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Assessment of Hypertension, Guideline-Directed Counseling, and Outcomes in the ACHD Population. Pediatr Cardiol 2022; 43:1615-1623. [PMID: 35380216 DOI: 10.1007/s00246-022-02890-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
Guidelines for the diagnosis and treatment of hypertension were published by the American Heart Association (AHA) in 2017. The prevalence of hypertension in adults with congenital heart disease (ACHD) under these guidelines has yet to be characterized. We sought to assess the prevalence, impact, and provider response to hypertension under current guidelines. Data were obtained retrospectively from records of routine clinic visits over a 10 year period. Potential hypertension-related adverse outcomes including stroke, myocardial infarction, surgical intervention for aortic aneurysm, aortic dissection, atrial fibrillation or flutter, cardiac transplantation and death were recorded. The 1070 patients who met inclusion criteria had a mean age of 30.8 ± 10.0 years. The prevalence of hypertension under the 2017 guidelines was 46.6%. Multivariate modeling identified cyanosis, male gender, older age, and overweight/obesity as independent risk factors for hypertension. Guideline-directed management of hypertension in ACHD patients occurred more frequently in ACHD and adult cardiology clinics than in pediatric cardiology clinics (44.1% and 45.1% vs. 24.0%, p < 0.01, respectively). Adverse outcomes were reported in 217 (20%) patients, the most prevalent of which was atrial fibrillation or flutter (11%). Multivariable modelling for any adverse outcome identified older age, hypertension, cyanosis, greater complexity ACHD, and obesity as risk factors. Modifiable risk factors for atherosclerotic cardiovascular disease are common and often under addressed in the ACHD population.
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Kopylova OV, Ershova AI, Meshkov AN, Kontsevaya AV, Drapkina OM. Life-long prevention of cardiovascular disease. Part II: childhood and adolescence. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
In recent years, researchers have increasingly noted that the development and health of cardiovascular system is influenced by both traditional risk factors (RF) and other determinants of human exposome — a combination of factors of the external and internal environment that affect genetics and epigenetics, as a result of which, one or another (more or less healthy) phenotype is formed. Exposome components have a continuous effect throughout all periods of life. Many RFs have a cumulative effect, and therefore it is important to start prevention of cardiovascular diseases (CVDs) as early as possible. The aim of this review was to consider various aspects of CVD prevention in childhood and adolescence. These periods are critical for the development of most behavioral habits, which maintain throughout life. Leading by personal example by parents and the immediate environment plays a paramount role in healthy lifestyle inclusion of children and adolescents. Targeted programs in kindergartens and schools aim at improving health literacy, early detection and timely changing traditional and non-traditional CVD RFs, diagnosis of genetic diseases involving the heart and blood vessels, prevention of sudden cardiac death are also important methods of CVD prevention in childhood and adolescence. Measures of population-based prevention are of great importance, including monitoring of advertising and media content, statutory ban of alcohol and tobacco sale, and the formation of healthy lifestyle.
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Affiliation(s)
- O. V. Kopylova
- National Medical Research Centre for Therapy and Preventive Medicine
| | - A. I. Ershova
- National Medical Research Centre for Therapy and Preventive Medicine
| | - A. N. Meshkov
- National Medical Research Centre for Therapy and Preventive Medicine
| | - A. V. Kontsevaya
- National Medical Research Centre for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Centre for Therapy and Preventive Medicine
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Andonian C, Langer F, Beckmann J, Bischoff G, Ewert P, Freilinger S, Kaemmerer H, Oberhoffer R, Pieper L, Neidenbach RC. Overweight and obesity: an emerging problem in patients with congenital heart disease. Cardiovasc Diagn Ther 2019; 9:S360-S368. [PMID: 31737542 PMCID: PMC6837933 DOI: 10.21037/cdt.2019.02.02] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/31/2019] [Indexed: 11/06/2022]
Abstract
Due to technological and medical advances the population of adults with congenital heart disease (ACHD) is constantly growing. Worldwide, congenital heart disease (CHD) affects 1.35-1.5 million children each year and the number of ACHD meanwhile exceeds the number of CHD children. It has been found that a substantial number of ACHD present problematic health behaviors, such as physical inactivity and bad nutritional habits. Recent studies document alarming rates of overweight and obesity among CHD patients which may consequently lead to further health complications in this population. The present article focuses on the distinct psychosocial effects resulting from the diagnosis of CHD and their impact on developing disordered eating patterns and excess weight. It seeks to identify unique risk factors and relevant explanations associated with the increasing prevalence of obesity among CHD patients. This review suggests a vital need to establish clinical guidelines for nutrition and weight management in this patient population as part of a holistic treatment approach.
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Affiliation(s)
- Caroline Andonian
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
- Technical University Munich, Munich, Germany
- Sigmund Freud University, Vienna, Austria
| | - Fabian Langer
- Department of Clinical Nutrition and Preventive Medicine, Hospital Barmherzige Brüder, Munich, Germany
| | - Jürgen Beckmann
- Technical University Munich, Munich, Germany
- University of Queensland, Brisbane, Australia
| | - Gert Bischoff
- Department of Clinical Nutrition and Preventive Medicine, Hospital Barmherzige Brüder, Munich, Germany
| | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Sebastian Freilinger
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
- Technical University Munich, Munich, Germany
| | - Lars Pieper
- Department of Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Rhoia Clara Neidenbach
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
- Technical University Munich, Munich, Germany
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Dendale P, Scherrenberg M, Sivakova O, Frederix I. Prevention: From the cradle to the grave and beyond. Eur J Prev Cardiol 2019; 26:507-511. [DOI: 10.1177/2047487318821772] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Present cardiac prevention mainly focuses on risk reduction later in life, and focuses also mainly on reducing risk factors for coronary heart disease. However, multiple studies have gathered evidence that the development risk of cardiovascular disease starts early in life and that even preconceptional influences play an important role in lifetime risk. Therefore, the importance of well-timed prevention strategies to reduce cardiovascular disease is well established. In this article, we discuss different risk factors for future cardiac disease, and how we can respond to lesser known cardiac risk factors in the different stages of life.
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Affiliation(s)
- Paul Dendale
- Heart Centre Hasselt, Jessa Hospital, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Belgium
| | - Martijn Scherrenberg
- Heart Centre Hasselt, Jessa Hospital, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Belgium
- Mobile Health Unit, Hasselt University, Belgium
| | - Oksana Sivakova
- National Research Center for Preventive Medicine, Russian Federation
| | - Ines Frederix
- Faculty of Medicine and Life Sciences, Antwerp University, Belgium
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da Silva Brito AL, Hardman CM, de Barros MVG. [Prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents]. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2015; 33:423-30. [PMID: 26298656 PMCID: PMC4685562 DOI: 10.1016/j.rpped.2015.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 02/19/2015] [Accepted: 02/27/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To analyze the prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents. METHODS A cross-sectional study was performed with a sample of high school students from state public schools in Pernambuco, Brazil (n=4,207, 14-19 years old). Data were obtained using a questionnaire. The co-occurrence of health risk behaviors was established based on the sum of five behavioral risk factors (low physical activity, sedentary behavior, low consumption of fruits/vegetables, alcohol consumption and tobacco use). The independent variables were gender, age group, time of day attending school, school size, maternal education, occupational status, skin color, geographic region and place of residence. Data were analyzed by ordinal logistic regression with proportional odds model. RESULTS Approximately 10% of adolescents were not exposed to health risk behaviors, while 58.5% reported being exposed to at least two health risk behaviors simultaneously. There was a higher likelihood of co-occurrence of health risk behaviors among adolescents in the older age group, with intermediate maternal education (9-11 years of schooling), and who reported living in the driest (semi-arid) region of the state of Pernambuco. Adolescents who reported having a job and living in rural areas had a lower likelihood of co-occurrence of risk behaviors. CONCLUSIONS The findings suggest a high prevalence of co-occurrence of health risk behaviors in this group of adolescents, with a higher chance in five subgroups (older age, intermediate maternal education, the ones that reported not working, those living in urban areas and in the driest region of the state).
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Prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rppede.2015.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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de Moraes ACF, Lacerda MB, Moreno LA, Horta BL, Carvalho HB. Prevalence of high blood pressure in 122,053 adolescents: a systematic review and meta-regression. Medicine (Baltimore) 2014; 93:e232. [PMID: 25501086 PMCID: PMC4602805 DOI: 10.1097/md.0000000000000232] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Several studies have reported high prevalence of risk factors for cardiovascular disease in adolescents. To perform: i) systematically review the literature on the prevalence of high blood pressure (HBP) in adolescents; ii) analyze the possible methodological factors associated with HBP; and iii) compare the prevalence between developed and developing countries. We revised 10 electronic databases up to August 11, 2013. Only original articles using international diagnosis of HBP were considered. The pooled prevalence's of HBP were estimated by random effects. Meta-regression analysis was used to identify the sources of heterogeneity across studies. Fifty-five studies met the inclusion criteria and total of 122,053 adolescents included. The pooled-prevalence of HBP was 11.2%, 13% for boys, and 9.6% for girls (P < 0.01). Method of measurement of BP and year in which the survey was conducted were associated with heterogeneity in the estimates of HBP among boys. The data indicate that HBP is higher among boys than girls, and that the method of measurement plays an important role in the overall heterogeneity of HBP value distributions, particularly in boys.
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Affiliation(s)
- Augusto César Ferreira de Moraes
- From the School of Medicine of the University of São Paulo (FMUSP)-Department of Preventive Medicine, São Paulo, Brazil (ACFdeM, MBL, HBC); YCARE (Youth/Child and cARdiovascular Risk and Environmental) Research Group, FMUSP/Brazil (ACFdeM, MBL, HBC); Faculty of Health of the University of Zaragoza, GENUD-Growth, Exercise, Nutrition and Development, Zaragoza, Spain (ACFdeM, LAM); Visiting Professor, School of Medicine of the University of São Paulo-Department of Preventive Medicine, São Paulo, Brazil (LAM); and School of Medicine of the Federal University of Pelotas, Pelotas, Brazil (BLH)
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Yu RX, Köcher W, Darvin ME, Büttner M, Jung S, Lee BN, Klotter C, Hurrelmann K, Meinke MC, Lademann J. Spectroscopic biofeedback on cutaneous carotenoids as part of a prevention program could be effective to raise health awareness in adolescents. JOURNAL OF BIOPHOTONICS 2014; 7:926-937. [PMID: 25538973 DOI: 10.1002/jbio.201300134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The cutaneous carotenoid concentration correlates with the overall antioxidant status of a person and can be seen as biomarker for nutrition and lifestyle. 50 high school students were spectroscopically measured for their cutaneous carotenoid concentrations initially in a static phase, followed by an intervention phase with biofeedback of their measured values, living a healthy lifestyle and on healthy food this time. The volunteers showed higher carotenoid concentrations than found in previous studies. A significant correlation of healthy lifestyle habits and a high antioxidant status could be determined. Subjects improved their nutritional habits and significantly increased their carotenoid concentration during intervention. Follow-up five months later showed a consolidation of the increase. The investigations show that a healthy diet and a well-balanced lifestyle correlate with a high cutaneous antioxidant concentration and that spectroscopic biofeedback measurement of cutaneous carotenoids as part of an integrated prevention program is a feasible and effective means to raise the health awareness in adolescents.
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Affiliation(s)
- Ruo-Xi Yu
- Charite´ – Universita¨tsmedizin Berlin, Department of Dermatology, Venerology and Allergology, Center of Experimental and Cutaneous Physiology (CCP), Charite´ platz 1, 10117 Berlin, Germany.
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9
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Barbiero SM, D'Azevedo Sica C, Schuh DS, Cesa CC, de Oliveira Petkowicz R, Pellanda LC. Overweight and obesity in children with congenital heart disease: combination of risks for the future? BMC Pediatr 2014; 14:271. [PMID: 25323400 PMCID: PMC4287310 DOI: 10.1186/1471-2431-14-271] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 08/15/2014] [Indexed: 11/10/2022] Open
Abstract
Background Children who have unhealthy lifestyles are predisposed to develop hypertension, dyslipidemia and other complications. The epidemic of obesity is also affecting children with congenital heart disease. The aim of this study is to estimate the prevalence of obesity and describe associated risk factors, including family history in children with congenital heart disease. Methods A cross-sectional study with 316 children and adolescents with congenital heart disease seen in an outpatient clinic of a reference hospital. Collected sociodemographic data included family history of chronic disease, dietary habits, laboratory tests (total cholesterol, HDL and LDL/cholesterol, triglycerides, fasting glucose, CRP, hematocrit and hemoglobin), and anthropometric assessment. Anthropometric data of the caregivers was self-reported. Results The prevalence of excess weight was 26.9%. Altered levels of total cholesterol were observed in 46.9%, of HDL in 32.7%, LDL in 23.6% and of triglycerides levels in 20.0%. A higher frequency of family history of obesity (42.6%; p = 0.001), dyslipidemia (48.1%; p = <0.001), diabetes (47.4%; p = 0.002), hypertension (39.2%; p = 0.006) and ischemic disease (43.7%; p = 0.023), as well as significantly higher values of triglycerides (p = 0.017), glycemia (p = 0.004) and C-reactive protein (p = 0.002) were observed among patients with excess weight. Conclusion The presence of modifiable risk factors and the variables associated to excess weight in this population was similar to that described in the literature for children without congenital disease. As these children already present the risks associated to heart disease, it is particularly important to promote a healthy lifestyle in this group.
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Affiliation(s)
| | | | | | | | | | - Lucia Campos Pellanda
- Post-Graduation Program in Health Sciences: Cardiology, Instituto de Cardiologia/Fundação Universitária de Cardiologia, Porto Alegre, Brazil.
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Müller-Riemenschneider F, Krist L, Bürger C, Ströbele-Benschop N, Roll S, Rieckmann N, Müller-Nordhorn J, Willich SN. Berlin evaluates school tobacco prevention - BEST prevention: study design and methodology. BMC Public Health 2014; 14:871. [PMID: 25150368 PMCID: PMC4155099 DOI: 10.1186/1471-2458-14-871] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 07/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The hazardous health effects of smoking are established, but there remains a need to evaluate existing smoking prevention strategies and to increase their effectiveness in adolescents. Strategies focusing on parental attitudes and rule setting have been identified as a potentially effective approach. The present manuscript describes objectives, study design and methodology of the BEST Prevention study. METHODS/DESIGN BEST Prevention is a three-armed cluster randomized-controlled trial among 7th grade (11-16 years) students in Berlin, Germany. Schools were enrolled between 2010 and 2011 and allocated using a centralized randomization list into 1) a student smoking prevention intervention (visit to an established interactive circuit), 2) the same intervention plus a parent intervention, and 3) a control group (visit to an established exercise and nutrition interactive circuit). Students were assessed at baseline, 12 and 24 months via self-report, as well as via carbon monoxide and cotinine in saliva at the 24 month follow-up. Statistical analyses uses multi-level regression models with cluster effects (school and class within school) based on the intention to treat population. Here we report descriptive baseline characteristics of recruited schools, and schools classes. Two schools from the control group dropped out after allocation. Hence, 47 secondary schools from all 12 districts of the city, including 161 school classes and 3023 students are participating in the study. Of those, 2801 students completed the baseline assessment. DISCUSSION The present manuscript provides details on the study design and methodology of a large school-based smoking prevention trial in a metropolitan area in Germany. Findings from this study will yield important insight into the long-term effectiveness of specific smoking prevention strategies, also in disadvantaged population groups. TRIAL REGISTRATION NCT01306552 (January 2011).
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Affiliation(s)
- Falk Müller-Riemenschneider
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, Luisenstrasse 57, 10117 Berlin, Germany
- />Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, Singapore, 117597 Singapore
| | - Lilian Krist
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, Luisenstrasse 57, 10117 Berlin, Germany
| | - Christin Bürger
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, Luisenstrasse 57, 10117 Berlin, Germany
| | - Nanette Ströbele-Benschop
- />Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstraße 12, 70599 Stuttgart, Germany
| | - Stephanie Roll
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, Luisenstrasse 57, 10117 Berlin, Germany
| | - Nina Rieckmann
- />Berlin School of Public Health, Charité Universitätsmedizin, Seestraße 73, 13347 Berlin, Germany
| | | | - Stefan N Willich
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, Luisenstrasse 57, 10117 Berlin, Germany
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Clustering of chronic disease behavioral risk factors among adolescents in Crete (Greece): associations with biological factors and cardiorespiratory fitness levels. J Public Health (Oxf) 2014. [DOI: 10.1007/s10389-014-0629-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Berglund L, Sacks F, Brunzell JD. Risk factors for cardiovascular disease: renewed interest in triglycerides. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/clp.12.81] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Rieks S, Willich SN, Mueller-Riemenschneider F. Trends in Age-Standardized and Age-Specific Cerebrovascular Mortality in Germany between 1980 and 2009. Cerebrovasc Dis 2012. [DOI: 10.1159/000343228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Silva KSD, Lopes ADS, Vasques DG, Costa FFD, Silva RCRD. Simultaneidade dos fatores de risco para doenças crônicas não transmissíveis em adolescentes: prevalência e fatores associados. REVISTA PAULISTA DE PEDIATRIA 2012. [DOI: 10.1590/s0103-05822012000300006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Estimar a prevalência e os padrões dos fatores de risco para doenças crônicas não transmissíveis segundo o nível socioeconômico e a idade dos adolescentes. MÉTODOS: Estudo transversal de base escolar envolvendo 1.675 adolescentes (53% do sexo feminino), com idades de 11 a 17 anos, de escolas públicas e privadas. O consumo de tabaco e álcool, o alto consumo de gordura na dieta e o baixo nível de atividade física constituíram as variáveis comportamentais. Circunferência da cintura e pressão arterial elevada, assim como e baixa aptidão cardiorrespiratória compuseram as variáveis biológicas. Regressão logística multinomial foi realizada para identificar variáveis associadas à simultaneidade dos fatores de risco para doenças crônicas não transmissíveis. RESULTADOS: Dos adolescentes, 62 e 31% apresentaram baixa aptidão cardiorrespiratória e elevado consumo de gordura, respectivamente. Dois em cada dez adolescentes tinha dois ou mais comportamentos de risco, e um terço deles tinham pelo menos dois fatores de risco biológicos para doenças crônicas não transmissíveis. No total, 62% dos adolescentes tinham pelo menos dois fatores de risco para doenças crônicas não transmissíveis, com maior frequência nos estudantes mais velhos. Na análise simultânea de todas as variáveis, observou-se que o aumento da idade esteve associado ao acúmulo de dois ou mais fatores de risco (sexo masculino com OR 2,10, e feminino com OR 5,74). CONCLUSÕES: Seis em cada dez adolescentes tinham pelo menos dois fatores de risco, enquanto a proporção do agrupamento desses fatores aumentou com a idade. Portanto, quanto mais precoce forem as intervenções, provavelmente menos adolescentes estarão acometidos por agravos à saúde em idades mais avançadas.
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Berglund L, Brunzell JD, Goldberg AC, Goldberg IJ, Sacks F, Murad MH, Stalenhoef AFH. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012; 97:2969-89. [PMID: 22962670 PMCID: PMC3431581 DOI: 10.1210/jc.2011-3213] [Citation(s) in RCA: 534] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aim was to develop clinical practice guidelines on hypertriglyceridemia. PARTICIPANTS The Task Force included a chair selected by The Endocrine Society Clinical Guidelines Subcommittee (CGS), five additional experts in the field, and a methodologist. The authors received no corporate funding or remuneration. CONSENSUS PROCESS Consensus was guided by systematic reviews of evidence, e-mail discussion, conference calls, and one in-person meeting. The guidelines were reviewed and approved sequentially by The Endocrine Society's CGS and Clinical Affairs Core Committee, members responding to a web posting, and The Endocrine Society Council. At each stage, the Task Force incorporated changes in response to written comments. CONCLUSIONS The Task Force recommends that the diagnosis of hypertriglyceridemia be based on fasting levels, that mild and moderate hypertriglyceridemia (triglycerides of 150-999 mg/dl) be diagnosed to aid in the evaluation of cardiovascular risk, and that severe and very severe hypertriglyceridemia (triglycerides of > 1000 mg/dl) be considered a risk for pancreatitis. The Task Force also recommends that patients with hypertriglyceridemia be evaluated for secondary causes of hyperlipidemia and that subjects with primary hypertriglyceridemia be evaluated for family history of dyslipidemia and cardiovascular disease. The Task Force recommends that the treatment goal in patients with moderate hypertriglyceridemia be a non-high-density lipoprotein cholesterol level in agreement with National Cholesterol Education Program Adult Treatment Panel guidelines. The initial treatment should be lifestyle therapy; a combination of diet modification and drug therapy may also be considered. In patients with severe or very severe hypertriglyceridemia, a fibrate should be used as a first-line agent.
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Affiliation(s)
- Lars Berglund
- University of California, Davis, Sacramento, California 95817, USA
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Costin A, Costin N, Cohen P, Eisenach C, Marchlinski F. Effect of exercise on heart-rate response to mental stress in teenagers. Eur J Prev Cardiol 2012; 20:593-6. [DOI: 10.1177/2047487312444369] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Alex Costin
- Princeton High School Biology Program, Princeton, New Jersey, USA
| | - Nathaniel Costin
- Princeton High School Biology Program, Princeton, New Jersey, USA
| | - Peter Cohen
- Princeton High School Biology Program, Princeton, New Jersey, USA
| | - Carson Eisenach
- Princeton High School Biology Program, Princeton, New Jersey, USA
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Mika P, Wilk B, Mika A, Marchewka A, Niżankowski R. The effect of pain-free treadmill training on fibrinogen, haematocrit, and lipid profile in patients with claudication. ACTA ACUST UNITED AC 2011; 18:754-60. [DOI: 10.1177/1741826710389421] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Piotr Mika
- Department of Clinical Rehabilitation, University School of Physical Education, Krakow, Poland
| | - Boguslaw Wilk
- CENC Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Anna Mika
- Department of Clinical Rehabilitation, University School of Physical Education, Krakow, Poland
| | - Anna Marchewka
- Department of Clinical Rehabilitation, University School of Physical Education, Krakow, Poland
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18
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Trends in age-standardised and age-specific mortality from ischaemic heart disease in Germany. Clin Res Cardiol 2010; 99:545-51. [DOI: 10.1007/s00392-010-0151-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Accepted: 03/11/2010] [Indexed: 12/21/2022]
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