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Hills AP, Misra A, Gill JMR, Byrne NM, Soares MJ, Ramachandran A, Palaniappan L, Street SJ, Jayawardena R, Khunti K, Arena R. Public health and health systems: implications for the prevention and management of type 2 diabetes in south Asia. Lancet Diabetes Endocrinol 2018; 6:992-1002. [PMID: 30287104 DOI: 10.1016/s2213-8587(18)30203-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 02/07/2023]
Abstract
Many non-communicable chronic diseases, including type 2 diabetes, are highly prevalent, costly, and largely preventable. The prevention and management of type 2 diabetes in south Asia requires a combination of lifestyle changes and long-term health-care management. However, public health and health-care systems in south Asian countries face serious challenges, including the need to provide services to many people with inadequate resources, and substantial between-population and within-population inequalities. In this Series paper, we explore the importance and particular challenges of public health and health systems in south Asian countries (Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka) with respect to the provision of culturally appropriate lifestyle modification to prevent and manage diabetes, especially in resource-poor settings. Effective primary prevention strategies are urgently needed to counter risk factors and behaviours preconception, in utero, in infancy, and during childhood and adolescence. A concerted focus on education, training, and capacity building at the community level would ensure the more widespread use of non-physician care, including community health workers. Major investment from governments and other sources will be essential to achieve substantial improvements in the prevention and management of type 2 diabetes in the region.
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Affiliation(s)
- Andrew P Hills
- College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia.
| | - Anoop Misra
- Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, India; National Diabetes, Obesity, and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
| | - Jason M R Gill
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Nuala M Byrne
- College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Mario J Soares
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Ambady Ramachandran
- India Diabetes Research Foundation & Dr A Ramachandran's Diabetes Hospitals, Guindy, Chennai, India
| | | | - Steven J Street
- College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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Ellapen TJ, Paul Y, Barnard M, Swanepoel M, Hammill HV, Strydom GL. Are There Sufficient Number of Exercise Therapists in South Africa In Order To Equitably Manage the Noncommunicable Disease Epidemic? INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 39:127-132. [PMID: 30482096 DOI: 10.1177/0272684x18811035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The mortality of South African noncommunicable diseases (NCDs) is rising. One of its primary contributors is physical inactivity. Therefore, South African National Health Plan included exercise therapy as part of their strategy to inhibit the NCDs upsurge. This study aimed to determine whether the number of South African exercise therapists is sufficient to equitably manage this NCD epidemic. The 2013 and 2017 Health Professions Council of South Africa reports identified the number of physiotherapists, biokineticists, and their respective students-in-training. In 2012, 10,623,820 people were identified with NCDs; however, South African Department of Health only treated 6,058,186 patients (57.0%) ( p < .05). South African Health Review has estimated a 28.7% increase in the number of NCDs patients treated from 2012 (6,058,186) to 2025 (7,799,770) ( p < .05). The average yearly growth of practicing physiotherapists (3.4%) and the physiotherapy student-in-training (2.2%) is inequitable to manage this NCD epidemic. In 2012, the extrapolated physiotherapist-to-NCD patient ratio was 1:5667. The South African Department of Health should consider including biokineticists to aid in the management of the NCD epidemic.
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Affiliation(s)
| | - Yvonne Paul
- 1 North-West University, Potchefstroom, South Africa
| | - Marco Barnard
- 1 North-West University, Potchefstroom, South Africa
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Affiliation(s)
- Thomas F Lüscher
- Editor-in-Chief, Zurich Heart House, Careum Campus, Moussonstrasse 4, 8091 Zurich, Switzerland
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Aynaci G, Akdemir O. The Relationship Between Lifestyle, Health Promotion Lifestyle Profile II And High Blood Pressure In University Students. Open Access Maced J Med Sci 2018; 6:1756-1761. [PMID: 30338003 PMCID: PMC6182521 DOI: 10.3889/oamjms.2018.314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Identifying and controlling systemic arterial blood pressure is important in young people, and it is possible to reduce the frequency of systemic arterial hypertension by improving the lifestyle. AIM The aim of the study is to assess the relationship between healthy lifestyle behaviors and systemic blood pressure in university students. MATERIALS The study sample consisted of 200 university students from a state university in Edirne. Lifestyles and habits were evaluated with Health Promotion Lifestyle Profile II. Students' blood pressure was measured from both arms twice. RESULTS The mean HPLP-II score of those who frequently feel good was significantly higher than those who rarely feel good. The mean score of those who frequently wake up between 06:00-09:00 in the morning was statistically significantly higher than those who wake up outside these hours. Those who perform social or artistic activities during their leisure times had a mean scale score higher than those who don't perform. Although there wasn't a statistically significant difference according to smoking status, the mean score of non-smokers was higher than smokers. The mean scale scores were higher in frequent salt users than non-frequent users; participants with low saturated fatty acid intake had higher scores than those with high intake, and rare fast food consumers had higher scores than frequent consumers. The statistically significant difference between blood pressure values of females and males was due to higher blood pressure in male students. Those working in a part-time job had higher blood pressure values than those who weren't working. Among the students whose body mass indexes could be evaluated, there were differences in blood pressure values. CONCLUSION It has been observed in our study that health-related responsibilities and lifestyle behaviours increase with better leisure time activities, improved eating habits and a positive outlook on life. Turning youngs' tendencies towards healthy lifestyle behaviours to habits can make them healthier, more collective and more productive regarding physical, social and psychological well-being.
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From HIV prevention to non-communicable disease health promotion efforts in sub-Saharan Africa: A Narrative Review. AIDS 2018; 32 Suppl 1:S63-S73. [PMID: 29952792 DOI: 10.1097/qad.0000000000001879] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To synthesize published literature on noncommunicable disease (NCD) behavior change communication (BCC) interventions in sub-Saharan Africa (SSA) among persons living with HIV (PLHIV) and in the general population to inform efforts to adopt similar HIV and NCD BCC intervention activities. METHODS We conducted a literature review of NCD BCC interventions and included 20 SSA-based studies. Inclusion criteria entailed describing a BCC intervention targeting any four priority NCDs (cardiovascular disease, type 2 diabetes, cervical cancer, and depression) or both HIV and any of the NCDs. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework was used to assess potential public health impact of these studies. We also solicited expert opinions from 10 key informants on the topic of HIV/NCD health promotion in five SSA countries. RESULTS The BCC interventions reviewed targeted multiple parts of the HIV and NCD continuum at both individual and community levels. Various strategies (i.e. health education, social marketing, motivational interviewing, mobile health, and peer support) were employed. However, few studies addressed more than one dimension of the RE-AIM framework. Opinions solicited from the key informants supported the feasibility of integrating HIV and NCD BCC interventions in SSA potentially improving access, service provision and service demand, especially for marginalized and vulnerable populations. CONCLUSION Although HIV/NCD integration can improve effectiveness of preventive services at individual and community levels, potential public health impact of such approaches remain unknown as reach, adoptability, and sustainability of both integrated and nonintegrated NCD BCC approaches published to date have not been well characterized.
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Villalobos F, Vinuesa A, Pedret R, Reche A, Domínguez E, Arija V. [Effect of a Physical activity program on self-esteem in subjects with chronic diseases. 'Pas a Pas' community intervention trial]. Aten Primaria 2018; 51:236-244. [PMID: 29728286 PMCID: PMC6839204 DOI: 10.1016/j.aprim.2017.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 11/05/2017] [Accepted: 11/21/2017] [Indexed: 11/08/2022] Open
Abstract
Objetivo Evaluar la efectividad de un Programa de actividad física (AF) supervisado, con actividades socioculturales y de 9 meses de duración, sobre la autoestima y su asociación sobre el control de las enfermedades crónicas en adultos usuarios de atención primaria. Diseño Ensayo de intervención comunitaria, aleatorizado, controlado y multicéntrico. Emplazamiento Cuatro centros de atención primaria de Reus-Tarragona, España. Participantes Un total de 364 sujetos, aleatorizados al grupo control (GC = 104) y grupo intervención (GI = 260). Intervención Programa supervisado de caminatas de 120 min/semana con actividades socioculturales mensuales. Mediciones principales En los momentos basal y postintervención se valoró: AF (IPAQ-S), autoestima (escala de Rosenberg) e indicadores cardiovasculares: tabaquismo, presión arterial sistólica (PAS) y diastólica (PAD), colesterol LDL y HDL séricos, y glucosa sérica. Se registran características sociodemográficas y diagnósticos de enfermedades crónicas. Resultados El Programa incrementó la AF en el GI (p = 0,001), mientras que disminuyó en el GC (p = 0,002), y también la autoestima en el conjunto de participantes (1,28 puntos; p = 0,006) y en los grupos con diagnósticos de hipertensión (1,60 puntos; p = 0,005), dislipidemia (1,62 puntos; p = 0,012), exceso de peso (1,24 puntos; p = 0,011) o ansiedad/depresión (1,53 puntos; p = 0,045), valorados mediante modelos estadísticos multivariantes. El incremento de la autoestima durante la intervención disminuyó la PAS −0,5 mmHg (p = 0,030) en el grupo de hipertensos, independientemente de la PAS basal y del efecto de la intervención. Conclusión El Programa de AF realizado incrementó la AF y la autoestima en adultos usuarios de atención primaria. El incremento de la autoestima mejoró el control de la PAS en hipertensos.
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Affiliation(s)
- Felipe Villalobos
- Grupo de investigación en Nutrición y Salud Mental (NUTRISAM), Facultad de Medicina y Ciencias de la Salud, Instituto de Investigación Sanitaria Pere Virgili (IISPV), Universidad Rovira i Virgili, Tarragona, España
| | - Angels Vinuesa
- Centros de Atención Primaria, Institut Català de la Salut, Reus, Tarragona, España
| | - Roser Pedret
- Centros de Atención Primaria, Institut Català de la Salut, Reus, Tarragona, España
| | - Alicia Reche
- Centros de Atención Primaria, Institut Català de la Salut, Reus, Tarragona, España
| | - Eva Domínguez
- Centros de Atención Primaria, Institut Català de la Salut, Reus, Tarragona, España
| | - Victoria Arija
- Grupo de investigación en Nutrición y Salud Mental (NUTRISAM), Facultad de Medicina y Ciencias de la Salud, Instituto de Investigación Sanitaria Pere Virgili (IISPV), Universidad Rovira i Virgili, Tarragona, España; Unitat de Suport a la Recerca de Tarragona-Reus, Institut d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, España.
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Arena R, Daugherty J, Bond S, Lavie CJ, Phillips S, Borghi-Silva A. The combination of obesity and hypertension: a highly unfavorable phenotype requiring attention. Curr Opin Cardiol 2018; 31:394-401. [PMID: 27070650 DOI: 10.1097/hco.0000000000000294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Body habitus is a key lifestyle characteristic whose current status and future projections are disconcerting. The percentage of the global population who are either overweight or obese has substantially increased, with no indication that any country has a solution to this issue. Hypertension is a key unfavorable health metric that, like obesity, has disastrous health implications if left uncontrolled. Poor lifestyle characteristics and health metrics often cluster together to create complex and difficult to treat phenotypes. Excess body mass is such an example, creating an obesity-hypertension phenotype, which is the focus of this review. RECENT FINDINGS An increased risk for hypertension is clearly linked to obesity, indicating that the two conditions are intimately linked. The cascade of obesity-induced pathophysiologic adaptations creates a clear path to hypertension. Adopting a healthy lifestyle is a primary intervention for the prevention as well as treatment of the obesity-hypertension phenotype. SUMMARY The obesity-hypertension phenotype is highly prevalent and has disastrous health implications. A primordial prevention strategy, focused on lifelong healthy lifestyle patterns, is the optimal approach for this condition. For those individuals already afflicted by the obesity-hypertension phenotype, interventions must aggressively focus on weight loss and blood pressure control.
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Affiliation(s)
- Ross Arena
- aDepartment of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences bDepartment of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois, Chicago, Illinois cDepartment of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine; New Orleans, Louisiana, USA dCardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
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Clinical Effects of Regular Dry Sauna Bathing: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:1857413. [PMID: 29849692 PMCID: PMC5941775 DOI: 10.1155/2018/1857413] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/14/2017] [Accepted: 01/08/2018] [Indexed: 12/13/2022]
Abstract
Introduction Many health benefits are claimed by individuals and facilities promoting sauna bathing; however the medical evidence to support these claims is not well established. This paper aims to systematically review recent research on the effects of repeated dry sauna interventions on human health. Methods A systematic search was made of medical databases for studies reporting on the health effects of regular dry sauna bathing on humans from 2000 onwards. Risk of bias was assessed according to the Cochrane Collaboration guidelines. Results Forty clinical studies involving a total of 3855 participants met the inclusion criteria. Only 13 studies were randomized controlled trials and most studies were small (n < 40). Reported outcome measures were heterogeneous with most studies reporting beneficial health effects. Only one small study (n = 10) reported an adverse health outcome of disrupted male spermatogenesis, demonstrated to be reversible when ceasing sauna activity. Conclusions Regular dry sauna bathing has potential health benefits. More data of higher quality is needed on the frequency and extent of adverse side effects. Further study is also needed to determine the optimal frequency and duration of distinct types of sauna bathing for targeted health effects and the specific clinical populations who are most likely to benefit.
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Das EK, Lai PY, Robinson AT, Pleuss J, Ali MM, Haus JM, Gutterman DD, Phillips SA. Regular Aerobic, Resistance, and Cross-Training Exercise Prevents Reduced Vascular Function Following a High Sugar or High Fat Mixed Meal in Young Healthy Adults. Front Physiol 2018; 9:183. [PMID: 29568273 PMCID: PMC5853082 DOI: 10.3389/fphys.2018.00183] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 02/20/2018] [Indexed: 01/19/2023] Open
Abstract
The postprandial state can negatively influence flow mediated dilation (FMD), a predictor of atherosclerosis and cardiovascular disease. This investigation was designed to determine the effect of regular aerobic and/or resistance exercise on postprandial FMD after a high sugar or high fat mixed meal. Forty-five healthy participants were recruited from one of four groups: lean sedentary (SED), runners, weight lifters, and cross-trainers. Participants were randomly crossed over to a high sugar meal (HSM) and a high fat mixed meal (HFMM; both fat and carbohydrate). Pre-and postprandial endothelial function was assessed for both meals using brachial artery FMD. Plasma lipids, insulin, glucose, hs-CRP, and SOD were also measured with both meals. Endothelium-independent dilation was determined via sublingual nitroglycerin. Brachial artery FMD was reduced in SED following the HSM (9.9 ± 0.9% at baseline, peak reduction at 60 min 6.5 ± 1.0%) and the HFMM (9.4 ± 0.9% at baseline, peak reduction at 120 min 5.9 ± 1.2%; P < 0.05 for both, Mean ± SEM). There was no change in FMD after either HSM or HFMM in runners, weight lifters, and cross-trainers. Post-prandial increases in blood glucose, insulin and triglycerides were less pronounced in the exercisers compared to SED. In addition, exercisers presented lower baseline plasma hs-CRP and higher SOD activity. Nitroglycerin responses were similar among groups. These results suggest that endothelial function is reduced in sedentary adults after a HSM or HFMM, but not in regular aerobic or resistance exercisers. This response may be due to favorable postprandial metabolic responses or lower postprandial levels of inflammation and oxidative stress. These findings may help to explain the cardioprotective effect of exercise.
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Affiliation(s)
- Emon K Das
- Department of Medicine, Cardiovascular Center and Clinical Research Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Pui Y Lai
- Department of Medicine, Cardiovascular Center and Clinical Research Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Austin T Robinson
- Department of Physical Therapy, University of Illinois, Chicago, IL, United States.,Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, United States.,Integrative Physiology Laboratory, University of Illinois, Chicago, IL, United States
| | - Joan Pleuss
- Department of Medicine, Cardiovascular Center and Clinical Research Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Mohamed M Ali
- Department of Physical Therapy, University of Illinois, Chicago, IL, United States.,Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, United States.,Integrative Physiology Laboratory, University of Illinois, Chicago, IL, United States
| | - Jacob M Haus
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, United States.,Integrative Physiology Laboratory, University of Illinois, Chicago, IL, United States
| | - David D Gutterman
- Department of Medicine, Cardiovascular Center and Clinical Research Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Shane A Phillips
- Department of Medicine, Cardiovascular Center and Clinical Research Center, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Physical Therapy, University of Illinois, Chicago, IL, United States.,Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, United States.,Integrative Physiology Laboratory, University of Illinois, Chicago, IL, United States.,Department of Medicine, University of Illinois, Chicago, IL, United States
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60
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Abbott P, Banerjee T, Aruquipa Yujra AC, Xie B, Piette J. Exploring chronic disease in Bolivia: A cross-sectional study in La Paz. PLoS One 2018; 13:e0189218. [PMID: 29415037 PMCID: PMC5802437 DOI: 10.1371/journal.pone.0189218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 11/13/2017] [Indexed: 01/24/2023] Open
Abstract
Purpose This study seeks to develop an understanding that can guide development of programs to improve health and care for individuals with Non-Communicable Diseases (NCDs) in La Paz, Bolivia, where NCDs are prevalent and primary care systems are weak. This exploratory investigation examines the characteristics of chronic disease patients in the region, key health related behaviors, and their perceptions of the care that they receive. The longer-term goal is to lay groundwork for interventional studies based on the principles of the Chronic Care Model (CCM). Subjects and methods The study is based on two surveys of adults (> 18 years old) administered in 2014 in La Paz, Bolivia. A total of 1165 adult patients participated in the first screening survey. A post-screening second survey, administered only on those who qualified based on Survey 1, collected more detailed information about the subjects’ general health and health related personal circumstances, several health behaviors, health literacy, and their perceptions of care received. A final data set of 651 merged records were used for analysis. Results Characteristic of a low-income country, the majority of participants had low levels of education, income, health literacy and high rates of under/unemployment. Nearly 50% of participants reported 2 or more NCDs. Seventy-four percent (74%) of respondents reported low levels of medication adherence and 26% of the population was found to have an undiagnosed depressive disorder. Overall, the perception of care quality was low (60%), particularly in those under the age of 45. Significant relationships emerged between several sociodemographic characteristics, health behaviors, and perceptions that have major implications for improving NCD care in this population. Conclusions These findings illustrate some of the challenges facing low-income countries where reversing the tide of NCDs is of great importance. The prevalence of NCDs coupled with challenging social determinants of health, poor medication adherence, low health literacy, and perceptions of low quality of healthcare highlight several areas of opportunity for intervention.
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Affiliation(s)
- Patricia Abbott
- University of Michigan School of Nursing; Ann Arbor, Michigan, United States of America
| | - Tanima Banerjee
- Institute for Healthcare Policy and Innovation, University of Michigan; Ann Arbor, Michigan, United States of America
| | | | - Boqin Xie
- Fudan University School of Nursing, Shanghai, China
| | - John Piette
- School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
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Tabassum R, Froeschl G, Cruz JP, Colet PC, Dey S, Islam SMS. Untapped aspects of mass media campaigns for changing health behaviour towards non-communicable diseases in Bangladesh. Global Health 2018; 14:7. [PMID: 29347986 PMCID: PMC5774160 DOI: 10.1186/s12992-018-0325-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 01/09/2018] [Indexed: 11/10/2022] Open
Abstract
In recent years, non-communicable diseases (NCDs) have become epidemic in Bangladesh. Behaviour changing interventions are key to prevention and management of NCDs. A great majority of people in Bangladesh have low health literacy, are less receptive to health information, and are unlikely to embrace positive health behaviours. Mass media campaigns can play a pivotal role in changing health behaviours of the population. This review pinpoints the role of mass media campaigns for NCDs and the challenges along it, whilst stressing on NCD preventive programmes (with the examples from different countries) to change health behaviours in Bangladesh. Future research should underpin the use of innovative technologies and mobile phones, which might be a prospective option for NCD prevention and management in Bangladesh.
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Affiliation(s)
- Reshman Tabassum
- Department of Management, Faculty of Business and Law, Deakin University, Melbourne, Australia
| | - Guenter Froeschl
- Center for International Health, Medical Center of the University of Munich (LMU), Munich, Germany.,Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | | | | | | | - Sheikh Mohammed Shariful Islam
- Non-Communicable Diseases Initiative, International Center for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. .,The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia. .,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Australia.
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Narayanan K, Bougouin W, Sharifzadehgan A, Waldmann V, Karam N, Marijon E, Jouven X. Sudden Cardiac Death During Sports Activities in the General Population. Card Electrophysiol Clin 2017; 9:559-567. [PMID: 29173402 DOI: 10.1016/j.ccep.2017.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Regular exercise reduces cardiovascular and overall mortality. Participation in sports is an important determinant of cardiovascular health and fitness. Regular sports activity is associated with a smaller risk of sudden cardiac death (SCD). However, there is a small risk of sports-related SCD. Sports-related SCD accounts for approximately 5% of total SCD. SCD among athletes comprises only a fraction of all sports-related SCD. Sport-related SCD has a male predominance and an average age of affliction of 45 to 50 years. Survival is better than for other SCD. This review summarizes links between sports and SCD and discusses current knowledge and controversies.
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Affiliation(s)
- Kumar Narayanan
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Cardiology Department, Maxcure Hospitals, Hitec City, Hyderabad 500081, India
| | - Wulfran Bougouin
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France
| | - Ardalan Sharifzadehgan
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France; Paris Descartes University, Rue de l'Ecole de Médecine, Paris 75006, France; Cardiology Department, European Georges Pompidou Hospital, 20, Rue Leblanc, Paris 75015, France
| | - Victor Waldmann
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France; Paris Descartes University, Rue de l'Ecole de Médecine, Paris 75006, France; Cardiology Department, European Georges Pompidou Hospital, 20, Rue Leblanc, Paris 75015, France
| | - Nicole Karam
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France; Paris Descartes University, Rue de l'Ecole de Médecine, Paris 75006, France; Cardiology Department, European Georges Pompidou Hospital, 20, Rue Leblanc, Paris 75015, France
| | - Eloi Marijon
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France; Paris Descartes University, Rue de l'Ecole de Médecine, Paris 75006, France; Cardiology Department, European Georges Pompidou Hospital, 20, Rue Leblanc, Paris 75015, France.
| | - Xavier Jouven
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France; Paris Descartes University, Rue de l'Ecole de Médecine, Paris 75006, France; Cardiology Department, European Georges Pompidou Hospital, 20, Rue Leblanc, Paris 75015, France
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Pasarica M, Kay D. Teaching evidence-based lifestyle management in family medicine training. EDUCATION FOR PRIMARY CARE 2017; 29:60-61. [PMID: 29139334 DOI: 10.1080/14739879.2017.1402375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Denise Kay
- a University of Central Florida , Orlando , Florida USA
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Pasarica M, Harris DM, Franklin AL. Medical students teaching peer athletes: an innovative way of instructing the physiology of exercise, nutrition, and sleep as fundamentals for lifestyle medicine. ADVANCES IN PHYSIOLOGY EDUCATION 2017; 41:432-435. [PMID: 28679583 DOI: 10.1152/advan.00201.2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/13/2017] [Accepted: 06/04/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Magdalena Pasarica
- Department of Medical Education, College of Medicine, University of Central Florida, Orlando, Florida
| | - David M Harris
- Department of Medical Education, College of Medicine, University of Central Florida, Orlando, Florida
| | - Ashley L Franklin
- Department of Medical Education, College of Medicine, University of Central Florida, Orlando, Florida
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Kones R, Rumana U. Cardiometabolic diseases of civilization: history and maturation of an evolving global threat. An update and call to action. Ann Med 2017; 49:260-274. [PMID: 27936950 DOI: 10.1080/07853890.2016.1271957] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Despite striking extensions of lifespan, leading causes of death in most countries now constitute chronic, degenerative diseases which outpace the capacity of health systems. Cardiovascular disease is the most common cause of death in both developed and undeveloped countries. In America, nearly half of the adult population has at least one chronic disease, and polypharmacy is commonplace. Prevalence of ideal cardiovascular health has not meaningfully improved over the past two decades. The fall in cardiovascular deaths in Western countries, half due to a fall in risk factors and half due to improved treatments, have plateaued, and this reversal is due to the dual epidemics of obesity and diabetes type 2. High burdens of cardiovascular risk factors are also evident globally. Undeveloped nations bear the burdens of both infectious diseases and high childhood death rates. Unacceptable rates of morbidity and mortality arise from insufficient resources to improve sanitation, pure water, and hygiene, ultimately linked to poverty and disparities. Simultaneously, about 80% of cardiovascular deaths now occur in low- and middle-income nations. For these reasons, risk factors for noncommunicable diseases, including poverty, health illiteracy, and lack of adherence, must be targeted with unprecedented vigor worldwide. Key messages In developed and relatively wealthy countries, chronic "degenerative" diseases have attained crisis proportions that threaten to reverse health gains made within the past decades. Although poverty, disparities, and poor sanitation still cause unnecessary death and despair in developing nations, they are now also burdened with increasing cardiovascular mortality. Poor adherence and low levels of health literacy contribute to the high background levels of cardiovascular risk.
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Affiliation(s)
- Richard Kones
- a Cardiology Section , The Cardiometabolic Research Institute , Houston , TX , USA
| | - Umme Rumana
- a Cardiology Section , The Cardiometabolic Research Institute , Houston , TX , USA
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Obeidat NA, Habashneh MA, Shihab RA, Hawari FI. Are Jordanian primary healthcare practitioners fulfilling their potential in cancer prevention and community health? Findings from a cross-sectional survey. BMJ Open 2017; 7:e015269. [PMID: 28389495 PMCID: PMC5558813 DOI: 10.1136/bmjopen-2016-015269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Primary healthcare practitioners (PHCPs) can contribute to the control of cancer by promoting healthy lifestyles to patients. Given the scarcity of data in the Middle East on this subject, we sought to determine, through a cross-sectional survey, the status of healthy lifestyle promotion by PHCPs (physicians, nurses, midwives, nurse aids) in Jordan. METHODS Building on published studies, an Arabic questionnaire was developed to measure knowledge, perceptions and practices of Jordanian PHCPs with regard to healthy lifestyle counselling. A purposive sample of 20 clinics covering the main regions of Jordan was selected and all PHCPs were asked to complete the questionnaire. RESULTS 322 practitioners (32.3% physicians) responded (a 75.1% response rate). 24.4% of PHCPs were current cigarette smokers (physicians 44.2%). Roughly 58% of physicians and 50% of non-physicians reported advising the majority of patients to quit tobacco, but proportions were lower for providing other services (eg, asking about frequency of tobacco use, inquiring about diet and exercise, providing evidence-based guidance on quitting tobacco or improving diet and activity). Only 8% of the sample reported collectively asking the majority of patients about smoking status, exercise and diet; and providing evidence-based tips to improve these. Among physicians and non-physicians, 14.2% and 40.4% were able to identify the lifestyle-related risk factors associated with breast, colorectal and lung cancer. In multivariable analyses, confidence was the only significant variable associated with provision of counselling on healthy lifestyles. CONCLUSIONS Among Jordanian PHCPs, primary prevention services are underprovided, and data suggest ample room to improve PHCPs' skills and practices.
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Affiliation(s)
- N A Obeidat
- Cancer Control Office, King Hussein Cancer Center, Amman, Jordan
| | - M A Habashneh
- Awareness and Communication Health Directorate, Ministry of Health, Amman, Jordan
| | - R A Shihab
- Cancer Control Office, King Hussein Cancer Center, Amman, Jordan
| | - F I Hawari
- Cancer Control Office, King Hussein Cancer Center, Amman, Jordan
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Berezowska A, Fischer AR, Trijp HCV. The moderating effect of motivation on health-related decision-making. Psychol Health 2017; 32:665-685. [DOI: 10.1080/08870446.2017.1293055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Thacher TD, Rajkumar SV, Lanier WL. Call for Papers on Clinical Practice Guidelines. Mayo Clin Proc 2017; 92:327-328. [PMID: 28259225 DOI: 10.1016/j.mayocp.2017.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 01/19/2017] [Indexed: 11/17/2022]
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Phillips SA, Martino S, Arena R. Research Opportunities and Challenges in the Era of Healthy Living Medicine: Unlocking the Potential. Prog Cardiovasc Dis 2017; 59:498-505. [PMID: 28132853 DOI: 10.1016/j.pcad.2017.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 01/21/2017] [Indexed: 12/28/2022]
Abstract
Non-communicable diseases, such as cardiovascular disease (CVD), obesity, cancer, pulmonary disease, and diabetes are a very high global health concern. The health costs of risk factors for CVD, such as hypertension (HTN), is mounting and are unrelenting. As an example, it is estimated that direct and indirect costs due to HTN amounted to $46.4 billion in 2011 and projections of six-fold increases by 2030; the importance of low-cost nonpharmacological interventions involving collaborative teams of health care professionals is at a critical junction. Certainly, the data supported by research including some clinical trials for healthy living interventions support deploying health education, nutrition, smoking cessation, and physical activity(PA) in preventing CVD risk, such as HTN. Exercise training (ET) for blood pressure (BP) control has been shown to be an effective and integral component of BP management. However, less is known about what optimization of PA/ET modalities with nutrition and lifestyle tracking with modern era technologies will bring to this equation. New research methods may need to consider how to collaborate to collect data in using teams of researchers while interacting with community centers, school systems, and in traditional health care practices. This review will discuss and present what is known about the research that support modern era healthy living medicine and how this data may be integrated in venues that support health lifestyle in the community (i.e. schools and the work place).
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Affiliation(s)
- Shane A Phillips
- Department of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL.
| | - Sharon Martino
- Department of Physical Therapy, School of Health Technology and Management, Rehabilitation Research and Movement Performance Laboratory, Stony Brook University, Stony Brook, NY
| | - Ross Arena
- Department of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
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Guo XY, Liu XM, Jin L, Wang TT, Ullah K, Sheng JZ, Huang HF. Cardiovascular and metabolic profiles of offspring conceived by assisted reproductive technologies: a systematic review and meta-analysis. Fertil Steril 2017; 107:622-631.e5. [PMID: 28104241 DOI: 10.1016/j.fertnstert.2016.12.007] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/08/2016] [Accepted: 12/08/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate cardiovascular and metabolic features of offspring conceived by in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI). DESIGN Literature review and meta-analysis. SETTING Not applicable. PATIENT(S) Offspring from IVF-ICSI versus natural conception. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Systolic and diastolic blood pressure (SBP and DBP), cardiovascular function, body mass index (BMI), and lipid and glucose profiles. RESULT(S) We included 19 studies that had recruited 2,112 IVF-ICSI and 4,096 naturally conceived offspring, ranging from childhood to early adulthood. The blood pressure levels of IVF-ICSI offspring were statistically significantly higher than those of naturally conceived offspring (weighted mean differences and confidence intervals: 1.88 mm Hg [95% CI, 0.27, 3.49] for SBP and 1.51 mm Hg [95% CI, 0.33, 2.70] for DBP). In addition, cardiac diastolic function was suboptimal and vessel thickness was higher among IVF-ICSI offspring. Compared with the metabolism of naturally conceived offspring, IVF-ICSI offspring displayed comparable BMI, lower low-density lipoprotein cholesterol levels, and higher fasting insulin levels. CONCLUSION(S) Children conceived by IVF-ICSI manifested a minor yet statistically significant increase in blood pressure without the clustering of increased BMI or impaired lipid metabolism by early adulthood. Our findings indicate a risk of cardiovascular disease among IVF-ICSI offspring, which calls for longer-term follow-ups and further investigation.
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Affiliation(s)
- Xiao-Yan Guo
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Zhejiang, People's Republic of China
| | - Xin-Mei Liu
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China; Institute of Embryo-Fetal Original Adult Disease, Affiliated to Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Li Jin
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China; Institute of Embryo-Fetal Original Adult Disease, Affiliated to Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Ting-Ting Wang
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China; Institute of Embryo-Fetal Original Adult Disease, Affiliated to Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Kamran Ullah
- Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Jian-Zhong Sheng
- Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - He-Feng Huang
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Zhejiang, People's Republic of China; International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China; Institute of Embryo-Fetal Original Adult Disease, Affiliated to Shanghai Jiao Tong University, Shanghai, People's Republic of China.
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Sagner M, McNeil A, Puska P, Auffray C, Price ND, Hood L, Lavie CJ, Han ZG, Chen Z, Brahmachari SK, McEwen BS, Soares MB, Balling R, Epel E, Arena R. The P4 Health Spectrum – A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan. PROGRESS IN PREVENTIVE MEDICINE 2017. [DOI: 10.1097/pp9.0000000000000002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Olsen MH, Angell SY, Asma S, Boutouyrie P, Burger D, Chirinos JA, Damasceno A, Delles C, Gimenez-Roqueplo AP, Hering D, López-Jaramillo P, Martinez F, Perkovic V, Rietzschel ER, Schillaci G, Schutte AE, Scuteri A, Sharman JE, Wachtell K, Wang JG. A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet Commission on hypertension. Lancet 2016; 388:2665-2712. [PMID: 27671667 DOI: 10.1016/s0140-6736(16)31134-5] [Citation(s) in RCA: 586] [Impact Index Per Article: 73.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Michael H Olsen
- Department of Internal Medicine, Holbæk Hospital and Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark; Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
| | - Sonia Y Angell
- Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Samira Asma
- Global NCD Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pierre Boutouyrie
- Department of Pharmacology and INSERM U 970, Georges Pompidou Hospital, Paris Descartes University, Paris, France
| | - Dylan Burger
- Kidney Research Centre, Ottawa Hospital Research Institute, Department of Cellular and Molecular Medicine, University of Ottawa, ON, Canada
| | - Julio A Chirinos
- Department of Medicine at University Hospital of Pennsylvania and Veteran's Administration, PA, USA
| | | | - Christian Delles
- Christian Delles: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Anne-Paule Gimenez-Roqueplo
- INSERM, UMR970, Paris-Cardiovascular Research Center, F-75015, Paris, France; Paris Descartes University, F-75006, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Genetics, F-75015, Paris, France
| | - Dagmara Hering
- The University of Western Australia-Royal Perth Hospital, Perth, WA, Australia
| | - Patricio López-Jaramillo
- Direccion de Investigaciones, FOSCAL and Instituto de Investigaciones MASIRA, Facultad de Medicina, Universidad de Santander, Bucaramanga, Colombia
| | - Fernando Martinez
- Hypertension Clinic, Internal Medicine, Hospital Clinico, University of Valencia, Valencia, Spain
| | - Vlado Perkovic
- The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia
| | - Ernst R Rietzschel
- Department of Cardiology, Ghent University and Biobanking & Cardiovascular Epidemiology, Ghent University Hospital, Ghent, Belgium
| | - Giuseppe Schillaci
- Department of Internal Medicine, University of Perugia, Terni University Hospital, Terni, Italy
| | - Aletta E Schutte
- Medical Research Council Unit on Hypertension and Cardiovascular Disease, Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Angelo Scuteri
- Hypertension Center, Hypertension and Nephrology Unit, Department of Medicien, Policlinico Tor Vergata, Rome, Italy
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Kristian Wachtell
- Department of Cardiology, Division of Cardiovascular and Pulmonary Diseases Oslo University Hospital, Oslo, Norway
| | - Ji Guang Wang
- The Shanghai Institute of Hypertension, RuiJin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Sagner M, Arena R, McNeil A, Brahmam GN, Hills AP, De Silva HJ, Karunapema RPP, Wijeyaratne CN, Arambepola C, Puska P. Creating a pro-active health care system to combat chronic diseases in Sri Lanka: the central role of preventive medicine and healthy lifestyle behaviors. Expert Rev Cardiovasc Ther 2016; 14:1107-17. [DOI: 10.1080/14779072.2016.1227703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Affiliation(s)
- Thomas F Lüscher
- Editor-in-Chief, Zurich Heart House, Careum Campus, Moussonstrasse 4, 8091 Zurich, Switzerland
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76
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Sagner M, McNeil A, Puska P, Auffray C, Price ND, Hood L, Lavie CJ, Han ZG, Chen Z, Brahmachari SK, McEwen BS, Soares MB, Balling R, Epel E, Arena R. The P4 Health Spectrum - A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan. Prog Cardiovasc Dis 2016; 59:506-521. [PMID: 27546358 DOI: 10.1016/j.pcad.2016.08.002] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 08/10/2016] [Indexed: 02/06/2023]
Abstract
Chronic diseases (i.e., noncommunicable diseases), mainly cardiovascular disease, cancer, respiratory diseases and type-2-diabetes, are now the leading cause of death, disability and diminished quality of life on the planet. Moreover, these diseases are also a major financial burden worldwide, significantly impacting the economy of many countries. Healthcare systems and medicine have progressively improved upon the ability to address infectious diseases and react to adverse health events through both surgical interventions and pharmacology; we have become efficient in delivering reactive care (i.e., initiating interventions once an individual is on the verge of or has actually suffered a negative health event). However, with slowly progressing and often 'silent' chronic diseases now being the main cause of illness, healthcare and medicine must evolve into a proactive system, moving away from a merely reactive approach to care. Minimal interactions among the specialists and limited information to the general practitioner and to the individual receiving care lead to a fragmented health approach, non-concerted prescriptions, a scattered follow-up and a suboptimal cost-effectiveness ratio. A new approach in medicine that is predictive, preventive, personalized and participatory, which we label here as "P4" holds great promise to reduce the burden of chronic diseases by harnessing technology and an increasingly better understanding of environment-biology interactions, evidence-based interventions and the underlying mechanisms of chronic diseases. In this concept paper, we propose a 'P4 Health Continuum' model as a framework to promote and facilitate multi-stakeholder collaboration with an orchestrated common language and an integrated care model to increase the healthspan.
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Affiliation(s)
- Michael Sagner
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA; SARENA Clinic, Medical Center and Research Institute.
| | - Amy McNeil
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Pekka Puska
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Charles Auffray
- European Institute for Systems Biology and Medicine, Paris and Lyon, France
| | | | - Leroy Hood
- Institute for Systems Biology, Seattle, WA, USA
| | - Carl J Lavie
- Department of Cardiovascular Diseases, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
| | - Ze-Guang Han
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhu Chen
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Samir Kumar Brahmachari
- Academy of Scientific and Innovative Research, CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Bruce S McEwen
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY, USA
| | | | - Rudi Balling
- Luxembourg Centre for Systems Biomedicine (LCSB), Esch-sur-Alzette, Luxembourg
| | - Elissa Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Ross Arena
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA; SARENA Clinic, Medical Center and Research Institute
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Sartini C, Barry SJE, Wannamethee SG, Whincup PH, Lennon L, Ford I, Morris RW. Effect of cold spells and their modifiers on cardiovascular disease events: Evidence from two prospective studies. Int J Cardiol 2016; 218:275-283. [PMID: 27240151 PMCID: PMC4917887 DOI: 10.1016/j.ijcard.2016.05.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/21/2016] [Accepted: 05/12/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate effects of cold weather spells on incidence of cardiovascular disease (CVD), and potential effect modification of socio-demographic, clinical, behavioural and environmental exposures. METHODS Data from two prospective studies were analysed: the British Regional Heart Study (BRHS), a population-based study of British men aged 60-79years, followed for CVD incidence from 1998-2000 to 2012; and the PROSPER study of men and women aged 70-82 recruited to a trial of pravastatin vs placebo from 1997 to 9 (followed until 2009). Cold spells were defined as at least three consecutive days when daily mean temperature fell below the monthly 10th percentile specific to the closest local weather station. A time-stratified case-crossover approach was used to estimate associations between cold spells and CVD events. RESULTS 921 of 4252 men from BRHS and 760 of 2519 participants from PROSPER suffered a first CVD event during follow-up. More CVD events were registered in winter in both studies. The risk ratio (RR) associated with cold spells was statistically significant in BRHS (RR=1.86, 95% CI 1.30-2.65, p<0.001), and independent of temperature level: results were similar whether events were fatal or non-fatal. Increased risk was particularly marked in BRHS for ever-smokers (RR of 2.44 vs 0.99 for never-smokers), in moderate/heavy drinkers (RR 2.59 vs 1.41), and during winter months (RR 3.28 vs 1.25). No increased risk was found in PROSPER. CONCLUSIONS Although CVD risks were higher in winter in both BRHS and PROSPER prospective studies, cold spells increased risk of CVD events, independently of cold temperature, in the BRHS only.
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Affiliation(s)
- Claudio Sartini
- Department of Primary Care & Population Health, University College London, Rowland Hill Street, NW3 2PF London. UK.
| | - Sarah J E Barry
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Robertson Centre for Biostatistics, Boyd Orr Building, Level 11 University of Glasgow, Glasgow G12 8QQ, UK
| | - S Goya Wannamethee
- Department of Primary Care & Population Health, University College London, Rowland Hill Street, NW3 2PF London. UK
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Lucy Lennon
- Department of Primary Care & Population Health, University College London, Rowland Hill Street, NW3 2PF London. UK
| | - Ian Ford
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Robertson Centre for Biostatistics, Boyd Orr Building, Level 11 University of Glasgow, Glasgow G12 8QQ, UK
| | - Richard W Morris
- School of Social & Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Rd, Bristol BS8 2PS, UK
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Félix-Redondo FJ, Lozano Mera L, Consuegra-Sánchez L, Giménez Sáez F, Garcipérez de Vargas FJ, Castellano Vázquez JM, Fernández-Bergés D. Risk factors and therapeutic coverage at 6 years in patients with previous myocardial infarction: the CASTUO study. Open Heart 2016; 3:e000368. [PMID: 27127637 PMCID: PMC4847157 DOI: 10.1136/openhrt-2015-000368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 01/30/2016] [Accepted: 02/02/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To determine the degree of risk factor control, the clinical symptoms and the therapeutic management of patients with a history of previous myocardial infarction. METHODS Cross-sectional study at 6 years of a first episode of acute myocardial infarction between 2000 and 2009, admitted at a hospital in the region of Extremadura (Spain). Of 2177 patients with this diagnosis, 1365 remained alive and therefore were included in the study. RESULTS We conducted a person-to-person survey in 666 (48.8%) individuals and telephone survey in 437 (31.9%) individuals. The former are analysed. 130 were female (19.5%). The mean age was 67.4 years and the median time since the event was 5.8 (IQR 3.6-8.2) years. Active smokers made up 13.8%, low-density lipoprotein (LDL) cholesterol was ≥70 mg/dL: 82%, blood pressure ≥140/90 mm Hg (≥140/85 in diabetics): 49.8%, fasting glucose ≥126 mg/dL: 26%, heart rate 50-59 bpm: 60.7%, and obesity: 45.9%. Patients reported presenting angina comprised 22.4% and those with dyspnoea, 29.3%. Drug coverage was: 88.0% antiplatelet drugs, 86.5% statins, 75.6% β-blockers and 65.8% blockers of the renin-angiotensin system. Patients receiving all four types of drugs made up 41.9%, with only 3.0% having jointly controlled cholesterol, blood pressure, heart rate and glycaemia. CONCLUSIONS LDL cholesterol, heart rate and blood pressure were risk factors with less control. More than 1/5 of patients had angina and more than 1/4, dyspnoea. Risk factor control and the clinical condition were far from optimal, as was drug coverage, although to a lesser degree.
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Affiliation(s)
- Francisco Javier Félix-Redondo
- Primary Care Unit "Villanueva Norte" , Programme of Investigation in Cardiovascular Diseases (PERICLES). GRIMEX Group , Villanueva de la Serena, Badajoz , Spain
| | - Luis Lozano Mera
- Primary Care Unit "Urbano I" , Programme of Investigation in Cardiovascular Diseases (PERICLES). GRIMEX Group . Mérida, Badajoz , Spain
| | - Luciano Consuegra-Sánchez
- Cardiac Hemodynamic Unit, Cardiology Department , Programme of Investigation in Cardiovascular Diseases (PERICLES). GRIMEX Group, "Santa Lucia" University Hospital , Cartagena, Murcia , Spain
| | - Fernando Giménez Sáez
- Cardiology Department , Don Benito-Villanueva de la Serena Hospital , Don Benito, Badajoz , Spain
| | | | - José María Castellano Vázquez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiology Department, Monteprincipe University Hospital (HM Hospitales), Boadilla del Monte, Madrid, Spain
| | - Daniel Fernández-Bergés
- Cardiology Department , Programme of Investigation in Cardiovascular Diseases (PERICLES). GRIMEX Group, Don Benito-Villanueva de la Serena Hospital , Don Benito, Badajoz , Spain
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Booth JN, Colantonio LD, Howard G, Safford MM, Banach M, Reynolds K, Cushman M, Muntner P. Healthy lifestyle factors and incident heart disease and mortality in candidates for primary prevention with statin therapy. Int J Cardiol 2016; 207:196-202. [PMID: 26803243 PMCID: PMC6311703 DOI: 10.1016/j.ijcard.2016.01.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 11/13/2015] [Accepted: 01/01/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND There are limited data on the use of healthy lifestyles among adults who are candidates for primary prevention of atherosclerotic cardiovascular disease (ASCVD) with statin therapy due to a 10-year predicted risk ≥7.5%. We determined the prevalence of healthy lifestyle factors and their association with incident ASCVD and all-cause mortality in the Reason for Geographic and Racial Differences in Stroke study participants (n=5709). METHODS Lifestyle factors (non-obese waist circumference, physical activity ≥5 times-per-week, non-smoking, low saturated-fat-intake, highest Mediterranean diet score quartile) were assessed during an in-home examination and interviewer-administered questionnaires. Adjudicated incident ASCVD (nonfatal/fatal stroke, nonfatal myocardial infarction or coronary heart disease death) and all-cause mortality were identified through active participant follow-up. RESULTS Overall, 5.1%, 28.9%, 36.9%, 21.7% and 7.5% had 0, 1, 2, 3, and ≥4 of the 5 healthy lifestyle factors studied. There were 377 incident ASCVD events (203 CHD events and 174 strokes) and 471 deaths during 5.8 and 6.0 median years of follow-up, respectively. ASCVD incidence rates (95% CI) per 1000-person-years associated with 0, 1, 2, 3 and ≥4 healthy lifestyles were 13.4 (7.3-19.5), 12.8 (10.4-15.2), 11.0 (9.0-12.9), 11.0 (8.3-13.7), and 8.7 (4.9-12.4), respectively. Mortality rates associated with 0, 1, 2, 3 and ≥4 healthy lifestyles were 20.6 (13.3-27.8), 15.9 (13.3-18.5), 13.1 (10.9-15.2), 12.6 (9.9-15.2) and 9.2 (5.3-13.2) per 1000-person-years, respectively. The use of more healthy lifestyles was associated with lower risks for ASCVD and mortality after multivariable adjustment. CONCLUSION Healthy lifestyles are underutilized among high-risk US adults and may substantially reduce their ASCVD risk.
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Affiliation(s)
- John N Booth
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - George Howard
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | | | | | - Paul Muntner
- University of Alabama at Birmingham, Birmingham, AL, USA.
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Guo T, Yin RX, Lin WX, Wang W, Huang F, Pan SL. Association of the variants and haplotypes in the DOCK7, PCSK9 and GALNT2 genes and the risk of hyperlipidaemia. J Cell Mol Med 2016; 20:243-65. [PMID: 26493351 PMCID: PMC4727555 DOI: 10.1111/jcmm.12713] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 09/07/2015] [Indexed: 01/09/2023] Open
Abstract
Little is known about the association between the single nucleotide polymorphisms (SNPs) and haplotypes of the dedicator of cytokinesis 7 (DOCK7), pro-protein convertase subtilisin/kexin type 9 (PCSK9) and polypeptide N-acetylgalactosaminyltransferase 2 (GALNT2) and serum lipid traits in the Chinese populations. This study was to determine the association between nine SNPs in the three genes and their haplotypes and hypercholesterolaemia (HCH)/hypertriglyceridaemia (HTG), and to identify the possible gene-gene interactions among these SNPs. Genotyping was performed in 733 HCH and 540 HTG participants. The haplotype of C-C-G-C-T-G-C-C-G [in the order of DOCK7 rs1168013 (G>C), rs10889332 (C>T); PCSK9 rs615563 (G>A), rs7552841 (C>T), rs11206517 (T>G); and GALNT2 rs1997947 (G>A), rs2760537 (C>T), rs4846913 (C>A) and rs11122316 (G>A) SNPs] was associated with increased risk of HCH and HTG. The haplotypes of C-C-G-C-T-G-C-C-A and G-C-G-T-T-G-T-C-G were associated with a reduced risk of HCH and HTG. The haplotypes of G-C-G-C-T-G-C-C-A and G-C-G-C-T-G-T-C-G were associated with increased risk of HCH. The haplotypes of C-T-G-C-T-G-C-C-G, G-C-A-C-T-G-C-C-G and G-C-G-C-T-G-C-C-A were associated with an increased risk of HTG. The haplotypes of G-C-G-C-T-G-T-C-A and G-C-G-T-T-G-T-C-G were associated with a reduced risk of HTG. In addition, possible inter-locus interactions among the DOCK7, PCSK9 and GALNT2 SNPs were also noted. However, further functional studies of these genes are still required to clarify which SNPs are functional and how these genes actually affect the serum lipid levels.
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Affiliation(s)
- Tao Guo
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Rui-Xing Yin
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Wei-Xiong Lin
- Department of Molecular Genetics, Medical Scientific Research Center, Guangxi Medical University, Nanning, Guangxi, China
| | - Wei Wang
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Feng Huang
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Shang-Ling Pan
- Department of Pathophysiology, School of Premedical Sciences, Guangxi Medical University, Nanning, Guangxi, China
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81
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Affiliation(s)
- E E van der Wall
- Netherlands Society of Cardiology/Holland Heart House, Moreelsepark 1, 3511 EP, Utrecht, The Netherlands.
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82
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Aron-Wisnewsky J, Clément K. The gut microbiome, diet, and links to cardiometabolic and chronic disorders. Nat Rev Nephrol 2015; 12:169-81. [PMID: 26616538 DOI: 10.1038/nrneph.2015.191] [Citation(s) in RCA: 221] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardiometabolic diseases (CMDs) have been associated with changes in the composition of the gut microbiota, with links between the host environment and microbiota identified in preclinical models. High-throughput sequencing technology has facilitated in-depth studies of the gut microbiota, bacterial-derived metabolites, and their association with CMDs. Such strategies have shown that patients with CMDs frequently exhibit enrichment or depletion of certain bacterial groups in their resident microbiota compared to healthy individuals. Furthermore, the ability to transfer resident gut microbiota from mice or humans into germ-free mouse models, or between human patients, has enabled researchers to characterize the causative role of the gut microbiota in CMDs. These approaches have helped identify that dietary intake of choline, which is metabolized by the gut microbiota, is associated with cardiovascular outcomes in mice and humans. Trimethylamine N-oxide (TMAO) - a metabolite derived from the gut microbiota - is also associated with poor cardiovascular outcomes in patients with cardiovascular disease and is elevated in patients with chronic kidney disease (CKD). TMAO might represent a biomarker that links the environment and microbiota with CKD. This Review summarizes data suggesting a link between the gut microbiota and derived metabolites with food intake patterns, metabolic alterations, and chronic CMDs.
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Affiliation(s)
- Judith Aron-Wisnewsky
- Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris, INSERM, Sorbonne Université, Paris 6, Pitié-Salpêtrière hospital, F-75013 Paris, France
| | - Karine Clément
- Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris, INSERM, Sorbonne Université, Paris 6, Pitié-Salpêtrière hospital, F-75013 Paris, France
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83
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Arena R, Lavie CJ, Guazzi M. Prescribing a Healthy Lifestyle Polypill With High Therapeutic Efficacy in Many Shapes and Sizes. Am J Lifestyle Med 2015; 11:476-478. [PMID: 30202373 DOI: 10.1177/1559827615619341] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The paradigm allowing for a lifestyle immersed in unhealthy behaviors to perpetuate to a point where a non-communicable disease (NCD) is eminent or manifests, and then initiating health care interventions, is deeply flawed, results in poor outcomes, and is unsustainable. This paradigm describes the current predominant healthcare model in many countries around the world and has resulted in the continual increase in unhealthy lifestyle patterns that have led to the global NCD epidemic. It is now broadly recognized that rapid integration of a new healthcare model, one heavily focused on primordial and primary NCD prevention, is needed. Being physically active, eating healthy and nutritious foods, not smoking and minimizing second-hand exposure, and maintaining an appropriate body weight are central to this new prevention model. Combined, these four characteristics can be viewed as the key ingredients for the "healthy lifestyle polypill". Recently, the American Heart Association (AHA), European Society of Cardiology (ESC), European Association for Cardiovascular Prevention and Rehabilitation (EACPR), and American College of Preventive Medicine (ACPM) came together to publish, in both the Mayo Clinic Proceedings and European Heart Journal, a policy statement entitled "Healthy Lifestyle Interventions to Combat Non-Communicable Disease: A Novel Non-Hierarchical Connectivity Model for Key Stakeholders". We hope the AHA-ESC-EACPR-ACPM healthy lifestyle policy statement prompts a massive increase in production of the healthy lifestyle polypill. Regulatory approval is not needed to start manufacturing and distributing this medication. The polypill can take many forms and have differing ingredients and dosages while still maintaining high therapeutic efficacy.
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Affiliation(s)
- Ross Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Science, University of Illinois at Chicago, Chicago, Illinois (RA).,Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana (CJL).,Heart Failure Unit and Cardiopulmonary Laboratory, Cardiology, I.R.C.C.S., Policlinico San Donato University Hospital, Milan, Italy (MG)
| | - Carl J Lavie
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Science, University of Illinois at Chicago, Chicago, Illinois (RA).,Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana (CJL).,Heart Failure Unit and Cardiopulmonary Laboratory, Cardiology, I.R.C.C.S., Policlinico San Donato University Hospital, Milan, Italy (MG)
| | - Marco Guazzi
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Science, University of Illinois at Chicago, Chicago, Illinois (RA).,Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana (CJL).,Heart Failure Unit and Cardiopulmonary Laboratory, Cardiology, I.R.C.C.S., Policlinico San Donato University Hospital, Milan, Italy (MG)
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Arena R, Lavie CJ, Hivert MF, Williams MA, Briggs PD, Guazzi M. Who will deliver comprehensive healthy lifestyle interventions to combat non-communicable disease? Introducing the healthy lifestyle practitioner discipline. Expert Rev Cardiovasc Ther 2015; 14:15-22. [DOI: 10.1586/14779072.2016.1107477] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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85
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Lüscher TF. Prevention of non-communicable diseases and special causes of heart failure. Eur Heart J 2015; 36:2019-2022. [DOI: 10.1093/eurheartj/ehv303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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