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Bernal-Jiménez MÁ, Calle-Pérez G, Gutiérrez-Barrios A, Gheorghe L, Solano-Mulero AM, Rodríguez-Martín A, Tur JA, Vázquez-García R, Santi-Cano MJ. Lifestyle and Treatment Adherence Intervention after a Coronary Event Based on an Interactive Web Application (EVITE): Randomized Controlled Clinical Trial Protocol. Nutrients 2021; 13:nu13061818. [PMID: 34071782 PMCID: PMC8226528 DOI: 10.3390/nu13061818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022] Open
Abstract
Coronary heart disease is one of the main causes of morbimortality around the world. Patients that survive a coronary event suffer a high risk of readmission, relapse and mortality, attributed to the sub-optimal control of cardiovascular risk factors (CVRF), which highlights the need to improve secondary prevention strategies aimed at improving their lifestyle and adherence to treatment. Through a randomized controlled clinical trial, this study aims to evaluate the effect of an intervention involving an online health application supported by a mobile telephone or tablet (mHealth) on lifestyle (diet, physical activity, and tobacco consumption) and treatment adherence among people with coronary heart disease after percutaneous coronary intervention. The sample will comprise 240 subjects (120 in each arm: intervention and usual care). They are assessed immediately and nine months after their hospital discharge about sociodemographic, clinical, CVRF, lifestyle, and treatment adherence characteristics. The educative intervention, involving a follow-up and self-monitoring, will be performed using an online mHealth tool consisting of an application for mobile phones and tablets. The quantitative primary outcomes from the two groups will be compared using an analysis of covariance (ANCOVA) adjusted for age and gender. A multivariate analysis will be performed to examine the association of the intervention with lifestyle habits, the control of CVRFs, and outcomes after discharge in terms of the use of health services, emergency visits, cardiovascular events and readmissions.
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Affiliation(s)
- María Ángeles Bernal-Jiménez
- Faculty of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (M.Á.B.-J.); (A.R.-M.)
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
| | - Germán Calle-Pérez
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Cardiology Unit, Puerta del Mar Hospital, 11009 Cadiz, Spain;
| | - Alejandro Gutiérrez-Barrios
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Cardiology Unit, Puerta del Mar Hospital, 11009 Cadiz, Spain;
| | - Livia Gheorghe
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Cardiology Unit, Puerta del Mar Hospital, 11009 Cadiz, Spain;
| | | | - Amelia Rodríguez-Martín
- Faculty of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (M.Á.B.-J.); (A.R.-M.)
- Biomedicine, Biotechnology and Public Health Department, University of Cadiz, 11003 Cádiz, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, IDISBA & CIBEROBN, 07122 Palma de Mallorca, Spain;
| | - Rafael Vázquez-García
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Cardiology Unit, Puerta del Mar Hospital, 11009 Cadiz, Spain;
| | - María José Santi-Cano
- Faculty of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (M.Á.B.-J.); (A.R.-M.)
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Research Group on Nutrition, Molecular, Pathophysiological and Social Issues, University of Cádiz, 11009 Cádiz, Spain
- Correspondence: ; Tel.: +34-956-019-042; Fax: +34-956-015-685
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The Association between Air Temperature and Mortality in Two Brazilian Health Regions. CLIMATE 2020. [DOI: 10.3390/cli8010016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Air temperature, both cold and hot, has impacts on mortality and morbidities, which are exacerbated by poor health service and protection responses, particularly in under-developed countries. This study was designed to analyze the effects of air temperature on the risk of deaths for all and specific causes in two regions of Brazil (Florianopolis and Recife), between 2005 and 2014. The association between temperature and mortality was performed through the fitting of a quasi-Poisson non-linear lag distributed model. The association between air temperature and mortality was identified for both regions. The results showed that temperature exerted influence on both general mortality indicators and specific causes, with hot and cold temperatures bringing different impacts to the studied regions. Cerebrovascular and cardiovascular deaths were more sensitive to cold temperatures for Florianopolis and Recife, respectively. Based on the application of the very-well documented state-of-the-art methodology, it was possible to conclude that there was evidence that extreme air temperature influenced general and specific deaths. These results highlighted the importance of consolidating evidence and research in tropical countries such as Brazil as a way of understanding climate change and its impacts on health indicators.
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Díaz J, Carmona R, Mirón IJ, Ortiz C, Linares C. Comparison of the effects of extreme temperatures on daily mortality in Madrid (Spain), by age group: The need for a cold wave prevention plan. ENVIRONMENTAL RESEARCH 2015; 143:186-91. [PMID: 26496852 DOI: 10.1016/j.envres.2015.10.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/30/2015] [Accepted: 10/15/2015] [Indexed: 05/16/2023]
Abstract
A number of studies have shown that there is a time trend towards a reduction in the effects of heat on mortality. In the case of cold, however, there is practically no research of this type and so there is no clearly defined time trend of the impact of cold on mortality. Furthermore, no other specific studies have yet analysed the time trend of the impact of both thermal extremes by age group. We analysed data on daily mortality due to natural causes (ICD-10: A00-R99) in the city of Madrid across the period 2001-2009 and calculated the impact of extreme temperatures on mortality using Poisson regression models for specific age groups. The groups of age selected coinciding with the pre-existing age-groups analyzed in previous papers. For heat waves the groups of age used were: <10 years, 10-17 years, 18-44 years, 45-64 years, 65-74 years and over-75 years. For cold waves the groups of age used were: <1 year; 1-5 years, 6-17 years, 18-44 years, 45-64 years, 65-74 years and over-75 years. <1, 1-17, 18-44, 45-66, 65-74 and over-75 years. We controlled for confounding variables, such as air pollution, noise, influenza, pollen, pressure and relative humidity, trend of the series, as well as seasonalities and autoregressive components of the series. The results of these models were compared to those obtained for the same city during the period 1986-1997 and published in different studies. Our results show a lightly reduction in the effects of heat, especially in the over-45-year age group. In the case of cold, the behaviour pattern was the opposite, with an increase in its effect. Heat adaptation and socio-economic and public-health prevention and action measures may be behind this amelioration in the effects of heat, whereas the absence of such actions in respect of low temperatures may account for the increase in the effects of cold on mortality. From a public health point of view, the implementation of cold wave prevention plans covering all age groups is thus called for.
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Affiliation(s)
- J Díaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
| | - R Carmona
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - I J Mirón
- Torrijos Public Health District, Castile-La Mancha Regional Health & Social Affairs Authority (Consejería de Sanidad y Asuntos Sociales de Castilla-La Mancha), Torrijos, Toledo, Spain
| | - C Ortiz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - C Linares
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
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Miron IJ, Linares C, Montero JC, Criado-Alvarez JJ, Díaz J. Changes in cause-specific mortality during heat waves in central Spain, 1975-2008. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1213-1222. [PMID: 25399358 DOI: 10.1007/s00484-014-0933-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 10/21/2014] [Accepted: 10/31/2014] [Indexed: 06/04/2023]
Abstract
The relationship between heat waves and mortality has been widely described, but there are few studies using long daily data on specific-cause mortality. This study is undertaken in central Spain and analysing natural causes, circulatory and respiratory causes of mortality from 1975 to 2008. Time-series analysis was performed using ARIMA models, including data on specific-cause mortality and maximum and mean daily temperature and mean daily air pressure. The length of heat waves and their chronological number were analysed. Data were stratified in three decadal stages: 1975-1985, 1986-1996 and 1997-2008. Heat-related mortality was triggered by a threshold temperature of 37 °C. For each degree that the daily maximum temperature exceeded 37 °C, the percentage increase in mortality due to circulatory causes was 19.3 % (17.3-21.3) in 1975-1985, 30.3 % (28.3-32.3) in 1986-1996 and 7.3 % (6.2-8.4) in 1997-2008. The increase in respiratory cause ranged from 12.4 % (7.8-17.0) in the first period, to 16.3 % (14.1-18.4) in the second and 13.7 % (11.5-15.9) in the last. Each day of heat-wave duration explained 5.3 % (2.6-8.0) increase in respiratory mortality in the first period and 2.3 % (1.6-3.0) in the last. Decadal scale differences exist for specific-causes mortality induced by extreme heat. The impact on heat-related mortality by natural and circulatory causes increases between the first and the second period and falls significantly in the last. For respiratory causes, the increase is no reduced in the last period. These results are of particular importance for the estimation of future impacts of climate change on health.
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Affiliation(s)
- Isidro Juan Miron
- Torrijos Public Health District, Castile-La Mancha Regional Health & Social Affairs Authority, Torrijos, Toledo, Spain,
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Gómez-Huelgas R, Martínez-Sellés M, Formiga F, Alemán Sánchez JJ, Camafort M, Galve E, Gil P, Lobos JM. Tratamiento de los factores de riesgo vascular en el paciente mayor de 80 años. Med Clin (Barc) 2014; 143:134.e1-11. [DOI: 10.1016/j.medcli.2014.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 04/23/2014] [Accepted: 04/24/2014] [Indexed: 12/31/2022]
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Ariza-Solé A, Teruel L, di Marco A, Lorente V, Sánchez-Salado JC, Sánchez-Elvira G, Romaguera R, Gómez-Lara J, Gómez-Hospital JA, Cequier À. Valor pronóstico de la oclusión total crónica de una arteria no responsable en el infarto agudo de miocardio tratado con angioplastia primaria. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2013.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ariza-Solé A, Teruel L, di Marco A, Lorente V, Sánchez-Salado JC, Sánchez-Elvira G, Romaguera R, Gómez-Lara J, Gómez-Hospital JA, Cequier A. Prognostic impact of chronic total occlusion in a nonculprit artery in patients with acute myocardial infarction undergoing primary angioplasty. ACTA ACUST UNITED AC 2014; 67:359-66. [PMID: 24774728 DOI: 10.1016/j.rec.2013.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 08/02/2013] [Indexed: 02/02/2023]
Abstract
INTRODUCTION AND OBJECTIVES The prognostic value of chronic total occlusion in nonculprit coronary arteries in patients with myocardial infarction undergoing primary angioplasty remains controversial. Several publications have described different methodologies and conflicting findings. In addition, causes of death were not reported. Our aim is to analyze the prognostic impact of chronic total occlusion in nonculprit coronary arteries and the role of left ventricular ejection fraction in this analysis. METHODS Prospective inclusion of consecutive patients with ST-segment elevation myocardial infarction who underwent primary angioplasty. We recorded baseline characteristics, in-hospital clinical course, and mortality and its causes during follow-up. We assessed the impact of chronic total occlusion on mortality using Cox regression analysis. RESULTS Chronic total occlusion in nonculprit arteries was present in 125 of 1176 patients (10.6%); in 79 of these 125 patients, chronic total occlusion was present in the proximal segments. The mean follow-up was 339 days; 64 (5.8%) patients died during the first 6 months. Patients with chronic total occlusions had more comorbidities, poorer ventricular function, and higher mortality (hazard ratio=2.79; 95% confidence interval, 1.71-4.56). Chronic total occlusion was also associated with noncardiac death (hazard ratio=3.83; 95% confidence interval, 2.10-7.01). Chronic total occlusion in proximal segments was associated with both cardiac (hazard ratio=3.22; 95% confidence interval, 1.42-7.30) and noncardiac deaths (hazard ratio=3.43; 95% confidence interval, 1.67-7.06). The multivariate analysis performed without including left ventricular ejection fraction showed a significant association between chronic total occlusion and mortality. However, when left ventricular ejection fraction was included in the analysis, this association was nonsignificant (hazard ratio=1.76; 95% confidence interval, 0.85-3.65; P=.166). CONCLUSIONS Chronic total occlusion in this clinical setting identified patients at higher risk with more comorbidities and higher mortality, but did not behave as an independent predictor of mortality when left ventricular ejection fraction was included in the analysis.
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Affiliation(s)
- Albert Ariza-Solé
- Unidad Coronaria, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Luis Teruel
- Unidad de Cardiología Intervencionista, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Andrea di Marco
- Unidad Coronaria, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Victòria Lorente
- Unidad Coronaria, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - José C Sánchez-Salado
- Unidad Coronaria, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Guillermo Sánchez-Elvira
- Unidad de Cardiología Intervencionista, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael Romaguera
- Unidad de Cardiología Intervencionista, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Gómez-Lara
- Unidad de Cardiología Intervencionista, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan A Gómez-Hospital
- Unidad de Cardiología Intervencionista, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Angel Cequier
- Unidad de Cardiología Intervencionista, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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