1
|
Educational Intervention in the Postural Hygiene of School-Age Children. Healthcare (Basel) 2022; 10:healthcare10050864. [PMID: 35628000 PMCID: PMC9140607 DOI: 10.3390/healthcare10050864] [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: 03/21/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 12/10/2022] Open
Abstract
Introduction: Healthy lifestyle habits formed in childhood provide the foundation for a healthy adult life; therefore, it is important to encourage healthy habits and to correct poor habits from an early age. Aim: In this study, we aim to evaluate the influence of educational intervention in order to modify postural hygiene habits in school-age children. Materials and methods: We randomly selected three public primary education schools in the Galician provinces of Orense and Pontevedra based on stratified multistage sampling. A sample of 479 students was obtained, representing 2% of all 6- to 12-year-old children registered during the 2015/2016 academic year in those provinces. Results: Following the intervention, the students’ postural hygiene improved. We found statistically significant differences regarding a reduction in the number of hours spent watching television (0.531 h/day); the way school books and supplies were carried, with an increase in the use of backpacks with wheels (from 58.5% to 64.1%); and an improvement in postural hygiene when watching television, with an increase from 63.7% to 80.8% of those surveyed opting to watch television whilst seated on a chair instead of lying down. Conclusions: Educational intervention by inculcating healthy postural hygiene habits in children at an early age can improve and correct unhealthy behaviours.
Collapse
|
2
|
Ference BA, Graham I, Tokgozoglu L, Catapano AL. Reprint of: Impact of Lipids on Cardiovascular Health: JACC Health Promotion Series. J Am Coll Cardiol 2019; 72:2980-2995. [PMID: 30522632 DOI: 10.1016/j.jacc.2018.10.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/03/2018] [Accepted: 06/26/2018] [Indexed: 12/23/2022]
Abstract
People who maintain ideal cardiovascular heath have a low lifetime risk of cardiovascular disease. Therefore, encouraging people to achieve ideal cardiovascular health represents an important opportunity to improve the prevention of cardiovascular disease. However, preventing cardiovascular disease by promoting ideal cardiovascular health requires shifting the focus from treating disease after it develops to preventing cardiovascular events before they happen by slowing the progression of atherosclerosis. Because atherogenic lipoproteins play a central causal role in the initiation and progression of atherosclerosis, maintaining optimal lipid levels is necessary to achieve ideal cardiovascular health. This review describes the cumulative effect of lipid-carrying lipoproteins on the risk of cardiovascular disease, estimates the magnitude of the clinical benefit that can be achieved by maintaining optimal lipid levels, identifies the most effective timing for implementing strategies designed to achieve optimal lipid levels, and provides a clinical pathway to help people achieve the lipid levels necessary for ideal cardiovascular health.
Collapse
Affiliation(s)
- Brian A Ference
- Centre for Naturally Randomized Trials, University of Cambridge, Cambridge, United Kingdom
| | - Ian Graham
- School of Medicine, Trinity College, Dublin, Ireland
| | - Lale Tokgozoglu
- Department of Cardiology, Hacettepe University, Ankara, Turkey
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy; IRCCS Multimedica, Milan, Italy.
| |
Collapse
|
3
|
Turco JV, Inal-Veith A, Fuster V. Reprint of: Cardiovascular Health Promotion: An Issue That Can No Longer Wait. J Am Coll Cardiol 2019; 72:2945-2950. [PMID: 30522629 DOI: 10.1016/j.jacc.2018.10.018] [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: 11/18/2022]
|
4
|
|
5
|
Fernandez-Jimenez R, Santos-Beneit G, Tresserra-Rimbau A, Bodega P, de Miguel M, de Cos-Gandoy A, Rodríguez C, Carral V, Orrit X, Haro D, Carvajal I, Ibañez B, Storniolo C, Domènech M, Estruch R, Fernández-Alvira JM, Lamuela-Raventós RM, Fuster V. Rationale and design of the school-based SI! Program to face obesity and promote health among Spanish adolescents: A cluster-randomized controlled trial. Am Heart J 2019; 215:27-40. [PMID: 31277052 DOI: 10.1016/j.ahj.2019.03.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/28/2019] [Indexed: 12/18/2022]
Abstract
Unhealthy habits in adolescents are increasing at an alarming rate. The school offers a promising environment in which to implement effective preventive strategies to improve adolescents' lifestyle behaviors. The SI! Program is a multilevel multicomponent school-based health-promotion intervention aimed at all stages of compulsory education in Spain. We present the study design of the SI! Program for Secondary Schools, targeting adolescents aged 12 to 16 years. AIM The main goal of this study is to evaluate the impact of the SI! Program educational intervention on adolescent lifestyle behaviors and health parameters. METHODS The study was designed as a cluster-randomized controlled intervention trial and enrolled 1326 adolescents from 24 public secondary schools in Spain, together with their parents/caregivers. Schools and their students were randomly assigned to the intervention group (the SI! curriculum-based educational program over 2 or 4 academic years) or to the control group (usual curriculum). The primary endpoint will be the change from baseline at 2-year and 4-year follow-up in the composite Ideal Cardiovascular Health (ICH) score, consisting of four health behaviors (body mass index, dietary habits, physical activity, and smoking) and three health factors (blood pressure, total cholesterol, and glucose). Secondary endpoints will include 2-year and 4-year changes from baseline in ICH score subcomponents, the Fuster-BEWAT health scale, adiposity markers (waist circumference and body composition), polyphenol and carotenoid intake, and emotion management. DISCUSSION The overarching goal of the SI! Program is to instill healthy behaviors in children and adolescents that can be sustained into adulthood. The SI! Program for Secondary School is a comprehensive health-promotion intervention targeting 12-16-year-old adolescents and their immediate environment. The present study addresses the optimal timing and impact of the educational intervention on health in adolescence.
Collapse
Affiliation(s)
- Rodrigo Fernandez-Jimenez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Centro de Investigación Biomédica En Red en enfermedades CardioVasculares (CIBERCV), Madrid, Spain; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Gloria Santos-Beneit
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Anna Tresserra-Rimbau
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Center, Universitat Rovira i Virgili, Reus, Spain; Biomedical Research Networking Center-Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Government of Spain, Madrid, Spain
| | - Patricia Bodega
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Mercedes de Miguel
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Amaya de Cos-Gandoy
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Carla Rodríguez
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Vanesa Carral
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Xavier Orrit
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Domènech Haro
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Isabel Carvajal
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Borja Ibañez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Centro de Investigación Biomédica En Red en enfermedades CardioVasculares (CIBERCV), Madrid, Spain; IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain
| | - Carolina Storniolo
- Biomedical Research Networking Center-Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Government of Spain, Madrid, Spain; Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences, XaRTA, INSA, University of Barcelona, Barcelona, Spain
| | - Mónica Domènech
- Biomedical Research Networking Center-Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Government of Spain, Madrid, Spain; Department of Internal Medicine, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ramon Estruch
- Biomedical Research Networking Center-Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Government of Spain, Madrid, Spain; Department of Internal Medicine, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | - Rosa Maria Lamuela-Raventós
- Biomedical Research Networking Center-Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Government of Spain, Madrid, Spain; Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences, XaRTA, INSA, University of Barcelona, Barcelona, Spain.
| | - Valentin Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, United States.
| |
Collapse
|
6
|
Rationale and design of the SI! Program for health promotion in elementary students aged 6 to 11 years: A cluster randomized trial. Am Heart J 2019; 210:9-17. [PMID: 30716509 DOI: 10.1016/j.ahj.2018.12.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 12/15/2018] [Indexed: 01/17/2023]
Abstract
Unhealthy habits in children are increasing at an alarming rate. The school provides a promising setting for effective preventive strategies to improve children's lifestyle behaviors. The SI! Program is a multilevel multicomponent school-based educational intervention aimed at all stages of compulsory education in Spain. Here, we present the design of the SI! Program for Elementary School cluster-randomized controlled trial, targeting children aged 6 to 11 years. This trial aims to study the impact of different timings and intensities of exposure to SI! Program activities on elementary school children and their immediate environment (parents/caregivers, teachers, and school). The trial includes 1770 children from 48 public elementary schools in Madrid (Spain), together with their parents and teachers. Schools and their children were randomly assigned to the intervention group (the SI! curriculum-based educational program over 3 or 6 academic years) or to the control group (standard curriculum). The primary outcomes are the change from baseline at 3-year and 6-year follow-up in children's scores for knowledge, attitudes, and habits (KAH) and health factors (blood pressure, height, weight, waist circumference, and skinfold thickness). Secondary outcomes include 3-year and 6-year changes from baseline in lifestyle questionnaire scores for parents/caregivers and teachers, and in the school environment questionnaire. The overarching goal of the SI! Program is to provide an effective and sustainable health promotion program for the adoption of healthy behaviors in children. The present trial will address the impact and the optimal timing and duration of this educational intervention in the elementary school setting.
Collapse
|
7
|
Impact of Lipids on Cardiovascular Health. J Am Coll Cardiol 2018; 72:1141-1156. [DOI: 10.1016/j.jacc.2018.06.046] [Citation(s) in RCA: 176] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/03/2018] [Accepted: 06/26/2018] [Indexed: 11/20/2022]
|
8
|
Aggarwal M, Devries S, Freeman AM, Ostfeld R, Gaggin H, Taub P, Rzeszut AK, Allen K, Conti RC. The Deficit of Nutrition Education of Physicians. Am J Med 2018; 131:339-345. [PMID: 29269228 DOI: 10.1016/j.amjmed.2017.11.036] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 11/24/2017] [Accepted: 11/27/2017] [Indexed: 11/24/2022]
Abstract
Globally, death rates from cardiovascular disease are increasing, rising 41% between 1990 and 2013, and are often attributed, at least in part, to poor diet quality. With urbanization, economic development, and mass marketing, global dietary patterns have become more Westernized to include more sugar-sweetened beverages, highly processed foods, animal-based foods, and fewer fruits and vegetables, which has contributed to increasing cardiovascular disease globally. In this paper, we will examine the trends occurring globally in the realm of nutrition and cardiovascular disease prevention and also present new data that international nutrition knowledge amongst cardiovascular disease providers is limited. In turn, this lack of knowledge has resulted in less patient education and counseling, which is having profound effects on cardiovascular disease prevention efforts worldwide.
Collapse
Affiliation(s)
- Monica Aggarwal
- Division of Cardiology, University of Florida, Gainesville, FL.
| | - Stephen Devries
- Gaples Institute for Integrative Cardiology, Deerfield, Ill; Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Andrew M Freeman
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, Colo
| | - Robert Ostfeld
- Division of Cardiology, Montefiore Medical Center, New York, NY
| | - Hanna Gaggin
- Division of Cardiology, Massachusetts General Hospital, Boston; Baim Institute for Clinical Research, Boston, Mass
| | - Pam Taub
- Cardiovascular Division, UC San Diego Health System, Calif
| | - Anne K Rzeszut
- Market Intelligence, American College of Cardiology, Washington, DC
| | - Kathleen Allen
- Department of Nutrition & Food Studies, New York University, New York, NY
| | - Richard C Conti
- Division of Cardiology, University of Florida, Gainesville, FL
| |
Collapse
|
9
|
Soto Rodríguez A, García Soidán JL, Arias Gómez MJ, Del Álamo Alonso A, Leirós Rodríguez R, Pérez Fernández MR. Educational intervention on cardiovascular parameters in perimenopausal women with a cardiovascular risk factor. Randomised clinical trial. Med Clin (Barc) 2018; 150:178-184. [PMID: 28743399 DOI: 10.1016/j.medcli.2017.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/12/2017] [Accepted: 06/15/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVE Randomised clinical trial performed in two urban health centres in Spain. To evaluate if educational intervention in women of perimenopausal age with hypertension, diabetes mellitus and/or dyslipidaemia could achieve significant changes in the reduction of biochemical and haemodynamic risk parameters. PATIENTS AND METHODS The study included 320 women aged between 45 and 60 years old who were diagnosed with hypertension, diabetes mellitus and/or dyslipidaemia. They were randomly assigned to the experimental group (n=160) and the control group (n=160). The intervention group received three educational sessions and the control group received an informative leaflet sent by mail. Haemodynamic and biochemical variables were evaluated at baseline and one year later in both groups. RESULTS Women in the intervention group showed a decrease in low density lipoprotein (P=.034), (-5.89±29.8; 95% CI: -13.1/0.27) and an increase in high density lipoprotein (P=.013), (2.71±10.6; 95% CI: -1.36/6.20), as well as improvements in systolic blood pressure (P=.016), (-2.16±11.8; 95% CI: -4.4/0.01) and frequency (P=.003), (-1.46±10.3; 95% CI: -3.34/0.42) compared to women in the control group. Women in the control group significantly increased glucose (P=.04), (4.84±15.5; 95% CI: -0.75/31.3) and gamma-glutamyltranspeptidase (P=.031), (3.61±14.7; 95% CI: 0.87/6.36) levels more than those in the experimental group. CONCLUSIONS An educational intervention can be an effective method of reducing the parameters associated with an increased likelihood of cardiovascular disease in women at perimenopausal age with hypertension, diabetes mellitus and/or dyslipidaemia.
Collapse
Affiliation(s)
- Anxela Soto Rodríguez
- Escuela Universitaria de Enfermería, Xerencia de Xestión Integrada de Ourense, SERGAS, Ourense, España
| | - José Luís García Soidán
- Facultad de Ciencias de la Educación y del Deporte, Universidad de Vigo, Campus Pontevedra, España
| | - María Jesús Arias Gómez
- Servicio de Atención Primaria A Ponte, Xerencia de Xestión Integrada de Ourense, SERGAS, Ourense, España
| | - Alberto Del Álamo Alonso
- Servicio de Atención Primaria Novoa Santos, Xerencia de Xestión Integrada de Ourense, SERGAS, Ourense, España
| | | | | |
Collapse
|
10
|
|
11
|
Affiliation(s)
- Ramachandran S Vasan
- From National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA (R.S.V., E.J.B.); Evans Department of Medicine, Whitaker Cardiovascular Institute (R.S.V., E.J.B.) and Preventive Medicine and Cardiology Sections, Department of Medicine (R.S.V., E.J.B.), Boston University School of Medicine, MA; and Department of Epidemiology, Boston University School of Public Health, MA (R.S.V., E.J.B.).
| | - Emelia J Benjamin
- From National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA (R.S.V., E.J.B.); Evans Department of Medicine, Whitaker Cardiovascular Institute (R.S.V., E.J.B.) and Preventive Medicine and Cardiology Sections, Department of Medicine (R.S.V., E.J.B.), Boston University School of Medicine, MA; and Department of Epidemiology, Boston University School of Public Health, MA (R.S.V., E.J.B.)
| |
Collapse
|
12
|
El papel del cardiólogo clínico en un programa de prevención cardiovascular. REVISTA COLOMBIANA DE CARDIOLOGÍA 2016. [DOI: 10.1016/j.rccar.2016.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
13
|
Jaramillo Gómez N. The role of the clinical cardiologist in a cardiovascular prevention program. REVISTA COLOMBIANA DE CARDIOLOGÍA 2016. [DOI: 10.1016/j.rccar.2016.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
14
|
Moreno-Martínez FL, Chávez-González E, Moreno-Valdés MT, Oroz Moreno R. Promoción de salud para reducir el retraso en buscar atención médica de los pacientes con síndrome coronario agudo. Rev Esp Cardiol (Engl Ed) 2016. [DOI: 10.1016/j.recesp.2016.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
15
|
Moreno-Martínez FL, Chávez-González E, Moreno-Valdés MT, Oroz Moreno R. Health Promotion to Reduce Delays in Seeking Medical Attention in Patients With Acute Coronary Syndrome. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2016; 69:713. [PMID: 27235287 DOI: 10.1016/j.rec.2016.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 03/14/2016] [Indexed: 06/05/2023]
Affiliation(s)
| | - Elibet Chávez-González
- Departamento de Electrofisiología y Arritmias, Cardiocentro Ernesto Che Guevara, Villa Clara, Cuba
| | | | | |
Collapse
|
16
|
Aranceta-Bartrina J, Pérez-Rodrigo C, Alberdi-Aresti G, Ramos-Carrera N, Lázaro-Masedo S. Prevalencia de obesidad general y obesidad abdominal en la población adulta española (25–64 años) 2014–2015: estudio ENPE. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.02.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
17
|
Aranceta-Bartrina J, Pérez-Rodrigo C, Alberdi-Aresti G, Ramos-Carrera N, Lázaro-Masedo S. Prevalence of General Obesity and Abdominal Obesity in the Spanish Adult Population (Aged 25-64 Years) 2014-2015: The ENPE Study. ACTA ACUST UNITED AC 2016; 69:579-87. [PMID: 27133458 DOI: 10.1016/j.rec.2016.02.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 02/11/2016] [Indexed: 12/26/2022]
Abstract
INTRODUCTION AND OBJECTIVES According to the 2013 analysis of the Institute of Health Metrics, high body mass index values are the most important risk factor for disease in Spain. Consequently, we describe the prevalence of total obesity and abdominal obesity in the Spanish adult population (25-64 years) for 2014-2015. METHODS The sample was taken from the ENPE study, a cross-sectional study with a representative sample of the noninstitutionalized population (n = 6800) carried out between May 2014 and May 2015. This analysis refers to the population between age 25 and 64 years (n = 3966). The anthropometric measurements were performed by trained observers at participants' homes according to standard international protocols. Body mass index ≥ 25 was defined as overweight and ≥ 30 as obesity. Abdominal obesity was classified as waist > 102 cm in men and > 88 cm in women. RESULTS The estimated prevalence of overweight in the Spanish adult population (25-64 years) was 39.3% 95% confidence interval [95%CI], 35.7%-42.9%). The prevalence of general obesity was 21.6% (95%CI, 19.0%-24.2%) and, more specifically, was 22.8% (95%CI, 20.6%-25.0%) among men and 20.5% (95%CI, 18.5%-22.5%) among women, and rose with age. The prevalence of abdominal obesity was estimated at 33.4% (95%CI, 31.1%-35.7%) and was higher among women (43.3%; 95%CI, 41.1%-45.8%) than among men (23.3%; 95%CI, 20.9%-25.5%), and also rose with age. CONCLUSIONS The prevalence of general obesity and abdominal obesity in Spain is high, although the distribution differs according to autonomous community. A comparison with earlier data reveals a considerable increase in overweight, indicating the need for routine monitoring and comprehensive initiatives.
Collapse
Affiliation(s)
- Javier Aranceta-Bartrina
- Medicina Preventiva y Salud Pública, Facultad de Farmacia, Universidad de Navarra, Pamplona, Navarra, Spain; Sociedad Española de Nutrición Comunitaria (SENC), Barcelona, Spain; Fundación FIDEC, Euskal Herriko Unibertsitatea-Universidad del País Vasco, Basurto-Bilbao, Bizkaia, Spain; CiberOBN, Instituto de Salud Carlos III, Madrid, Spain.
| | - Carmen Pérez-Rodrigo
- Sociedad Española de Nutrición Comunitaria (SENC), Barcelona, Spain; Fundación FIDEC, Euskal Herriko Unibertsitatea-Universidad del País Vasco, Basurto-Bilbao, Bizkaia, Spain
| | - Goiuri Alberdi-Aresti
- Sociedad Española de Nutrición Comunitaria (SENC), Barcelona, Spain; School of Medicine, University College of Dublin, Dublin, Ireland
| | | | | |
Collapse
|
18
|
Howard G, Banach M, Cushman M, Goff DC, Howard VJ, Lackland DT, McVay J, Meschia JF, Muntner P, Oparil S, Rightmyer M, Taylor HA. Is blood pressure control for stroke prevention the correct goal? The lost opportunity of preventing hypertension. Stroke 2015; 46:1595-600. [PMID: 25953369 DOI: 10.1161/strokeaha.115.009128] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/13/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND PURPOSE Although pharmacological treatment of hypertension has important health benefits, it does not capture the benefit of maintenance of ideal health through the prevention or delay of hypertension. METHODS A total of 26 875 black and white participants aged 45+ years were assessed and followed for incident stroke events. The association was assessed between incident stroke and: (1) systolic blood pressure (SBP)categorized as normal (<120 mm Hg), prehypertension (120-139 mm Hg), stage 1 hypertension (140-159 mm Hg), and stage 2 hypertension (160 mm Hg+), and (2) number of classes of antihypertensive medications, classified as none, 1, 2, or 3 or more. RESULTS During 6.3 years of follow-up, 823 stroke events occurred. Nearly half (46%) of the population were successfully treated (SBP<140 mm Hg) hypertensives. Within blood pressure strata, the risk of stroke increased with each additional class of required antihypertensive medication, with hazard ratio [HR], 1.33; 95% confidence interval, 1.16 to 1.52 for normotensive, HR, 1.15; 95% confidence interval, 1.05 to 1.26 for prehypertension, and HR, 1.22; 95% confidence interval, 1.06 to 1.39 for stage 1 hypertension. A successfully treated (SBP<120 mm Hg) hypertensive person on 3+ antihypertensive medication classes was at marginally higher stroke risk than a person with untreated stage 1 hypertension (HR, 2.48 versus HR=2.19; relative to those with SBP <120 on no antihypertensive medications). CONCLUSIONS Maintaining the normotensive status solely through pharmacological treatment has a profound impact, as nearly half of this general population cohort were treated to guideline (SBP<140 mm Hg) but failed to return to risk levels similar to normotensive individuals. Even with successful treatment, there is a substantial potential gain by prevention or delay of hypertension.
Collapse
Affiliation(s)
- George Howard
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.).
| | - Maciej Banach
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| | - Mary Cushman
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| | - David C Goff
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| | - Virginia J Howard
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| | - Daniel T Lackland
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| | - Jim McVay
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| | - James F Meschia
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| | - Paul Muntner
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| | - Suzanne Oparil
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| | - Melanie Rightmyer
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| | - Herman A Taylor
- From the Departments of Biostatistics (G.H.) and Epidemiology (V.J.H., P.M.), UAB School of Public Health, Birmingham, AL; Department of Hypertension, Medical University of Lodz, Lodz, Poland (M.B.); Department of Medicine, University of Vermont, Burlington (M.C.); Office of the Dean, Colorado School of Public Health, Aurora, CO (D.C.G.); Department of Neurosciences, Medical University of South Carolina, Charleston (D.T.L.); Bureau of Health Promotion and Chronic Disease, Alabama Department of Public Health, Montgomery (J.M.V., M.R.); Department of Neurology, Mayo Clinic, Jacksonville, FL (J.F.M.); Department of Medicine, UAB School of Medicine, Birmingham, AL (S.O.); and Department of Medicine, Morehouse School of Medicine, Atlanta, GA (H.A.T.)
| |
Collapse
|
19
|
Roger VL, Gerber Y. Muertes por enfermedad coronaria: desde las cohortes de nacimiento a la prevención. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
20
|
Roger VL, Gerber Y. Coronary Disease Deaths: From Birth Cohorts to Prevention. ACTA ACUST UNITED AC 2015; 68:361-2. [PMID: 25770881 DOI: 10.1016/j.rec.2014.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 12/15/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Véronique L Roger
- Division of Cardiovascular Diseases, Department of Internal Medicine and Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States.
| | - Yariv Gerber
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
21
|
Sanchis J, Avanzas P, Bayes-Genis A, Pérez de Isla L, Heras M. 2014 annual summary and new projects in Revista Española de Cardiología. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2015; 68:265-272. [PMID: 25721166 DOI: 10.1016/j.rec.2015.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 01/22/2015] [Indexed: 06/04/2023]
Affiliation(s)
- Juan Sanchis
- Editor-in-Chief, Revista Española de Cardiología.
| | | | | | | | - Magda Heras
- Former Editor, Revista Española de Cardiología
| |
Collapse
|
22
|
Sanchis J, Avanzas P, Bayes-Genis A, Isla LPD, Heras M. Resumen anual y novedades en el año 2014 de REVISTA ESPAÑOLA DE CARDIOLOGÍA. Rev Esp Cardiol (Engl Ed) 2015. [DOI: 10.1016/j.recesp.2015.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
23
|
Barrios V, Escobar C, Llisterri J, Rodríguez Roca G, Badimón J, Vergara J, Prieto M, Serrano A, Cinza S, Murillo C. Características clínicas basales y manejo de los pacientes incluidos en el estudio IBERICAN. Semergen 2015; 41:3-12. [DOI: 10.1016/j.semerg.2014.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 09/29/2014] [Indexed: 12/18/2022]
|
24
|
Heras M, Bayes-Genis A, Pérez de Isla L, Sanchis J, Avanzas P. Continuing medical education: a priority in Revista Española de Cardiología. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2014; 67:1068-1073. [PMID: 25455757 DOI: 10.1016/j.rec.2014.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 09/18/2014] [Indexed: 06/04/2023]
|
25
|
Heras M, Bayes-Genis A, Pérez de Isla L, Sanchis J, Avanzas P. Formación médica continuada: un objetivo prioritario en Revista Española de Cardiología. Rev Esp Cardiol (Engl Ed) 2014. [DOI: 10.1016/j.recesp.2014.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|