1
|
Opheim LØ, Engeskaug I, Bjerre Trent PK, Thorsen L, Staff AC, Nordskar NJ, Utne I, Hagen M, Eriksson AGZ. Associations between modifiable lifestyle factors and health-related quality of life among endometrial carcinoma survivors - A cross-sectional study. Gynecol Oncol 2023; 179:52-62. [PMID: 37924595 DOI: 10.1016/j.ygyno.2023.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE To explore possible associations between modifiable lifestyle factors and health-related quality of life (HRQoL) in endometrial carcinoma survivors by assessing differences in HRQoL between survivors meeting and not meeting the World Health Organization's (WHO) recommendations regarding physical activity, BMI, and smoking. METHODS This was a cross-sectional population-based study in women having undergone surgery for assumed early-stage endometrial carcinoma. Thresholds for clinical importance based on the EORTC QoL working group were used to interpret scores. Effect size (ES) was interpreted as small (d = 0.2-0.49), medium (d = 0.5-0.8), and large (d > 0.8). RESULTS In total, 1200 evaluable women were included. Meeting physical activity recommendations and BMI <25 kg/m2 was associated with significantly better global health status, (ES) = 0.18 and ES = -0.11, respectively. On multivariate analysis, women meeting physical activity recommendations had significantly higher scores on physical- (ES = 0.31), role- (ES = 0.15), and social functioning (ES = 0.15), and lower levels of fatigue (ES = -0.16), pain (ES = -0.10), and appetite loss (ES = -0.15) (all p < 0.05) compared to non-meeting survivors. Participants with BMI ≥25 kg/m2 had lower scores for social functioning (ES = -0.10), and higher levels of pain (ES = 0.13) and dyspnea (ES = 0.12) (all p < 0.05) compared to those with BMI <25 kg/m2. Smokers had lower scores for emotional functioning (ES = -0.09) and higher levels of diarrhea (ES = 0.10) (all p < 0.05) compared to non-smokers. CONCLUSION Meeting WHO recommendations for modifiable life-style factors is associated with better HRQoL among endometrial carcinoma survivors: Being sufficiently physical active and having a BMI <25 kg/m2 are significantly associated with better self-reported global health status. All modifiable factors are associated with better functioning, and reduced symptom-burden.
Collapse
Affiliation(s)
- Linn Ø Opheim
- Department of Gynecologic Oncology, Division of Cancer Medicine, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway; Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ida Engeskaug
- Department of Gynecologic Oncology, Division of Cancer Medicine, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway; Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Pernille K Bjerre Trent
- Department of Gynecologic Oncology, Division of Cancer Medicine, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Nina Jebens Nordskar
- Section of Gynecologic Oncology, Dept. of Obstetrics and Gynecology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Milada Hagen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ane Gerda Z Eriksson
- Department of Gynecologic Oncology, Division of Cancer Medicine, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| |
Collapse
|
2
|
Association of obesity and cardiovascular disease and progress in pharmacotherapy: what is next for obesity? Int J Rehabil Res 2023; 46:14-25. [PMID: 36727942 DOI: 10.1097/mrr.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Obesity has recently emerged as one of the most severe health concerns. Obesity is a key autonomous risk factor for heart failure and contributes to cardiovascular disease (CVD) risk factors such as hypertension, type 2 diabetes, and metabolic abnormalities. Obesity is caused by a metabolic imbalance, which occurs when calories burnt are fewer than the number of calories consumed. There are several pathways accountable for the adverse impacts of obesity on the cardiovascular system. Inflammatory cell infiltration develops in the adipose tissue, the pancreas, and other issues similar to the progression of obesity. Inflammation is triggered by immune cells that invade dysfunctional adipose tissue. The atherosclerotic inflammation phase, related to obesity, induces coronary calcification. Obesity is linked to elevated levels of leptin and high blood pressure. Leptin causes systemic vasoconstriction, sodium retention, and increased blood pressure by influencing the synthesis of nitric oxide and activating the sympathetic nervous system. Obesity is a well-known risk factor for CVD and is one of the leading causes of the greater risk of diseases, including dyslipidemia, hypertension, depression, metabolic syndrome, atrial fibrillation, and heart failure in adults and children. When used with dietary improvements, antiobesity drugs improve the probability of experiencing clinically healthy (5%) weight loss. This review aimed to address the consequences of obesity on cardiac structure and function, risk factors, the impact of the obesity paradox, pharmacological treatment strategies for managing and recommended exercise and diet.
Collapse
|
3
|
The combined role of obesity and depressive symptoms in the association with ischaemic heart disease and its subtypes. Sci Rep 2022; 12:14419. [PMID: 36002471 PMCID: PMC9402922 DOI: 10.1038/s41598-022-18457-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/11/2022] [Indexed: 11/08/2022] Open
Abstract
This cross-sectional study aimed to explore the combined effects of depression and obesity on ischemic heart disease and its subtypes. Data from the National Health and Nutrition Examination Survey 2007–2018 were used. A total of 29,050 participants aged 20 years or older were included in the analyses. Logistic regression models and restricted cubic spline models were applied to evaluate the associations between depression symptom and ischemic heart disease. There were significant correlations between depressive symptoms and ischemic heart disease [OR and 95% CI 2.44 (1.91, 3.10)] and its subtypes: coronary heart disease [2.32 (1.67, 3.23)], heart attack [2.18 (1.71, 2.78)], and angina [2.72 (1.96, 3.79)].The synergistic effects of depression with obesity (BMI ≥ 30) and central obesity (waist ≥ 102/88 cm for men/women) on ischemic heart disease were estimated and expressed using the relative excess risk due to interaction (RERI) and the attributable proportion due to interaction (AP). The RERI and AP with 95% CIs of depression and central obesity for ischemic heart disease were 1.10 (0.01, 2.19) and 0.35 (0.06, 0.64). When we analysed the other three subtypes of ischemic heart disease, we only found depressive symptoms and central obesity could have a meaningful synergistic effect on heart attack (RERI: 0.84 (− 0.28, 1.96) AP: (0.31 (0.00, 0.69)).
Collapse
|
4
|
Depressive Symptoms After Acute Myocardial Infarction and Its Association With Low Functional Capacity and Physical Activity. J Cardiopulm Rehabil Prev 2022; 42:442-448. [PMID: 35383650 DOI: 10.1097/hcr.0000000000000689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Depressive symptoms after acute myocardial infarction (AMI) are related with adverse health outcomes. However, the risk factors and course of depressive symptoms after AMI have not been widely investigated, especially in Asian populations. We aimed to evaluate changes in the prevalence of depressive symptoms and the associated risk factors at 3 mo after AMI. We also investigated the associations among functional capacity, physical activity (PA), and depressive symptoms. METHODS This cross-sectional study was conducted for 1545 patients who were admitted for AMI and referred to cardiac rehabilitation (CR) between August 2015 and March 2019. Of these patients, 626 patients completed the Patient Health Questionnaire-9 (PHQ-9), the Korean Activity Scale Index (KASI), and the International Physical Activity Questionnaire (IPAQ) 3 mo following AMI. A PHQ-9 score of ≥5 was considered to indicate depressive symptoms. RESULTS The prevalence of depressive symptoms was 30% at baseline and decreased to 12% at 3 mo after AMI. Depressive symptoms were significantly associated with low functional capacity (OR = 2.20, P = .004) and unemployment status (OR = 1.82, P = .023). After adjusting for variables including functional capacity, depressive symptoms exhibited a significant relationship with low PA after AMI (OR = 1.80, P = .023). CONCLUSION Systematic screening and treatment for depressive symptoms and efforts to promote CR may help to improve PA and functional capacity in Korean patients with AMI. Such efforts may aid in reducing the depressive symptoms and related adverse outcomes.
Collapse
|
5
|
Bojanić I, Sund ER, Sletvold H, Bjerkeset O. Prevalence trends of depression and anxiety symptoms in adults with cardiovascular diseases and diabetes 1995-2019: The HUNT studies, Norway. BMC Psychol 2021; 9:130. [PMID: 34465377 PMCID: PMC8406588 DOI: 10.1186/s40359-021-00636-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background Symptoms of depression and anxiety are common in adults with cardiovascular diseases (CVDs) and diabetes mellitus (DM). The literature on depression and anxiety in CVDs and DM populations is extensive; however, studies examining these relationships over time, directly compared to adults without these conditions, are still lacking. This study aimed to investigate trends in depression and anxiety symptom prevalence over more than 20 years in adults with CVDs and DM compared to the general population. Methods We used data from the population-based Trøndelag Health Study (HUNT), Norway, including adults (≥ 20 years) from three waves; the HUNT2 (1995–97; n = 65,228), HUNT3 (2006–08; n = 50,800) and HUNT4 (2017–19; n = 56,042). Depressive and anxiety symptom prevalence was measured independently by the Hospital Anxiety and Depressions scale (HADS) in sex-stratified samples. We analyzed associations of these common psychological symptoms with CVDs and DM over time using multi-level random-effects models, accounting for repeated measurements and individual variation. Results Overall, the CVDs groups reported higher levels of depression than those free of CVDs in all waves of the study. Further, depressive and anxiety symptom prevalence in adults with and without CVDs and DM declined from HUNT2 to HUNT4, whereas women reported more anxiety than men. Positive associations of depression and anxiety symptoms with CVDs and DM in HUNT2 declined over time. However, associations of CVDs with depression symptoms remained over time in men. Moreover, in women, DM was associated with increased depression symptom risk in HUNT2 and HUNT4. Conclusions Depression and anxiety symptoms are frequent in adults with CVDs. Further, our time trend analysis indicates that anxiety and depression are differentially related to CVDs and DM and sex. This study highlights the importance of awareness and management of psychological symptoms in CVDs and DM populations. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00636-0.
Collapse
Affiliation(s)
- Ivana Bojanić
- Faculty of Nursing and Health Sciences, Nord University, PB 93, 7601, Levanger, Norway.
| | - Erik R Sund
- Faculty of Nursing and Health Sciences, Nord University, PB 93, 7601, Levanger, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology, NTNU, Levanger, Norway.,Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Hege Sletvold
- Faculty of Nursing and Health Sciences, Nord University, PB 93, 7601, Levanger, Norway
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, PB 93, 7601, Levanger, Norway.,Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| |
Collapse
|
6
|
Varghese TP, Kumar AV, Varghese NM, Chand S. Depression Related Pathophysiologies Relevant in Heart Disease: Insights into the Mechanism Based on Pharmacological Treatments. Curr Cardiol Rev 2020; 16:125-131. [PMID: 31775601 PMCID: PMC7460711 DOI: 10.2174/1573403x15666191127104520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/05/2019] [Accepted: 11/21/2019] [Indexed: 01/08/2023] Open
Abstract
Depressive symptoms are highly prevalent in patients with cardiac diseases. Co-morbid Depression in cardiac patients causes a significant reduction in health-related quality of life for the patients and inflicts an economic burden on the society. Two types of mechanisms that may explain the link between depression and cardiac diseases are the psychosocial and physiopathological mechanisms. Physiopathological mechanisms are direct biological mechanisms, which include hyperactivity of non-adrenergic and Hypothalamic Pituitary Adrenal Axis (HPA), abnormal platelet activation, endothelial dysfunction, and inflammatory process. Psychosocial factors include behavioral or lifestyle factors like smoking alcoholism and physical inactivity. Pharmacologic and therapeutic interventions are effective at reducing symptoms of depression in patients with cardiac disorders. Among pharmacological treatment, SSRIs seems to be effective for the reduction of depressive symptoms among patients with cardiac disorders because of their good efficacy and minimal cardiovascular side effects. Mechanisms of action of SSRI’s in depressive patients with cardiac disorders are associated with their ability to reduce inflammation, platelet, and endothelial dysfunction. This review focuses on the potential pathophysiological and psychosocial links between cardiac diseases and depression, the treatment options, and the importance of routine screening of depressive symptoms in cardiac settings.
Collapse
Affiliation(s)
- Treesa P Varghese
- Department of Pharmacy Practice, NGSMIPS, Nitte (Deemed to be University), Mangaluru, Karnataka 575018, India
| | - Anand V Kumar
- Department of Pharmacology, JSS College of Pharmacy, Ooty, Tamilnadu, India
| | - Nila M Varghese
- Department of Pharmaceutics, St. Johnes College of Pharmaceutical Sciences and Research, Idukki, Kerala, India
| | - Sharad Chand
- Department of Pharmacy Practice, NGSMIPS, Nitte (Deemed to be University), Mangaluru, Karnataka 575018, India
| |
Collapse
|
7
|
De Bortoli MM, Fell AKM, Svendsen MV, Henneberger PK, Kongerud J, Oellingrath IM. Lifestyle, sick leave and work ability among Norwegian employees with asthma-A population-based cross-sectional survey conducted in Telemark County, Norway. PLoS One 2020; 15:e0231710. [PMID: 32302337 PMCID: PMC7164599 DOI: 10.1371/journal.pone.0231710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/30/2020] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate whether physician-diagnosed asthma modifies the associations between multiple lifestyle factors, sick leave and work ability in a general working population. Methods A cross-sectional study was conducted in Telemark County, Norway, in 2013. A sample of 16 099 respondents completed a self-administered questionnaire. We obtained complete data on lifestyle, work ability and sick leave for 10 355 employed persons aged 18–50 years. We modelled sick leave and work ability using multiple logistic regression, and introduced interaction terms to investigate whether associations with lifestyle factors were modified by asthma status. Results Several lifestyle risk factors and a multiple lifestyle risk index were associated with sick leave and reduced work ability score among persons both with and without physician-diagnosed asthma. A stronger association between lifestyle and sick leave among persons with asthma was confirmed by including interaction terms in the analysis: moderate lifestyle risk score * asthma OR = 1.4 (95% CI 1.02–2.1); high lifestyle risk score * asthma OR = 1.6 (95% CI 1.1–2.3); very high lifestyle risk score * asthma OR = 1.6 (95% CI 0.97–2.7); obesity * asthma OR = 1.5 (95% CI 1.02–2.1); past smoking * asthma OR = 1.4 (95% CI 1.01–1.9); and current smoking * asthma OR = 1.4 (95% CI 1.03–2.0). There was no significant difference in the association between lifestyle and work ability score among respondents with and without asthma. Conclusions In the present study, we found that physician-diagnosed asthma modified the association between lifestyle risk factors and sick leave. Asthma status did not significantly modify these associations with reduced work ability score. The results indicate that lifestyle changes could be of particular importance for employees with asthma.
Collapse
Affiliation(s)
- Marit Müller De Bortoli
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern, Porsgrunn, Vestfold and Telemark, Norway
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Vestfold and Telemark, Norway
- * E-mail:
| | - Anne Kristin Møller Fell
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Vestfold and Telemark, Norway
| | - Martin Veel Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Vestfold and Telemark, Norway
| | - Paul K. Henneberger
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, United States of America
| | - Johny Kongerud
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Inger M. Oellingrath
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern, Porsgrunn, Vestfold and Telemark, Norway
| |
Collapse
|
8
|
Yeom HE, Lee J. Gender Difference in the Relationship Among Family Function, Health Behavior, and Stress in Midlife. Int J Aging Hum Dev 2020; 91:476-500. [DOI: 10.1177/0091415019896225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study investigated whether there are gender-based differences in the process wherein family functions influence stress through various health behaviors in midlife adults. A cross-sectional study was done using a convenience sample of 250 middle-aged Koreans. Data on the family APGAR index, four health behaviors (i.e., seeking health information, physical activity, healthy diet, and social interaction), and stress were collected by a self-administered survey and analyzed using hierarchical multiple linear regression analyses and a PROCESS macro for SPSS. The study results showed that an indirect effect of family function on stress through health behaviors was significant in women, whereas such a relationship was not shown in men. This study found that the process wherein family function is linked with stress through health behaviors differs by gender. Developing gender-specific interventions is essential to decrease stress in midlife adults.
Collapse
Affiliation(s)
- Hyun-E Yeom
- College of Nursing, Chungnam National University, Jung-gu, Dae-jeon, South Korea
| | - Jungmin Lee
- Youth Independence & Competencies Research Office, National Youth Policy Institute, Sicheong-daero, Sejong-si, South Korea
| |
Collapse
|
9
|
The effects of cardiac rehabilitation on haemodynamic parameters measured by impedance cardiography in patients with coronary artery disease. VOJNOSANIT PREGL 2020. [DOI: 10.2298/vsp200810126s] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background / Aim. Well-organized cardiovascular rehabilitation (CVR) reduces
cardiovascular burden by influencing cardiovascular risk factors, improving
the quality of life and reducing mortality and hospital readmission.
However, its effects on hemodynamic status are largely unknown. The aim of
our study was to evaluate the influence of three-week CVR program on
hemodynamic status and to investigate if there is a correlation between
physical strain tolerance and hemodynamic parameters measured by impedance
cardiography (ICG) before and after CVR program in patients with coronary
artery disease. Methods. Fifty-two patients attended a three-week CVR
program. At the beginning and at the end of rehabilitation program
laboratory tests, exercise stress tests (EST) and ICG measurements were
taken. Results. Patients showed better strain tolerance on the second
exercise stress test (EST2) by achieving higher strain level (Z=2,315;
p=0,021) and longer duration of test (Z=2,305; p=0,021). There was a strong
positive correlation between the level of EST2 and cardiac output (CO)
(r=0,538; p<0,001) and stroke volume (SV) (r=0,380; p=0,017) on the second
ICG (ICG2). Also, there was a strong negative correlation between EST2 level
and systemic vascular resistance (SVR) (r=-0,472; p=0,002) and SVR index
(SSVRI) (r=-0,407; p=0,010) on ICG2. There was a strong positive correlation
between EST2 duration and CO (r=0.517; p=0.001) as well as between EST2
duration and SV (r=0.340; p=0.034), and a strong negative correlation
between EST2 duration and SVR (r=-0.504; p=0.001) as well as between EST2
duration and SVRI (r=-0.448; p=0.004), according to ICG2. Conclusion. Our
study showed that a well-designed CVR program can lead to better physical
strain tolerance. Furthermore, CVR led to a significant positive correlation
between EST and cardiac output as well as between EST and stroke volume
measured by ICG. On the other hand, there was a significant negative
correlation between EST and vascular related parameters according to ICG at
the end of the CVR program.
Collapse
|
10
|
O'Keefe EL, O'Keefe JH, Lavie CJ. Exercise Counteracts the Cardiotoxicity of Psychosocial Stress. Mayo Clin Proc 2019; 94:1852-1864. [PMID: 31451292 DOI: 10.1016/j.mayocp.2019.02.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/15/2019] [Accepted: 02/19/2019] [Indexed: 12/12/2022]
Abstract
Physical inactivity and psychosocial stress are prevalent in residents of the United States. The purpose of this article is to review the interaction between these 2 conditions and examine the effects of exercise on stress and cardiovascular (CV) health. A query of scientific references between 1974 to 2018 was performed using the PubMed search engine accessing the MEDLINE database using the search terms psychosocial stress, CV disease (CVD), physical activity, exercise, cardiac rehabilitation, and team sports. Psychosocial stress is a strong independent risk factor for adverse CV events. Conversely, people who experience CV events subsequently have drastically elevated rates of new-onset mental health disorders, including depression and anxiety. Psychosocial stress and CVD often trigger self-reinforcing feedback loops that can worsen mental health and cardiac prognosis. Exercise predictably improves CV health and prognosis and also is effective at lowering levels of psychosocial stress. Group exercise in particular seems to provide social support while at the same time boosting fitness levels and, thus, may be the single most important intervention for patients with concomitant CVD and emotional stress. Collaborative physical activity, such as group exercise, team sports, interactive physical play, and cardiac rehabilitation programs, have the potential to improve mental health and CV prognosis.
Collapse
Affiliation(s)
- Evan L O'Keefe
- Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - James H O'Keefe
- University of Missouri-Kansas City and Saint Luke's Mid America Heart Institute, New Orleans, LA
| | - Carl J Lavie
- Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, New Orleans, LA.
| |
Collapse
|
11
|
Kachur S, Lavie CJ, Morera R, Ozemek C, Milani RV. Exercise training and cardiac rehabilitation in cardiovascular disease. Expert Rev Cardiovasc Ther 2019; 17:585-596. [DOI: 10.1080/14779072.2019.1651198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Sergey Kachur
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
| | - Carl J. Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
| | - Rebecca Morera
- Department of Graduate Medical Education, Ocala Regional Medical Center, Ocala, FL, USA
| | - Cemal Ozemek
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Richard V. Milani
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
| |
Collapse
|
12
|
Sever S, Harrison AS, Golder S, Doherty P. Determinants of depression in patients with comorbid depression following cardiac rehabilitation. Open Heart 2019; 6:e000973. [PMID: 31168379 PMCID: PMC6519417 DOI: 10.1136/openhrt-2018-000973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/23/2019] [Accepted: 03/04/2019] [Indexed: 11/08/2022] Open
Abstract
Background A prior history of depression, at the point patients start cardiac rehabilitation (CR), is associated with poor outcomes; however, little is known about which factors play a part in determining the extent of benefit following CR. Therefore, we aim to identify and evaluate determinants of CR depression outcomes in patients with comorbid depression. Methods An observational study of routine practice using the British Heart Foundation National Audit of Cardiac Rehabilitation data between April 2012 and March 2017. Baseline characteristics were examined with independent samples t-test and χ2 test. A binary logistic regression was used to predict change in depression outcome following CR. Results The analysis included 2715 CR participants with depression history. The determinants of Hospital Anxiety and Depression Scale (HADS) depression measurement post-CR were higher total number of comorbidities (OR 0.914, 95% CI 0.854 to 0.979), a higher HADS anxiety score (OR 0.883, 95% CI 0.851 to 0.917), physical inactivity (OR 0.707, 95% CI 0.514 to 0.971), not-smoking at baseline (OR 1.774, 95% CI 1.086 to 2.898) and male gender (OR 0.721, 95% CI 0.523 to 0.992). Conclusion Baseline characteristics of patients with comorbid depression such as higher anxiety, higher total number of comorbidities, smoking, physical inactivity and male gender were predictors of their depression levels following CR. CR programmes need to be aware of comorbid depression and these related patient characteristics associated with better CR outcomes.
Collapse
Affiliation(s)
| | | | - Su Golder
- Health Sciences, University of York, York, UK
| | | |
Collapse
|
13
|
Oellingrath IM, De Bortoli MM, Svendsen MV, Fell AKM. Lifestyle and work ability in a general working population in Norway: a cross-sectional study. BMJ Open 2019; 9:e026215. [PMID: 30948597 PMCID: PMC6500250 DOI: 10.1136/bmjopen-2018-026215] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/18/2019] [Accepted: 01/28/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the association between multiple lifestyle-related risk factors (unhealthy diet, low leisure-time physical activity, overweight/obesity and smoking) and self-rated work ability in a general working population. SETTING Population-based cross-sectional study, in Telemark County, Norway, 2013. PARTICIPANTS A random sample of 50 000 subjects was invited to answer a self-administered questionnaire and 16 099 responded. Complete data on lifestyle and work ability were obtained for 10 355 participants aged 18-50 years all engaged in paid work during the preceding 12 months. OUTCOME MEASURE Work ability was assessed using the Work Ability Score (WAS)-the first question in the Work Ability Index. To study the association between multiple lifestyle risk factors and work ability, a lifestyle risk index was constructed and relationships examined using multiple logistic regression analysis. RESULTS Low work ability was more likely among subjects with an unhealthy diet (ORadj 1.3, 95% CI 1.02 to 1.5), inactive persons (ORadj 1.4, 95% CI 1.2 to 1.6), obese respondents (ORadj 1.5, 95% CI 1.3 to 1.7) and former and current smokers (ORadj 1.2, 95% CI 1.1 to 1.4 and 1.3, 95% CI 1.2 to 1.5, respectively). An additive relationship was observed between the lifestyle risk index and the likelihood of decreased work ability (moderate-risk score: ORadj 1.3; 95% CI 1.1 to 1.6; high-risk score: ORadj 1.9; 95% CI 1.6 to 2.2; very high risk score: ORadj 2.4; 95% CI 1.9 to 3.0). The overall population attributable fraction (PAF) of low work ability based on the overall risk index was 38%, while the PAFs of physical activity, smoking, body mass index and diet were 16%, 11%, 11% and 6%, respectively. CONCLUSIONS Lifestyle risk factors were associated with low work ability. An additive relationship was observed. The findings are considered relevant to occupational intervention programmes aimed at prevention and improvement of decreased work ability.
Collapse
Affiliation(s)
- Inger M Oellingrath
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Porsgrunn, Norway
| | - Marit Müller De Bortoli
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Porsgrunn, Norway
| | - Martin Veel Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | | |
Collapse
|
14
|
Bahall M. Prevalence and associations of depression among patients with cardiac diseases in a public health institute in Trinidad and Tobago. BMC Psychiatry 2019; 19:4. [PMID: 30616551 PMCID: PMC6323684 DOI: 10.1186/s12888-018-1977-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 12/07/2018] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Psychosocial issues are major determinants as well as consequences of cardiovascular disease (CVD). This study sought to assess the prevalence and identify factors associated with depression among patients with cardiac disease in a public health institute in Trinidad and Tobago. METHODS A cross-sectional study was conducted with a convenience sample of 388 hospitalised, stable, adult patients with cardiac disease admitted in the only tertiary public health institute in South Trinidad. Patients were identified and interviewed 3 to 5 days after admission using a questionnaire comprising questions on demographic, medical, and lifestyle issues and the 9-item Patient Health Questionnaire (PHQ-9). RESULTS The prevalence of clinically significant depression (PHQ-9 > 9) among hospitalised patients with cardiac disease was 40.0%. However, the prevalence of non-minimal depression (PHQ-9 ≥ 5) in this study was 78.4%. It was greater among women (83.1%) than among men (72.9%). Non-minimal depression was associated with sex (p = 0.015), employment status (p = 0.007), hypertension (p = 0.017), stressful life (p ≤ 0.001), feelings of depression (p ≤ 0.001), regular exercise (p ≤ 0.001), and living alone (p = 0.006). Age, ethnicity, education level, income, or religious affiliations were not associated (p > 0.05) with depression. Participants diagnosed with depression commonly reported feeling tired (81.2%), having trouble sleeping (74.7%), and moving/speaking slowly (73.5%). Patients with self-claimed depression (past or current) were four times more likely to have depression and those with self-reported stress and loneliness were twice as likely to have depression. Employed patients and those who exercised regularly were approximately 50% less likely to have depression. CONCLUSIONS Clinical depression prevalence among hospitalised patients with cardiac disease was 40.0%. Approximately twice as many (78.4%) had non-minimal depression, with higher prevalence among women. Employment, sex, hypertension, stressful life, feelings of depression, regular exercise, and living alone were associated with non-minimal depression. Patients with self-claimed depression, stress, and those living alone had a much higher likelihood of having depression, while those who were employed and exercised regularly were approximately half as likely to have depression.
Collapse
Affiliation(s)
- Mandreker Bahall
- School of Medicine and Arthur Lok Jack Graduate School of Business, University of the West Indies, St. Augustine, House #57 LP 62, Calcutta Road Number 3, McBean, Couva Trinidad, Trinidad and Tobago.
| |
Collapse
|
15
|
Sever S, Golder S, Doherty P. Factors associated with acute depressive symptoms in patients with comorbid depression attending cardiac rehabilitation. BMC Cardiovasc Disord 2018; 18:230. [PMID: 30526515 PMCID: PMC6288923 DOI: 10.1186/s12872-018-0974-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 12/03/2018] [Indexed: 12/01/2022] Open
Abstract
Background The literature suggests that comorbid depression, defined in this paper as a history of depression prior to a cardiovascular event, has an impact on later onset depression as well as constituting increased risk of mortality and adverse cardiac events. However, which factors are associated with depression, specifically in patients with comorbid depression, is unclear. Therefore, this paper investigates the factors associated with depression in patients with comorbid depression attending cardiac rehabilitation (CR). Methods This observational study used routinely collected data from the British Heart Foundation National Audit of Cardiac Rehabilitation for the time period between April 2012 and March 2017. CR participants with comorbid depression were selected as the study population. An independent t-test and chi-square test were used to compare the association between acute depression symptoms and baseline characteristics in this population. Results A total of 2715 CR patients with comorbid depression were analysed. Characteristics associated with acute depressive symptoms in patients with comorbid depression were found to be: young age (MD: 2.71, 95% CI 1.91, 3.50), increased number of comorbidities (MD: -0.50, 95% CI -0.66, − 0.34), increased weight (MD: -1.94, 95% CI -3.35, − 0.52), high BMI (MD: -1.94, 95% CI -3.35, − 0.52), HADS anxiety (MD: -5.17, 95% CI -5.47, − 4.87), comorbid anxiety (52.4%, p < 0.001), physical inactivity (150 min moderate physical activity a week and 75 min vigorous exercise a week; 27.5%, p < 0.001; 5.6%, p < 0.001 respectively), smoking (12.7%, p < 0.001), and being less likely to be partnered (63.6%, p < 0.001). Conclusion The study demonstrated the association between a variety of clinical and socio-demographic factors and depression. The findings of the research indicated that, at CR baseline assessment, caution must be taken with patients with comorbid depression, specifically those with higher level depressive symptoms at the start of rehabilitation. Furthermore, their multi-comorbid condition must also be taken into account. Patients with higher depression symptoms and comorbid depression scored five points higher on the HADS anxiety scale in comparison to patients with lower level depression symptoms at the start of CR, which demonstrated that anxiety and depression are interrelated and present together.
Collapse
Affiliation(s)
- Serdar Sever
- Department of Health Sciences, Faculty of Science, University of York, York, UK.
| | - Su Golder
- Department of Health Sciences, Faculty of Science, University of York, York, UK
| | - Patrick Doherty
- Department of Health Sciences, Faculty of Science, University of York, York, UK
| |
Collapse
|
16
|
Caccamo F, Saltini S, Marogna C, Sava V, Carlon R, Vignaga F. The positive impact of a four-week Cardiac Rehabilitation program on depression levels of cardiological patients. COR ET VASA 2018. [DOI: 10.1016/j.crvasa.2017.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
17
|
Altino DM, Nogueira-Martins LA, Gonçalves MAB, Barros ALBLD, Lopes JDL. Impact of anxiety and depression on morbidity and mortality of patients with coronary syndrome. Rev Bras Enferm 2018; 71:3048-3053. [DOI: 10.1590/0034-7167-2017-0709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 05/25/2018] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: Evaluate the impact of anxiety and depression on morbidity and mortality of patients with acute coronary syndrome. Method: Retrospective cohort study, with follow-up of two years, conducted with 94 patients. The morbidity and mortality (readmission, myocardial revascularization, and death) was evaluated immediately after discharge and after one and two years. Anxiety and depression were evaluated by the State-Trait Anxiety Inventory and by Beck’s Depression Inventory. The Kaplan-Meier estimator and the Logrank test were used. The significance level adopted was 0.05. Results: We observed that 76.6% of the patients did not present symptoms of depression or had mild signs, while 78.8% had low to moderate anxiety. The symptoms of depression and anxiety were not related to morbidity (need for MR p=0.098 and 0.56, respectively; readmission p=0.962 and 0.369, respectively) and mortality (p=0.434 and 0.077, respectively). Conclusion: No relationship was found between levels of anxiety and depression with the morbidity and mortality of patients.
Collapse
|
18
|
Kazukauskiene N, Burkauskas J, Macijauskiene J, Duoneliene I, Gelziniene V, Jakumaite V, Brozaitiene J. Mental Distress Factors and Exercise Capacity in Patients with Coronary Artery Disease Attending Cardiac Rehabilitation Program. Int J Behav Med 2018; 25:38-48. [PMID: 28702757 DOI: 10.1007/s12529-017-9675-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE There is still insufficient data on mental distress factors contributing to exercise capacity (EC) improvement before and after cardiac rehabilitation (CR) in patients with coronary artery disease (CAD). The aim of our study was to evaluate the associations between various mental distress factors and EC before and after exercise-based CR (EBCR). METHODS Over 12 months, 223 CAD patients (70% men, mean age 58 ± 9 years) were evaluated for socio-demographic, clinical, and mental distress symptoms as measured by the Hospital Anxiety and Depression scale (HADS), Beck Depression Inventory-II (BDI-II), and Spielberger State-Trait Anxiety Inventory (STAI). Patients were tested for EC at baseline and after EBCR. RESULTS In a multivariate linear regression model, EC before EBCR was associated with HADS anxiety subscale (β = -.186, p = .002) and BDI-II somatic/affective subscale (β = -.249, p < .001). EC after EBCR was associated with HADS anxiety and depression subscales (β = -.198, p < .001; β = -.170, p = .002, respectively) and BDI-II (β = -.258, p < .001). The BDI-II somatic/affective subscale was the best predictor of reduced EC before and after EBCR. CONCLUSIONS Mental distress and somatic/affective symptoms of depression are strongly associated with EC both at the beginning and after EBCR. Analysis of possible mediating or moderating factors was beyond the scope of our study. Future studies should focus on comprehensive evaluation of EC risk factors including other mental distress characteristics, subjectively experienced fatigue, and post-operative CAD symptoms.
Collapse
Affiliation(s)
- Nijole Kazukauskiene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135, Palanga, Lithuania
| | - Julius Burkauskas
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135, Palanga, Lithuania.
| | - Jurate Macijauskiene
- Faculty of Nursing, Lithuanian University of Health Sciences, A. Mickeviciaus str. 9, LT-44313, Kaunas, Lithuania
| | - Inga Duoneliene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135, Palanga, Lithuania
| | - Vaidute Gelziniene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135, Palanga, Lithuania
| | - Vilija Jakumaite
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135, Palanga, Lithuania
| | - Julija Brozaitiene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135, Palanga, Lithuania
| |
Collapse
|
19
|
Caru M, Curnier D, Bousquet M, Kern L. Evolution of depression during rehabilitation program in patients with cardiovascular diseases. Disabil Rehabil 2018; 42:378-384. [PMID: 30299991 DOI: 10.1080/09638288.2018.1499824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Cardiovascular diseases represent the main cause of death in the world. Rehabilitation through exercise is more and more used in cardiac patients. Given that these patients suffer from depressive symptoms, the risk of having recurrent cardiovascular problems increases. Thus, the aim of this study is to identify the effects of a rehabilitation program on the physiological and psychological parameters; with a particular attention on the depression scores between the scales.Methods: Twenty-eight cardiac patients participated in this study during a cardiovascular rehabilitation program. They are tested at their entry and at their exit with an evaluation of their physical fitness on an electromagnetic cycle ergometer and by four depression scales (Beck Depression Inventory, Hospital Anxiety and Depression Scale (HADS), Center for Epidemiologic Studies - Depression and Geriatric Depression Screening).Results: We observe that 21.4-50% of these patients have depressive symptoms, according to depression scales. The women have depression scores significantly higher than the men. The rehabilitation program improves their maximal oxygen consumption and their maximal aerobic power. At the end of the rehabilitation program, our analysis identifies a significant decrease in the depression score for the HADS. Regardless of the physical deconditioning level and of the improvement of the maximal oxygen consumption, our results show an effect of the rehabilitation program on the depression scores. No correlation between the physical deconditioning and the different depression scores is observed.Conclusions: This study shows the importance of measuring depression and its severity to improve the care of patients. Our findings show that between 21.4% and 50% of patients have depressive symptoms which challenges the categorical approach of the self-report depression scales.Implications for rehabilitationDepression and cardiovascular diseases have an impact on the patients' physical fitness.The rehabilitation program, primarily based around exercise, reduces depressive symptoms.As soon as cardiovascular diseases patients enter in a rehabilitation program, the depression should be measured by a psychologist.Taking into account the depressive symptoms of the patients as soon as their cardiac event occurs makes it possible to improve the care of patients.
Collapse
Affiliation(s)
- M Caru
- Department of Psychology, University of Paris Nanterre, Nanterre, France.,Department of Kinesiology, Laboratory of Pathophysiology of EXercise (LPEX), University of Montreal, Montreal, Canada.,Laboratoire EA 4430 - Clinique Psychanalyse Developpement (CliPsyD), University of Paris Ouest Nanterre La Defense, Nanterre, France
| | - D Curnier
- Department of Kinesiology, Laboratory of Pathophysiology of EXercise (LPEX), University of Montreal, Montreal, Canada.,University of Montreal Hospital Research Center (CRCHUM), Montreal, Canada
| | - M Bousquet
- Saint-Orens Cardiovascular and Pulmonary Rehabilitation Center, Saint-Orens-de-Gameville, France
| | - L Kern
- Laboratoire EA 4430 - Clinique Psychanalyse Developpement (CliPsyD), University of Paris Ouest Nanterre La Defense, Nanterre, France.,Department of Science and Technology of Physical Activities and Sports, University of Paris Nanterre, Nanterre, France.,Laboratoire EA 2931 - Centre de recherches sur le sport et le mouvement (CeRSM), UFR STAPS, University of Paris Nanterre, Nanterre, France
| |
Collapse
|
20
|
Carlsen T, Salvesen Ø, Sui X, Lavie CJ, Blair SN, Wisløff U, Ernstsen L. Long-term Changes in Depressive Symptoms and Estimated Cardiorespiratory Fitness and Risk of All-Cause Mortality: The Nord-Trøndelag Health Study. Mayo Clin Proc 2018; 93:1054-1064. [PMID: 29625728 DOI: 10.1016/j.mayocp.2018.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 12/20/2017] [Accepted: 01/12/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess the independent and combined associations of long-term changes in depressive symptoms (DSs) and estimated cardiorespiratory fitness (eCRF) with all-cause mortality. PARTICIPANTS AND METHODS This is a longitudinal cohort study of 15,217 middle-aged and older individuals attending both the second (from August 15, 1995, through June 18, 1997) and third (from October 3, 2006, through June 25, 2008) health surveys of the Nord-Trøndelag Health Study, Norway, and followed until December 31, 2014. Depressive symptoms were estimated using the validated Hospital Anxiety and Depression Scale, and a validated nonexercise model estimated eCRF. Hazard ratios (HRs) were computed using Cox regression. All-cause mortality was ascertained using the Norwegian Cause of Death Registry. RESULTS The mean age was 63.3±8.9 years, and 7932 (52.1%) were women. During the follow-up period of 7.1±1.1 years, 1157 participants (7.6%) died. Multivariable-adjusted analyses revealed that persistently low DSs were independently associated with a 28% risk reduction of all-cause mortality (HR, 0.72; 95% CI, 0.56-0.92; P=.008) as compared with persistently high DSs. Persistently high eCRF independently predicted a 26% lower risk of death (HR, 0.76; 95% CI, 0.66-0.88; P<.001) relative to low eCRF. Analyses of changes in DSs and eCRF revealed that persistently high eCRF combined with decreased or persistently low DSs decreased mortality risk by 49% (HR, 0.51; 95% CI, 0.28-0.91; P=.02) and 47% (HR, 0.53; 95% CI, 0.37-0.76, P=.001), respectively. CONCLUSION Maintaining low DSs and high eCRF was independently associated with a lower risk of all-cause mortality. The lowest mortality risk was observed for persistently high eCRF combined with decreased or persistently low DSs. These results emphasize the effect of preventing DSs and maintaining high CRF on long-term mortality risk, which is potentially important for long-term population health.
Collapse
Affiliation(s)
- Trude Carlsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øyvind Salvesen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - Steven N Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Ulrik Wisløff
- K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Australia
| | - Linda Ernstsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| |
Collapse
|
21
|
Correlates of memory loss and depression among myocardial infarction patients in Al-Qassim, Saudi Arabia. J Saudi Heart Assoc 2018; 30:240-246. [PMID: 29983498 PMCID: PMC6026394 DOI: 10.1016/j.jsha.2018.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/20/2018] [Accepted: 04/18/2018] [Indexed: 11/21/2022] Open
Abstract
Background After myocardial infarction (MI), patients have an elevated risk for depression, which has a negative impact on morbidity and mortality for patients. As depression and memory function are associated, we examined them in the context of one another. Our objectives were to determine the proportion of patients with either depression only, memory loss only, or both depression and memory loss and to examine the correlates with each outcome. Methods This study was a cohort of 264 patients who had myocardial infarction. Data sources included medical records and phone interviews. Results The participants’ mean age was 62 ± 12.2 years and mean body mass index was 28.4 ± 5.8 kg/m2. Of the participants, 6.4% had memory loss alone, 23.17% had depression alone, and 6.1% had combined memory loss and depression. Activity level and poor health were significantly associated with depression only (p < 0.05). Poor health was significantly associated with combined memory loss and depression (p < 0.05). Conclusion Activity level and poor health were identified as correlates of depression as well as combined memory loss and depression. Future studies should aim to improve screening for depression among post-MI patients and develop appropriate interventions to raise the level of activity.
Collapse
|
22
|
Lavie CJ, Sui X, Milani RV. Emotional distress after myocardial infarction: Importance of cardiorespiratory fitness. Eur J Prev Cardiol 2018; 25:906-909. [DOI: 10.1177/2047487318770516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Affiliation(s)
- Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, USA
| | - Xuemei Sui
- Department of Exercise Science, University of South Carolina, USA
| | - Richard V Milani
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, USA
| |
Collapse
|
23
|
Zhu FX, Zhang XY, Ding XK, Han B. Protective effect of regular physical activity on major depressive episodes in patients with early stages of chronic kidney disease. Ren Fail 2018; 39:602-606. [PMID: 28805539 PMCID: PMC6446172 DOI: 10.1080/0886022x.2017.1361833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Previous studies have demonstrated an association between physical activity (PA) and depression in diverse population. The purpose of our study is to examine if PA within the recommended level over time is associated with major depressive episode (MDE) in patients with early stages of chronic kidney disease (CKD) in Mainland China. Patients with stages 2–5 CKD not receiving dialysis were enrolled from a nephrology outpatient clinic between May 2014 and February 2016. Based on the patterns of PA over time, all patients were divided into four groups: persistently active, from inactive to active, from active to inactive, and persistently inactive. An MDE was diagnosed by using the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)-based the Mini International Neuropsychiatric Interview. Among 150 patients, 34 had a current MDE (22.7%) and 116 did not (77.3%). After multivariable adjustment, patients being persistently active had significantly lower odds of having an MDE (odds ratio 0.102, 95% confidence interval, 0.022–0.467, p = .003) compared with those who were persistently inactive. Additionally, patients with diabetes mellitus had significantly higher odds of having an MDE (odds ratio 4.287, 95% confidence interval, 1.473–12.483, p = .008) compared with those without diabetes mellitus. Our results suggest a protective effect of regular PA on MDE in patients with early stages of CKD in Mainland China.
Collapse
Affiliation(s)
- Fu-Xiang Zhu
- a Department of Nephrology , First Affiliated Hospital of Jiaxing University , Jiaxing , China
| | - Xiang-Yang Zhang
- b Menninger Department of Psychiatry and Behavioral Sciences , Baylor College of Medicine , Houston , TX , USA
| | - Xiao-Kai Ding
- c Department of Nephrology , First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China
| | - Bin Han
- a Department of Nephrology , First Affiliated Hospital of Jiaxing University , Jiaxing , China
| |
Collapse
|
24
|
Shah NP, AbuHaniyeh A, Ahmed H. Cardiac Rehabilitation: Current Review of the Literature and Its Role in Patients with Heart Failure. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2018; 20:12. [PMID: 29478150 DOI: 10.1007/s11936-018-0611-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Cardiovascular (CV) disease remains the leading cause of death in the USA despite major advances in its treatment. With time, cardiac rehabilitation (CR) programs have gathered interest to help increase CV health and improve functional status after a CV event. Patients with heart failure have also been shown to benefit. In this review, we will evaluate the current literature showcasing the benefits of CR, particularly in patients with heart failure, discuss current limitations, and avenues for future investigation. RECENT FINDINGS Studies have shown that CR is beneficial in reducing morbidity, mortality, hospitalizations, activity-related symptoms, and increasing quality of life. Similar findings have also been observed in patients with heart failure who underwent CR in addition to optimal medical management. The positive effects of CR are well established in patients with coronary disease. Recent literature is also showing a trend to benefit in patients with heart failure, though much of the evidence is limited to patients with systolic dysfunction. Despite recommendations by professional societies, the use of CR remains underutilized. Further investigation is needed to better understand the impact of CR in heart failure. Moreover, strategies to increase CR utilization must be explored.
Collapse
Affiliation(s)
- Nishant P Shah
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. .,, 9500 Euclid Avenue J3-6, Cleveland, OH, 44095, USA.
| | - Ahmed AbuHaniyeh
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Haitham Ahmed
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
25
|
Soleimani MA, Pahlevan Sharif S, Allen KA, Yaghoobzadeh A, Sharif Nia H, Gorgulu O. Psychometric Properties of the Persian Version of Spiritual Well-Being Scale in Patients with Acute Myocardial Infarction. JOURNAL OF RELIGION AND HEALTH 2017; 56:1981-1997. [PMID: 27629419 PMCID: PMC5653727 DOI: 10.1007/s10943-016-0305-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The purpose of this study was to assess the psychometric properties of the Persian version of Spiritual Well-Being Scale (SWBS) in patients with acute myocardial infarction. A multisite, cross-sectional survey was employed to determine the instrument's reliability (Cronbach's α and construct reliability) and validity (face, content, and construct). Using systematic sampling of adult outpatients at primary care clinic sites in the Qazvin City, Iran (N = 300), it was found that the Cronbach's alpha and construct reliability of both factors associated with the SWBS were above 0.7. The construct validity of the scale was determined using exploratory factor analysis. The findings supported two factors: relation with God and relation with life. Further investigation through confirmatory factor analysis (eigenvalues of greater than one) confirmed a third factor construct associated with the SWBS. A total of 50.65 % of the variance were explained by these three factors. The overall findings of the study demonstrated that the SWBS is a valid and reliable instrument that has potential utility in future research and clinical practice settings.
Collapse
Affiliation(s)
- Mohammad Ali Soleimani
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saeed Pahlevan Sharif
- Taylor’s Business School, Taylor’s University, No. 1, Jalan Taylor’s, 47500 Subang Jaya, Selangor Malaysia
| | - Kelly A. Allen
- The Melbourne Graduate School of Education, The University of Melbourne, Melbourne, Australia
| | - Ameneh Yaghoobzadeh
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ozkan Gorgulu
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ahi Evran University, Kırşehir, Turkey
| |
Collapse
|
26
|
|
27
|
Impact of cardiac rehabilitation and exercise training programs in coronary heart disease. Prog Cardiovasc Dis 2017; 60:103-114. [PMID: 28689854 DOI: 10.1016/j.pcad.2017.07.002] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 07/04/2017] [Indexed: 12/14/2022]
Abstract
Cardiovascular rehabilitation (CR) is the process of developing and maintaining an optimal level of physical, social, and psychological well-being in order to promote recovery from cardiovascular (CV) illness. It is a multi-disciplinary approach encompassing supervised exercise training, patient counseling, education and nutritional guidance that may also enhance quality of life. Beneficial CV effects may include improving coronary heart disease risk factors; particularly exercise capacity, reversing cardiac remodeling, and favorably modifying metabolism and systemic oxygen transport. We review the historical basis for contemporary CR, the indications and critical components of CR, as well as the potential salutary physiological and clinical effects of exercise-based CR.
Collapse
|
28
|
Sui X, Ott J, Becofsky K, Lavie CJ, Ernstsen L, Zhang J, Blair SN. Cardiorespiratory Fitness and All-Cause Mortality in Men With Emotional Distress. Mayo Clin Proc 2017; 92:918-924. [PMID: 28499513 PMCID: PMC5524050 DOI: 10.1016/j.mayocp.2017.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 01/03/2017] [Accepted: 01/27/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Mental health and emotional disorders are often associated with higher mortality risk. Whether higher cardiorespiratory fitness (CRF) reduces the risk for all-cause mortality in individuals with emotional distress is not well known. PATIENTS AND METHODS Participants were 5240 men (mean age 46.5±9.5 years) with emotional distress (including depression, anxiety, thoughts of suicide, or a history of psychiatric or psychological counseling) who completed an extensive medical examination between 1987 and 2002, and were followed for all-cause mortality through December 31, 2003. Cardiorespiratory fitness was quantified as maximal treadmill exercise test duration and was grouped for analysis as low, moderate, and high. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% CIs. RESULTS During a median of 8.7 years (range, 1.0-16.9 years) and 46,217 person-years of follow-up, there were 128 deaths from any cause. Age- and examination year-adjusted all-cause mortality rates per 10,000 person-years according to low, moderate, and high CRF groups were 64.7 (95% CI, 44.9-89.3), 28.0 (95% CI, 23.8-31.5), and 19.6 (95% CI, 17.1-21.6) (trend P<.001) in men who reported any emotional distress. Overall, the multivariable-adjusted HRs and 95% CIs across incremental CRF categories were 1.00 (referent), 0.54 (0.32-0.90), and 0.47 (0.26-0.85), linear trend P =.03. CONCLUSION Among men with emotional distress, higher CRF is associated with lower risk of dying, independent of other clinical mortality predictors. Our findings underscore the importance of promoting physical activity to maintain a healthful level of CRF in individuals with emotional distress.
Collapse
Affiliation(s)
- Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
- Reprints and Correspondence: Xuemei Sui, MD, MPH, PhD, 921 Assembly Street, Columbia, SC 29208; Telephone: 803-777-3881; Fax: 803-777-2504;
| | - John Ott
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
- Reprints and Correspondence: Xuemei Sui, MD, MPH, PhD, 921 Assembly Street, Columbia, SC 29208; Telephone: 803-777-3881; Fax: 803-777-2504;
| | - Katie Becofsky
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA
| | - Carl J. Lavie
- Department of Cardiovascular Diseases, John Ochsner Hearth and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA
| | - Linda Ernstsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Steven N. Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| |
Collapse
|
29
|
Krokstad S, Ding D, Grunseit AC, Sund ER, Holmen TL, Rangul V, Bauman A. Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study - The HUNT Study. BMC Public Health 2017; 17:58. [PMID: 28068991 PMCID: PMC5223537 DOI: 10.1186/s12889-016-3993-x] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 12/23/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Lifestyle risk behaviours are responsible for a large proportion of disease burden and premature mortality worldwide. Risk behaviours tend to cluster in populations. We developed a new lifestyle risk index by including emerging risk factors (sleep, sitting time, and social participation) and examine unique risk combinations and their associations with all-cause and cardio-metabolic mortality. METHODS Data are from a large population-based cohort study in a Norway, the Nord-Trøndelag Health Study (HUNT), with an average follow-up time of 14.1 years. Baseline data from 1995-97 were linked to the Norwegian Causes of Death Registry. The analytic sample comprised 36 911 adults aged 20-69 years. Cox regression models were first fitted for seven risk factors (poor diet, excessive alcohol consumption, current smoking, physical inactivity, excessive sitting, too much/too little sleep, and poor social participation) separately and then adjusted for socio-demographic covariates. Based on these results, a lifestyle risk index was developed. Finally, we explored common combinations of the risk factors in relation to all-cause and cardio-metabolic mortality outcomes. RESULTS All single risk factors, except for diet, were significantly associated with both mortality outcomes, and were therefore selected to form a lifestyle risk index. Risk of mortality increased as the index score increased. The hazard ratio for all-cause mortality increased from 1.37 (1.15-1.62) to 6.15 (3.56-10.63) as the number of index risk factors increased from one to six respectively. Among the most common risk factor combinations the association with mortality was particularly strong when smoking and/or social participation were included. CONCLUSIONS This study adds to previous research on multiple risk behaviours by incorporating emerging risk factors. Findings regarding social participation and prolonged sitting suggest new components of healthy lifestyles and potential new directions for population health interventions.
Collapse
Affiliation(s)
- Steinar Krokstad
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, NSW Australia
- Centre for Chronic Disease Prevention, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD Australia
| | - Anne C. Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, NSW Australia
| | - Erik R. Sund
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
| | - Vegar Rangul
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
| | - Adrian Bauman
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, NSW Australia
| |
Collapse
|