cellular and Molecular Medicine (H.-B.L., Y.O., L.Z., G.H.L., D.S., W.L., K.-H.K., P.P.L.), University of Ottawa, Canada
| | - Mary-Ellen Harper
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine (G.K., B.R., M.-E.H.), University of Ottawa, Canada
| | - Peter P Liu
- University of Ottawa Heart Institute (H.-B.L., Y.O., G.F., L.Z., G.H.L., D.S., W.L., B.R., K.-H.K., P.P.L.), University of Ottawa, Canada.,Departments of Medicine and Cellular and Molecular Medicine (H.-B.L., Y.O., L.Z., G.H.L., D.S., W.L., K.-H.K., P.P.L.), University of Ottawa, Canada.,Department of Physiology, Institute of Medical Science (M.M., P.P.L.), University of Toronto, Canada.,University Health Network (K.N., A.V., F.D., M.M., Y.L., P.P.L.), University of Toronto, Canada
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27
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Liu PP, Yang SN, Dai HP, Wang C. [The role of exosome in the lung diseases]. Zhonghua Jie He He Hu Xi Za Zhi 2020; 43:692-697. [PMID: 32727184 DOI: 10.3760/cma.j.cn112147-20190914-00629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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28
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Zhang XJ, Qin JJ, Cheng X, Shen L, Zhao YC, Yuan Y, Lei F, Chen MM, Yang H, Bai L, Song X, Lin L, Xia M, Zhou F, Zhou J, She ZG, Zhu L, Ma X, Xu Q, Ye P, Chen G, Liu L, Mao W, Yan Y, Xiao B, Lu Z, Peng G, Liu M, Yang J, Yang L, Zhang C, Lu H, Xia X, Wang D, Liao X, Wei X, Zhang BH, Zhang X, Yang J, Zhao GN, Zhang P, Liu PP, Loomba R, Ji YX, Xia J, Wang Y, Cai J, Guo J, Li H. In-Hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19. Cell Metab 2020; 32:176-187.e4. [PMID: 32592657 PMCID: PMC7311917 DOI: 10.1016/j.cmet.2020.06.015] [Citation(s) in RCA: 342] [Impact Index Per Article: 85.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/11/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023]
Abstract
Statins are lipid-lowering therapeutics with favorable anti-inflammatory profiles and have been proposed as an adjunct therapy for COVID-19. However, statins may increase the risk of SARS-CoV-2 viral entry by inducing ACE2 expression. Here, we performed a retrospective study on 13,981 patients with COVID-19 in Hubei Province, China, among which 1,219 received statins. Based on a mixed-effect Cox model after propensity score-matching, we found that the risk for 28-day all-cause mortality was 5.2% and 9.4% in the matched statin and non-statin groups, respectively, with an adjusted hazard ratio of 0.58. The statin use-associated lower risk of mortality was also observed in the Cox time-varying model and marginal structural model analysis. These results give support for the completion of ongoing prospective studies and randomized controlled trials involving statin treatment for COVID-19, which are needed to further validate the utility of this class of drugs to combat the mortality of this pandemic.
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Affiliation(s)
- Xiao-Jing Zhang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Juan-Juan Qin
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xu Cheng
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Lijun Shen
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Yan-Ci Zhao
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Yufeng Yuan
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Fang Lei
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Ming-Ming Chen
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Huilin Yang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Liangjie Bai
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xiaohui Song
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Lijin Lin
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Meng Xia
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Feng Zhou
- Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jianghua Zhou
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Lihua Zhu
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xinliang Ma
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA 19004, USA
| | - Qingbo Xu
- Centre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Ping Ye
- Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430072, China
| | - Guohua Chen
- Department of Neurology, Wuhan First Hospital/Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan 430072, China
| | - Liming Liu
- Department of General Surgery, Ezhou Central Hospital, Ezhou 436000, China
| | - Weiming Mao
- Department of General Surgery, Huanggang Central Hospital, Huanggang 438000, China
| | - Youqin Yan
- Wuhan Seventh Hospital, Wuhan 430072, China
| | - Bing Xiao
- Department of Stomatology, Xiantao First People's Hospital, Xiantao 433000, China
| | - Zhigang Lu
- Department of Neurology, The First People's Hospital of Jingmen Affiliated to Hubei Minzu University, Jingmen 448000, China
| | - Gang Peng
- Department of Hepatobiliary and Pancreatic Surgery, Suizhou Central Hospital Affiliated to Hubei Medical College, Suizhou 441300, China
| | - Mingyu Liu
- The Ninth Hospital of Wuhan City, Wuhan 430072, China
| | - Jun Yang
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital and Institute of Cardiovascular Diseases, China Three Gorges University, Yichang 443000, China
| | - Luyu Yang
- Department of Intensive Care Unit, Wuhan Third Hospital & Tongren Hospital of Wuhan University, Wuhan, China
| | - Changjiang Zhang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, China
| | - Haofeng Lu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Changjiang University, Jingzhou, China
| | - Xigang Xia
- Department of Hepatobiliary Surgery, Jingzhou Central Hospital, Jingzhou, China
| | - Daihong Wang
- Department of Hepatobiliary and Pancreatic Surgery, Xianning Central Hospital, Xianning, Hubei Province, China
| | - Xiaofeng Liao
- Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Xiang Wei
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bing-Hong Zhang
- Department of Neonatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xin Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Juan Yang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Guang-Nian Zhao
- Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Peng Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Peter P Liu
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Rohit Loomba
- NAFLD Research Center, Division of Gastroenterology and Epidemiology, University of California, San Diego, San Diego, CA, USA
| | - Yan-Xiao Ji
- Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jiahong Xia
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yibin Wang
- Departments of Anesthesiology, Physiology, and Medicine, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Jingjing Cai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha 410000, China.
| | - Jiao Guo
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine & Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China & Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou 510006, China.
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China; Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
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29
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Zhou F, Liu YM, Xie J, Li H, Lei F, Yang H, Qin JJ, Cai J, Zhang XJ, Wu B, Xia M, Xiang D, Yang C, Ma X, Xu Q, Lu Z, Lu H, Xia X, Wang D, Liao X, Peng G, Yang J, Huang X, Zhang BH, Yuan Y, Wei X, Liu PP, Wang Y, Zhang P, She ZG, Xia J, Li H. Comparative Impacts of ACE (Angiotensin-Converting Enzyme) Inhibitors Versus Angiotensin II Receptor Blockers on the Risk of COVID-19 Mortality. Hypertension 2020; 76:e15-e17. [PMID: 32493070 DOI: 10.1161/hypertensionaha.120.15622] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Feng Zhou
- From the Medical Science Research Center, Zhongnan Hospital of Wuhan University, China (F.Z., P.Z., Hongliang Li)
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
- Basic Medical School (F.Z., Hongliang Li), Wuhan University, China
- Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China
| | - Ye-Mao Liu
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
- Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China
| | - Jing Xie
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
- Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China
| | - Haomiao Li
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
- Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China
| | - Fang Lei
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
| | - Huilin Yang
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
| | - Juan-Juan Qin
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
- Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China
| | - Jingjing Cai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.C.)
| | - Xiao-Jing Zhang
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
- Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China
| | - Bin Wu
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
- Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China
| | - Meng Xia
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
| | - Da Xiang
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
| | - Chengzhang Yang
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
| | - Xinliang Ma
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania (X.M.)
| | - Qingbo Xu
- Centre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, United Kingdom (Q.X.)
| | - Zhigang Lu
- Department of Neurology, The First People’s Hospital of Jingmen affiliated to Hubei Minzu University, Jingmen, China (Z.L.)
| | - Haofeng Lu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Changjiang University, Jingzhou, China (Haofeng Lu)
| | - Xigang Xia
- Department of Hepatobiliary Surgery, Jingzhou Central Hospital, China (X.X.)
| | - Daihong Wang
- Department of Hepatobiliary and Pancreatic Surgery, Xianning Central Hospital, Hubei Province, China (D.W.)
| | - Xiaofeng Liao
- Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, China (X.L.)
| | - Gang Peng
- Department of Hepatobiliary and Pancreatic Surgery, Suizhou central Hospital Affiliated to Hubei Medical College, China (G.P.)
| | - Jun Yang
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital and Institute of Cardiovascular Diseases, China Three Gorges University (J.Y.)
| | - Xiaodong Huang
- Department of Gastroenterology, Wuhan Third Hospital & Tongren Hospital of Wuhan University, China (X.H.)
| | - Bing-Hong Zhang
- Departments of Neonatology (B.-H.Z.), Renmin Hospital of Wuhan University, China
| | - Yufeng Yuan
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, China (Y.Y)
| | - Xiang Wei
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (X.W.)
| | - Peter P. Liu
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, ON, Canada (P.P.L.)
| | - Yibin Wang
- Departments of Anesthesiology, Physiology and Medicine, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles (Y.W.)
| | - Peng Zhang
- From the Medical Science Research Center, Zhongnan Hospital of Wuhan University, China (F.Z., P.Z., Hongliang Li)
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
| | - Zhi-Gang She
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
- Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China
| | - Jiahong Xia
- Department of Cardiovascular Surgery, Union Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, China (J.X.)
| | - Hongliang Li
- From the Medical Science Research Center, Zhongnan Hospital of Wuhan University, China (F.Z., P.Z., Hongliang Li)
- Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China
- Basic Medical School (F.Z., Hongliang Li), Wuhan University, China
- Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China
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Affiliation(s)
- Han-Bin Lin
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Departments of Medicine and Cellular and Molecular Medicine, University of Ottawa, Ontario, Canada
| | - Peter P Liu
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Departments of Medicine and Cellular and Molecular Medicine, University of Ottawa, Ontario, Canada
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31
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Qin JJ, Cheng X, Zhou F, Lei F, Akolkar G, Cai J, Zhang XJ, Blet A, Xie J, Zhang P, Liu YM, Huang Z, Zhao LP, Lin L, Xia M, Chen MM, Song X, Bai L, Chen Z, Zhang X, Xiang D, Chen J, Xu Q, Ma X, Touyz RM, Gao C, Wang H, Liu L, Mao W, Luo P, Yan Y, Ye P, Chen M, Chen G, Zhu L, She ZG, Huang X, Yuan Y, Zhang BH, Wang Y, Liu PP, Li H. Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19. Hypertension 2020; 76:1104-1112. [PMID: 32673499 PMCID: PMC7375179 DOI: 10.1161/hypertensionaha.120.15528] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Supplemental Digital Content is available in the text. The prognostic power of circulating cardiac biomarkers, their utility, and pattern of release in coronavirus disease 2019 (COVID-19) patients have not been clearly defined. In this multicentered retrospective study, we enrolled 3219 patients with diagnosed COVID-19 admitted to 9 hospitals from December 31, 2019 to March 4, 2020, to estimate the associations and prognostic power of circulating cardiac injury markers with the poor outcomes of COVID-19. In the mixed-effects Cox model, after adjusting for age, sex, and comorbidities, the adjusted hazard ratio of 28-day mortality for hs-cTnI (high-sensitivity cardiac troponin I) was 7.12 ([95% CI, 4.60–11.03] P<0.001), (NT-pro)BNP (N-terminal pro-B-type natriuretic peptide or brain natriuretic peptide) was 5.11 ([95% CI, 3.50–7.47] P<0.001), CK (creatine phosphokinase)-MB was 4.86 ([95% CI, 3.33–7.09] P<0.001), MYO (myoglobin) was 4.50 ([95% CI, 3.18–6.36] P<0.001), and CK was 3.56 ([95% CI, 2.53–5.02] P<0.001). The cutoffs of those cardiac biomarkers for effective prognosis of 28-day mortality of COVID-19 were found to be much lower than for regular heart disease at about 19%–50% of the currently recommended thresholds. Patients with elevated cardiac injury markers above the newly established cutoffs were associated with significantly increased risk of COVID-19 death. In conclusion, cardiac biomarker elevations are significantly associated with 28-day death in patients with COVID-19. The prognostic cutoff values of these biomarkers might be much lower than the current reference standards. These findings can assist in better management of COVID-19 patients to improve outcomes. Importantly, the newly established cutoff levels of COVID-19–associated cardiac biomarkers may serve as useful criteria for the future prospective studies and clinical trials.
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Affiliation(s)
- Juan-Juan Qin
- From the Department of Cardiology (J.-J.Q.), Zhongnan Hospital of Wuhan University, China.,Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Xu Cheng
- Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Feng Zhou
- Medical Science Research Center (F.Z., P.Z., H.L.), Zhongnan Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Fang Lei
- Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Gauri Akolkar
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (G.A., A.B., P.P.L.)
| | | | - Xiao-Jing Zhang
- Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Alice Blet
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (G.A., A.B., P.P.L.)
| | - Jing Xie
- Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.,Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (G.A., A.B., P.P.L.)
| | - Peng Zhang
- Medical Science Research Center (F.Z., P.Z., H.L.), Zhongnan Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).,Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (G.A., A.B., P.P.L.)
| | - Ye-Mao Liu
- Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Zizhen Huang
- Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Ling-Ping Zhao
- Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Lijin Lin
- Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Meng Xia
- Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Ming-Ming Chen
- Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Xiaohui Song
- Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Liangjie Bai
- Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Ze Chen
- Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Xingyuan Zhang
- Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Da Xiang
- Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Jing Chen
- Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Qingbo Xu
- Centre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, United Kingdom (Q.X.)
| | - Xinliang Ma
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania (X.M.)
| | - Rhian M Touyz
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, United Kingdom (R.M.T.)
| | - Chen Gao
- Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles (C.G., Y.W.)
| | - Haitao Wang
- Department of Hepatobiliary and Pancreatic Surgery (H.W., Y. Yuan), Zhongnan Hospital of Wuhan University, China
| | - Liming Liu
- Department of General Surgery, Ezhou Central Hospital, Wuhan, China (L.L.)
| | - Weiming Mao
- Department of General Surgery, Huanggang Central Hospital, Wuhan, China (W.M.)
| | - Pengcheng Luo
- Department of Urology (P.L.), Wuhan Third Hospital and Tongren Hospital of Wuhan University, China
| | | | - Ping Ye
- Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, China (P.Y., M.C.)
| | - Manhua Chen
- Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, China (P.Y., M.C.)
| | - Guohua Chen
- Department of Neurology, Wuhan First Hospital/Wuhan Hospital of Traditional Chinese and Western Medicine, Hubei, China (G.C.)
| | - Lihua Zhu
- Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Zhi-Gang She
- Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
| | - Xiaodong Huang
- Department of Gastroenterology (X.H.), Wuhan Third Hospital and Tongren Hospital of Wuhan University, China
| | - Yufeng Yuan
- Department of Hepatobiliary and Pancreatic Surgery (H.W., Y. Yuan), Zhongnan Hospital of Wuhan University, China
| | - Bing-Hong Zhang
- Department of Neonatology (B.-H.Z.), Renmin Hospital of Wuhan University, China
| | - Yibin Wang
- Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles (C.G., Y.W.)
| | | | - Hongliang Li
- Medical Science Research Center (F.Z., P.Z., H.L.), Zhongnan Hospital of Wuhan University, China.,Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).,Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.,Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.)
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Zhang P, Zhu L, Cai J, Lei F, Qin JJ, Wang Y, Yuan Y, Rohit L, Liu PP, Li H. Response by Zhang et al to Letter Regarding Article, "Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19". Circ Res 2020; 126:e142-e143. [PMID: 32496914 PMCID: PMC7265881 DOI: 10.1161/circresaha.120.317242] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Peng Zhang
- From the Department of Cardiology, Renmin Hospital of Wuhan University, China (P.Z., L.Z., J.-J.Q., H.L.)
- Medical Science Research Center (P.Z., H.L.)
- Institute of Model Animal of Wuhan University, China (P.Z., L.Z., F.L., J.-J.Q., H.L.)
| | - Lihua Zhu
- From the Department of Cardiology, Renmin Hospital of Wuhan University, China (P.Z., L.Z., J.-J.Q., H.L.)
- Institute of Model Animal of Wuhan University, China (P.Z., L.Z., F.L., J.-J.Q., H.L.)
| | - Jingjing Cai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.C.)
| | - Fang Lei
- Institute of Model Animal of Wuhan University, China (P.Z., L.Z., F.L., J.-J.Q., H.L.)
| | - Juan-Juan Qin
- From the Department of Cardiology, Renmin Hospital of Wuhan University, China (P.Z., L.Z., J.-J.Q., H.L.)
- Institute of Model Animal of Wuhan University, China (P.Z., L.Z., F.L., J.-J.Q., H.L.)
| | - Yibin Wang
- Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles (Y.W.)
| | - Yufeng Yuan
- Department of Hepatobiliary and Pancreatic Surgery (Y.Y.), Zhongnan Hospital of Wuhan University, China
| | - Loomba Rohit
- NAFLD Research Center, Division of Gastroenterology and Epidemiology, University of California San Diego (L.R.)
| | - Peter P Liu
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, ON, Canada (P.P.L.)
| | - Hongliang Li
- From the Department of Cardiology, Renmin Hospital of Wuhan University, China (P.Z., L.Z., J.-J.Q., H.L.)
- Medical Science Research Center (P.Z., H.L.)
- Institute of Model Animal of Wuhan University, China (P.Z., L.Z., F.L., J.-J.Q., H.L.)
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Zhang P, Zhu L, Cai J, Lei F, Qin JJ, Xie J, Liu YM, Zhao YC, Huang X, Lin L, Xia M, Chen MM, Cheng X, Zhang X, Guo D, Peng Y, Ji YX, Chen J, She ZG, Wang Y, Xu Q, Tan R, Wang H, Lin J, Luo P, Fu S, Cai H, Ye P, Xiao B, Mao W, Liu L, Yan Y, Liu M, Chen M, Zhang XJ, Wang X, Touyz RM, Xia J, Zhang BH, Huang X, Yuan Y, Loomba R, Liu PP, Li H. Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19. Circ Res 2020; 126:1671-1681. [PMID: 32302265 PMCID: PMC7265882 DOI: 10.1161/circresaha.120.317134] [Citation(s) in RCA: 853] [Impact Index Per Article: 213.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Supplemental Digital Content is available in the text. Use of ACEIs (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) is a major concern for clinicians treating coronavirus disease 2019 (COVID-19) in patients with hypertension.
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Affiliation(s)
- Peng Zhang
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Medical Science Research Center (P.Z., Y.-X.J., H.L.), Zhongnan Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.).,Basic Medical School, Wuhan University (P.Z., L. Lin, H.L.)
| | - Lihua Zhu
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Jingjing Cai
- Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J. Cai)
| | - Fang Lei
- Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Juan-Juan Qin
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Jing Xie
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
| | - Ye-Mao Liu
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Yan-Ci Zhao
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Xuewei Huang
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Lijin Lin
- Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.).,Basic Medical School, Wuhan University (P.Z., L. Lin, H.L.)
| | - Meng Xia
- Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Ming-Ming Chen
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Xu Cheng
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Xiao Zhang
- Eye Center (X.Z.), Renmin Hospital of Wuhan University
| | - Deliang Guo
- Hepatobiliary and Pancreatic Surgery (D.G., H.W., Y. Yuan), Zhongnan Hospital of Wuhan University
| | - Yuanyuan Peng
- Cardiology (Y.P.), Zhongnan Hospital of Wuhan University
| | - Yan-Xiao Ji
- Medical Science Research Center (P.Z., Y.-X.J., H.L.), Zhongnan Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Jing Chen
- Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Zhi-Gang She
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Yibin Wang
- Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles (Y.W.)
| | - Qingbo Xu
- Centre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, United Kingdom (Q.X.)
| | - Renfu Tan
- Wuhan Kanghuashuhai Technology Company (R.T.), Wuhan
| | - Haitao Wang
- Hepatobiliary and Pancreatic Surgery (D.G., H.W., Y. Yuan), Zhongnan Hospital of Wuhan University
| | - Jun Lin
- Gastroenterology (J.L.), Zhongnan Hospital of Wuhan University
| | - Pengcheng Luo
- Urology (P.L.), Wuhan Third Hospital & Tongren Hospital of Wuhan University
| | - Shouzhi Fu
- Intensive Care Unit (S.F.), Wuhan Third Hospital & Tongren Hospital of Wuhan University
| | | | - Ping Ye
- Cardiology, The Central Hospital of Wuhan (P.Y., M.C.)
| | - Bing Xiao
- Stomatology, Xiantao First People's Hospital (B.X.)
| | - Weiming Mao
- General Surgery, Huanggang Central Hospital, Wuhan, China (W.M.)
| | - Liming Liu
- General Surgery, Ezhou Central Hospital (L. Liu)
| | - Youqin Yan
- Infections Department, Wuhan Seventh Hospital (Y. Yan)
| | | | - Manhua Chen
- Cardiology, The Central Hospital of Wuhan (P.Y., M.C.)
| | - Xiao-Jing Zhang
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
| | - Xinghuan Wang
- Center for Evidence-Based and Translational Medicine (X.W.), Zhongnan Hospital of Wuhan University.,Urology (X.W.), Zhongnan Hospital of Wuhan University
| | - Rhian M Touyz
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, United Kingdom (R.M.T.)
| | - Jiahong Xia
- Cardiovascular Surgery, Union Hospital (J.Xia), Tongji Medical College, Huazhong University of Science and Technology
| | | | - Xiaodong Huang
- Gastroenterology (X.H.), Wuhan Third Hospital & Tongren Hospital of Wuhan University
| | - Yufeng Yuan
- Hepatobiliary and Pancreatic Surgery (D.G., H.W., Y. Yuan), Zhongnan Hospital of Wuhan University
| | - Rohit Loomba
- NAFLD Research Center, Division of Gastroenterology and Epidemiology, University of California San Diego, CA (L.R.)
| | - Peter P Liu
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (P.P.L.)
| | - Hongliang Li
- From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.,Medical Science Research Center (P.Z., Y.-X.J., H.L.), Zhongnan Hospital of Wuhan University.,Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.).,Basic Medical School, Wuhan University (P.Z., L. Lin, H.L.)
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Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected health and economy worldwide on an unprecedented scale. Patients have diverse clinical outcomes, but those with preexisting cardiovascular disease, hypertension, and related conditions incur disproportionately worse outcome. The high infectivity of severe acute respiratory syndrome coronavirus 2 is in part related to new mutations in the receptor binding domain, and acquisition of a furin cleavage site in the S-spike protein. The continued viral shedding in the asymptomatic and presymptomatic individuals enhances its community transmission. The virus uses the angiotensin converting enzyme 2 receptor for internalization, aided by transmembrane protease serine 2 protease. The tissue localization of the receptors correlates with COVID-19 presenting symptoms and organ dysfunction. Virus-induced angiotensin converting enzyme 2 downregulation may attenuate its function, diminish its anti-inflammatory role, and heighten angiotensin II effects in the predisposed patients. Lymphopenia occurs early and is prognostic, potentially associated with reduction of the CD4+ and some CD8+ T cells. This leads to imbalance of the innate/acquired immune response, delayed viral clearance, and hyperstimulated macrophages and neutrophils. Appropriate type I interferon pathway activation is critical for virus attenuation and balanced immune response. Persistent immune activation in predisposed patients, such as elderly adults and those with cardiovascular risk, can lead to hemophagocytosis-like syndrome, with uncontrolled amplification of cytokine production, leading to multiorgan failure and death. In addition to the airways and lungs, the cardiovascular system is often involved in COVID-19 early, reflected in the release of highly sensitive troponin and natriuretic peptides, which are all extremely prognostic, in particular, in those showing continued rise, along with cytokines such as interleukin-6. Inflammation in the vascular system can result in diffuse microangiopathy with thrombosis. Inflammation in the myocardium can result in myocarditis, heart failure, cardiac arrhythmias, acute coronary syndrome, rapid deterioration, and sudden death. Aggressive support based on early prognostic indicators with expectant management can potentially improve recovery. Appropriate treatment for heart failure, arrhythmias, acute coronary syndrome, and thrombosis remain important. Specific evidence-based treatment strategies for COVID-19 will emerge with ongoing global collaboration on multiple approaches being evaluated. To protect the wider population, antibody testing and effective vaccine will be needed to make COVID-19 history.
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Affiliation(s)
- Peter P Liu
- University of Ottawa Heart Institute (P.P.L., A.B., D.S.), University of Ottawa, Ontario, Canada.,Departments of Medicine and Cellular & Molecular Medicine (P.P.L., D.S.), University of Ottawa, Ontario, Canada
| | - Alice Blet
- University of Ottawa Heart Institute (P.P.L., A.B., D.S.), University of Ottawa, Ontario, Canada.,Department of Anesthesiology, Critical Care and Burn Center, Lariboisière - Saint-Louis Hospitals, DMU Parabol, AP-HP Nord, University of Paris, France (A.B.).,Inserm UMR-S 942, Cardiovascular Markers in Stress Conditions (MASCOT), University of Paris, France (A.B.)
| | - David Smyth
- University of Ottawa Heart Institute (P.P.L., A.B., D.S.), University of Ottawa, Ontario, Canada.,Departments of Medicine and Cellular & Molecular Medicine (P.P.L., D.S.), University of Ottawa, Ontario, Canada
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital (H.L.), Wuhan University, China.,Medical Science Research Center, Zhongnan Hospital (H.L.), Wuhan University, China.,Basic Medical School (H.L.), Wuhan University, China
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35
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Almufleh A, Zhang L, Mielniczuk LM, Stadnick E, Davies RA, Du Q, Rayner K, Liu PP, Chih S. Biomarker discovery in cardiac allograft vasculopathy using targeted aptamer proteomics. Clin Transplant 2019; 34:e13765. [DOI: 10.1111/ctr.13765] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/01/2019] [Accepted: 11/25/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Aws Almufleh
- Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada
- Cardiac Sciences Department King Saud University Riyadh Saudi Arabia
| | - Liyong Zhang
- Cardiac function laboratory University of Ottawa Heart Institute Ottawa Ontario Canada
| | - Lisa M. Mielniczuk
- Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada
| | - Ellamae Stadnick
- Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada
| | - Ross A. Davies
- Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada
| | - Qiujiang Du
- Cardiac function laboratory University of Ottawa Heart Institute Ottawa Ontario Canada
| | - Katey Rayner
- Cardiometabolic microRNA Laboratory University of Ottawa Heart Institute Ottawa Ontario Canada
| | - Peter P. Liu
- Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada
- Cardiac function laboratory University of Ottawa Heart Institute Ottawa Ontario Canada
- Department of Medicine and Cellular & Molecular Medicine University of Ottawa Ottawa Ontario Canada
| | - Sharon Chih
- Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada
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36
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Abstract
BACKGROUND Urinary tract infections (UTIs) are one of the most common infectious diseases in clinic. Urine flow cytometry is receiving more and more attention due to its rapid forecast of UTIs. METHODS The Urine Flow Cytometer UF1000i has a series of software programs to quantify bacteria (BACT) and white blood cells (WBC), and describe the scatter diagram of bacteria. The UTIs were predicted based on the cutoff values with the Receiver Operating Characteristic (ROC) curves of BACT and WBC counts. To evaluate the diagnostic performance of UF1000i for UTIs, the sensitivity and specificity of 889 urine samples were determined in comparison to the results of urine culture. Meanwhile the bacterial morphology indication of the UF1000i was evaluated in order to help doctors choose antibiotics. The angle of the scatter cloud with the x-axis was used to classify the infected bacteria as bacilli (< 30°) or cocci (≥ 30°). RESULTS The best cutoff value of BACT counts for predicting UTIs was 119 per µL, and the sensitivity and specificity were 95.5% and 88.7%, respectively. While the best cutoff value of WBC counts was 81.5 per µL, and the sensitivity and specificity were 77.6% and 76.7%, respectively. In addition, the best cutoff values for females were 583 BACT per µL and 137.5 WBC per µL. They were much higher than for males (118 BACT per µL and 91 WBC per µL). The coincidence of the bacterial morphology information between the UF1000i software indication and the bacterial actual morphology identified by urine culture was 83% (bacilli) and 68% (cocci), respectively. CONCLUSIONS Data demonstrated that the performance of BACT counts for UTIs is superior to WBC counts. In addition, the bacterial morphology could preliminarily be predicated by the scatter diagram. Since the urine flow cytometer UF1000i can provide the data of both BACT counts and the scatter diagram, the urine flow cytometry was regarded as a suitable method for screening UTIs. Moreover, it would be better to take gender into consideration when setting the best cutoff value for diagnosis of UTIs in clinic.
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37
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Al-Khalaf MH, Akolkar G, Liu PP. Abstract 485: STING(ing) the Heart: How DNA Damage and Inflammation Orchestrate Cardiac Remodeling and Heart Failure. Circ Res 2019. [DOI: 10.1161/res.125.suppl_1.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
We aimed to investigate the role of DNA breaks in inducing inflammation leading to adverse remodeling, premature senescence, and cardiac dysfunction leading to onset of heart failure.
Methods:
in vivo
: Heart-focused IR (using XRad225Cx from PXi) on adult Sprague Dawley rats; 4-5 per group; dose: 0, 15, 30, 45 Gy (endpoint 12 weeks post-IR). Serial echocardiogram and blood collection, P/V at endpoint; whole heart harvest analysis.
in vitro
: Primary cardiomyocytes from adult rats; human derived cardiac AC16 cell line; UVB ionizing radiation; protein extraction, western probing; gene expression analysis; immunofluorescence staining and microscopy.
Results:
DNA damage response, as illustrated by XRCC1 protein expression, is upregulated in multiple heart injury/failure models (TAC, MI, aging) and differ depending on cell stage and/or age (
in vitro
proliferative vs differentiated AC16 cells). Using
in vitro
UVB radiation, exposure alters cardiomyocyte morphology, illustrated by α-actinin immunostaining, and activates innate inflammation and senescence, as illustrated by westerns and immunostaining of cGAS, STING, p16 and other relevant proteins. We demonstrate using heart-focused ionizing radiation a novel technique to induce aging related DNA damage and onset of diastolic heart dysfunction. Serial ECG show significant increase in E/A ratios at 8- and 12-week post irradiation of 30 and 45 Gy (E/A>2.0). We show P/V analysis supporting ECG data (~50% decrease in dPdt min, 2-fold increase in Tau, and significant [p<0.01] increase in End diastolic pressure, and no change in End systolic pressure). Using an inhibitor targeting cytosolic DNA sensor cGAS, we show attenuation of cardiac remodeling and expression of senescence.
Conclusions:
We elucidate the molecular pathway originating from the onset of DNA damage accumulation, leading to activation of specialized innate immunity proteins that ultimately upregulate inflammation and senescence. Here we uncover and connect key interactions between multiple pathways converging towards heart failure, and provide evidence for a novel therapeutic drug targeting cardiac aging.
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Bonaca MP, Olenchock BA, Salem JE, Wiviott SD, Ederhy S, Cohen A, Stewart GC, Choueiri TK, Di Carli M, Allenbach Y, Kumbhani DJ, Heinzerling L, Amiri-Kordestani L, Lyon AR, Thavendiranathan P, Padera R, Lichtman A, Liu PP, Johnson DB, Moslehi J. Myocarditis in the Setting of Cancer Therapeutics: Proposed Case Definitions for Emerging Clinical Syndromes in Cardio-Oncology. Circulation 2019; 140:80-91. [PMID: 31390169 PMCID: PMC6779326 DOI: 10.1161/circulationaha.118.034497] [Citation(s) in RCA: 244] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Recent developments in cancer therapeutics have improved outcomes but have also been associated with cardiovascular complications. Therapies harnessing the immune system have been associated with an immune-mediated myocardial injury described as myocarditis. Immune checkpoint inhibitors are one such therapy with an increasing number of case and cohort reports describing a clinical syndrome of immune checkpoint inhibitor–associated myocarditis. Although the full spectrum of immune checkpoint inhibitor–associated cardiovascular disease still needs to be fully defined, described cases of myocarditis range from syndromes with mild signs and symptoms to fatal events. These observations in the clinical setting stand in contrast to outcomes from randomized clinical trials in which myocarditis is a rare event that is investigator reported and lacking in a specific case definition. The complexities associated with diagnosis, as well as the heterogeneous clinical presentation of immune checkpoint inhibitor–associated myocarditis, have made ascertainment and identification of myocarditis with high specificity challenging in clinical trials and other data sets, limiting the ability to better understand the incidence, outcomes, and predictors of these rare events. Therefore, establishing a uniform definition of myocarditis for application in clinical trials of cancer immunotherapies will enable greater understanding of these events. We propose an operational definition of cancer therapy-associated myocarditis that may facilitate case ascertainment and report and therefore may enhance the understanding of the incidence, outcomes, and risk factors of this novel clinical syndrome.
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Affiliation(s)
- Marc P Bonaca
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Benjamin A Olenchock
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Joe-Elie Salem
- Division of Cardiovascular Medicine, Clinical Pharmacology, Cardio-Oncology Program, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN.,Division of Oncology, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN.,UNICO APHP 6 Cardio-Oncology Program,Sorbonne Universite, INSERM Clinical Investigation Center Paris-Est Assistance Publique - Hopitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - Stephen D Wiviott
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Stephane Ederhy
- UNICO APHP 6 Cardio-Oncology Program,Service de cardiologie Hôpitaux Universitaires Est Parisien, Hôpital Saint Antoine, Assistance Publique–Hôpitaux de Paris, INSERM 856, Sorbonne-université, France
| | - Ariel Cohen
- UNICO APHP 6 Cardio-Oncology Program,Sorbonne-Université and INSERM 856, Hôpital Saint Antoine, Paris, France
| | - Garrick C Stewart
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Marcelo Di Carli
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Yves Allenbach
- Sorbonne University, AP-PH, Pitié Salpêtrière Hospital, Department of Internal Medicine and Clinical Immunology, Paris, France
| | - Dharam J Kumbhani
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | | | - Laleh Amiri-Kordestani
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Alexander R Lyon
- Cardio-Oncology Service, Royal Brompton Hospital, London, United Kingdom
| | - Paaladinesh Thavendiranathan
- Peter Munk Cardiac Centre, Ted Rogers Program in Cardiotoxicity Prevention and Department of Medical Imaging, University Health Network, University of Toronto, Ontario, Canada
| | - Robert Padera
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Andrew Lichtman
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Peter P Liu
- Departments of Medicine and Cellular & Molecular Medicine, University of Ottawa Heart Institute, Ontario, Canada
| | - Douglas B Johnson
- Division of Oncology, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Javid Moslehi
- Division of Cardiovascular Medicine, Clinical Pharmacology, Cardio-Oncology Program, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN.,Division of Oncology, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN
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Sun LY, Kimmoun A, Takagi K, Liu PP, Bader Eddeen A, Mebazaa A. Ethnic differences in acute heart failure outcomes in Ontario. Int J Cardiol 2019; 291:177-182. [PMID: 31153653 DOI: 10.1016/j.ijcard.2019.05.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Previous studies have identified ethnic differences in outcomes after episodes of acute heart failure in natives of Asia as compared to those of Europe. Whether these ethnic differences in outcomes would still exist, years after migration to a different geographical and cultural setting remain unclear. We investigated the one-year mortality after an episode of acute heart failure admission in Ontario residents of South Asian and Chinese descent as compared to the General Population. METHODS We conducted a population-based, retrospective cohort study of adult Ontarions who were hospitalized for AHF between April 1, 2010 and March 31, 2016. Ethnicity was categorized using validated surname-based algorithms. The primary outcome was all-cause one-year mortality. Mortality rates were calculated using the Kaplan-Meier method. The relative hazard of death was assessed using a multivariable Cox proportional hazard model. RESULTS Of 82,125 patients, 1287 (1.6%) were Chinese, 1662 (2.0%) were South Asians, and the remaining 79,176 (96.4%) were of the General Population. The risk of mortality was markedly lower amongst South Asians (adjusted HR 0.81, 95% CI [0.73-0.89]) relative to the General Population. There was no statistically significant difference in the risk of mortality between Chinese and the General Population (adjusted HR 1.00 [0.91-1.10]). In addition, guideline-directed medical therapies were associated with similar survival benefit in patients of all three ethnic origins. CONCLUSIONS We found a lower risk of one-year mortality after acute heart failure hospitalization amongst South Asians compared to Chinese and the General Population, and similar benefit of medical therapy in all three groups. Further studies are needed to explore the etiologies of these ethnic disparities to truly improve outcomes at the population level.
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Affiliation(s)
- Louise Y Sun
- Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada.
| | - Antoine Kimmoun
- Medical Intensive Care Unit Brabois, Institut Lorrain du Cœur et des Vaisseaux, CHRU de Nancy, Vandoeuvre-les-Nancy, France; Inserm U942, Lariboisière University Hospital, Paris, France
| | - Koji Takagi
- Inserm U942, Lariboisière University Hospital, Paris, France
| | - Peter P Liu
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | - Alexandre Mebazaa
- Department of Anaesthesia, Burn, and Critical Care, Saint-Louis Lariboisière University Hospital, Paris, France; Université de Paris, France
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40
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Jabagi H, Mielniczuk LM, Liu PP, Ruel M, Sun LY. Biomarkers in the Diagnosis, Management, and Prognostication of Perioperative Right Ventricular Failure in Cardiac Surgery-Are We There Yet? J Clin Med 2019; 8:jcm8040559. [PMID: 31027170 PMCID: PMC6517903 DOI: 10.3390/jcm8040559] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 03/27/2019] [Accepted: 04/22/2019] [Indexed: 12/19/2022] Open
Abstract
Right ventricular failure (RVF) is a major risk factor for end organ morbidity and mortality following cardiac surgery. Perioperative RVF is difficult to predict and detect, and to date, no convenient, accurate, or reproducible measure of right ventricular (RV) function is available. Few studies have examined the use of biomarkers in RVF, and even fewer have examined their utility in the perioperative setting of patients undergoing cardiac surgery. Of the available classes of biomarkers, this review focuses on biomarkers of (1) inflammation and (2) myocyte injury/stress, due to their superior potential in perioperative RV assessment, including Galectin 3, ST2/sST2, CRP, cTN/hs-cTn, and BNP/NT-proBNP. This review was performed to help highlight the importance of perioperative RV function in patients undergoing cardiac surgery, to review the current modalities of RV assessment, and to provide a review of RV specific biomarkers and their potential utilization in the clinical and perioperative setting in cardiac surgery. Based on current evidence, we suggest the potential utility of ST2, sST2, Gal-3, CRP, hs-cTn, and NT-proBNP in predicting and detecting RVF in cardiac surgery patients, as they encompass the multifaceted nature of perioperative RVF and warrant further investigation to establish their clinical utility.
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Affiliation(s)
- Habib Jabagi
- Divisions of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
| | - Lisa M Mielniczuk
- Cardiology, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
| | - Peter P Liu
- Cardiology, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
| | - Marc Ruel
- Divisions of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
| | - Louise Y Sun
- Cardiac Anesthesiology, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada.
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41
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Abstract
The innate immune system is an evolutionarily conserved system that senses and defends against infection and irritation. Innate immune signaling is a complex cascade that quickly recognizes infectious threats through multiple germline-encoded cell surface or cytoplasmic receptors and transmits signals for the deployment of proper countermeasures through adaptors, kinases, and transcription factors, resulting in the production of cytokines. As the first response of the innate immune system to pathogenic signals, inflammatory responses must be rapid and specific to establish a physical barrier against the spread of infection and must subsequently be terminated once the pathogens have been cleared. Long-lasting and low-grade chronic inflammation is a distinguishing feature of type 2 diabetes and cardiovascular diseases, which are currently major public health problems. Cardiometabolic stress-induced inflammatory responses activate innate immune signaling, which directly contributes to the development of cardiometabolic diseases. Additionally, although the innate immune elements are highly conserved in higher-order jawed vertebrates, lower-grade jawless vertebrates lack several transcription factors and inflammatory cytokine genes downstream of the Toll-like receptors (TLRs) and retinoic acid-inducible gene-I (RIG-I)-like receptors (RLRs) pathways, suggesting that innate immune signaling components may additionally function in an immune-independent way. Notably, recent studies from our group and others have revealed that innate immune signaling can function as a vital regulator of cardiometabolic homeostasis independent of its immune function. Therefore, further investigation of innate immune signaling in cardiometabolic systems may facilitate the discovery of new strategies to manage the initiation and progression of cardiometabolic disorders, leading to better treatments for these diseases. In this review, we summarize the current progress in innate immune signaling studies and the regulatory function of innate immunity in cardiometabolic diseases. Notably, we highlight the immune-independent effects of innate immune signaling components on the development of cardiometabolic disorders.
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Affiliation(s)
- Meng Xu
- Department of Cardiology, Renmin Hospital of Wuhan University , Wuhan , China ; Medical Research Center, Zhongnan Hospital of Wuhan University , Wuhan , China ; Animal Experiment Center, Wuhan University , Wuhan , China ; Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario , Canada
| | - Peter P Liu
- Department of Cardiology, Renmin Hospital of Wuhan University , Wuhan , China ; Medical Research Center, Zhongnan Hospital of Wuhan University , Wuhan , China ; Animal Experiment Center, Wuhan University , Wuhan , China ; Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario , Canada
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University , Wuhan , China ; Medical Research Center, Zhongnan Hospital of Wuhan University , Wuhan , China ; Animal Experiment Center, Wuhan University , Wuhan , China ; Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario , Canada
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Schultheiss HP, Fairweather D, Caforio ALP, Escher F, Hershberger RE, Lipshultz SE, Liu PP, Matsumori A, Mazzanti A, McMurray J, Priori SG. Dilated cardiomyopathy. Nat Rev Dis Primers 2019; 5:32. [PMID: 31073128 PMCID: PMC7096917 DOI: 10.1038/s41572-019-0084-1] [Citation(s) in RCA: 302] [Impact Index Per Article: 60.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Dilated cardiomyopathy (DCM) is a clinical diagnosis characterized by left ventricular or biventricular dilation and impaired contraction that is not explained by abnormal loading conditions (for example, hypertension and valvular heart disease) or coronary artery disease. Mutations in several genes can cause DCM, including genes encoding structural components of the sarcomere and desmosome. Nongenetic forms of DCM can result from different aetiologies, including inflammation of the myocardium due to an infection (mostly viral); exposure to drugs, toxins or allergens; and systemic endocrine or autoimmune diseases. The heterogeneous aetiology and clinical presentation of DCM make a correct and timely diagnosis challenging. Echocardiography and other imaging techniques are required to assess ventricular dysfunction and adverse myocardial remodelling, and immunological and histological analyses of an endomyocardial biopsy sample are indicated when inflammation or infection is suspected. As DCM eventually leads to impaired contractility, standard approaches to prevent or treat heart failure are the first-line treatment for patients with DCM. Cardiac resynchronization therapy and implantable cardioverter-defibrillators may be required to prevent life-threatening arrhythmias. In addition, identifying the probable cause of DCM helps tailor specific therapies to improve prognosis. An improved aetiology-driven personalized approach to clinical care will benefit patients with DCM, as will new diagnostic tools, such as serum biomarkers, that enable early diagnosis and treatment.
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Affiliation(s)
- Heinz-Peter Schultheiss
- Institute for Cardiac Diagnostics and Therapy (IKDT), Berlin, Germany. .,Department of Cardiology, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
| | - DeLisa Fairweather
- Mayo Clinic, Department of Cardiovascular Medicine, Jacksonville, FL, USA.
| | - Alida L. P. Caforio
- 0000 0004 1757 3470grid.5608.bDivision of Cardiology, Department of Cardiological Thoracic and Vascular Sciences and Public Health, University of Padua, Padova, Italy
| | - Felicitas Escher
- grid.486773.9Institute for Cardiac Diagnostics and Therapy (IKDT), Berlin, Germany ,0000 0001 2218 4662grid.6363.0Department of Cardiology, Charité–Universitaetsmedizin Berlin, Berlin, Germany ,0000 0004 5937 5237grid.452396.fDZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Ray E. Hershberger
- 0000 0001 2285 7943grid.261331.4Divisions of Human Genetics and Cardiovascular Medicine in the Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH USA
| | - Steven E. Lipshultz
- 0000 0004 1936 9887grid.273335.3Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY USA ,0000 0000 9958 7286grid.413993.5Oishei Children’s Hospital, Buffalo, NY USA ,Roswell Park Comprehensive Cancer Center, Buffalo, NY USA
| | - Peter P. Liu
- 0000 0001 2182 2255grid.28046.38University of Ottawa Heart Institute, Ottawa, Ontario Canada
| | - Akira Matsumori
- grid.410835.bClinical Research Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Andrea Mazzanti
- 0000 0004 1762 5736grid.8982.bDepartment of Molecular Medicine, University of Pavia, Pavia, Italy ,Department of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy
| | - John McMurray
- 0000 0001 2193 314Xgrid.8756.cBritish Heart Foundation (BHF) Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Silvia G. Priori
- 0000 0004 1762 5736grid.8982.bDepartment of Molecular Medicine, University of Pavia, Pavia, Italy ,Department of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy
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Tobe SW, Yeates K, Campbell NRC, Maar MA, Perkins N, Liu PP, Sleeth J, McAllister C, Hua-Stewart D, Wells G, Bernick J. Diagnosing hypertension in Indigenous Canadians (DREAM-GLOBAL): A randomized controlled trial to compare the effectiveness of short message service messaging for management of hypertension: Main results. J Clin Hypertens (Greenwich) 2018; 21:29-36. [PMID: 30474909 DOI: 10.1111/jch.13434] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/22/2018] [Accepted: 09/07/2018] [Indexed: 12/13/2022]
Abstract
Hypertension, the leading cause of cardiovascular morbidity and mortality, affects more than 1 billion people globally. The rise in mobile health in particular the use of mobile phones and short message service (SMS) to support disease management provides an opportunity to improve hypertension awareness, treatment, and control, in remote and vulnerable patient populations. The primary objective of this randomized controlled study was to assess the effect of active (with hypertension specific management SMS) or passive (health behaviors SMS alone) on the difference in blood pressure (BP) reduction between the active and passive SMS groups in hypertensive Canadian First Nations people from six rural and remote communities. Pragmatic features of the study included shifting of BP measures to non-medical health workers. Despite an overall reduction in BP over the study, there was no difference in the BP change between groups from baseline to final for systolic 0.8 (95% CI -4.2 to 5.8 mm Hg) or diastolic -1.0 (95% CI -3.7 to 1.8 mm Hg, P = 0.5) BP. Achieved BP control was 37.5% (25.6%-49.4%, 95% CI) in the active group and 32.8% (20.6%-44.8%, 95% CI) in the passive group (difference in proportions -4.74% (-21.7% to 12.2%, 95% CI, P = 0.6). The study looked at changes in health services delivery, mobile health technologies, and patient engagement to support better management of hypertension in Canadian First Nations communities. The active hypertension specific SMS did not lead to improvements in BP control.
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Affiliation(s)
- Sheldon W Tobe
- Department of Medicine, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Faculty of Medicine, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Karen Yeates
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Norm R C Campbell
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Marion A Maar
- Faculty of Medicine, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Nancy Perkins
- Department of Medicine, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Peter P Liu
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jessica Sleeth
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | | | - Diane Hua-Stewart
- Department of Medicine, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - George Wells
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jordan Bernick
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Sun LY, Tu JV, Lee DS, Beanlands RS, Ruel M, Austin PC, Eddeen AB, Liu PP. Disability-free survival after coronary artery bypass grafting in women and men with heart failure. Open Heart 2018; 5:e000911. [PMID: 30487983 PMCID: PMC6242014 DOI: 10.1136/openhrt-2018-000911] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 09/02/2018] [Accepted: 09/26/2018] [Indexed: 01/01/2023] Open
Abstract
Objective Heart failure (HF) impairs survival post coronary artery bypass grafting (CABG), but little is known about the postoperative quality of life (QoL) in patients with HF. We derived a patient-centred QoL surrogate and assessed the impact of different HF subtypes on this surrogate in the year post-CABG. Methods We surveyed 3112 cardiovascular patients to derive a patient-centred disability outcome and studied this outcome in a population-based cohort. We defined preserved ejection fraction as ≥50% and reduced ejection fraction as <50%. The primary outcome was disability, defined according to compiled patient-derived values. The secondary outcomes consisted of each individual component of disability, and death. The incidence of disability was calculated using cumulative incidence functions, with death as a competing risk. We identified predictors of disability using cause-specific hazard models. Results Patient-derived disability outcome consisted of stroke, nursing home admission and recurrent hospitalisations. When applied to 40 083 CABG patients (20.6% women), the incidence of disability was 5.4% while the incidence of death was 3.7% in the year post-CABG. Female sex was associated with an adjusted HR of 1.25 (95% CI 1.13 to 1.37) for disability. Women with HF with preserved ejection fraction had an adjusted HR of 1.73 (95% CI 1.52 to 1.98) for disability. Conclusions Disability was a more frequent complication than death in the year post-CABG. Women experienced higher burden of disability than men, and female sex and the presence of HF were important disability risk factors. Efforts should be dedicated to disability risk prediction to enable patient-centred operative decision-making and to developing sex-specific treatment strategies to improve outcomes.
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Affiliation(s)
- Louise Y Sun
- Division of Cardiac Anesthesiology, Department of Anesthesiology and Pain Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Cardiovascular Research Program, Institute for Clinical Evaluative Sciences, Ontario, Canada
| | - Jack V Tu
- Cardiovascular Research Program, Institute for Clinical Evaluative Sciences, Ontario, Canada.,Sunnybrook Schulich Heart Centre, University of Toronto, Toronto, Ontario, Canada
| | - Douglas S Lee
- Cardiovascular Research Program, Institute for Clinical Evaluative Sciences, Ontario, Canada.,Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Rob S Beanlands
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Marc Ruel
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Peter C Austin
- Cardiovascular Research Program, Institute for Clinical Evaluative Sciences, Ontario, Canada
| | - Anan Bader Eddeen
- Cardiovascular Research Program, Institute for Clinical Evaluative Sciences, Ontario, Canada
| | - Peter P Liu
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Tobe SW, Stone JA, Anderson T, Bacon S, Cheng AYY, Daskalopoulou SS, Ezekowitz JA, Gregoire JC, Gubitz G, Jain R, Keshavjee K, Lindsay P, L'Abbe M, Lau DCW, Leiter LA, O'Meara E, Pearson GJ, Rabi DM, Sherifali D, Selby P, Tu JV, Wharton S, Walker KM, Hua-Stewart D, Liu PP. Canadian Cardiovascular Harmonized National Guidelines Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2018 update. CMAJ 2018; 190:E1192-E1206. [PMID: 30301743 PMCID: PMC6175624 DOI: 10.1503/cmaj.180194] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Sheldon W Tobe
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont.
| | - James A Stone
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Todd Anderson
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Simon Bacon
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Alice Y Y Cheng
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Stella S Daskalopoulou
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Justin A Ezekowitz
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Jean C Gregoire
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Gord Gubitz
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Rahul Jain
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Karim Keshavjee
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Patty Lindsay
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Mary L'Abbe
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - David C W Lau
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Lawrence A Leiter
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Eileen O'Meara
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Glen J Pearson
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Doreen M Rabi
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Diana Sherifali
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Peter Selby
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Jack V Tu
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Sean Wharton
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Kimberly M Walker
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Diane Hua-Stewart
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
| | - Peter P Liu
- Libin Cardiovascular Institute, Cumming School of Medicine (Anderson), University of Calgary, Calgary, Alta.; Department of Health, Kinesiology, and Applied Physiology (Bacon), Concordia University, Montreal, Que. & Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Que.; St. Michael's Hospital (Cheng), University of Toronto, Toronto, Ont.; McGill University (Daskalopoulou), Montreal, Que.; Department of Medicine (Ezekowitz), University of Alberta, Edmonton, Alta.; Institut de cardiologie de Montreal (Gregoire), Montreal, Que.; Universite de Montreal (Gubitz), Montreal, Que.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Keshavjee), University of Toronto, Toronto, Ont.; Department of Nutritional Sciences (L'Abbe), University of Toronto, Toronto, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael's Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O'Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community Health and Cardiac Sciences (Rabi), University of Calgary, Calgary, Alta.; Centre for Addiction and Mental Health, Departments of Family and Community Medicine, Psychiatry and Public Health Sciences (Selby), University of Toronto, Toronto, Ont.; School of Nursing and Health Research Methods, Evidence and Impact, Faculty of Health Sciences (Sherifali), McMaster University, Hamilton, Ont.; Libin Cardiovascular Institute (Stone), University of Calgary, Calgary, Alta.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; ICES, Sunnybrook Research Institute (Tu), University of Toronto, Toronto, Ont.; St. Joseph's Health Care Centre (Walker), Toronto, Ont.; McMaster University (Wharton), Hamilton Ont.; York University (Wharton), Toronto, Ont
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46
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Sun LY, Tu JV, Bader Eddeen A, Liu PP. Prevalence and Long-Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction. J Am Heart Assoc 2018; 7:JAHA.118.008902. [PMID: 29909401 PMCID: PMC6220539 DOI: 10.1161/jaha.118.008902] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Heart failure (HF) with reduced ejection fraction (rEF) is a widely regarded prognosticator after coronary artery bypass grafting. HF with preserved ejection fraction (pEF) accounts for up to half of all HF cases and is associated with considerable morbidity and mortality in hospitalized cohorts. However, HFpEF outcomes have not been elucidated in cardiac surgical patients. We investigated the prevalence and outcomes of HFpEF and HFrEF in women and men following coronary artery bypass grafting. Methods and Results We conducted a retrospective cohort study in Ontario, Canada, between October 1, 2008, and March 31, 2015, using Cardiac Care Network and Canadian Institute of Health Information data. HF is captured through a validated population‐based database of all Ontarians with physician‐diagnosed HF. We defined pEF as ejection fraction ≥50% and rEF as ejection fraction <50%. The primary outcome was all‐cause mortality. Analyses were stratified by sex. Mortality rates were calculated using Kaplan–Meier method. The relative hazard of death was assessed using multivariable Cox proportional hazard models. Of 40 083 patients (20.6% women), 55.5% had pEF without HF, 25.7% had rEF without HF, 6.9% had HFpEF, and 12.0% had HFrEF. Age‐standardized HFpEF mortality rates at 4±2 years of follow‐up were similar in women and men. HFrEF standardized HFpEF mortality rates were higher in women than men. Conclusions We found a higher prevalence and poorer prognosis of HFpEF in women. A history of HF was a more important prognosticator than ejection fraction. Preoperative screening and extended postoperative follow‐up should be focused on women and men with HF rather than on rEF alone.
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Affiliation(s)
- Louise Y Sun
- Division of Cardiac Anesthesiology, Department of Anesthesiology and Pain Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada .,School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Ontario, Canada
| | - Jack V Tu
- Institute for Clinical Evaluative Sciences, Ontario, Canada.,Sunnybrook Schulich Heart Centre, University of Toronto, Ontario, Canada
| | | | - Peter P Liu
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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47
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Bian ZY, Wei X, Deng S, Tang QZ, Feng J, Zhang Y, Liu C, Jiang DS, Yan L, Zhang LF, Chen M, Fassett J, Chen Y, He YW, Yang Q, Liu PP, Li H. Erratum to: Disruption of mindin exacerbates cardiac hypertrophy and fibrosis. J Mol Med (Berl) 2017; 95:1251-1253. [PMID: 28856378 DOI: 10.1007/s00109-017-1588-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Zhou-Yan Bian
- Department of Cardiology, Renmin Hospital of Wuhan University, JieFang Road 238, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute of Wuhan University, Wuhan, 430060, People's Republic of China
| | - Xiang Wei
- Department of Thoracic and Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shan Deng
- Department of Cardiology, Institute of Cardiovascular Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi-Zhu Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, JieFang Road 238, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute of Wuhan University, Wuhan, 430060, People's Republic of China
| | - Jinghua Feng
- Department of Cardiology, Renmin Hospital of Wuhan University, JieFang Road 238, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute of Wuhan University, Wuhan, 430060, People's Republic of China
| | - Yan Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, JieFang Road 238, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute of Wuhan University, Wuhan, 430060, People's Republic of China
| | - Chen Liu
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ding-Sheng Jiang
- Department of Cardiology, Renmin Hospital of Wuhan University, JieFang Road 238, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute of Wuhan University, Wuhan, 430060, People's Republic of China
| | - Ling Yan
- Department of Cardiology, Renmin Hospital of Wuhan University, JieFang Road 238, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute of Wuhan University, Wuhan, 430060, People's Republic of China
| | - Lian-Feng Zhang
- Key Laboratory of Human Disease Comparative Medicine, Ministry of Health, Beijing, China
| | - Manyin Chen
- Division of Cardiology, Heart and Stroke/Richard Lewar Centre of Excellence, University Health Network, University of Toronto, M5S3E2, Toronto, ON, Canada
| | - John Fassett
- Cardiovascular Division, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Yingjie Chen
- Cardiovascular Division, University of Minnesota, Minneapolis, MN, 55455, USA
| | - You-Wen He
- Department of Immunology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Qinglin Yang
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, 35294-3360, USA
| | - Peter P Liu
- Division of Cardiology, Heart and Stroke/Richard Lewar Centre of Excellence, University Health Network, University of Toronto, M5S3E2, Toronto, ON, Canada
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, JieFang Road 238, Wuhan, 430060, People's Republic of China. .,Cardiovascular Research Institute of Wuhan University, Wuhan, 430060, People's Republic of China.
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48
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Chen HT, Deng SQ, Li ZY, Wang ZL, Li Q, Gao JK, Zhong YH, Suo DM, Lu LN, Pan SL, Chen HX, Cui YY, Fan JH, Wen JY, Zhong LR, Han FZ, Wang YH, Hu SJ, Liu PP. [Investigation of pregestational diabetes mellitus in 15 hospitals in Guangdong province]. Zhonghua Fu Chan Ke Za Zhi 2017; 52:436-442. [PMID: 28797149 DOI: 10.3760/cma.j.issn.0529-567x.2017.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the morbidity, diagnostic profile and perinatal outcome of pregestational diabetes mellitus (PGDM) in 15 hospitals in Guangdong province. Methods: A total of 41 338 women delivered in the 15 hospitals during the 6 months, 195 women with PGDM (PGDM group) and 195 women with normal glucose test result (control group) were recruited from these tertiary hospitals in Guangdong province from January 2016 to June 2016. The morbidity and diagnostic profile of PGDM were analyzed. The complications during pregnancy and perinatal outcomes were compared between the two groups. In the PGDM group, pregnancy outcomes were analyzed in women who used insulin treatment (n=91) and women who did not (n=104). Results: (1) The incidence of PGDM was 0.472%(195/41 338). Diabetes mellitus were diagnosed in 59 women (30.3%, 59/195) before pregnancy, and 136 women (69.7%,136/195) were diagnosed as PGDM after conceptions. Forty-six women (33.8%) were diagnosed by fasting glucose and glycohemoglobin (HbA1c) screening. (2) The maternal age, pre-pregnancy body mass index (BMI) , prenatal BMI, percentage of family history of diabetes, incidence of macrosomia, concentration of low density lipoprotein were significantly higher in PGDM group than those in control group (all P<0.05). Women in PGDM group had significantly higher HbA1c concentration ((6.3±1.3)% vs (5.2±0.4)%) , fasting glucose [(6.3±2.3) vs (4.8±1.1) mmol/L], oral glucose tolerance test (OGTT) -1 h glucose ((12.6±2.9) vs (7.1±1.3) mmol/L) and OGTT-2 h glucose [(12.0±3.0) vs (6.4±1.0) mmol/L] than those in control group (P<0.01). (3) The morbidity of preterm births was significantly higher (11.3% vs 1.0%, P<0.01), and the gestational age at delivery in PGDM group was significantly smaller [(37.6±2.3) vs (39.2±1.2) weeks, P<0.01]. Cesarean delivery rate in the PGDM group (70.8% vs 29.7%) was significantly higher than the control group (P<0.01). There was significantly difference between PGDM group and control in the neonatal male/female ratio (98/97 vs 111/84, P=0.033). The neonatal birth weight in PGDM group was significantly higher ((3 159±700) vs (3 451±423) g, P<0.01) . And the incidence of neonatal hypoglycemia in the PGDM group was higher than the control group (7.7% vs 2.6%, P=0.036). (4) In the PGDM group, women who were treated with insulin had a smaller gestational age at delivery [(36.9±2.9) vs (37.9±2.5) weeks, P<0.01], and the neonates had a higher neonatal ICU (NICU) admission rate (24.2% vs 9.6%, P<0.01). Conclusions: The morbidity of PGDM in the 15 hospitals in Guangdong province is 0.472%. The majority of PGDM was diagnosed during pregnancy; HbA1c and fasting glucose are reliable parameters for PGDM screening. Women with PGDM have obvious family history of diabetes and repeated pregnancy may accelerate the process of diabetes mellitus. Women with PGDM have higher risk for preterm delivery and neonatal hypoglycemia. Unsatisfied glucose control followed by insulin treatment may increase the need for NICU admission.
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Affiliation(s)
- H T Chen
- Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
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49
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Zelt JGE, Liu PP, Erthal F, deKemp RA, Wells G, O'Meara E, Garrard L, Beanlands RSB, Mielniczuk LM. N-Terminal Pro B-Type Natriuretic Peptide and High-Sensitivity Cardiac Troponin T Levels Are Related to the Extent of Hibernating Myocardium in Patients With Ischemic Heart Failure. Can J Cardiol 2017; 33:1478-1488. [PMID: 28966019 DOI: 10.1016/j.cjca.2017.06.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/07/2017] [Accepted: 06/20/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Increased N-terminal pro b-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) can identify patients with heart failure (HF) who are at increased risk of cardiac events. The relationship of these biomarkers to the extent of hibernating myocardium and scar has not been previously characterized in patients with ischemic left ventricular dysfunction and HF. METHODS Patients with ischemic HF meeting recruitment criteria and undergoing perfusion and fluorodeoxyglucose-positron emission tomography to define myocardial hibernation and scar were included in the study. A total of 39 patients (mean age 67 ± 8 years) with New York Heart Association class II-IV HF and ischemic cardiomyopathy (ejection fraction [EF], 27.9% ± 8.5%) were enrolled in the study. RESULTS Serum NT-proBNP and hs-cTnT levels were elevated in patients with ≥ 10% hibernating myocardium compared with those with < 10% (NT-pro-BNP, 7419.10 ± 7169.5 pg/mL vs 2894.6 ± 2967.4 pg/mL; hs-cTnT, 789.3 ± 1835.3 pg/mL vs 44.8 ± 78.9 pg/mL; P < 0.05). The overall receiver operating characteristic under the curve value for NT-proBNP and hs-cTnT to predict hibernating myocardium was 0.76 and 0.78, respectively (P < 0.05). The NT-proBNP (P = 0.02) and hs-cTnT (P < 0.0001) levels also correlated with hibernation, particularly in patients with ≥ 10% scar, independent of EF, age, and estimated glomerular filtration rate. No differences were noted in biomarker levels for patients with vs those without ≥ 10% scar. CONCLUSIONS NT-proBNP and hs-cTnT levels are elevated in patients with ischemic HF hibernation and are correlated with the degree of hibernation but not with the presence or extent of scar. Taken together, these data support the novel concept that NT-proBNP and hs-cTnT release in patients with ischemic HF reflects the presence and extent of hibernating myocardium.
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Affiliation(s)
- Jason G E Zelt
- Molecular Function and Imaging Program, The National Cardiac PET Centre, and the Advanced Heart Disease Program, Division of Cardiology, Department of Medicine, and the Cardiac Research Methods Centre, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter P Liu
- Molecular Function and Imaging Program, The National Cardiac PET Centre, and the Advanced Heart Disease Program, Division of Cardiology, Department of Medicine, and the Cardiac Research Methods Centre, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Departments of Medicine and Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Fernanda Erthal
- Molecular Function and Imaging Program, The National Cardiac PET Centre, and the Advanced Heart Disease Program, Division of Cardiology, Department of Medicine, and the Cardiac Research Methods Centre, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Ontario, Canada
| | - Robert A deKemp
- Molecular Function and Imaging Program, The National Cardiac PET Centre, and the Advanced Heart Disease Program, Division of Cardiology, Department of Medicine, and the Cardiac Research Methods Centre, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Ontario, Canada
| | - George Wells
- Molecular Function and Imaging Program, The National Cardiac PET Centre, and the Advanced Heart Disease Program, Division of Cardiology, Department of Medicine, and the Cardiac Research Methods Centre, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Ontario, Canada
| | - Eileen O'Meara
- Division of Cardiology, Montréal Heart Institute, Montréal, Québec, Canada
| | - Linda Garrard
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Rob S B Beanlands
- Molecular Function and Imaging Program, The National Cardiac PET Centre, and the Advanced Heart Disease Program, Division of Cardiology, Department of Medicine, and the Cardiac Research Methods Centre, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lisa M Mielniczuk
- Molecular Function and Imaging Program, The National Cardiac PET Centre, and the Advanced Heart Disease Program, Division of Cardiology, Department of Medicine, and the Cardiac Research Methods Centre, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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50
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Chow SL, Maisel AS, Anand I, Bozkurt B, de Boer RA, Felker GM, Fonarow GC, Greenberg B, Januzzi JL, Kiernan MS, Liu PP, Wang TJ, Yancy CW, Zile MR. Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association. Circulation 2017; 135:e1054-e1091. [PMID: 28446515 DOI: 10.1161/cir.0000000000000490] [Citation(s) in RCA: 353] [Impact Index Per Article: 50.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers. METHODS The writing group used systematic literature reviews, published translational and clinical studies, clinical practice guidelines, and expert opinion/statements to summarize existing evidence and to identify areas of inadequacy requiring future research. The panel reviewed the most relevant adult medical literature excluding routine laboratory tests using MEDLINE, EMBASE, and Web of Science through December 2016. The document is organized and classified according to the American Heart Association to provide specific suggestions, considerations, or contemporary clinical practice recommendations. RESULTS A number of biomarkers associated with HF are well recognized, and measuring their concentrations in circulation can be a convenient and noninvasive approach to provide important information about disease severity and helps in the detection, diagnosis, prognosis, and management of HF. These include natriuretic peptides, soluble suppressor of tumorgenicity 2, highly sensitive troponin, galectin-3, midregional proadrenomedullin, cystatin-C, interleukin-6, procalcitonin, and others. There is a need to further evaluate existing and novel markers for guiding therapy and to summarize their data in a standardized format to improve communication among researchers and practitioners. CONCLUSIONS HF is a complex syndrome involving diverse pathways and pathological processes that can manifest in circulation as biomarkers. A number of such biomarkers are now clinically available, and monitoring their concentrations in blood not only can provide the clinician information about the diagnosis and severity of HF but also can improve prognostication and treatment strategies.
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