Barbara S Turner

Duke University, Durham, North Carolina, United States

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Publications (3)4.11 Total impact

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    ABSTRACT: BACKGROUND:: Acute coronary syndromes (ACSs) occur in deployed military personnel, yet little is known about the cardiovascular (CV) risk profile of deployed US military service members who experience ACS. Stress and socioeconomic status (SES) as risk factors for ACS in service members deployed in ongoing Overseas Contingency Operations have not been considered. RESEARCH OBJECTIVE:: To compare CV risk factors between service members who experienced ACS and healthy service members who did not experience ACS while deployed while controlling for nontraditional CV risk factors. SUBJECTS:: Deployed service members who experienced ACS (n = 93) and matched controls who did not experience ACS (n = 137). METHODS:: Healthy controls and ACS cases were matched on rank, area of operations, and ethnicity to control for confounding effects of SES, combat stress exposure, and ethnicity. RESULTS:: Acute myocardial infarction occurred in 81.7% of the cases, and 18.3% had unstable angina. Most major CV risk factors were different between the 2 groups except blood sugar and history of dyslipidemia. In a univariate conditional logistic regression model, all CV risk factors except blood sugar were significant predictors of ACS. In a multivariate logistic regression model, older age (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.11-1.40), higher total cholesterol/high density lipoprotein cholesterol ratio (OR, 2.87; 95% CI, 1.65-4.97), and family history of premature coronary artery disease (OR, 4.83 [95% CI, 1.64-14.26]) independently predicted ACS in deployed service personnel. CONCLUSION:: Controlling for SES, combat stress exposure, and ethnicity, traditional CV risk factors remain independent predictors of ACS in deployed service members.
    The Journal of cardiovascular nursing 11/2010; 26(1). DOI:10.1097/JCN.0b013e3181efea7e · 2.05 Impact Factor
  • Leigh Kyle McGraw · Barbara S. Turner · Kathleen Dracup ·
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    ABSTRACT: Purpose: To assess cardiovascular (CV) risk factors and socioeconomic status in military men deployed in support of the Global War on Terror with premature coronary artery disease (CAD). Background: Young military men are regarded as the epitome of health and fitness, yet little is known about the major CV risk factor profile or socioeconomic status of those with premature CAD who are deployed overseas in the Global War on Terror. Methods: This descriptive study includes military men < 55 years deployed in the Global War on Terror evacuated for definitive treatment of acute coronary syndromes (ACS) (N=85). Records were identified using International Classification of Diseases-9 codes at a military medical center in. Demographic information and major CV risk factors were obtained from medical records. Rank was utilized as a surrogate marker for socioeconomic status. Results: Demographic and clinical characteristics are reported using descriptive statistics. The average age of subjects was 42.5 years ( ± 6.2; range 29-54). Of the 85 subjects, 82.4% had an acute myocardial infarction and 17.6% had unstable angina. Major risk factors in the sample included 41% with a family history of premature CAD, and 49% classified as current smokers. Past medical history of hyperlipidemia, hypertension, and glucose abnormalities were noted in 37.6%, 24.7%, and 4.7%, respectively. Average total cholesterol was 177 mg/dl (± 44), low density lipoprotein cholesterol was 120 mg/dl (± 41), high density lipoprotein cholesterol was 34 mg/dl (±8), triglycerides were 149 mg/dl (± 75), and total cholesterol/high density lipoprotein cholesterol ratio was 5.4 (± 1.6). Fasting blood sugar was 101mg/dl (± 32), mean systolic blood pressure was 123 mmHg (± 16) and mean diastolic blood pressure was 76 mmHg (± 12). While the sample was overweight (mean BMI 28.0 kg/m² ± 3.2), their risk score was 7.1% (± 3.7), or “low risk” for ACS. Most of the participants were enlisted personnel (80%) and reservists (54%). Implications: Report of CV risk factors and socioeconomic status in deployed military men with a definitive diagnosis of premature CAD does not exist. Identification of risk factors associated with premature CAD can lead to policy changes on CV risk surveillance programs and risk management in young military men, especially prior to an overseas deployment. Findings from this study suggest that most military men with premature CAD are of lower socioeconomic status and require counseling about smoking cessation, weight management, and improving dyslipidemia. This study was funded in part by the American Academy of Nurse Practitioners Foundation (Uniformed NP Association 2007 NP Doctoral Dissertation Research Grant), the American Nurses Foundation (2007 Sayre Memorial Fund Scholar), and the UCSF Graduate Dean’s Health Sciences Fellowship Your uploaded file(s): * WIN 2009 Abstract Premature CAD_FINAL.doc (29.0KB) - Research paper
    42nd Annual Communicating Nursing Research Conference Western Institute of Nursing; 04/2009
  • Leigh K McGraw · Barbara S Turner · Nancy A Stotts · Kathleen A Dracup ·
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    ABSTRACT: As the civilian population exhibits increasing trends in major cardiovascular (CV) risk factors in younger age groups, the US military is observing similar trends. These worrisome developments are seen even in young adulthood. Despite the need for a fit, combat-ready force, increases in CV risk are increasingly evident in the military population. This review provides an overview of coronary artery disease in the young and the prevalence of risk factors in the military population. With increases in current military operations in an acutely stressful environment, the role of stress and the manifestation of CV disease are also examined.
    The Journal of cardiovascular nursing 01/2008; 23(4):338-44. DOI:10.1097/01.JCN.0000317437.75081.e7 · 2.05 Impact Factor

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