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Pavía-López AA, Alcocer-Gamba MA, Ruiz-Gastelum ED, Mayorga-Butrón JL, Mehta R, Díaz-Aragón FA, Aldrete-Velasco JA, López-Juárez N, Cruz-Bautista I, Chávez-Mendoza A, Secchi-Nicolás NC, Guerrero-Martínez FJ, Cossio-Aranda JE, Mendoza-Zubieta V, Fanghänel-Salmon G, Valdivia-Proa M, Olmos-Domínguez L, Aguilar-Salinas CA, Dávila-Maldonado L, Vázquez-Rangel A, Pavia-Aubry V, Nava-Hernández MDLA, Hinojosa-Becerril CA, Anda-Garay JC, Ríos-Ibarra MODL, Berni-Betancourt AC, López-Cuellar J, Araiza-Garaygordobil D, Rivera-Reyes R, Borrayo-Sánchez G, Tapia-Hernández M, Cano-Nigenda CV, Guerra-López A, Elías-López J, Figueroa-Morales MA, Montaño-Velázquez BB, Velasco-Hidalgo L, Rodríguez-Lozano AL, Pimentel-Hernández C, Baquero-Hoyos MM, Romero-Moreno F, Rodríguez-Vega M. Guía de práctica clínica mexicana para el diagnóstico y tratamiento de las dislipidemias y enfermedad cardiovascular aterosclerótica. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2022; 92:1-62. [PMID: 35275904 PMCID: PMC9290432 DOI: 10.24875/acm.m22000081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/14/2022] [Indexed: 11/17/2022] Open
Abstract
ANTECEDENTES Las enfermedades cardiovasculares son la principal causa mundial de mortalidad y México no es la excepción. Los datos epidemiológicos obtenidos en 1990 mostraron que los padecimientos cardiovasculares representaron el 19.8% de todas las causas de muerte en nuestro país; esta cifra se incrementó de manera significativa a un 25.5% para 2015. Diversas encuestas nacionales sugieren que más del 60% de la población adulta tiene al menos un factor de riesgo para padecer enfermedades cardiovasculares (obesidad o sobrepeso, hipertensión, tabaquismo, diabetes, dislipidemias). Por otro lado, datos de la Organización Panamericana de la Salud han relacionado el proceso de aterosclerosis como la primer causa de muerte prematura, reduciendo la expectativa de vida de manera sensible, lo que tiene una enorme repercusión social. OBJETIVO Este documento constituye la guía de práctica clínica (GPC) elaborada por iniciativa de la Sociedad Mexicana de Cardiología en colaboración con la Sociedad Mexicana de Nutrición y Endocrinología, A.C., Asociación Nacional de Cardiólogos de México, A.C., Asociación Mexicana para la Prevención de la Aterosclerosis y sus Complicaciones, A.C., Comité Normativo Nacional de Medicina General, A.C., Colegio Nacional de Medicina Geriátrica, A.C., Colegio de Medicina Interna de México, A.C., Sociedad Mexicana de Angiología y Cirugía Vascular y Endovenosa, A.C., Instituto Mexicano de Investigaciones Nefrológicas, A.C. y la Academia Mexicana de Neurología, A.C.; con el apoyo metodológico de la Agencia Iberoamericana de Desarrollo y Evaluación de Tecnologías en Salud, con la finalidad de establecer recomendaciones basadas en la mejor evidencia disponible y consensuadas por un grupo interdisciplinario de expertos. El objetivo de este documento es el de brindar recomendaciones basadas en evidencia para ayudar a los tomadores de decisión en el diagnóstico y tratamiento de las dislipidemias en nuestro país. MATERIAL Y MÉTODOS Este documento cumple con estándares internacionales de calidad, como los descritos por el Instituto de Medicina de EE.UU., el Instituto de Excelencia Clínica de Gran Bretaña, la Red Colegiada para el Desarrollo de Guías de Escocia y la Red Internacional de Guías de Práctica Clínica. Se integró un grupo multidisciplinario de expertos clínicos y metodólogos con experiencia en revisiones sistemáticas de la literatura y el desarrollo de guías de práctica clínica. Se consensuó un documento de alcances, se establecieron las preguntas clínicas relevantes, se identificó de manera exhaustiva la mejor evidencia disponible evaluada críticamente en revisiones sistemáticas de la literatura y se desarrollaron las recomendaciones clínicas. Se utilizó la metodología de Panel Delphi modificado para lograr un nivel de consenso adecuado en cada una de las recomendaciones contenidas en esta GPC. RESULTADOS Se consensuaron 23 preguntas clínicas que dieron origen a sus respectivas recomendaciones clínicas. CONCLUSIONES Esperamos que este documento contribuya a la mejor toma de decisiones clínicas y se convierta en un punto de referencia para los clínicos y pacientes en el manejo de las dislipidemias y esto contribuya a disminuir la morbilidad y mortalidad derivada de los eventos cardiovasculares ateroscleróticos en nuestro país. BACKGROUND Cardiovascular diseases are the leading cause of mortality worldwide and Mexico is no exception. The epidemiological data obtained in 1990 showed that cardiovascular diseases represented 19.8% of all causes of death in our country. This figure increased significantly to 25.5% for 2015. Some national surveys suggest that more than 60% of the adult population has at least one risk factor for cardiovascular disease (obesity or overweight, hypertension, smoking, diabetes, dyslipidemias). On the other hand, data from the Pan American Health Organization have linked the process of atherosclerosis as the first cause of premature death, significantly reducing life expectancy, which has enormous social repercussions. OBJECTIVE This document constitutes the Clinical Practice Guide (CPG) prepared at the initiative of the Mexican Society of Cardiology in collaboration with the Mexican Society of Nutrition and Endocrinology, AC, National Association of Cardiologists of Mexico, AC, Mexican Association for the Prevention of Atherosclerosis and its Complications, AC, National Normative Committee of General Medicine, AC, National College of Geriatric Medicine, AC, College of Internal Medicine of Mexico, AC, Mexican Society of Angiology and Vascular and Endovenous Surgery, AC, Mexican Institute of Research Nephrological, AC and the Mexican Academy of Neurology, A.C.; with the methodological support of the Ibero-American Agency for the Development and Evaluation of Health Technologies, in order to establish recommendations based on the best available evidence and agreed upon by an interdisciplinary group of experts. The objective of this document is to provide evidence-based recommendations to help decision makers in the diagnosis and treatment of dyslipidemias in our country. MATERIAL AND METHODS This document complies with international quality standards, such as those described by the Institute of Medicine of the USA, the Institute of Clinical Excellence of Great Britain, the Scottish Intercollegiate Guideline Network and the Guidelines International Network. A multidisciplinary group of clinical experts and methodologists with experience in systematic reviews of the literature and the development of clinical practice guidelines was formed. A scope document was agreed upon, relevant clinical questions were established, the best available evidence critically evaluated in systematic literature reviews was exhaustively identified, and clinical recommendations were developed. The modified Delphi Panel methodology was used to achieve an adequate level of consensus in each of the recommendations contained in this CPG. RESULTS 23 clinical questions were agreed upon which gave rise to their respective clinical recommendations. CONCLUSIONS We consider that this document contributes to better clinical decision-making and becomes a point of reference for clinicians and patients in the management of dyslipidemias and this contributes to reducing the morbidity and mortality derived from atherosclerotic cardiovascular events in our country.
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Affiliation(s)
| | - Marco A Alcocer-Gamba
- Sociedad Mexicana de Cardiología, Ciudad de México, México
- Facultad de Medicina, Universidad Autónoma de Querétaro, Qro., México
| | | | - José L Mayorga-Butrón
- Departamento de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
- Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de México, México
| | - Roopa Mehta
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Filiberto A Díaz-Aragón
- Asociación Nacional de Cardiólogos de México, Ciudad de México, México
- Departamento de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | - Nitzia López-Juárez
- Unidad Médica de Alta Especialidad Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
- Sociedad Mexicana de Nutrición y Endocrinología, Ciudad de México, México
| | - Ivette Cruz-Bautista
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
- Sociedad Mexicana de Nutrición y Endocrinología, Ciudad de México, México
| | - Adolfo Chávez-Mendoza
- Unidad Médica de Alta Especialidad Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | - Francisco J Guerrero-Martínez
- Sociedad Mexicana de Cardiología, Ciudad de México, México
- Asociación Mexicana para la Prevención de la Aterosclerosis y sus Complicaciones, Ciudad de México, México
| | | | | | - Guillermo Fanghänel-Salmon
- Asociación Mexicana para la Prevención de la Aterosclerosis y sus Complicaciones, Ciudad de México, México
| | | | - Luis Olmos-Domínguez
- Unidad Médica de Alta Especialidad Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | | | | | | | - María de Los A Nava-Hernández
- Sociedad Mexicana de Cardiología, Ciudad de México, México
- Facultad de Medicina, Universidad Autónoma de Querétaro, Qro., México
| | | | - Juan C Anda-Garay
- Colegio de Medicina Interna de México, Ciudad de México, México
- Hospital de especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | | | | | | | - Romina Rivera-Reyes
- Sociedad Mexicana de Cardiología, Ciudad de México, México
- Facultad de Medicina, Universidad Autónoma de Querétaro, Qro., México
| | - Gabriela Borrayo-Sánchez
- Asociación Nacional de Cardiólogos de México, Ciudad de México, México
- Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | | | | | - Josué Elías-López
- Unidad Médica de Alta Especialidad Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Marco A Figueroa-Morales
- Unidad Médica de Alta Especialidad Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Bertha B Montaño-Velázquez
- Ibero American Agency for Development & Assessment of Health Technologies (A2DAHT), Ciudad de México, México
| | | | - Ana L Rodríguez-Lozano
- Departamento de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | | | | | - Mario Rodríguez-Vega
- Ibero American Agency for Development & Assessment of Health Technologies (A2DAHT), Ciudad de México, México
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Posadzki P, Pieper D, Bajpai R, Makaruk H, Könsgen N, Neuhaus AL, Semwal M. Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews. BMC Public Health 2020; 20:1724. [PMID: 33198717 PMCID: PMC7670795 DOI: 10.1186/s12889-020-09855-3] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 11/08/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sedentary lifestyle is a major risk factor for noncommunicable diseases such as cardiovascular diseases, cancer and diabetes. It has been estimated that approximately 3.2 million deaths each year are attributable to insufficient levels of physical activity. We evaluated the available evidence from Cochrane systematic reviews (CSRs) on the effectiveness of exercise/physical activity for various health outcomes. METHODS Overview and meta-analysis. The Cochrane Library was searched from 01.01.2000 to issue 1, 2019. No language restrictions were imposed. Only CSRs of randomised controlled trials (RCTs) were included. Both healthy individuals, those at risk of a disease, and medically compromised patients of any age and gender were eligible. We evaluated any type of exercise or physical activity interventions; against any types of controls; and measuring any type of health-related outcome measures. The AMSTAR-2 tool for assessing the methodological quality of the included studies was utilised. RESULTS Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I2 = 26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES) = 0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I2 = 74.3%; PI -0.18, 0.53], MES = 0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions. CONCLUSION There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns. TRIAL REGISTRATION Registered in PROSPERO ( CRD42019120295 ) on 10th January 2019.
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Affiliation(s)
- Pawel Posadzki
- Kleijnen Systematic Reviews Ltd., York, UK
- Nanyang Technological University, Singapore, Singapore
| | - Dawid Pieper
- Institute for Research in Operative Medicine, Witten/Herdecke University, Witten, Germany.
| | - Ram Bajpai
- School of Medicine, Keele University, Staffordshire, UK
| | - Hubert Makaruk
- Jozef Pilsudski University of Physical Education in Warsaw, Faculty Physical Education and Health, Biala Podlaska, Poland
| | - Nadja Könsgen
- Institute for Research in Operative Medicine, Witten/Herdecke University, Witten, Germany
| | - Annika Lena Neuhaus
- Institute for Research in Operative Medicine, Witten/Herdecke University, Witten, Germany
| | - Monika Semwal
- Health Outcomes Division, University of Texas at Austin College of Pharmacy, Austin, USA
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Dağıstan Akgöz A, Ozer Z, Gözüm S. The effect of lifestyle physical activity in reducing cardiovascular disease risk factors (blood pressure and cholesterol) in women: A systematic review. Health Care Women Int 2020; 42:4-27. [PMID: 33175658 DOI: 10.1080/07399332.2020.1828422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cardiovascular diseases (CVD) are the most important cause of death in older women. Although there is strong evidence in the literature that moderate lifestyle physical activity (PA) is effective in modifiable CVD risk factors, there is limited evidence demonstrating which activities are effective in women. This systematic review was conducted to evaluate the effect of lifestyle PA interventions on CVD risk factors in women. Various databases were searched for English articles from 2000 to 2019. Eight articles met the selection criteria. It is recommended to use different combinations of interventions including moderate PA, to reduce CVD risk factors in women.
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Affiliation(s)
| | - Zeynep Ozer
- Department of Internal Medicine Nursing, Akdeniz Universitesi, Antalya, Turkey
| | - Sebahat Gözüm
- Department of Public Health Nursing, Akdeniz Universitesi, Antalya, Turkey
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Pereira de Lima M, Conopca S, Miyabara R, Romeiro G, Campos LA, Baltatu OC. Cardiovascular and Quality of Life Outcomes of a 3-Month Physical Exercise Program in Two Brazilian Communities. Front Med (Lausanne) 2020; 7:568796. [PMID: 33195316 PMCID: PMC7606879 DOI: 10.3389/fmed.2020.568796] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/15/2020] [Indexed: 12/21/2022] Open
Abstract
Background: A reduction in physical activity levels in older people is associated with declining quality of life and lower cardiorespiratory fitness levels associated with cardiovascular disease outcomes and mortality from all causes. Evidence supports the positive effect of community-based exercise (CEXE) programs on cardiovascular health and quality of life. This research aimed to examine the effects of a 3-month CEXE on health-related quality of life and cardiovascular risk factors in two Brazilian populations. Methods: Adults with an average age of 70.2 ± 5.4 years were recruited to engage in an individually designed group based CEXE program two to three times/week (aerobic exercise, circuit resistance training, and stretching exercises for 1 h each time). Once a week, competitions were held to improve socialization and collaboration capacity among group members. The CEXE group was compared with a sedentary group. Cardiovascular outcomes were blood pressure, triglycerides, body mass index, waist circumference, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, total cholesterol, and glycemia. Health-related quality of life was evaluated using the Short Form-36. Results: Of the cardiovascular outcomes studied, the CEXE program significantly reduced systolic blood pressure [5.7 (95% CI 0.2 to 11.3), p < 0.05] and the triglyceride-HDL-C ratio [0.8 (95% CI 0.05 to 1.5), p < 0.05], whereas HDL-C was significantly increased [4.4 (95% CI 0.02 to 8.8), p < 0.05]. A significant improvement in the Short Form-36 subscales occurred in CEXE but not in the control group: physical functioning score [increase of 24.2 (95% CI 11.8 to 36.5) vs. -9.2 (95% CI -21.5 to 3.2), p < 0.001], physical role functioning score [increase of 35.4 (95% CI 12.8 to 58.0) vs. 16.7 (95% CI -6.0 to 39.3), p < 0.01], and general health score [increase of 23.7 (95% CI: 36.9. to 10.4) vs. 2.4 (95% CI -10.9 to 15.7), p < 0.001]. Conclusion: This study shows that in older adults, a 12-week physical activity program can significantly decrease cardiovascular risk and improve health-related quality of life measures. An important transferable sociocultural strategy of our exercise program was to establish social interactions during and outside the CEXE program.
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Affiliation(s)
- Marcelo Pereira de Lima
- Center of Innovation, Technology and Education (CITE), Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil
- Institute of Biomedical Engineering, Anhembi Morumbi University - Laureate International Universities, Sao Jose dos Campos, Brazil
| | - Severo Conopca
- Center of Innovation, Technology and Education (CITE), Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil
- Physiotherapy School, University Centre of Espirito Santo, Colatina, Brazil
| | - Renata Miyabara
- Center of Innovation, Technology and Education (CITE), Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil
- Department of Health, Santa Rita University Center, São Paulo, Brazil
| | - Geovanna Romeiro
- Institute of Biomedical Engineering, Anhembi Morumbi University - Laureate International Universities, Sao Jose dos Campos, Brazil
| | - Luciana A. Campos
- Center of Innovation, Technology and Education (CITE), Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil
- Institute of Biomedical Engineering, Anhembi Morumbi University - Laureate International Universities, Sao Jose dos Campos, Brazil
- College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Ovidiu C. Baltatu
- Center of Innovation, Technology and Education (CITE), Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil
- Institute of Biomedical Engineering, Anhembi Morumbi University - Laureate International Universities, Sao Jose dos Campos, Brazil
- College of Medicine & Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
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Byrkjeland R, Stensæth KH, Anderssen S, Njerve IU, Arnesen H, Seljeflot I, Solheim S. Effects of exercise training on carotid intima-media thickness in patients with type 2 diabetes and coronary artery disease. Influence of carotid plaques. Cardiovasc Diabetol 2016; 15:13. [PMID: 26801098 PMCID: PMC4724125 DOI: 10.1186/s12933-016-0336-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 01/14/2016] [Indexed: 02/08/2023] Open
Abstract
Background Carotid intima-media thickness (cIMT) holds prognostic information for future cardiovascular disease and is associated with the extent of coronary atherosclerosis. We investigated the effect of exercise on cIMT progression in patients with both type 2 diabetes and coronary artery disease (CAD). Methods Patients with type 2 diabetes and CAD (n = 137) were randomized to exercise training or standard follow-up. The 12 month exercise program contained 150 min weekly of combined aerobic and resistance training. High-resolution ultrasonography of the distal part of the common carotid artery (CCA) was performed to measure cIMT before and after the intervention. The CCA and the carotid bulb were scanned for the presence of atherosclerotic plaques. Differences in changes between the randomized groups were calculated by one-way ANCOVA. Results In the total population no difference in changes of cIMT from baseline to 12 months was observed between the exercise group and controls [−0.016 mm (95 % CI −0.037 to 0.006) vs. −0.007 mm (95 % CI −0.029 to 0.015), p = 0.57]. However, there was a significant interaction between the effect of exercise training and the presence of carotid plaques (p = 0.013), and significant reduced cIMT was demonstrated in the exercise group compared with controls in patients without identified carotid plaques (n = 65) [−0.034 mm (95 % CI −0.060 to 0.008) vs. 0.013 mm (95 % CI −0.011 to 0.038), p = 0.010]. Conclusion One year of exercise training in patients with type 2 diabetes and CAD did not significantly change cIMT progression. However, in patients without identified carotid plaques, beneficial effect of exercise training on cIMT progression was demonstrated.
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Affiliation(s)
- Rune Byrkjeland
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, PO box 4956, Nydalen, 0424, Oslo, Norway. .,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | | | - Sigmund Anderssen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
| | - Ida U Njerve
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, PO box 4956, Nydalen, 0424, Oslo, Norway. .,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Harald Arnesen
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, PO box 4956, Nydalen, 0424, Oslo, Norway. .,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ingebjørg Seljeflot
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, PO box 4956, Nydalen, 0424, Oslo, Norway. .,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Svein Solheim
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, PO box 4956, Nydalen, 0424, Oslo, Norway. .,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway.
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Cardiorespiratory fitness and physical activity in children with cancer. Support Care Cancer 2015; 24:2259-2268. [PMID: 26581899 PMCID: PMC4805718 DOI: 10.1007/s00520-015-2993-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 10/26/2015] [Indexed: 12/21/2022]
Abstract
Purpose This study assessed cardiorespiratory fitness (CRF), physical activity (PA), and sedentary behavior (SB), as well as factors associated with these outcomes in children during or shortly after cancer treatment. Methods Cross-sectionally, CRF data, obtained by the cardiopulmonary exercise test, and PA and SB data, obtained by an accelerometer, were assessed in children with cancer (8–18 years old). Linear regression models were used to determine associations between CRF, PA, or SB and patient characteristics. Results Among 60 children with cancer, mean age 12.6 years, 35 boys, 28 % were during cancer treatment. CRF, reported as the z score of VO2peak, showed that 32 children had a VO2peakz score which was −2 below the predicted value. CRF was significantly associated with PA and SB: each additional activity count per minute resulted in 0.05 ml/kg/min VO2peak increase and each additional minute sedentary reduced VO2peak by 0.06 ml/kg/min. Multiple linear regression models of PA and SB showed that decreased activity was significantly associated with higher age, being fatigued, being during childhood cancer treatment (p < 0.001), or having a higher percentage of fat mass. The multiple linear regression model showed that lower CRF was significantly associated with increased fatigue, being during cancer treatment, having a higher percentage of fat mass, and lower belief of own athletic competence (p < 0.001). Conclusion This study revealed that children during or shortly after cancer treatment have low CRF scores. The most inactive children had a higher fat mass, were fatigued, older, and during childhood cancer treatment. Unexpectedly, treatment-related factors showed no significant association with activity behavior.
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Netz Y, Zijlstra W. EURAPA moves to open access: Research trends and challenges in physical activity in old age. Eur Rev Aging Phys Act 2015; 12:1. [PMID: 26865865 PMCID: PMC4743859 DOI: 10.1186/s11556-015-0149-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 08/25/2015] [Indexed: 01/04/2023] Open
Affiliation(s)
- Yael Netz
- The European Group for Research into Elderly and Physical Activity, Wingate College, Wingate Institute, Netanya, 4290200 Israel
| | - Wiebren Zijlstra
- Institute of Movement and Sport Gerontology, German Sport University, Cologne, 50933 Germany
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Johnson EJ, Dieter BP, Marsh SA. Evidence for distinct effects of exercise in different cardiac hypertrophic disorders. Life Sci 2015; 123:100-6. [PMID: 25632833 PMCID: PMC4339313 DOI: 10.1016/j.lfs.2015.01.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 12/05/2014] [Accepted: 01/02/2015] [Indexed: 02/08/2023]
Abstract
Aerobic exercise training (AET) attenuates or reverses pathological cardiac remodeling after insults such as chronic hypertension and myocardial infarction. The phenotype of the pathologically hypertrophied heart depends on the insult; therefore, it is likely that distinct types of pathological hypertrophy require different exercise regimens. However, the mechanisms by which AET improves the structure and function of the pathologically hypertrophied heart are not well understood, and exercise research uses highly inconsistent exercise regimens in diverse patient populations. There is a clear need for systematic research to identify precise exercise prescriptions for different conditions of pathological hypertrophy. Therefore, this review synthesizes existing evidence for the distinct mechanisms by which AET benefits the heart in different pathological hypertrophy conditions, suggests strategic exercise prescriptions for these conditions, and highlights areas for future research.
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Affiliation(s)
- Emily J Johnson
- Graduate Program in Pharmaceutical Sciences, College of Pharmacy, Washington State University, Spokane, WA, USA
| | - Brad P Dieter
- Graduate Program in Movement Sciences, College of Education, University of Idaho, Moscow, ID, USA; Section of Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, WA, USA
| | - Susan A Marsh
- Section of Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, WA, USA.
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