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Borg S, Öberg B, Nilsson L, Alfredsson J, Söderlund A, Bäck M. Effectiveness of a behavioral medicine intervention in physical therapy on secondary psychological outcomes and health-related quality of life in exercise-based cardiac rehabilitation: a randomized, controlled trial. BMC Sports Sci Med Rehabil 2023; 15:42. [PMID: 36964593 PMCID: PMC10037812 DOI: 10.1186/s13102-023-00647-x] [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: 11/01/2022] [Accepted: 03/14/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Interventions promoting adherence to exercise-based cardiac rehabilitation (exCR) are important to achieve positive physical and psychological outcomes, but knowledge of the added value of behavioral medicine interventions for these measures is limited. The aim of the study was to investigate the added value of a behavioral medicine intervention in physical therapy (BMIP) in routine exCR on psychological outcomes and health-related quality of life (HRQoL) versus routine exCR alone (RC). METHODS A total of 170 patients with coronary artery disease (136 men), mean age 62.3 ± 7.9 years, were randomized at a Swedish university hospital to a BMIP plus routine exCR or to RC for four months. The outcome assessments included HRQoL (SF-36, EQ-5D), anxiety and depression (HADS), patient enablement and self-efficacy and was performed at baseline, four and 12 months. Between-group differences were tested with an independent samples t-test and, for comparisons within groups, a paired t-test was used. An intention-to-treat and a per-protocol analysis were performed. RESULTS No significant differences in outcomes between the groups were shown between baseline and four months or between four and 12 months. Both groups improved in most SF-36 domains, EQ-VAS and HADS anxiety at the four-month follow-up and sufficient enablement remained at the 12-months follow-up. CONCLUSION A BMIP added to routine exCR care had no significant effect on psychological outcomes and HRQoL compared with RC, but significant improvements in several measures were shown in both groups at the four-month follow-up. Since recruited participants showed a better psychological profile than the general coronary artery disease population, further studies on BMIP in exCR, tailored to meet individual needs in broader patient groups, are needed. Trial registration number NCT02895451, 09/09/2016, retrospectively registered.
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Affiliation(s)
- Sabina Borg
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, 581 83, Linköping, Sweden.
- Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Birgitta Öberg
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, 581 83, Linköping, Sweden
| | - Lennart Nilsson
- Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden
| | - Joakim Alfredsson
- Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Anne Söderlund
- Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Maria Bäck
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, 581 83, Linköping, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
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van der Voorn B, Hollanders JJ, Kieviet N, Dolman KM, de Rijke YB, van Rossum EF, Rotteveel J, Honig A, Finken MJ. Maternal Stress During Pregnancy Is Associated with Decreased Cortisol and Cortisone Levels in Neonatal Hair. Horm Res Paediatr 2019; 90:299-307. [PMID: 30541006 PMCID: PMC6492510 DOI: 10.1159/000495007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 10/30/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Hair glucocorticoids (GCs) offer a retrospective view on chronic GC exposure. We assessed whether maternal pre- and postnatal stress was associated with neonatal and maternal hair GCs postpartum (pp). METHODS On the first day pp 172 mother-infant pairs donated hair, of whom 67 had consulted a centre of expertise for psychiatric disorders during pregnancy. Maternal stress was scored on the Hospital Anxiety and Depression Scale during the first/second (n = 46), third trimester (n = 57), and pp (n = 172). Hair cortisol and cortisone levels were determined by liquid chromatography-tandem mass spectrometry, and associations with maternal hospital anxiety subscale (HAS) and hospital depression subscale (HDS) scores, and antidepressant use were analyzed with linear regression. RESULTS Neonatal hair GCs were negatively associated with elevated HAS-scores during the first/second trimester, log 10 (β [95% CI]) cortisol -0.19 (-0.39 to 0.02) p = 0.07, cortisone -0.10 (-0.25 to 0.05) p = 0.17; third trimester, cortisol -0.17 (-0.33 to 0.00) p = 0.05, cortisone -0.17 (-0.28 to -0.05) p = 0.01; and pp, cortisol -0.14 (-0.25 to -0.02) p = 0.02, cortisone -0.07 (-0.16 to 0.02) p = 0.10. A similar pattern was observed for elevated HDS-scores. Maternal hair GCs were positively associated with elevated HAS-scores pp (cortisol 0.17 [0.01 to 0.32] p = 0.04, cortisone 0.18 [0.06 to 0.31] p = 0.01), but not prenatally or with elevated HDS-scores. Antidepressant use was associated with elevated maternal hair GCs (p ≤ 0.05), but not with neonatal hair GCs. CONCLUSION Exposure to excessive pre- and perinatal maternal stress was associated with a decrease in neonatal hair GCs, while elevated stress-scores around birth were associated with increased maternal hair GCs and elevated stress-scores earlier in gestation were not associated with maternal hair GCs pp. Further studies are needed to test associations with infant neurodevelopment.
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Affiliation(s)
- Bibian van der Voorn
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands,
| | - Jonneke J. Hollanders
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - Noera Kieviet
- Department of Pediatrics, Psychiatry Obstetrics Pediatrics Expert Center, OLVG West, Amsterdam, The Netherlands
| | - Koert M. Dolman
- Department of Pediatrics, Psychiatry Obstetrics Pediatrics Expert Center, OLVG West, Amsterdam, The Netherlands
| | - Yolanda B. de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Elisabeth F.C. van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Joost Rotteveel
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - Adriaan Honig
- Department of Pediatrics, Psychiatry Obstetrics Pediatrics Expert Center, OLVG West, Amsterdam, The Netherlands,Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn J.J. Finken
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
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Coviello JS. Cardiovascular and Cancer Risk: The Role of Cardio-oncology. J Adv Pract Oncol 2018; 9:160-176. [PMID: 30588351 PMCID: PMC6303003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cardio-oncology is a subspecialty of cardiology. It was created to address oncology data indicating that newly developed drugs for cancer treatment were having unanticipated cardiac side effects. Cardio-oncology designs primary and secondary risk strategies through surveillance as well as interventions to reduce cardiovascular risk (CVR), prevent cardiotoxicities, and manage the side effects that may occur. Rather than discuss in detail the cardiotoxicities of specific therapies or radiation, this review article will explore the interplay of cancer, cancer treatment, and CVR. It will examine the link between CVR and cancer risk, define mechanisms associated with cardiotoxicity, and describe screening and surveillance for patients undergoing cancer treatment. Finally, effective preventative and management strategies used to reduce the incidence of cardiotoxicities in those receiving chemotherapeutics or radiation will be presented.
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Borg S, Öberg B, Nilsson L, Söderlund A, Bäck M. The role of a behavioural medicine intervention in physiotherapy for the effects of rehabilitation outcomes in exercise-based cardiac rehabilitation (ECRA) - the study protocol of a randomised, controlled trial. BMC Cardiovasc Disord 2017; 17:134. [PMID: 28545400 PMCID: PMC5445354 DOI: 10.1186/s12872-017-0557-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 05/07/2017] [Indexed: 12/17/2022] Open
Abstract
Background To help patients with coronary artery disease (CAD) benefit from the positive health effects attained by exercise-based cardiac rehabilitation (CR), adherence to these programmes according to international guidelines is important. Strategies to increase adherence to exercise-based CR are mainly an unexplored area. The objective of this study is to investigate the effects of a behavioural medicine intervention in physiotherapy, containing goal-setting, self-monitoring and feedback, with the aim of improving rehabilitation outcomes for exercise-based CR, compared with usual care. Methods This is a randomised, controlled trial. A total of 160 patients with CAD will be included consecutively at the Coronary Care Unit at a university hospital in Sweden. Patients are randomised 1:1 using sealed envelopes to usual care or a behavioural medicine intervention in physiotherapy, in addition to usual care for 4 months. Outcome assessment at baseline, 4 and 12 months includes submaximal aerobic capacity (primary outcome), exercise adherence, muscle endurance, level of physical activity, biomarkers, anxiety and depression, health-related quality of life, patient enablement and self-efficacy (secondary outcomes). Discussion This is the first study to evaluate the role of an integrated behavioural medicine intervention in exercise-based CR in the effects of rehabilitation outcomes. The results of this study will provide valuable information about the effect of these interventions in exercise-based CR and it has the potential to inform and assist in further treatment in secondary prevention for patients with CAD. Trial registration The study include all items from the World Health Organization Trial Registration Data Set. Trial registration number: NCT02895451, 2016-08-16, retrospectively registered.
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Affiliation(s)
- Sabina Borg
- Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, SE-581 83, Linköping, Sweden.,Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Birgitta Öberg
- Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, SE-581 83, Linköping, Sweden
| | - Lennart Nilsson
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
| | - Anne Söderlund
- Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Maria Bäck
- Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, SE-581 83, Linköping, Sweden.
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Norris CM, Johnson NL, Hardwicke-Brown E, McEwan M, Pelletier R, Pilote L. The Contribution of Gender to Apparent Sex Differences in Health Status Among Patients with Coronary Artery Disease. J Womens Health (Larchmt) 2016; 26:50-57. [PMID: 27400270 DOI: 10.1089/jwh.2016.5744] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While it has been identified that gender (socially manufactured roles, behaviors, expressions, and identities) plays a central role in men's and women's health, the distinction between gender and sex (biological attributes) has largely been ignored in health science research. The purpose of this study was to look at the unique contributions of sex, age, and the Gender Index (GI) to baseline health status in a cohort of patients with coronary artery disease (CAD). PARTICIPANTS AND METHODS Questions that comprised the GI were included in the follow-up questionnaire sent to patients in the APPROACH registry. To examine the relationship between sex, gender, and health status, a sequential linear regression modeling approach was used. RESULTS A total of 632 patients completed the GI between July and August 2015. The women were significantly older (68 years vs. 66 years, p = 0.02) and significantly more likely to have hypertension (50.8% vs. 38.8%, p = 0.02) compared to the men. Women reported significantly lower mean Seattle Angina Questionnaire (SAQ) scores compared to men. The inclusion of age into the models did not change the relationship between sex and the SAQ scales. However, the inclusion of the GI attenuated the relationship between sex and the SAQ scale scores. CONCLUSIONS Our results support the concept that sex differences in health status outcomes may be better explained by patient's gender-related characteristics, than biological sex characteristics. More importantly, the GI offers a pragmatic composite score to assess the effects of psychosocial factors that researchers interested in measuring gender could use in studies of subjects with CAD.
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Affiliation(s)
- Colleen M Norris
- 1 Faculty of Nursing, University of Alberta , Edmonton, Alberta.,2 Heart Health and Stroke Strategic Clinical Network, Alberta Health Services , Edmonton, Alberta.,3 Division of CV Surgery, Faculty of Medicine, University of Alberta , Edmonton, Alberta
| | | | | | - Matthew McEwan
- 2 Heart Health and Stroke Strategic Clinical Network, Alberta Health Services , Edmonton, Alberta
| | - Roxanne Pelletier
- 5 Division of Clinical Epidemiology, Research Institute of the McGill University , Montreal, Québec
| | - Louise Pilote
- 5 Division of Clinical Epidemiology, Research Institute of the McGill University , Montreal, Québec.,6 Division of General Internal Medicine, McGill University , Montreal, Québec
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Richter VC, Coelho M, Arantes EDC, Dessotte CAM, Schmidt A, Dantas RAS, Rossi LA, Furuya RK. Health status and mental health in patients after percutaneous coronary intervention. Rev Bras Enferm 2015; 68:589-95, 676-82. [PMID: 26422040 DOI: 10.1590/0034-7167.2015680415i] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to assess the association between perceived health status and the mental health of patients submitted to percutaneous coronary intervention after hospital discharge. METHOD a quantitative and cross-sectional study involving 101 participants. The following instruments were used: a sociodemographic and clinical characterization instrument, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). Participants were divided into three groups: no anxiety and no depression (G1); anxiety or depression (G2); and both (G3). The ANOVA test was used for the intergroup comparison of means on the SF-36 domains. RESULTS There was an association between perceived health status and mental health. The participants in G1 presented higher scores in all SF-36 domains in comparison with participants in G2 and G3. CONCLUSION Participants with no anxiety and depression presented better-perceived health status in comparison with those with anxiety or depression, or both.
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Affiliation(s)
- Vitor Cesar Richter
- Curso de Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Mariana Coelho
- Curso de Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Eliana de Cássia Arantes
- Programa de Pós-Graduação em Enfermagem Fundamental, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Carina Aparecida Marosti Dessotte
- Departamento de Enfermagem Geral e Especializada, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - André Schmidt
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Rosana Aparecida Spadoti Dantas
- Departamento de Enfermagem Geral e Especializada, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Lídia Aparecida Rossi
- Departamento de Enfermagem Geral e Especializada, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Rejane Kiyomi Furuya
- Programa de Pós-Graduação Interunidades de Doutoramento em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
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An K, Salyer J, Brown RE, Kao HFS, Starkweather A, Shim I. Salivary Biomarkers of Chronic Psychosocial Stress and CVD Risks. Biol Res Nurs 2015; 18:241-63. [DOI: 10.1177/1099800415604437] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The use of salivary biomarkers in stress research is increasing, and the precision and accuracy with which researchers are able to measure these biomarkers have dramatically improved. Chronic psychosocial stress is often linked to the pathogenesis of cardiovascular disease (CVD). Salivary biomarkers represent a noninvasive biological method of characterizing the stress phenomenon that may help to more fully describe the mechanism by which stress contributes to the pathogenesis and outcomes of CVD. Objectives: We conducted a systematic review of 40 research articles to identify the salivary biomarkers researchers have most commonly used to help describe the biological impact of chronic psychosocial stress and explore its associations with CVD risk. We address strengths and weaknesses of specimen collection and measurement. Methods: We used PubMed, CINAHL, EBSCO host, Web of Science, BIOSIS Previews, Biological Sciences (ProQuest), and Dissertations/Theses (ProQuest) to retrieve 387 initial articles. Once we applied our inclusion/exclusion criteria to specifically target adult human studies dealing with chronic stress rather than acute/laboratory-induced stress, 40 studies remained, which we synthesized using Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Results: Cortisol was the biomarker used most frequently. Sources of psychosocial stress included job strain, low socioeconomic status, and environmental factors. Overall, psychosocial stress was associated with CVD risks such as vascular pathology (hypertension, blood pressure fluctuation, and carotid artery plaque) as well as metabolic factors such as abnormal blood glucose, dyslipidemia, and elevated cardiac enzymes. Conclusion: Diverse salivary biomarkers have been useful in stress research, particularly when linked to CVD risks.
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Affiliation(s)
- Kyungeh An
- School of Nursing, Virginia Commonwealth University, Richmond VA, USA
| | - Jeanne Salyer
- School of Nursing, Virginia Commonwealth University, Richmond VA, USA
| | - Roy E. Brown
- School of Nursing, Virginia Commonwealth University, Richmond VA, USA
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Furuya RK, Costa EDCA, Coelho M, Richter VC, Dessotte CAM, Schmidt A, Dantas RAS, Rossi LA. [Anxiety and depression among men and women who underwent percutaneous coronary intervention]. Rev Esc Enferm USP 2014; 47:1333-7. [PMID: 24626358 DOI: 10.1590/s0080-623420130000600012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 09/27/2013] [Indexed: 11/22/2022] Open
Abstract
A descriptive, cross-sectional, correlational study aimed to investigate the association of sex and the presence of anxiety and depression after hospital discharge in patients who underwent percutaneous coronary intervention (PCI). Fifty-nine patients undergoing PCI and receiving outpatient treatment in the first seven months after hospital discharge were evaluated. To assess the symptoms of anxiety and depression the Hospital Anxiety and Depression Scale (HADS) was used. To test the possible associations between the variables anxiety, depression and sex the Chi-square test was used with a significance level of 5%. The results indicated a greater number of women with depression and the association between the variables sex and depression was statistically significant. In relation to anxiety, cases were more frequent in males and the association between the variables sex and anxiety was not statistically significant.
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Affiliation(s)
- Rejane Kiyomi Furuya
- Escola de Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Doutoranda, Programa Interunidades, Escola de Enfermagem , Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Eliana de Cássia Arantes Costa
- Universidade de Franca, Brasil, SP, Terapeuta Ocupacional. Especialista em Saúde Pública, Universidade de Franca , SP , Brasil
| | - Mariana Coelho
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Graduanda em Enfermagem, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Vitor César Richter
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Graduando em Enfermagem, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Carina Aparecida Marosti Dessotte
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Doutora em Enfermagem, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - André Schmidt
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Médico. Professor Doutor, Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Rosana Aparecida Spadoti Dantas
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Professora Associada, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Lídia Aparecida Rossi
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Professora Titular, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
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Knobf MT, Coviello J. Lifestyle interventions for cardiovascular risk reduction in women with breast cancer. Curr Cardiol Rev 2011; 7:250-7. [PMID: 22758626 PMCID: PMC3322443 DOI: 10.2174/157340311799960627] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Revised: 09/16/2011] [Accepted: 11/27/2011] [Indexed: 01/24/2023] Open
Abstract
PURPOSE The purpose of this paper is to identify risk factors for cardiovascular disease in women with breast cancer and review healthy lifestyle behaviors as essential risk reduction strategies. FINDINGS Women with breast cancer account for 22% of the 12 million cancer survivors. Women diagnosed with breast cancer often present with modifiable and non-modifiable cardiovascular risk factors and/or pre-existing co-morbid illness. Any one or a combination of these factors may increase the risk of cardiovascular disease. There is strong evidence that healthy eating and routine physical activity can reduce cardiovascular disease. Exercise improves cardiovascular fitness, body composition and quality of life in breast cancer survivors and observational studies suggest a survival benefit. CLINICAL IMPLICATIONS Lifestyle interventions including a healthy diet, regular physical activity, weight management and smoking cessation should be integrated into a survivorship care plan to reduce cardiovascular disease risk and promote better health for women with breast cancer.
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Affiliation(s)
- M Tish Knobf
- Yale University School of Nursing, 100 Church Street South, New Haven, CT 06536-0740, USA.
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Psychophysiological Responses to Sedative Music in Patients Awaiting Cardiac Catheterization Examination. J Cardiovasc Nurs 2011; 26:E11-8. [DOI: 10.1097/jcn.0b013e3181fb711b] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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