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Koziolova NA, Chernyavina AI, Polyanskaya EA. Predictors of the Development of Associated Clinical Conditions in Working-Age Patients With Cardiovascular Risk Factors in Conditions of High Adherence to Treatment. KARDIOLOGIIA 2024; 64:52-62. [PMID: 38323445 DOI: 10.18087/cardio.2024.1.n2594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/23/2023] [Indexed: 02/08/2024]
Abstract
AIM To determine predictors for the development of associated clinical conditions (ACC) in patients of working age with cardiovascular risk factors (CVRFs) in the conditions of high compliance with the treatment and healthy lifestyle (HLS). MATERIAL AND METHODS The study included 364 patients with CVRFs without target organ damage and a history of ACC. Mean age was 42.24±8.08 years. Patients were examined in consistency with the Russian Society of Cardiology (RSC) 2020 guidelines for arterial hypertension and chronic heart failure. The follow-up period was 6.45±0.42 years. 350 patients completed the study, 9 patients died during the follow-up period, and 5 were lost to follow-up. Patients were divided into two groups based on the development of ACC. The first group consisted of 56 (16%) patients with verified ACC, the second group included 294 (84%) patients without ACC. RESULTS Regression logistic and correlation analyses confirmed the prognostic significance for the development of ACC by 12 indicators. The risk of ACC in smokers was increased more than 7 times (odds ratio (OR) 7.44, 95% confidence interval (CI): 3.42-16.21), and when type 2 diabetes mellitus (DM) developed, more than 9 times (OR 9.47, 95% CI: 4.36-20.59); with chronic kidney disease (CKD), more than 6 times (OR 6.75, 95% CI: 3.41-13, 37); with a history of COVID-19 (COronaVIrus Disease 2019) pneumonia, 7 times (OR 7.11, 95% CI: 3.04-16.58); with left ventricular hypertrophy (LVH), 6 times (OR 6, 35, 95% CI: 3.14-12.83); with CAVI index>7.2, almost 3 times (OR 2.69, 95% CI: 1.48-4.86); with PVWcf (carotid-femoral pulse wave velocity) >13 m/s, more than 5 times (OR 5.61, 95% CI: 2.79-11.28); with R-AI index (augmentation index) >1, more than 2 times (OR 2.26, 95% CI: 1.3-3.9); and with an increase in the indexed left atrial volume (ILAV) >27 ml/m2, more than 8 times (OR 8.80, 95% CI: 4.61-16.79). In the presence of polymorphisms in the form of homozygosity for the minor allele of the AGT gene (Thr174Met, rs4762), the risk of developing ACC increased 14 times (OR 14.13, 95% CI: 4.69-42.57), the APOE gene (Cys130Arg, rs429358), 11 times (OR 11.18, 95% CI: 4.18-29.93), and in the intron of the PRARα gene (rs4253778), 8 times (OR 8.11, 95% CI: 3.75-17.53). CONCLUSION The development of ACC in patients with high compliance with treatment and a healthy lifestyle is associated with smoking, type 2 diabetes and CKD, a history of COVID-19 pneumonia, LVH, increased ILAV >27 g/m2, more pronounced arterial stiffness assessed by an increase in CAVI indices >7.2, R-AI >1, and PWVcf >13 m/s; and with the presence of polymorphism of the AGT, APOE and PPARα genes in the form of homozygosity for the minor allele.
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Wang L, Liu J, Fang H, Wang X. Factors associated with participation in cardiac rehabilitation in patients with acute myocardial infarction: A systematic review and meta-analysis. Clin Cardiol 2023; 46:1450-1457. [PMID: 37594292 PMCID: PMC10642335 DOI: 10.1002/clc.24130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Cardiac rehabilitation (CR) is effective in reducing morbidity and mortality in patients with acute myocardial infarction (AMI), but the participation rate is low and its influencing factors vary. Our study aimed to systematically review the literature and investigate the participation rates and influencing factors of CR in patients with AMI. METHODS We searched 10 databases, including PubMed, Web of Science, Cochrane Library, and so forth. A systematic review and meta-analysis were conducted on the studies on the factors affecting CR participation in AMI. The Q tests and the I2 tests were used to assess heterogeneity between studies. The combined effect size and odds ratio (OR) and their respective 95% confidence interval (CI) for CR participation rate and its influences are expressed, respectively. Stata 17.0 software was used for statistical analysis. RESULTS We included 14 studies with 114 542 participants. Current evidence indicates a CR participation rate of 34% (95% CI: 21%-46%) in patients with AMI. The pooled OR values and CI of each influencing factor are as follows: over 60 years old (OR = 0.865; 95% CI: 0.772-0.969), male (OR = 1.690; 95% CI: 1.276-2.239), college education or above (OR = 2.526; 95% CI: 1.117-5.711), ST-segment elevation myocardial infarction (OR = 4.257; 95% CI: 2.004-9.045), decrease in left ventricular ejection fraction (OR = 0.918; 95% CI: 0.868-0.971), higher economic level (OR = 1.282; 95% CI: 1.108-1.483), history of coronary heart disease(OR = 0.667; 95% CI: 0.509-0.875), smoking (OR = 0.665; 95% CI: 0.550-0.805), combined hypertension (OR = 0.638; 95% CI: 0.562-0.723), and combined hyperlipidemia (OR = 0.577; 95% CI: 0.512-0.651). CONCLUSIONS The overall participation rate of CR in AMI patients is low, and various factors affect the participation rate. Specialist medical staff are needed to further promote CR rehabilitation concepts and scientific knowledge, and take appropriate measures to address the influencing factors to increase CR utilization and improve patient prognosis.
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Affiliation(s)
- Lingyu Wang
- Nursing SchoolAnhui University of Chinese MedicineHefeiAnhuiChina
| | - Jingyu Liu
- Nursing SchoolAnhui University of Chinese MedicineHefeiAnhuiChina
| | - Haiyan Fang
- Nursing SchoolAnhui University of Chinese MedicineHefeiAnhuiChina
| | - Xiang Wang
- Nursing SchoolAnhui University of Chinese MedicineHefeiAnhuiChina
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Tessitore E, Schmid JP, Hermann M, Schmied C, Wilhelm M, Meyer P. Cardiovascular Rehabilitation Delivery and Outcomes in Switzerland in More Than a Hundred Thousand Patients Over the Last Decade. J Cardiopulm Rehabil Prev 2023; 43:305-307. [PMID: 36857104 PMCID: PMC10287049 DOI: 10.1097/hcr.0000000000000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Elena Tessitore
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| | - Jean-Paul Schmid
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| | - Matthias Hermann
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| | - Christian Schmied
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| | - Matthias Wilhelm
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| | - Philippe Meyer
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
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Zhamaliyeva LM, Zhamankulova DG, Abenova NA, Koshmaganbetova GK. Educational Intervention Effects on Depression and Anxiety in Patients after Myocardial Infarction: A Randomized Controlled Trial. J Cardiovasc Dev Dis 2023; 10:267. [PMID: 37504523 PMCID: PMC10380402 DOI: 10.3390/jcdd10070267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Depression and anxiety in cardiovascular disease worsen the prognosis of patients. Treatments for these disorders often provide limited improvement. The present study aimed to test, for the first time, the impact of educational technology on anxiety and depressive symptoms in patients participating in a cardiac rehabilitation program. A 12-month randomized controlled trial was conducted, in which 207 patients were randomly assigned to either the experimental (n = 76) or control (n = 69) groups. The intervention involved a structured patient education program provided by medical students who had undergone specially designed training in cardiac rehabilitation. The primary outcomes were death, hospitalization, heart failure, and recurrent myocardial infarction. The study also assessed anxiety and depression. A year later, the experimental group showed a statistically significant decrease in anxiety and depression on the HADS scale, with reductions of 2.0 and 1.9 points, respectively (p < 0.05). The control group showed reductions of 1.5 and 1.2 points (p < 0.05). The difference in the Hamilton Rating Scale for Depression between the groups at 12 months was -1.29 in favor of the main group (95% CI, -0.7 to -1.88), and the standardized mean difference was 0.36 (95% CI, 0.03 to 0.69). No treatment-related adverse events were observed. The results suggest that educational interventions can have a positive impact on mental health. The study's strengths include a structured intervention, randomization, and long-term follow-up. The limitations include the lack of blinding of study participants and a relatively small sample size.
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Affiliation(s)
- Lazzat M Zhamaliyeva
- Department of Family Medicine, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
| | - Damira G Zhamankulova
- Department of Internal Diseases, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
| | - Nurgul A Abenova
- Department of General Practice 1, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
| | - Gulbakit K Koshmaganbetova
- Department of Master's and Doctoral Studies, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
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Raspe M, Bals R, Bölükbas S, Faber G, Krabbe B, Landmesser U, Al Najem S, Przibille O, Raupach T, Rupp A, Rustler C, Tuffman A, Urlbauer M, Voigtländer T, Andreas S. [Smoking cessation in hospitalised patients - Initiate among inpatients, continue when outpatients - A Position Paper by the German Respiratory Society (DGP) Taskforce for Smoking Cessation]. Pneumologie 2023. [PMID: 37186277 DOI: 10.1055/a-2071-8900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Tobacco smoking is the greatest preventable health risk. The effects are serious, both individually and societal. Nevertheless, the current prevalence of tobacco smokers in Germany is still high at around 35 %. A recent strong increase in actively smoking adolescents (14- to 17-year-olds, current prevalence approx. 16 %) and young adults (18- to 24-year-olds, current prevalence approx. 41 %) is also a cause for concern. About a third of all inpatients continue smoking while being treated. The hospitalization of active smokers in acute and rehabilitation hospitals serves as a "teachable moment" for initiation of cessation offers. An intervention that begins in hospital and continues for at least a month after discharge results in about 40 % additional smokefree patients. It is scientifically well-researched, effective and cost-efficient. After initiation in hospital these measures can be continued via ambulatory cessation programs, rehabilitation facilities, an Internet or telephone service. In Germany, there are structured and quality-assured cessation offers, both for the inpatient and for the outpatient area. The biggest obstacle to broad establishment of such offers is the lack of reimbursement. Two feasible ways to change this would be the remuneration of the existing OPS 9-501 "Multimodal inpatient treatment for smoking cessation" and the establishment of quality contracts according to § 110a SGB V. An expansion of tobacco cessation measures in healthcare facilities would reduce smoking prevalence, associated burden of disease and consecutive costs.
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Affiliation(s)
- Matthias Raspe
- Charité - Universitätsmedizin Berlin, Mitglied der Freien Universität Berlin, Humboldt-Universität zu Berlin, und des Berlin Institute of Health, Fächerverbund für Infektiologie, Pneumologie und Intensivmedizin, Klinik für Pneumologie, Beatmungsmedizin und Intensivmedizin mit dem Arbeitsbereich Schlafmedizin, Berlin
| | - Robert Bals
- Klinik für Innere Medizin V - Pneumologie, Allergologie, Beatmungsmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Serve Bölükbas
- Klinik für Thoraxchirurgie, Universitätsmedizin Essen - Ruhrlandklinik, Essen
| | - Gerhard Faber
- CELENUS Teufelsbad Fachklinik Blankenburg, Blankenburg
| | - Bernd Krabbe
- Herz-Kreislaufmedizin/Angiologie, UKM Marienhospital Steinfurt, Steinfurt
| | - Ulf Landmesser
- Deutsches Herzzentrum der Charité, Klinik für Kardiologie, Angiologie und Intensivmedizin, Berlin
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin
- DZHK (German Centre for Cardiovascular Research), partner site Berlin
| | | | | | - Tobias Raupach
- Universitätsklinikum Bonn (AÖR), Institut für Medizindidaktik, Bonn
| | | | - Christa Rustler
- Deutsches Netz Rauchfreier Krankenhäuser & Gesundheitseinrichtungen DNRfK e. V., Berlin
| | - Amanda Tuffman
- Medizinische Klinik und Poliklinik V, Klinikum der Universität München, Standort Innenstadt, München, außerdem Deutsches Zentrum für Lungenforschung
| | - Matthias Urlbauer
- Medizinische Klinik 3 (Schwerpunkt Pneumologie) am Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Nürnberg
| | - Thomas Voigtländer
- Deutsche Herzstiftung e. V., Frankfurt
- MVZ CCB Frankfurt und Main-Taunus, Frankfurt
| | - Stefan Andreas
- Lungenfachklinik Immenhausen, Immenhausen, außerdem Abteilung Kardiologie und Pneumologie der Universitätsmedizin Göttingen und Deutsches Zentrum für Lungenforschung
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Iannetta D, Rouleau CR, Chirico D, Fontana FY, Hauer T, Wilton SB, Aggarwal S, Austford LD, Arena R, Murias JM. An evaluation of the role of the exercise training dose for changes in exercise capacity following a standard cardiac rehabilitation program. Int J Cardiol 2023; 379:104-110. [PMID: 36934989 DOI: 10.1016/j.ijcard.2023.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/21/2023] [Accepted: 03/16/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND To retrospectively characterize and compare the dose of exercise training (ET) within a large cohort of patients demonstrating different levels of improvement in exercise capacity following a cardiac rehabilitation (CR) program. METHODS A total of 2310 patients who completed a 12-week, center-based, guidelines-informed CR program between January 2018 and December 2019 were included in the analysis. Peak metabolic equivalents (METpeak) were determined pre- and post-CR during which total duration (ET time) and intensity [percent of heart rate peak (%HRpeak)] of supervised ET were also obtained. Training responsiveness was quantified on the basis of changes in METpeak from pre- to post-CR. A cluster analysis was performed to identity clusters demonstrating discrete levels of responsiveness (i.e., negative, low, moderate, high, and very-high). These were compared for several baseline and ET-derived variables which were also included in a multivariable linear regression model. RESULTS At pre-CR, baseline METpeak was progressively lower with greater training responsiveness (F(4,2305) = 44.2, P < 0.01, η2p = 0.71). Likewise, average training duration (F(4,2305) = 10.7 P < 0.01, η2p = 0.02) and %HRpeak (F(4,2305) = 25.1 P < 0.01, η2p = 0.042) quantified during onsite ET sessions were progressively greater with greater training responsiveness. The multivariable linear regression model confirmed that baseline METpeak, training duration and intensity during ET, BMI, and age (P < 0.001) were significant predictors of METpeak post-CR. CONCLUSIONS Along with baseline METpeak, delta BMI, and age, the dose of ET (i.e., training duration and intensity) predicts METpeak at the conclusion of CR. A re-evaluation of current approaches for exercise intensity prescription is recommended to extend the benefits of completing CR to all patients.
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Affiliation(s)
- Danilo Iannetta
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Codie R Rouleau
- Department of Psychology, University of Calgary, Calgary, Canada; TotalCardiology™ Research Network, Calgary, Canada
| | - Daniele Chirico
- Faculty of Kinesiology, University of Calgary, Calgary, Canada; TotalCardiology™ Research Network, Calgary, Canada
| | - Federico Y Fontana
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Trina Hauer
- TotalCardiology™ Rehabilitation, Calgary, Canada; TotalCardiology™ Research Network, Calgary, Canada
| | - Stephen B Wilton
- TotalCardiology™ Research Network, Calgary, Canada; Libin Cardiovascular Institute, University of Calgary, Calgary, Canada
| | - Sandeep Aggarwal
- TotalCardiology™ Research Network, Calgary, Canada; Department of Cardiac Science, University of Calgary, Calgary, Canada
| | | | - Ross Arena
- TotalCardiology™ Research Network, Calgary, Canada; Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Juan M Murias
- Faculty of Kinesiology, University of Calgary, Calgary, Canada.
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Esmailiyan M, Amerizadeh A, Vahdat S, Ghodsi M, Doewes RI, Sundram Y. Effect of Different Types of Aerobic Exercise on Individuals With and Without Hypertension: An Updated Systematic Review. Curr Probl Cardiol 2023; 48:101034. [PMID: 34718034 DOI: 10.1016/j.cpcardiol.2021.101034] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/16/2021] [Indexed: 02/01/2023]
Abstract
High blood pressure (BP) is one of the main modifiable risk factors for cardiovascular disease (CVD) and preventing it greatly reduces the vascular consequences of aging and, along with intensive treatment of hypertension, eliminates a large portion of the burden of CVD-related mortality. Many meta-analyses and studies proved that regular aerobic exercise (AE) reduces BP but most of these studies consider only hypertensive populations or only AE but not resistant exercise or their combination. In this review, we aimed to study the effect of different types of physical activity (PA)/AE on various populations including normotensive, prehypertensive, primary hypertensive, and resistant hypertensive with different comorbidities. We searched PubMed, Web of Science, and Google Scholar for English articles with keywords for physical activity, aerobic exercise, and blood pressure from January 2010 until September 2021. Finally, 24 studies were included. Results showed that chronic or acute AE (long-term or short-term), either alone or as combined with different sessions and programs can reduce systolic and diastolic BP in every group including normotensive, prehypertensive, primary hypertensive, resistant hypertensive individuals and diabetic patients and those with kidney problems but not in people with chronic heart failure. Isometric exercise training showed to be useful in reducing BP in all groups either as low intensity or as high intensity but the rate of reduction was different in terms of gender. AE showed to be effective in terms of BP reduction in a different age range. It can be seen that different types and duration of AE independent of the modality and programs and independent of the BP medical situation of individuals have been successful in terms of BP reduction. For those with chronic heart failure, more concern and help might be needed to decrease BP via exercise.
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Affiliation(s)
| | - Atefeh Amerizadeh
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Sahar Vahdat
- Isfahan Kidney Diseases Research Center, Khorshid Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Ghodsi
- Assistant Prof. of Cardiovascular surgery, Department of Surgery, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Rumi Iqbal Doewes
- Faculty of Pharmacy, Asia Metropolitan University, Malaysia; Faculty of Sport, Universitas Sebelas Maret, Jl. Ir. Sutami, 36A, Kentingan, Surakarta, Indonesia
| | - Yamuna Sundram
- Faculty of Pharmacy, Asia Metropolitan University, Malaysia
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Allagbé I, Zeller M, Thomas D, Airagnes G, Limosin F, Boussadi A, Chagué F, Le Faou AL. Cardiovascular Risk Among Patients Who Smoke: Risk Profiles and Differences by Sex. Am J Prev Med 2022; 63:800-808. [PMID: 35773102 DOI: 10.1016/j.amepre.2022.04.028] [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] [Received: 01/16/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Smoking is particularly harmful to the cardiovascular system, and smoking-cessation is a key target for cardiovascular prevention. From a large nationwide database on subjects who visited smoking-cessation services, this study assessed the profile and abstinence rate comparing female with male smokers at high cardiovascular risk. METHODS This was an observational study from the French smoking-cessation services cohort (French national cohort Consultations de Dépendance Tabagique) between 2001 and 2018. Inclusion criteria were being aged ≥18 years and having ≥1 cardiovascular risk factor. Abstinence was self-reported (stopping cigarettes or other tobacco products use ≥28 consecutive days) and confirmed by exhaled carbon monoxide <10 parts per million. Analysis was conducted in 2021. RESULTS Among 36,864 people who smoke, 15,407 (42%) were women. Women were 3 years younger (48 vs 51 years, p<0.001) and more educated (≥high school diploma: 54% vs 45%, p<0.001) than men. The burden of cardiovascular risk factors was slightly lower in women than in men and, for hypercholesterolemia, hypertension, diabetes, and cardiovascular diseases, were half as frequent in women as they were in men (16% vs 32%, p<0.001). However, women suffered more often from obesity, respiratory diseases, and anxiety‒depression symptoms (53% vs 39%, p<0.001). Finally, although women were less nicotine dependent, their abstinence rate was slightly lower (52.6% vs 55.2%, p<0.001). CONCLUSIONS Women who smoked had a high burden of risk factors, especially obesity and elevated rates of lung diseases, and a lower abstinence rate, with more common anxiety‒depression symptoms. Men who smoked had a higher prevalence of cardiovascular disease, higher nicotine dependence, and coaddictions. These findings highlight the need to strengthen cardiovascular prevention strategies through comprehensive sex-tailored smoking-cessation interventions.
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Affiliation(s)
- Ingrid Allagbé
- Physiopathology and Epidemiology Cerebro-cardiovascular (PEC2, EA 7460), Faculty of Health Science (UFR des Sciences de Santé), University Burgundy and Franche-Comté, Dijon, France; Outpatient Addictology Center, AP-HP Center, University of Paris, Paris, France; Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France.
| | - Marianne Zeller
- Physiopathology and Epidemiology Cerebro-cardiovascular (PEC2, EA 7460), Faculty of Health Science (UFR des Sciences de Santé), University Burgundy and Franche-Comté, Dijon, France; Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France
| | - Daniel Thomas
- Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; Institut de Cardiologie, Hôpital Pitié Salpêtrière, AP-HP, Université Paris-Sorbonne, Paris, France
| | - Guillaume Airagnes
- Outpatient Addictology Center, AP-HP Center, University of Paris, Paris, France
| | - Frédéric Limosin
- DMU Psychiatry and Addictology, AP-HP Centre-University of Paris, Paris, France
| | - Abdelali Boussadi
- Medical Informatics, Biostatistics and Public Health Department, Georges Pompidou University Hospital, Paris, France
| | - Frédéric Chagué
- Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; Cardiology Department, Dijon University Hospital, Dijon, France
| | - Anne-Laurence Le Faou
- Outpatient Addictology Center, AP-HP Center, University of Paris, Paris, France; Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; DMU Psychiatry and Addictology, AP-HP Centre-University of Paris, Paris, France; University Hospital Federation - Network of Research in Substance Use Disorder, Paris, France
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Liu D, Han S, Zhou C. The Influence of Physical Exercise Frequency and Intensity on Individual Entrepreneurial Behavior: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12383. [PMID: 36231684 PMCID: PMC9564728 DOI: 10.3390/ijerph191912383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
Physical exercise can benefit individuals' physical and mental health and also influence individuals' long-term behavioral choices. Doing exercise is particularly important given that physical exercise can impact individuals' cognitive abilities and positive emotional states, which may further impact entrepreneurial behavior. Therefore, understanding the relationship between exercise and entrepreneurial behavior is essential, because it can provide policy suggestions for popularizing athletic activities and boosting entrepreneurship. Consequently, the present study examined whether physical exercise could predict entrepreneurial behavior and the possible psychological mechanisms within this relationship. Based on the 2017 Chinese General Social Survey (CGSS2017), this study tested the hypotheses using the Probit and Tobit models. The results showed that individuals' physical exercise intensity and frequency positively affected their entrepreneurial behavior. In addition, five variables moderated the relationships between physical exercise and individual entrepreneurial behavior: urban-rural differences, education level, marital status, the existence of minor children, and age. Moreover, positive emotions and physical/mental health mediated the influence of physical exercise (exercise frequency and exercise intensity) on individual entrepreneurial behavior. Endogeneity explanations were ruled out by including instrumental variable, copula terms and adopting coarsened exact matching.
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Affiliation(s)
- Dewen Liu
- School of Management, Nanjing University of Posts and Telecommunications, Nanjing 210003, China
| | - Shenghao Han
- College of Business, Shanghai University of Finance and Economics, Shanghai 200433, China
| | - Chunyang Zhou
- College of Business, Shanghai University of Finance and Economics, Shanghai 200433, China
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Bryndal A, Glowinski S, Grochulska A. Influence of Risk Factors on Exercise Tolerance in Patients after Myocardial Infarction—Early Cardiac Rehabilitation in Poland. J Clin Med 2022; 11:jcm11195597. [PMID: 36233465 PMCID: PMC9572875 DOI: 10.3390/jcm11195597] [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: 08/08/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Prognosis in patients with cardiovascular diseases is significantly influenced by lifestyle and the control of risk factors. Patients after myocardial infarction require special care and promptly introduced cardiac rehabilitation. The primary aim of this study was to identify risk factors and their influence on exercise tolerance before and after cardiac rehabilitation (CR) provided under the Coordinated Specialist Care Programme—Infarct (CSC-Infarct). (2) Methods: The study was carried out at the Cardiac Rehabilitation Centre of Slupsk Specialist Hospital on a group of 112 patients aged 35–87 (62.78 ± 10.09 years) after myocardial infarction (MI), participating in CSC-Infarct. An exercise test (treadmill ECG test), the 6 min walk test (6MWT), echocardiography, blood test (total cholesterol, HDL, LDL, TG), measurement of diastolic pressure ratio (DPr), waist-to-hip ratio (WHR), and BMI were performed in participants on the first and last day of CR. Rating of perceived exertion was assessed with Borg’s scale. (3) Results: The overweight variable had the strongest effect on the increased value of initial: HR rest, HR max, and HR 1 min after exercise compared to subjects with normal BMI. DPr values before and after CR were also higher in overweight patients. Scores of 6MWT were higher in smokers compared to non-smokers. The final MET value was significantly higher in non-diabetic subjects. Hyperlipidaemia was associated with a higher initial HR max and initial HR 1 min after exercise. DPr before CR was also higher. The initial and final MET values were lower in hypertensive patients. Borg’s rating of perceived exertion measured after the final exercise test was also higher in hypertensive patients. Hypertension influenced the initial and final 6MWT scores, which were significantly higher in normotensive patients. (4) Conclusions: CR within CSC-infarction in patients after myocardial infarction improves exercise tolerance. Exercise tolerance in post-MI patients with concomitant risk factors is lower compared to post-MI patients without risk factors.
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Affiliation(s)
- Aleksandra Bryndal
- Department of Physiotherapy, Institute of Health Sciences, Slupsk Pomeranian University, 76200 Slupsk, Poland
- Correspondence:
| | - Sebastian Glowinski
- State Higher School of Vocational Education in Koszalin, 75-582 Koszalin, Poland
| | - Agnieszka Grochulska
- Department of Physiotherapy, Institute of Health Sciences, Slupsk Pomeranian University, 76200 Slupsk, Poland
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11
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Pogosova NV. [The importance of cardiorehabilitation in the era of modern treatment of cardio-vascular diseases]. KARDIOLOGIIA 2022; 62:3-11. [PMID: 35569158 DOI: 10.18087/cardio.2022.4.n2015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/04/2022] [Indexed: 06/15/2023]
Abstract
Cardiac rehabilitation (CR) has a class IA indication in international and national guidelines as an intervention with proven efficacy for decreasing cardiovascular and all-cause mortality in various categories of cardiological patients. However, CR is one of the least used current technologies for the treatment of patients with cardiovascular diseases worldwide. This article presents the state of the CR problem during the epoch of high-tech treatments of cardiovascular diseases; the prevalence of using CR in various countries; traditional and new methodological approaches, including telemedicine; and clinical and prognostic effects of CR in various categories of patients with cardiovascular diseases.
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Affiliation(s)
- N V Pogosova
- National Medical Research Center of Cardiology, Moscow
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12
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Abstract
Cardiovascular disease is a leading cause of morbidity and mortality in males and females in the United States and globally. Cardiac rehabilitation (CR) is recommended by the American Heart Association/American College of Cardiology for secondary prevention for patients with cardiovascular disease. CR participation is associated with improved cardiovascular disease risk factor management, quality of life, and exercise capacity as well as reductions in hospital admissions and mortality. Despite these advantageous clinical outcomes, significant sex disparities exist in outpatient phase II CR programming. This article reviews sex differences that are present in the spectrum of care provided by outpatient phase II CR programming (ie, from referral to clinical management). We first review CR participation by detailing the sex disparities in the rates of CR referral, enrollment, and completion. In doing so, we discuss patient, health care provider, and social/environmental level barriers to CR participation with a particular emphasis on those barriers that majorly impact females. We also evaluate sex differences in the core components incorporated into CR programming (eg, patient assessment, exercise training, hypertension management). Next, we review strategies to mitigate these sex differences in CR participation with a focus on automatic CR referral, female-only CR programming, and hybrid CR. Finally, we outline knowledge gaps and areas of future research to minimize and prevent sex differences in CR programming.
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Affiliation(s)
- Joshua R. Smith
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Randal J. Thomas
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | | | - Shane M. Hammer
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Thomas P. Olson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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13
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Doewes RI, Gharibian G, Zadeh FA, Zaman BA, Vahdat S, Akhavan-Sigari R. An updated systematic review on the effects of aerobic exercise on human blood lipid profile. Curr Probl Cardiol 2022; 48:101108. [PMID: 35016988 DOI: 10.1016/j.cpcardiol.2022.101108] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/03/2022] [Indexed: 02/06/2023]
Abstract
Sedentary lifestyle and dyslipidemia are well-recognized risk factors for cardiovascular diseases (CVD). Changes in blood lipid profile (total cholesterol (TC), triglycerides, high-density lipoprotein [HDL], and low-density lipoprotein [LDL]) due to the exercise may be beneficial for decreasing CVD-related events. In this review we aimed to investigate the effect of different types of exercise on lipid profile components in people with different health conditions and age ranges. A systematic search was performed covering PubMed, Web of Science, and Google Scholar for English articles from 2010 until November 2021. Finally, 31 studies were included in our study. Results showed that exercise in younger individuals sometimes resulted in no significant changes of any of the variables or some of them; however, efficient improvement was observed in all studies of older and middle-age groups. In terms of health condition and gender; healthy individuals, overweight people, subjects with type 2 diabetes and obesity, and male participants found to have benefited more from the exercise. In patients with chronic kidney diseases lipid profile improvement was not significant. The cardiac rehabilitation program, particularly comprehensive cardiac rehabilitation, proved to be more beneficial than exercise alone in the case of cardiovascular patients and those at elevated risk of CVD. In conclusion exercise is beneficial in terms of improving lipid profile but for younger population, and those with kidney problems and CVD patients, more further preparations are needed under the supervision of experts in the field of sports and medicine to achieve the desired result. Also, more studies are needed for these groups in order to provide a definite and reliable conclusion.
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Affiliation(s)
- Rumi Iqbal Doewes
- Faculty of Sport, Universitas Sebelas Maret, Jl. Ir. Sutami, 36A, Kentingan, Surakarta, Indonesia
| | - Ghazal Gharibian
- Department of physical therapy, Faculty of rehabilitation sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| | | | - Burhan Abdullah Zaman
- Basic Sciences Department, College of Pharmacy, University of Duhok, Kurdistan Region, Iraq
| | - Sahar Vahdat
- Isfahan Kidney Diseases Research Center, Khorshid Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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14
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Lutz AH, Forman DE. Cardiac rehabilitation in older adults: Apropos yet significantly underutilized. Prog Cardiovasc Dis 2022; 70:94-101. [PMID: 35016915 PMCID: PMC8930627 DOI: 10.1016/j.pcad.2022.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/03/2022] [Indexed: 01/12/2023]
Abstract
Cardiac Rehabilitation (CR) is a comprehensive disease management program that utilizes exercise training, behavioral modification, education, and psychosocial counseling to optimize outcomes and functionality in patients with cardiovascular disease (CVD)1). While CR was initially designed as an exercise training and fitness program for younger patients, usually men, after debilitating hospitalizations for myocardial infarction or cardiac surgery, evidence has expanded to also include other types of CVD in women as well as men, including heart failure, valvular disease, and peripheral arterial disease2-4). As the population of older adults continues to expand, age-related CVD is endemic and is commonly associated with exercise decline, diminished quality of life, and dependence. CR has the potential to counterbalance these patterns, and therefore stands out as a particularly important consideration for older adults with CVD. Nevertheless, CR remains highly underutilized5,6). Novel approaches to CR including home-based and hybrid CR programs show promise for enhanced outreach to patients who may not otherwise participate. This review summarizes the current data available regarding CR in older adults with CVD with a focus on geriatric-specific complexities, current barriers to utilization, and approaches to enhance participation and effectiveness.
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Affiliation(s)
| | - Daniel E. Forman
- University of Pittsburgh, Department of Medicine, Divisions of Geriatrics and Cardiology Pittsburgh Geriatrics Research, Education and Clinical Center, VA Pittsburgh Healthcare System
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Lovatt S, Wong CW, Holroyd E, Butler R, Phan T, Patwala A, Loke YK, Mallen CD, Kwok CS. Smoking cessation after acute coronary syndrome: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14894. [PMID: 34541754 DOI: 10.1111/ijcp.14894] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/02/2021] [Accepted: 09/17/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Smoking cessation is an effective secondary prevention measure after acute coronary syndrome (ACS). We conducted a systematic review with the aim to better understand which patients have a greater propensity to quit smoking and the risk factors for continued smoking after ACS. METHODS We searched MEDLINE and EMBASE for studies that evaluated smoking cessation after ACS. The pooled rate of smoking cessation across included studies was performed. Random effects meta-analysis for different variables and their association with smoking cessation was conducted. RESULTS A total of 39 studies with 11 228 patients were included in this review. The pooled rate of smoking cessation following ACS across 38 studies was 45.0%. Factors associated with greater likelihood of smoking cessation were attendance at cardiac rehabilitation (OR 1.90 95% CI 1.44-2.51), married/not alone (OR 1.68 95% CI 1.32-2.13), intention/attempt to quit smoking (OR 1.27 95% CI 1.11-1.46), diabetes mellitus (OR 1.24 95% CI 1.03-1.51) and hospitalised duration (OR 1.09 95% CI 1.02-1.15). Variables associated with a lower likelihood of smoking cessation were depression (OR 0.57 95% CI 0.43-0.75), chronic obstructive pulmonary disease/lung disease (OR 0.73 95% CI 0.57-0.93), previous admission with acute myocardial infarction/cardiac admission (OR 0.61 95% CI 0.47-0.80), cerebrovascular disease/transient ischaemic attack (OR 0.42 95% CI 0.30-0.58) and unemployment (OR 0.37 95% CI 0.17-0.80). CONCLUSIONS The majority of smokers with an ACS continue to smoke after admission. Patients attending cardiac rehabilitation show increased odds of quitting while people who are depressed and those with chronic lung disease were less likely to quit smoking and should be targeted for intensive smoking cessation interventions.
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Affiliation(s)
- Saul Lovatt
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Chun Wai Wong
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Eric Holroyd
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Rob Butler
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Thanh Phan
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Ashish Patwala
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Yoon K Loke
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Chun Shing Kwok
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
- School of Medicine, Keele University, Stoke-on-Trent, UK
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Environmental and economics-related factors of smoking among Iranian adults aged 35-70: a PERSIAN cohort-based cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:45365-45374. [PMID: 33864220 DOI: 10.1007/s11356-021-13941-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/12/2021] [Indexed: 12/31/2022]
Abstract
The prevalence of smoking in developing countries is known as a significant public health problem, and it is correlated with different demographic and socio-economic factors. This study aimed to determine the environmental and economical related factors of smoking among Iranian adults aged 35 to 70 years. The study sample consisted of 20,152 of Ardabil population aged 35-70 years which was enrolled in the PERSIAN cohort study. Smoking status during the last year was defined as dependent variable and demographic and socio-economic factors considered as independent variables. To identify the main socio-economic factors affecting the smoking prevalence in Ardabil, multivariable logistic regression was used. The prevalence of smoking was 16.1 (95%, CI 15.5-16.4) in this study, where the prevalence of smoking was for men and women 33.4% and 1.4%, respectively. The prevalence of smoking had significant association with old age (2.05, 95% CI, 1.66 to 2.53), male gender (45.15, 95% CI, 37.14 to 54.89), being married (2.60, 95% CI, 1.51 to 4.46), having cardiovascular disease (1.54, 95% CI, 1.32 to 1.79), and negative association with illiteracy (0.50, 95% CI, 0.40 to 0.64), being obese (0.83, 95% CI, 0.73 to 0.94), and lower socio-economic status (0.74, 95% CI, 0.64 to 0.84). The study showed that the prevalence of smoking in Ardabil is higher than many other countries, and different factors, especially socio-economic status, have an association with the prevalence. There are deep needs to policies and regulations such as increasing the taxation on a cigarette to reduce the negative effect of smoking in Iran.
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