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Denham AMJ, Haracz K, Simpson D, Bird ML, Mabotuwana N, Janssen H. Caring for yourself while you care for someone else: a qualitative study exploring the mental and cardiovascular health behaviours of female carers of stroke survivors. Disabil Rehabil 2024:1-9. [PMID: 39235424 DOI: 10.1080/09638288.2024.2399229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 08/20/2024] [Accepted: 08/28/2024] [Indexed: 09/06/2024]
Abstract
PURPOSE Female carers of stroke survivors may experience increased risk of developing chronic health issues, such as cardiovascular disease. This study aims to understand: (i) how female carers of stroke survivors manage their mental and cardiovascular health and (ii) the characteristics they would find helpful in an intervention to support their ability to manage their health and wellbeing. MATERIALS AND METHODS A qualitative descriptive design was used with data collected via semi-structured interviews and analysed using inductive thematic analysis. RESULTS Eighteen female carers of stroke survivors participated in the study. Three key themes were identified: (i) struggling to prioritise own health and wellbeing; (ii) new roles and responsibilities impact on self-care; and (iii) peer-support improves mental health and well-being. Carers described preferences for group interventions to include peer support and have flexible delivery to allow easy access to information. One-to-one sessions with different health professionals may also be useful at times through the caregiving journey. CONCLUSIONS These findings suggest that current interventions do not address cardiovascular risk self-management for female carers and provide insight into characteristics of interventions that may increase acceptability and feasibility of interventions to support long-term cardiovascular and mental health-promoting behaviours.
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Affiliation(s)
- A M J Denham
- School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - K Haracz
- School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - D Simpson
- School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - M L Bird
- School of Health Sciences, University of Tasmania, Hobart, Australia
| | - N Mabotuwana
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
| | - H Janssen
- School of Health Sciences, University of Newcastle, Callaghan, Australia
- Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, Australia
- Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, Australia
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Lillo A, Antoncecchi E, Antoncecchi V, Zito GB. The Cardiovascular Risk Awareness and Health Lifestyle of Italian Women. J Clin Med 2024; 13:3253. [PMID: 38892964 PMCID: PMC11172804 DOI: 10.3390/jcm13113253] [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: 04/11/2024] [Revised: 05/21/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Cardiovascular (CV) disease is the leading cause of death in women, but few of them are aware of the CV risks (CVRs). Most women are not aware of all the CV risk factorsand their knowledge often still does not improve their lifestyle. Methods: The Carin Women is a survey conducted among Italian women by filling out a questionnaire in the waiting rooms of clinics. The aim was to determine the level of awareness of women's cardiovascular risk, knowledge of risk factors, and lifestyle. A total of 5590 questionnaires were completed in two different periods. Results: Median age was 56 (IQR 46-65); BMI was 25 (IQR 22-29). Schooling, marital status, and rate of risk conditions were assessed; 311 women (5.57%) had already suffered a cardiovascular event. The relationship between the CV events and the number of traditional risk factors was significant. A similar curve, but without significant differences, was reported for non-traditional risk factors. From the total number of women, 23% with a high CVR and 62% with a very high CVR underestimated thei risk regardless of their level of education. Up to 43% of women underestimated female CV risk compared to male risk. Women showed a good knowledge of traditional risk factors, but only a few of them had a healthy lifestyle: 21.86% were smokers, only 45.88% performed sufficient physical activity, 27.55% did not recognize they were overweight, and only 30.4% consumed more than two daily portions of fruit and vegetables. Most women (86%) need more information about CVR. Conclusions: Italian women underestimate female CVRs and their own CVR.
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Affiliation(s)
- Adele Lillo
- Outpatient Cardiology Ospedale “Fallacara” Triggiano, 70019 Triggiano (BA), Italy;
| | | | - Valeria Antoncecchi
- Outpatient Cardiology Ospedale “Fallacara” Triggiano, 70019 Triggiano (BA), Italy;
| | - Giovanni Battista Zito
- Cardiology Service, Local Health Unit (LHU) Naples 3 South, Associazioni Regionali Cardiologi Ambulatoriali (A.R.C.A.), 80045 Rome, Italy;
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Szakun N, Liva S, Bodner ME, Wolff A, Kim MY, Cote AT. Prevalence of Sex-Specific Cardiovascular Disease Risk Factors, Medical Risk, and Engagement in Health-Promoting Behaviours in Premenopausal Females. CJC Open 2024; 6:301-313. [PMID: 38487073 PMCID: PMC10935687 DOI: 10.1016/j.cjco.2023.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/04/2023] [Indexed: 03/17/2024] Open
Abstract
Background Several sex-specific risk factors (SS-RFs) increase a women's risk for cardiovascular disease (CVD) but are often overlooked during risk assessment. The purpose of this study was to identify the prevalence of SS-RFs and assess CVD risk, knowledge, perceptions and behaviours in premenopausal Canadian women. Methods An online survey was distributed across Canada to premenopausal biological females (19-49 years of age). The survey gathered demographics, medical history, engagement in health-promoting behaviours, and knowledge and perceptions of CVD risk. CVD risk was calculated using medical risk and SS-RFs were tabulated from medical history. Results A total of 2559 participants (33 ± 8 years) completed the survey. The majority of our sample (82%) was classified as low medical risk. Of those classified as low risk, 35% had at least 1 SS-RF. Of high-risk individuals, 70% underestimated their risk, 21% of whom perceived themselves as low risk. Engagement in health behaviours was suboptimal. Knowledge of traditional CVD risk factors and prevention was relatively high; however, less than one-half were aware of SS-RFs such as early menopause (39.4%). Conclusions Considering both traditional and SS-RFs, 47% of premenopausal Canadian women may be at risk for developing CVD. Of those deemed low medical risk for developing CVD, more than one-third reported having at least 1 SS-RF. Canadian women have poor knowledge of the risks associated with SS-RFs, lack sufficient awareness of the need for prevention of CVD, and are not engaging in sufficient health-promoting behaviours to mitigate future CVD risk.
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Affiliation(s)
- Natalie Szakun
- School of Human Kinetics, Trinity Western University, Langley, British Columbia, Canada
| | - Sarah Liva
- School of Nursing, Trinity Western University, Langley, British Columbia, Canada
| | - Michael E. Bodner
- School of Human Kinetics, Trinity Western University, Langley, British Columbia, Canada
| | - Angela Wolff
- School of Nursing, Trinity Western University, Langley, British Columbia, Canada
| | - Mi-Yeon Kim
- School of Nursing, Trinity Western University, Langley, British Columbia, Canada
| | - Anita T. Cote
- School of Human Kinetics, Trinity Western University, Langley, British Columbia, Canada
- Faculty of Medicine, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
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Makaryus AN, Rosen SE, Kang L, Shaw LJ, Nash B, Gajer R, Coppolino W, Mieres JH. Racial and Ethnic Differences in Awareness and Prevalence of Unidentified Cardiovascular Risk Factors Among Health System Employees. Am J Health Promot 2023; 37:1091-1099. [PMID: 37492930 DOI: 10.1177/08901171231192484] [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] [Indexed: 07/27/2023]
Abstract
PURPOSE To evaluate awareness about cardiovascular (CVD) risk among a racially and ethnically diverse cohort of health system employees. DESIGN Cross-sectional study. SETTING Voluntary survey of health system employees during an annual CVD awareness and screening event. SUBJECTS 759 health system employees. MEASURES We performed initial CVD screening measurements (blood pressure, body mass index) and collected patient-reported answers to questions about their own CVD risk factors (hypertension, high cholesterol, diabetes, overweight, smoking, physical inactivity and family history of CVD) and whether or not they believed that CVD is preventable. Subjects were offered in-depth follow-up CVD screening (lipid panel, hs-CRP, hemoglobin A1c), if interested. ANALYSIS Continuous measures were compared across sex and racial/ethnic subsets using a t test and analysis of variance technique. Univariable and multivariable logistic regression models were used to estimate the employee's willingness to undergo further comprehensive screening. RESULTS African American, Hispanic, and Asian employees were younger than white employees (P < .0001). More than one-quarter of African Americans reported a history of hypertension, a higher rate than for other subgroups (P = .001). The rate of self-reported diabetes was highest in African American and Asian employees (P = .001). African Americans had a 54% reduced odds of electing to pursue follow-up CVD screening (odds ratio: .46, 95% confidence interval = .24-.91, P = .025). CONCLUSION Presence of CVD risk factors and knowledge of their importance differ among racial and ethnic groups of health system employees in our cohort as does interest in pursuing follow-up screening once risk factors are identified. Development of evidence-based customization strategies by racial and ethnic group may improve understanding of and interest in CVD risk factors and advance prevention. The data from this study will inform future research and strategies for employee health promotion.
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Affiliation(s)
- Amgad N Makaryus
- Department of Cardiology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, NY, USA
- Department of Cardiology, NuHealth, Nassau University Medical Center, East Meadow, NY, USA
| | - Stacey E Rosen
- Department of Cardiology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, NY, USA
- Katz Institute for Women's Health at Northwell Health, Lake Success, NY, USA
| | - Leslie Kang
- Katz Institute for Women's Health at Northwell Health, Lake Success, NY, USA
| | - Leslee J Shaw
- Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Beth Nash
- Katz Institute for Women's Health at Northwell Health, Lake Success, NY, USA
| | - Reva Gajer
- Katz Institute for Women's Health at Northwell Health, Lake Success, NY, USA
| | | | - Jennifer H Mieres
- Department of Cardiology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, NY, USA
- Katz Institute for Women's Health at Northwell Health, Lake Success, NY, USA
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Xue H, Zhang J, Sagae K, Nishimine B, Fukuoka Y. Analyzing Public Conversations of Heart Disease and Heart Health on Facebook from 2016 to 2021: A Retrospective Observational Study Applying Latent Dirichlet Allocation Topic Modeling (Preprint). JMIR Cardio 2022; 6:e40764. [DOI: 10.2196/40764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/02/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022] Open
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Dai H, Younis A, Kong JD, Puce L, Jabbour G, Yuan H, Bragazzi NL. Big Data in Cardiology: State-of-Art and Future Prospects. Front Cardiovasc Med 2022; 9:844296. [PMID: 35433868 PMCID: PMC9010556 DOI: 10.3389/fcvm.2022.844296] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/24/2022] [Indexed: 11/23/2022] Open
Abstract
Cardiological disorders contribute to a significant portion of the global burden of disease. Cardiology can benefit from Big Data, which are generated and released by different sources and channels, like epidemiological surveys, national registries, electronic clinical records, claims-based databases (epidemiological Big Data), wet-lab, and next-generation sequencing (molecular Big Data), smartphones, smartwatches, and other mobile devices, sensors and wearable technologies, imaging techniques (computational Big Data), non-conventional data streams such as social networks, and web queries (digital Big Data), among others. Big Data is increasingly having a more and more relevant role, being highly ubiquitous and pervasive in contemporary society and paving the way for new, unprecedented perspectives in biomedicine, including cardiology. Big Data can be a real paradigm shift that revolutionizes cardiological practice and clinical research. However, some methodological issues should be properly addressed (like recording and association biases) and some ethical issues should be considered (such as privacy). Therefore, further research in the field is warranted.
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Affiliation(s)
- Haijiang Dai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Arwa Younis
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York, NY, United States
| | - Jude Dzevela Kong
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Luca Puce
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Georges Jabbour
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Hong Yuan
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
- Hong Yuan
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Postgraduate School of Public Health, Department of Health Sciences, University of Genoa, Genoa, Italy
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, NIHR Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Chapel Allerton Hospital, Leeds, United Kingdom
- *Correspondence: Nicola Luigi Bragazzi
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Effects of Somatic, Depression Symptoms, and Sedentary Time on Sleep Quality in Middle-Aged Women with Risk Factors for Cardiovascular Disease. Healthcare (Basel) 2021; 9:healthcare9101378. [PMID: 34683058 PMCID: PMC8544469 DOI: 10.3390/healthcare9101378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/24/2022] Open
Abstract
Cardiovascular disease (CVD) is the second leading cause of death among Korean women, and its incidence is dramatically elevated in middle-aged women. This study aimed to identify the predictors of sleep quality, a CVD risk factor, in middle-aged women with CVD risk factors to provide foundational data for developing intervention strategies for the prevention of CVD. The subjects, 203 middle-aged women (40–65 years old) with one or more CVD risk factors were selected through convenience sampling and included in this descriptive correlational study. The effects of somatic symptoms, depression symptoms, and sedentary time on sleep quality were examined. CVD-related characteristics were analyzed using descriptive statistics, whereas the mean values of the independent variables were analyzed using t-tests and analysis of variance. Predictors of sleep quality were analyzed using multiple regression analysis. The results showed that sleep quality increased with decreasing somatic symptoms (β = −0.36, p < 0.001), depression symptom score (β = −0.17, p = 0.023), and daily sedentary time (β = −0.13, p = 0.041), and the regression model was significant (F = 19.80, p < 0.001). Somatic symptoms are the most potent predictors of sleep quality in middle-aged women. Thus, intervention strategies that improve somatic symptoms are crucial for the enhancement of sleep quality, which deteriorates with advancing age.
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Lee S, Pantik C, Duggirala S, Lindquist R. A Comparison Between Self-Reported and Investigator-Measured Cardiovascular Risk-Related Biometric Numbers. West J Nurs Res 2021; 44:724-733. [PMID: 33955791 DOI: 10.1177/01939459211013580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine individuals' knowledge of cardiovascular risk-related biometric numbers and to compare self-reported and investigator-measured numbers in a convenience sample of adults in the Midwest region. Sociodemographic data and personal knowledge of cardiovascular risk-related biometric numbers were assessed using self-reported questionnaires. Investigators conducted health assessments to obtain biometric numbers. Among the 224 participants, participants' reported knowledge about their cardiovascular risk-related biometric numbers was low, especially for high-density lipoprotein and fasting blood glucose levels. Participants' knowledge was associated with education level and the recency of their last healthcare visit for health assessment. We found statistically significant mean differences between self-reported and investigator-measured blood pressure, and weight. This study found that there were discrepancies between self-reported and investigator-measured cardiovascular risk-related numbers. Future research is needed to develop educational interventions to improve personal knowledge of cardiovascular risks.
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Affiliation(s)
- Sohye Lee
- Loewenberg College of Nursing, University of Memphis, Memphis, TN, USA
| | - Catherine Pantik
- Loewenberg College of Nursing, University of Memphis, Memphis, TN, USA
| | - Sree Duggirala
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Ruth Lindquist
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
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Mujamammi AH, Alluhaymid YM, Alshibani MG, Alotaibi FY, Alzahrani KM, Alotaibi AB, Almasabi AA, Sabi EM. Awareness of cardiovascular disease associated risk factors among Saudis in Riyadh City. J Family Med Prim Care 2020; 9:3100-3105. [PMID: 32984180 PMCID: PMC7491763 DOI: 10.4103/jfmpc.jfmpc_458_20] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/25/2020] [Accepted: 05/11/2020] [Indexed: 11/19/2022] Open
Abstract
Objective: The aim of this study was to estimate the awareness of Saudi population in Riyadh regarding cardiovascular diseases (CVDs) and their risk factors. Methods: This was a cross-sectional study that used self-administered questionnaires conducted in universities, primary care centers, and electronic copies distributed in social media websites. Results: Overall, 47.1% of the respondents had a good awareness of CVD and associated risk factors. However, awareness of the symptoms of stroke and heart attack was low. Pulmonary embolism and deep vein thrombosis were the most commonly identified types of CVD, with 39.2% aware of these conditions. The most well-known symptom of heart attack was shortness of breath (known by 54.4% of the respondents). In relation to stroke, the most commonly recognized symptom was “sudden dizziness, trouble walking, or loss of balance” (45.4%). Respondents’ awareness of CVD risk factors was moderate. The most common factors—identified by over two-thirds of participants—were unhealthy diet, smoking, dyslipidemia, and physical inactivity. Independent predictors of good CVD awareness were age 35–44 years, living in the north of Riyadh and following a healthy diet. Conclusions: The awareness of CVD and associated risk factors is insufficient among Saudis in Riyadh City. This study emphasizes the necessity for effective education to increase the awareness about CVD in Saudi Arabia. High awareness may lead to early recognition of the risk factors and lead to early implementation of primary prevention which the cornerstone of family medicine practice.
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Affiliation(s)
- Ahmed H Mujamammi
- Department of Pathology, Clinical Biochemistry Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | - Essa M Sabi
- Department of Pathology, Clinical Biochemistry Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Vidal-Almela S, Czajkowski B, Prince SA, Chirico D, Way KL, Pipe AL, Reed JL. Lessons learned from community- and home-based physical activity programs: A narrative review of factors influencing women's participation in cardiac rehabilitation. Eur J Prev Cardiol 2020; 28:761-778. [PMID: 33611528 DOI: 10.1177/2047487320907748] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/30/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiovascular disease remains a leading cause of death in women. Despite the well-known benefits of cardiac rehabilitation, it remains underutilized, especially among women. Physical activity programs in the community, however, attract a large female population, suggesting that they overcome barriers to physical activity encountered by women. The characteristics of interventions that extend beyond the traditional cardiac rehabilitation model and promote physical activity merit examination. OBJECTIVES This narrative review aimed to: (a) summarize women's barriers to attend cardiac rehabilitation; (b) examine the characteristics of community- and home-based physical activity or lifestyle coaching interventions; and (c) discuss which barriers may be addressed by these alternative programs. METHODS Studies were included if they: (a) were published within the past 10 years; (b) included ≥70% women with a mean age ≥45 years; (c) implemented a community- or home-based physical activity intervention or a lifestyle education/behavioral coaching program; and (d) aimed to improve physical activity levels or physical function. RESULTS Most interventions reported high (≥70%) participation rates and significant increases in physical activity levels at follow-up; some improved physical function and/or cardiovascular disease risk factors. Community- and home-based interventions address women's cardiac rehabilitation barriers by: implementing appealing modes of physical activity (e.g. dancing, group-walking, technology-based balance exercises); adapting the program to meet participants' needs; offering flexible options regarding timing and setting (e.g. closer to home, the workplace or faith-based institutions); and promoting social interactions. CONCLUSION Cardiac rehabilitation can be enhanced by understanding the specific needs of women; novel elements such as program offerings, convenient settings and opportunities for socialization should be considered when designing cardiac rehabilitation programs.
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Affiliation(s)
- Sol Vidal-Almela
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada
- Institut du savoir Montfort, l'Hôpital Montfort, Canada
| | - Brenna Czajkowski
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Stephanie A Prince
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Daniele Chirico
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Kimberley L Way
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Andrew L Pipe
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
- Faculty of Medicine, University of Ottawa, Canada
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Canada
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Kim KA, Hwang SY. [Effects of a Daily Life-Based Physical Activity Enhancement Program for Middle-Aged Women at Risk for Cardiovascular Disease]. J Korean Acad Nurs 2019; 49:113-125. [PMID: 31064965 DOI: 10.4040/jkan.2019.49.2.113] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/22/2018] [Accepted: 11/29/2018] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to examine the effects of a daily life-based physical activity enhancement program performed by middle-aged women at risk for cardiovascular disease. METHODS This study used a randomized control group pretest-posttest design. Middle-aged women aged 45 to 64 were recruited from two outpatient cardiology departments, and randomly assigned to an experimental group (n=28) and a control group (n=30). For the experimental group, after providing one-on-one counseling and education, we provided customized text messages to motivate them in daily life. To monitor the practice of physical activity, they also used an exercise diary and mobile pedometer for 12 weeks. Subjects' physical activities (MET-min/week) were measured using the International Physical Activity Questionnaire (IPAQ). Their physiological data were obtained by blood tests using a portable analyzer, and the data were analyzed using the SPSS 21.0/WIN program. RESULTS There were significant differences in exercise self-efficacy, health behavior, IPAQ score, body fat, body muscle, and fasting blood sugar between the two groups. However, there were no significant differences in total cholesterol, hemoglobin A1c, high-density lipoprotein cholesterol, and waist-to-hip ratio. CONCLUSION Strengthening physical activity in daily life without being limited by cost burden and time and space constraints. Therefore, it is essential to motivate middle-aged women at risk for cardiovascular disease to practice activities that are easily performed in their daily lives.
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Affiliation(s)
- Kyung Ae Kim
- College of Nursing, Gyeongdong University, Wonju, Korea
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Gonsalves CA, McGannon KR. Constructing women’s heart health and risk: A critical discourse analysis of cardiovascular disease portrayals on Facebook by a US non-profit organization. J Health Psychol 2018; 25:2317-2327. [DOI: 10.1177/1359105318796187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Women’s cardiovascular disease portrayals were explored on Facebook by the US non-profit organization Women’s Heart Alliance and public users in February 2017. Portrayals were explored using critical discourse analysis which also identified subject positions. Women’s cardiovascular disease was constructed within two central discourses: achieving health equity and healthism, with the following subject positions: altruistic fighters, health activists, and compliant patients and consumers. These findings affirmed and resisted problematic forms of cardiovascular disease risk reduction. Recommendations are made using discursive resources and subject positions within social media forms as concrete entry points of resistance and change to raise women’s cardiovascular disease awareness.
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Gonsalves CA, McGannon KR, Schinke RJ. Social media for health promotion: What messages are women receiving about cardiovascular disease risk by the Canadian Heart and Stroke Foundation? J Health Psychol 2017; 25:1017-1029. [PMID: 29226735 DOI: 10.1177/1359105317743802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to explore the meanings of women's cardiovascular disease constructed within the Canadian Heart and Stroke Foundation Facebook page. Posts from Heart and Stroke Foundation and public user comments surrounding the launch of the Heart and Stroke Foundation re-branding were of interest. Ethnographic content analysis was employed to analyse text (n = 40), images (n = 32), videos (n = 6), user comments and replies (n = 42) from November 2016 to March 2017. Constructions (re)presented on Facebook of 'typical' women at risk and risk reduction were problematic as women most at risk were excluded through the use of consumerist, medicalized identities which also excluded promotion of healthy behaviour changes.
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Dahl M, Lindholt J, Søgaard R, Frost L, Andersen LS, Lorentzen V. An interview-based study of nonattendance at screening for cardiovascular diseases and diabetes in older women: Nonattendees' perspectives. J Clin Nurs 2017; 27:939-948. [PMID: 28815826 DOI: 10.1111/jocn.14018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2017] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES This study explored nonattendees' perspectives on a screening programme for cardiovascular disease and diabetes mellitus among women aged 60-77 years. BACKGROUND Nonattendance in screening is a common concern and has been associated with increased morbidity and mortality. Whether nonattendees need targeted information to participate in screening is unknown. Thus, it is important to explore the reasons for nonattendance, particularly as nonattendees' perspectives have not been fully explored. DESIGN An interview study. METHODS The data were obtained through semistructured interviews with 10 women sampled from a population who declined to participate in a women's screening programme for cardiovascular disease and diabetes mellitus. Additionally, reflective notes on the interview context were documented. The data were collected in 2013. Kvale and Brinkmann's method for data analysis was applied. RESULTS All informants found the screening offer personally irrelevant, but this belief was changeable. The informants' perceptions of screening were based on subjective health and risk beliefs, personal knowledge of diseases and the screening programme, and distrust in the healthcare system. CONCLUSION Personal experiences, beliefs and self-protective strategies influence individuals' subjective interpretations of a screening programme's relevance. The perception that screening is irrelevant seems to be rooted in nonattendees' personal health-related assessment and knowledge. Consequently, whether nonattendance is determined by an informed decision is questionable. Negative experiences with the healthcare system led to hesitation towards screening in general. RELEVANCE TO CLINICAL PRACTICE This study is relevant to healthcare workers as well as decision-makers from a screening and preventive perspective. The findings highlight important issues that should be addressed to encourage invitees to accept screening invitations and to facilitate informed decision-making about screening participation.
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Affiliation(s)
- Marie Dahl
- Cardiovascular Research Centre, Regional Hospital Central Jutland, Viborg, Denmark.,Department of Clinical Medicine, Aarhus University Health, Aarhus, Denmark
| | - Jes Lindholt
- Cardiovascular Research Centre, Regional Hospital Central Jutland, Viborg, Denmark.,Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
| | - Rikke Søgaard
- Department of Public Health, Aarhus University, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lars Frost
- Cardiovascular Research Centre, Regional Hospital Central Jutland, Viborg, Denmark.,Department of Medicine, Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Lene Søndergaard Andersen
- Cardiovascular Research Centre, Regional Hospital Central Jutland, Viborg, Denmark.,Centre for Research in Clinical Nursing, Regional Hospital Central Jutland/VIA University College, Viborg, Denmark
| | - Vibeke Lorentzen
- Cardiovascular Research Centre, Regional Hospital Central Jutland, Viborg, Denmark.,Centre for Research in Clinical Nursing, Regional Hospital Central Jutland/VIA University College, Viborg, Denmark
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Supervía M, Medina-Inojosa JR, Yeung C, Lopez-Jimenez F, Squires RW, Pérez-Terzic CM, Brewer LC, Leth SE, Thomas RJ. Cardiac Rehabilitation for Women: A Systematic Review of Barriers and Solutions. Mayo Clin Proc 2017; 92:S0025-6196(17)30026-5. [PMID: 28365100 PMCID: PMC5597478 DOI: 10.1016/j.mayocp.2017.01.002] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 12/28/2016] [Accepted: 01/04/2017] [Indexed: 10/19/2022]
Abstract
Cardiac rehabilitation (CR) services improve various clinical outcomes in patients with cardiovascular disease, but such services are underutilized, particularly in women. The aim of this study was to identify evidence-based barriers and solutions for CR participation in women. A literature search was carried out using PubMed, EMBASE, Cochrane, OVID/Medline, and CINAHL to identify studies that have assessed barriers and/or solutions to CR participation. Titles and abstracts were screened, and then the full-text of articles that met study criteria were reviewed. We identified 24 studies that studied barriers to CR participation in women and 31 studies that assessed the impact of various interventions to improve CR referral, enrollment, and/or completion of CR in women. Patient-level barriers included lower education level, multiple comorbid conditions, non-English native language, lack of social support, and high burden of family responsibilities. We found support for the use of automatic referral and assisted enrollment to improve CR participation. A small number of studies suggest that incentive-based strategies, as well as home-based programs, may contribute to improving CR attendance and completion rates. A systematic approach to CR referral, including automatic CR referral, may help overcome barriers to CR referral in women and should be implemented in clinical practice. However, more studies are needed to help identify the best methods to improve CR attendance and completion of CR rates in women.
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Affiliation(s)
- Marta Supervía
- Cardiovascular Rehabilitation Program, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Jose R Medina-Inojosa
- Cardiovascular Rehabilitation Program, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Colin Yeung
- Cardiovascular Rehabilitation Program, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Francisco Lopez-Jimenez
- Cardiovascular Rehabilitation Program, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Ray W Squires
- Cardiovascular Rehabilitation Program, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Carmen M Pérez-Terzic
- Cardiovascular Rehabilitation Program, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN; Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - LaPrincess C Brewer
- Cardiovascular Rehabilitation Program, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Shawn E Leth
- Cardiovascular Rehabilitation Program, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Randal J Thomas
- Cardiovascular Rehabilitation Program, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
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16
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Dean CA, Arnold LD, Hauptman PJ, Wang J, Elder K. Patient, Physician, and Practice Characteristics Associated with Cardiovascular Disease Preventive Care for Women. J Womens Health (Larchmt) 2017; 26:491-499. [PMID: 28437218 DOI: 10.1089/jwh.2015.5613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death for American women. Although CVD preventive care has the potential to reduce a significant number of these deaths, the degree to which healthcare providers deliver such care is unknown. The purpose of this study was to identify patient, physician, and practice characteristics that significantly influence the provision of CVD preventive care during ambulatory care visits for female patients. METHODS The National Ambulatory Medical Care Survey datasets from 2005 to 2010 were utilized. The study sample included female patients ≥20 years of age whose healthcare provider performed CVD preventive care and who had visits for a new health problem, a routine chronic problem, management of a chronic condition, and preventive care. Binary logistic regression models estimated the association of patient, physician, and practice characteristics and CVD preventive care; cholesterol testing, body mass index (BMI) screening, and tobacco education. RESULTS Of the 32,009 visits, 15.9% involved cholesterol testing, 50.3% involved BMI screening, and 3.20% involved tobacco education. Obstetricians/gynecologists were less likely to perform cholesterol testing (aOR: 0.39; 95% CI: 0.25-0.61) and tobacco education (aOR: 0.56; 95% CI: 0.32-0.98) than general/family physicians. CONCLUSION The delivery of CVD preventive care varied by healthcare provider type, with obstetricians/gynecologists having lower odds of providing two of the three services. The amount of time a physician spent with a patient was a significant predictor for the provision of all three services. These findings demonstrate the need to implement multifaceted approaches to address predicting characteristics of CVD preventive care.
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Affiliation(s)
- Caress A Dean
- 1 Master of Public Health Program, School of Health Sciences, Oakland University , Rochester, Michigan
| | - Lauren D Arnold
- 2 Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University , St. Louis, Missouri
| | - Paul J Hauptman
- 3 Division of Cardiology, Saint Louis University School of Medicine, Saint Louis University Hospital , St. Louis, Missouri
| | - Jing Wang
- 4 Department of Biostatistics, College for Public Health and Social Justice, Saint Louis University , St. Louis, Missouri
| | - Keith Elder
- 5 School of Public Health, Samford University , Birmingham, Alabama
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18
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de Lima MM, da Silva GR, Jensem Filho SS, Granja F. Association between perceived lifetime risk of cardiovascular disease and calculated risk in a male population in Brazil. Vasc Health Risk Manag 2016; 12:279-86. [PMID: 27382297 PMCID: PMC4922778 DOI: 10.2147/vhrm.s107874] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM Cardiovascular disease is the major cause of morbidity and mortality across the world. Despite health campaigns to improve awareness of cardiovascular risk factors, there has been little improvement in cardiovascular mortality. In this study, we sought to examine the association between cardiovascular risk factors and people's perception on cardiovascular risk. METHODS This was an epidemiological, cross-sectional, descriptive, prospective study of Masonic men aged >40 years in Boa Vista, Brazil. Participants completed a health survey, which included three questions about perception of their stress level, overall health status, and risk of a heart attack. In addition, demographic and biological data were collected. RESULTS A total of 101 Masonic men took part in the study; their mean age (± standard deviation) was 55.35±9.17 years and mean body mass index was 28.77±4.51 kg/m(2). Answers to the lifestyle questionnaire suggested an overall healthy lifestyle, including good diet and moderate exercise, although despite this ~80% were classified as overweight or obese. The majority of participants felt that they had a low stress level (66.3%), good overall general health (63.4%), and were at low risk of having a heart attack (71.3%). Masons who were overweight were significantly more likely to perceive themselves to be at risk of a heart attack (P=0.025). CONCLUSION Despite over half of participants having a moderate to high risk of cardiovascular disease according to traditional risk factors, less than a third perceived themselves to be at high risk. Public health campaigns need to better communicate the significance of traditional cardiovascular risk in order to improve awareness of risk among the general population.
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Affiliation(s)
| | | | | | - Fabiana Granja
- Biodiversity Research Center, Federal University of Roraima (CBio/UFRR), Roraima, Brazil
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Villablanca AC, Slee C, Lianov L, Tancredi D. Outcomes of a Clinic-Based Educational Intervention for Cardiovascular Disease Prevention by Race, Ethnicity, and Urban/Rural Status. J Womens Health (Larchmt) 2016; 25:1174-1186. [PMID: 27356155 DOI: 10.1089/jwh.2015.5387] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND PURPOSE Heart disease is the leading killer of women and remains poorly recognized in high-risk groups. We assessed baseline knowledge gaps and efficacy of a survey-based educational intervention. METHODS Four hundred seventy-two women in clinical settings completed pre-/post-surveys for knowledge of: heart disease as the leading killer, risk factors (general and personal levels), heart attack/stroke symptoms, and taking appropriate emergency action. They received a clinic-based educational intervention delivered by healthcare professionals in the course of their clinical care. Change score analyses tested pre-/post-differences in knowledge after the educational intervention, comparing proportions by race, ethnicity, and urban/nonurban status. RESULTS Knowledge and awareness was low in all groups, especially for American Indian women (p < 0.05). Awareness was overall highest for heart disease as the leading killer, but it was the lowest for taking appropriate action (13% of Hispanic, 13% of American Indian, 29% of African American, and 18% of nonurban women; p < 0.05). For all women, knowledge of the major risk factors was low (58%) as was knowledge of their personal levels for risk factors (73% awareness for hypertension, 54% for cholesterol, and 50% for diabetes). The intervention was effective (% knowledge gain) in all groups of women, particularly for raising awareness of: (1) heart disease as the leading killer in American Indian (25%), Hispanic (18%), and nonurban (15%) women; (2) taking appropriate action for American Indian (80%), African American (64%), non-Hispanic (55%), and urban (56%) women; (3) heart disease risk factors for Hispanic (56%) and American Indian (47%) women; and (4) heart disease and stroke symptoms in American Indian women (54% and 25%, respectively). CONCLUSIONS Significant knowledge gaps persist for heart disease in high-risk women, suggesting that these gaps and groups should be targeted by educational programs. We specify areas of need, and we demonstrate efficacy of a clinic-based educational intervention that can be of utility to busy healthcare professionals.
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Affiliation(s)
- Amparo C Villablanca
- 1 Division of Cardiovascular Medicine, University of California , Davis, Davis, California
| | - Christina Slee
- 2 Clinical Affairs Division, University of California , Davis Medical Center, Davis, California
| | - Liana Lianov
- 3 Department of Internal Medicine, American College of Lifestyle Medicine, University of California , Davis, Davis, California
| | - Daniel Tancredi
- 4 Department of Pediatrics, Center for Healthcare Policy and Research, University of California , Davis, Davis, California
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Brewer LC, Svatikova A, Mulvagh SL. The Challenges of Prevention, Diagnosis and Treatment of Ischemic Heart Disease in Women. Cardiovasc Drugs Ther 2016. [PMID: 26210899 DOI: 10.1007/s10557-015-6607-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Increasing evidence suggests that there are significant differences in the presentation, diagnosis and treatment of ischemic heart disease in women compared to men. Women often present with atypical symptoms, and this, in association with a consistent underestimation of their risk for ischemic heart disease, leads to underdiagnosis and undertreatment in women. Cardiovascular risk factors unique to women have only recently been recognized, and moreover, traditional risk factors have recently been shown to have greater impacts on women. Consequently, women suffer more disability and poorer clinical outcomes, with higher cardiovascular morbidity and mortality. These discrepancies may in part be secondary to the higher prevalence of nonobstructive coronary artery disease in women with persistent chest pain symptoms as compared to men when evaluated invasively. Focused diagnostic and therapeutic strategies unique to women are thus needed, but unfortunately, such sex-specific guidelines do not yet exist, largely due to lack of awareness, both on the part of providers and patients, as well as a paucity of evidence-based research specific to women. Although underutilized in women, diagnostic modalities, including functional and anatomic cardiac tests as well as physiologic assessments of endothelial and microvascular function, are useful for establishing the diagnosis and prognosis of suspected ischemic heart disease in women. This review discusses the current challenges of prevention, diagnosis and treatment of ischemic heart disease in women.
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Garcia M, Miller VM, Gulati M, Hayes SN, Manson JE, Wenger NK, Bairey Merz CN, Mankad R, Pollak AW, Mieres J, Kling J, Mulvagh SL. Focused Cardiovascular Care for Women: The Need and Role in Clinical Practice. Mayo Clin Proc 2016; 91:226-40. [PMID: 26848004 DOI: 10.1016/j.mayocp.2015.11.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 11/03/2015] [Accepted: 11/05/2015] [Indexed: 12/17/2022]
Abstract
Over the past decade, an emerging clinical research focus on cardiovascular (CV) disease (CVD) risk in women has highlighted sex-specific factors that are uniquely important in the prevention and early detection of coronary atherosclerosis in women. Concurrently, a 30% decrease in the number of female deaths from CVD has been observed. Despite this, CVD continues to be the leading cause of death in women, outnumbering deaths from all other causes combined. Clinical practice approaches that focus on the unique aspects of CV care for women are needed to provide necessary resources for the prevention, diagnosis, and treatment of CVD in women. In addition to increasing opportunities for women to participate in CV research, Women's Heart Clinics offer unique settings in which to deliver comprehensive CV care and education, ensuring appropriate diagnostic testing, while monitoring effectiveness of treatment. This article reviews the emerging need and role of focused CV care to address sex-specific aspects of diagnosis and treatment of CVD in women.
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Affiliation(s)
- Mariana Garcia
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Virginia M Miller
- Department of Surgery, Mayo Clinic, Rochester, MN; Department of Physiology, Mayo Clinic, Rochester, MN; Department of Biomedical Engineering, Mayo Clinic, Rochester, MN
| | - Martha Gulati
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Nanette K Wenger
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA
| | - Rekha Mankad
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Amy W Pollak
- Division of Cardiovascular Diseases, Mayo Clinic, Jacksonville, FL
| | - Jennifer Mieres
- Department of Cardiology, Hofstra North Short-LIJ School of Medicine, Hempstead, NY
| | - Juliana Kling
- Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ
| | - Sharon L Mulvagh
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
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Castañeda Valencia CR. Instrumento para la valoración de síntomas coronarios en la mujer. AVANCES EN ENFERMERÍA 2016. [DOI: 10.15446/av.enferm.v33n3.41989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
<p>Objetivo: Diseñar y validar un instrumento para la valoración de los síntomas en la mujer con enfermedad coronaria, enmarcada en la Teoría de los Síntomas Desagradables Metodología: Estudio metodológico, psicométrico, orientado por los Síntomas, concepto central de la Teoría de los Síntomas Desagradables de Lenz y colaboradores. Se realizó una crítica teórica del constructo elegido, demostrando su utilidad en la investigación y en la práctica disciplinar. Se ponderaron 260 evidencias por medio de una rigurosa crítica metodológica y empírica, aplicando el Sistema de Revisión Integrativa articulada al Modelo Conceptual Empírico de Fawcett y Garity. Se obtuvieron 30 piezas investigativas utilizadas para la construcción de los ítems. A los síntomas de Lenz se suman los síntomas psicosociales reportados en mujeres con enfermedad coronaria, generándose un primer instrumento compuesto por 87 ítems. Resultados: Se realizó una Validación de Contenido de expertos: Modelo Escobar y Cuervo 2008 (análisis estadístico SPSS 20) obteniéndose un Coeficiente de Correlación de Kendall de 0,682 (0,05), con buena concordancia entre jueces. El Modelo de Lawshe normalizado por Tristán 2008 reportó una Content Validity Ratio de 0,57 y un Index Validity Content de 0,797, demostrando que los ítems son unidades de análisis esenciales. Finalmente, la Validación Facial realizada mediante una prueba piloto a 21 mujeres que cumplieron los criterios de inclusión permitió la discriminación semiótica de los ítems, obteniéndose un instrumento compuesto por 67 ítems. Conclusiones: Éste es un remanente investigativo que requiere nuevas validaciones para elevar su capacidad psicométrica.</p>
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Abstract
PURPOSE Our aim was to compare the biopsychosocial characteristics of young women with those of older women who were enrolled in cardiac rehabilitation (CR). The baseline characteristics of women who prematurely terminated CR participation were also explored. METHODS Baseline physiological and psychosocial indices of women ≤ 55 years compared with older women eligible for CR were evaluated 1 week before enrolling in either a traditional CR or a gender-specific, motivationally enhanced CR. RESULTS A greater proportion of young women (n = 65) compared with their older counterparts (n = 187) were diagnosed with acute myocardial infarction during their index hospitalization. They demonstrated lower high-density lipoprotein cholesterol, higher total cholesterol/high-density lipoprotein cholesterol ratios, and greater body weight compared with older women and were more likely to be active smokers. Young women compared with older women reported significantly worse health perceptions, quality of life, optimism, hope, social support, and stress and significantly more symptoms of depression and anxiety. Women who prematurely terminated CR participation were younger, more obese, with worse quality of life, and greater symptoms of depression and anxiety compared with women completing CR. CONCLUSIONS Notable differences in physiological and psychosocial profiles of young women compared with older women enrolled in CR were evident, placing them at high risk for nonadherence to secondary prevention interventions as well as increased risk for disease progression and subsequent cardiac adverse events. Continued existence of these health differentials represents an important public health problem and warrants further research to address these age-related and sex-specific health disparities among women with coronary heart disease.
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Kelly KM, Chopra I, Dolly B. Breastfeeding: An Unknown Factor to Reduce Heart Disease Risk Among Breastfeeding Women. Breastfeed Med 2015; 10:442-7. [PMID: 26436588 DOI: 10.1089/bfm.2015.0082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Breastfeeding confers many health benefits not only to babies but also to their lactating mothers. Breastfeeding is a notable protective factor in the Gail model for breast cancer and is protective for heart disease. Although individuals in the Appalachian region have lower risk of developing breast cancer, their risk of heart disease is elevated compared with the national value for the United States. SUBJECTS AND METHODS We surveyed 155 predominantly breastfeeding mothers of toddlers under 3 years old, recruited through parenting groups, daycares, and county extension in Appalachian West Virginia. Participants were asked their perceived comparative risks for breast cancer and heart disease and why they felt their risk was higher, same, or lower than that of the general population. RESULTS For breast cancer, 29.7% felt their risk was lower than the general population. For heart disease, 26.5% felt their risk was lower than the general population. Although these risks were highly correlated (p=0.006), there was considerable variability in responses (p<0.03). Qualitative responses for breast cancer risk frequently included breastfeeding (30.3%) and family history (30.3%). Qualitative responses for heart disease noted family history (36.1%) but did not include breastfeeding. A regression analysis found that greater family history, shorter duration of breastfeeding, and fewer pregnancies were associated with greater breast cancer risk perceptions. Family history, lower household income, and current smoking were associated with greater heart disease risk perceptions. CONCLUSIONS These well-educated, predominantly lactating women did not know the protective effects of breastfeeding for heart disease. Increased educational efforts about heart disease may be helpful to encourage more women to breastfeed.
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Affiliation(s)
- Kimberly M Kelly
- School of Pharmacy, West Virginia University , Morgantown, West Virginia
| | - Ishveen Chopra
- School of Pharmacy, West Virginia University , Morgantown, West Virginia
| | - Brandon Dolly
- School of Pharmacy, West Virginia University , Morgantown, West Virginia
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Céspedes Cuevas VM. Atypical nature of coronary artery disease in women: a proposal for measurement and classification. AVANCES EN ENFERMERÍA 2015. [DOI: 10.15446/av.enferm.v33n1.47855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
<p><strong>Objective:</strong> To identify subgroups of women with Acute Coronary Syndrome according to symptom experience: perception, evaluation and response, based on the Symptom Management Conceptual Model.</p><p><strong>Methodology:</strong> Quantitative, descriptive, exploratory, cross-sectional study. The sample was made of 380 women positively diagnosed with Acute Coronary Syndrome, hospitalized in two institutions in Bogotá, Colombia. A measurement instrument was designed and validated.</p><p><strong>Results:</strong> Final instrument was made of 37 items that reported content validity, scale validity, discriminant validity, and construct validity. A Cronbach’s Alpha coefficient of 0,76 was obtained, which guarantees homogeneity in the measurement<br />according to the Maximum Validity-Maximum Reliability Model.<br />A total of 11 subgroups of women with Acute Coronary Syndrome were identified, those were characterized by atypical coronary heart disease symptomatology, evaluation processes<br />related to extra-cardiac causes and inadequate symptom management strategies. It was possible to demonstrate that psychosocial factors, previous coronary heart disease and delays were variables making a significant influence on the components of symptom experience.</p><p><strong>Conclusions:</strong> Women with Acute Coronary Syndrome, belonging to the 11 subgroups that were identified<br />and studied, showed atypical symptoms. The instrument designed features a proven psychometric quality; it was valid, reliable, and useful for clinical research and practice.</p>
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Tran DMT, Pullen CH, Zimmerman LM, Hageman PA. Do Modifiable Cardiovascular Risk Factors Differ By Rural Classification in Women Who Enroll in a Weight Loss Intervention? ONLINE JOURNAL OF RURAL NURSING AND HEALTH CARE 2015; 15:42-59. [PMID: 26161046 PMCID: PMC4494758 DOI: 10.14574/ojrnhc.v15i1.339] [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] [Indexed: 11/15/2022] Open
Abstract
PURPOSE If clinicians and researchers are aware of specific cardiovascular risks associated with women's rural status, whether it be large or small/isolated rural areas, it may help in developing more relevant rural resources. The purpose of this study was to examine whether there were differences in modifiable cardiovascular risk factors of overweight and obese rural women living in large or small/isolated rural areas. SAMPLE This secondary analysis examined baseline cross-sectional data from the "Web-based Weight Loss and Weight Maintenance Intervention for Older Rural Women" clinical trial. Analysis included data from 299 rural Midwestern women, ages 40-69 years with a baseline body mass index of 28-45 kg/m2, who provided rural classification data and were randomized into groups. METHODS Demographic and biomarker baseline data were used. Chi-square and independent t-tests were used for data analyses. FINDINGS There are no significant differences found in overweight and obese women with cardiovascular risk factors when compared to rural classification, with one exception. Total cholesterol was associated with rural classification (p=0.047), where women living in large rural areas were more likely to have elevated total cholesterol levels (≥240 mg/dL) compared to women living in small/isolated areas (18.5% vs. 10.0%, respectively). Demographic characteristics such as age and education demonstrated no significant differences by rural classification; however, the majority of women in this study were of high socioeconomic status. CONCLUSIONS Although this secondary analysis found that rural women have similar cardiovascular risk factors and demographic characteristics, this study highlights the need for clinicians to carefully consider the rural community characteristics for primary prevention.
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Affiliation(s)
- Dieu-My Thi Tran
- University of Nebraska Medical Center, College of Nursing, Omaha, Nebraska
| | - Carol H. Pullen
- University of Nebraska Medical Center, College of Nursing, Omaha, Nebraska
| | - Lani M. Zimmerman
- University of Nebraska Medical Center, College of Nursing, Lincoln, Nebraska
| | - Patricia A Hageman
- University of Nebraska Medical Center, Division of Physical Therapy Education, College of Medicine, Omaha, Nebraska
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Guedj M, Mullet E, Cambon-Thomsen A. Judging health risk as a function of risk factors and type of illness: Do people weight risk factors in a flexible way? J Health Psychol 2014; 21:832-43. [PMID: 24984716 DOI: 10.1177/1359105314539532] [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] [Indexed: 11/17/2022] Open
Abstract
We examined the extent to which lay people and health professionals are able to assess occurrence risks for multifactorial diseases. We asked 341 participants to assess the risk of developing lung cancer, coronary artery disease or rheumatoid arthritis in 16 scenarios, each featuring a combination of four factors (family history, daily alcohol intake, daily tobacco consumption and genetic test results). Participants considered all factors. However, they accorded more weight to tobacco and genetic test results. Moreover, it appears that where one of the factors (e.g. the presence of the incriminated gene) exerted a strong influence, the influence of the other factor(s) was correspondingly weaker. The health risk judgements of health professionals were more dependent on the specific disease and were also influenced to a greater degree by genetic information than lay people.
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Petr EJ, Ayers CR, Pandey A, de Lemos JA, Powell-Wiley TM, Khera A, Lloyd-Jones DM, Berry JD. Perceived lifetime risk for cardiovascular disease (from the Dallas Heart Study). Am J Cardiol 2014; 114:53-8. [PMID: 24834788 PMCID: PMC4440865 DOI: 10.1016/j.amjcard.2014.04.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 11/26/2022]
Abstract
Lifetime risk estimation for cardiovascular disease (CVD) has been proposed as a useful strategy to improve risk communication in the primary prevention setting. However, the perception of lifetime risk for CVD is unknown. We included 2,998 subjects from the Dallas Heart Study. Lifetime risk for developing CVD was classified as high (≥39%) versus low (<39%) according to risk factor burden as described in our previously published algorithm. Perception of lifetime risk for myocardial infarction was assessed by way of a 5-point scale. Baseline characteristics were compared across levels of perceived lifetime risk. Multivariable logistic regression analyses were performed to determine the association of participant characteristics with level of perceived lifetime risk for CVD and with correctness of perceptions. Of the 2,998 participants, 64.8% (n = 1,942) were classified as having high predicted lifetime risk for CVD. There was significant discordance between perceived and predicted lifetime risk. After multivariable adjustment, family history of premature myocardial infarction, high self-reported stress, and low perceived health were all strongly associated with high perceived lifetime risk (odds ratio [OR] 2.37, 95% confidence interval [CI] 1.72 to 3.27; OR 2.17, 95% CI 1.66 to 2.83; and OR 2.71, 95% CI 2.09 to 3.53; respectively). However, the association between traditional CVD risk factors and high perceived lifetime risk was more modest. In conclusion, misperception of lifetime risk for CVD is common and frequently reflects the influence of factors other than traditional risk factor levels. These findings highlight the importance of effectively communicating the significance of traditional risk factors in determining the lifetime risk for CVD.
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Affiliation(s)
- Elisabeth Joye Petr
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Colby R Ayers
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ambarish Pandey
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - James A de Lemos
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Tiffany M Powell-Wiley
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Amit Khera
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois; Department of Medicine, Northwestern University, Chicago, Illinois
| | - Jarett D Berry
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
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Zullig LL, Sanders LL, Shaw RJ, McCant F, Danus S, Bosworth HB. A randomised controlled trial of providing personalised cardiovascular risk information to modify health behaviour. J Telemed Telecare 2014; 20:147-52. [PMID: 24647384 DOI: 10.1177/1357633x14528446] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We conducted a feasibility study of a web-based intervention, which provided personalized cardiovascular disease (CVD) risk information, behavioural risk reduction strategies and educational resources. Participants were block-randomized to the 3-month intervention (n = 47) or to usual care (n = 49). Participants in the intervention group were presented with their CVD risk based on the Framingham risk score, and in three subsequent online encounters could select two behavioural/lifestyle modules, giving them an opportunity to complete six modules over the course of the study. Because it was self-guided, participants had differing levels of engagement with intervention materials. Most intervention group participants (77%, n = 36) completed all modules. After 3 months there were no significant differences between the intervention and usual care groups for systolic blood pressure, body-mass index, CVD risk, smoking cessation or medication non-adherence. The study suggests that modest clinical improvements can be achieved by interventions that are entirely web-administered. However, web-based interventions do not replace the need for human interaction to communicate CVD risk and assist with decision-making.
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Affiliation(s)
- Leah L Zullig
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, USA
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30
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Biopsychosocial Determinants of Health and Quality of life Among Young Women with Coronary Heart Disease. CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0366-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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