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Gaalema DE, Allencherril J, Khadanga S, Klemperer E. Differential effects of cigarette smoking on cardiovascular disease in females: A narrative review and call to action. Prev Med 2024:108013. [PMID: 38815766 DOI: 10.1016/j.ypmed.2024.108013] [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: 03/19/2024] [Revised: 05/23/2024] [Accepted: 05/26/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE Cigarette smoking continues to be a major driver in the incidence and progression of cardiovascular disease (CVD). As females become an increasingly larger fraction of those who smoke it is imperative that the sex-specific effects of smoking be further explored and acted upon. METHODS This narrative review describes current evidence on the differential effects of smoking on CVD in females and the need to improve treatment. RESULTS Evidence to date suggests that smoking has disproportionately negative effects on the cardiovascular (CV) system in females, especially in those who are younger. Usually, the onset of CVD is later in females than males, but smoking decreases or eliminates this gap. Females are also more likely to develop types of CVD closely tied to smoking, such as ST-elevated myocardial infarctions, with even higher rates among those who are younger. Possible mechanisms for these worse outcomes in females include a complex interplay between nicotine, other products of combusted cigarettes, and hormones. Sex differences also exist in treatment for smoking. In females, Varenicline appears more effective than either Bupropion or nicotine replacement therapy while in males, all three therapies show similar efficacy. Disparities in smoking are also apparent in secondary prevention settings. Females and males are entering secondary prevention with equal rates of smoking, with potentially higher levels of exposure to the byproducts of smoking in females. CONCLUSIONS These disproportionately negative outcomes for females who smoke require additional research and these persisting rates of smoking suggest a need for female-specific approaches for treating smoking.
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Moraleda-Cibrián M, Palomares-Gonell I, Albares-Tendero J, Chung S. Stress, Mental Health, Sleep, and Healthy Habits in Spanish Healthcare Professionals Along the Pandemic: A Case-Control, and Follow-Up Study. Psychiatry Investig 2024; 21:487-495. [PMID: 38810997 PMCID: PMC11136581 DOI: 10.30773/pi.2023.0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/08/2024] [Accepted: 01/21/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE The aim of this study was to assess short and medium-term impact of the coronavirus disease-2019 (COVID-19) pandemic on stress, mental health, and sleep in Spanish healthcare professionals (HCP), and analyze the association between healthy habits, anxiety, and depression during the same period. METHODS An online survey including five validated scales (the Perceived Stress Scale, the Goldberg Anxiety and Depression Scales, the Pre-Sleep Arousal Scale, and the Pittsburgh Sleep Quality Index), and some questions about healthy habits were completed by HCP in charge of patients without and with coronavirus. Once for the control group (baseline), and twice for the case group (baseline and follow-up). RESULTS Overall 563 questionnaires were included. Moderate-severe stress was reported by 98.1% of subjects, anxiety and depression by 55.1% and 78.7% respectively, and poor sleep quality by 96.6%. Anxiety was reported more frequently by females and singles. HCP in charge of COVID-19 patients showed, in the baseline, a higher frequency of anxiety compared to controls (58.9% vs. 42.8%, p=0.002), and of depression (82.1% vs. 67.6%, p=0.001), that persisted in the follow-up assessment. Furthermore, HCP in charge of COVID-19 patients also exhibited more elevated mean scores for stress (p=0.005) and poor sleep (p=0.019). A decrease of sunlight exposure was associated with an increase of anxiety and depression symptoms, and less physical activity with depression. CONCLUSION Stress, sleep, and mental problems were common in Spanish HCP, especially in those in charge of COVID patients. These findings persisted throughout the pandemic, and may impact in the post-pandemic mental health of HCP.
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Affiliation(s)
- Marta Moraleda-Cibrián
- Sleep Disorders Center, Centro Médico Teknon, Barcelona, Spain
- Department of Pediatrics and Sleep Medicine, Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain
| | | | | | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Ross EJ, Jimenez DE, Ghanooni D, Mendez A, Hirshfield S, Horvath KJ, DeVries B, Dilworth SE, Carrico AW, Martinez CA. Loneliness, Methamphetamine Use, and Cardiovascular Risk Factors Among Sexual Minority Men in the COVID-19 Era. Int J Behav Med 2024:10.1007/s12529-024-10288-0. [PMID: 38684565 DOI: 10.1007/s12529-024-10288-0] [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] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Important gaps exist in our understanding of loneliness and biobehavioral outcomes among sexual minority men (SMM), such as faster HIV disease progression. At the same time, SMM who use methamphetamine are approximately one-third more likely than non-users to develop cardiovascular disease. This study examined associations of loneliness, stimulant use, and cardiovascular risk in SMM with and without HIV. METHOD Participants were enrolled from August 2020 to February 2022 in a 6-month prospective cohort study. The study leveraged self-report baseline data from 103 SMM, with a subset of 56 SMM that provided a blood sample to measure markers of cardiovascular risk. RESULTS Loneliness showed negative bivariate associations with total cholesterol and LDL cholesterol in the cardiometabolic subsample (n = 56). SMM with methamphetamine use (t(101) = 2.03, p < .05; d = .42) and those that screened positive for a stimulant use disorder (t(101) = 2.07, p < .05; d = .46) had significantly higher mean loneliness scores. In linear regression analyses, negative associations of loneliness with LDL and total cholesterol were observed only among SMM who used methamphetamine. CONCLUSION We observed lower cholesterol in SMM reporting loneliness and methamphetamine use. Thus, in addition to the observed associations of loneliness with cholesterol, there are important medical consequences of methamphetamine use including cardiovascular risk, higher HIV acquisition risk and progression, as well as stimulant overdose death. This cross-sectional study underscores the need for clinical research to develop and test interventions targeting loneliness among SMM with stimulant use disorders.
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Affiliation(s)
- Emily J Ross
- Department of Public Health Sciences, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Daniel E Jimenez
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1436, Miami, FL, 33136, USA
| | - Delaram Ghanooni
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Armando Mendez
- Division of Endocrinology, Diabetes and Metabolism and the Diabetes Research Institute, Department of Medicine, University of Miami Miller School of Medicine, 1450 NW 10 Ave, Miami, FL, 33136, USA
| | - Sabina Hirshfield
- Department of Medicine, STAR Program, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Keith J Horvath
- Department of Psychology, San Diego State University, Alvarado Court, San Diego, 6363, CA, USA
| | - Britt DeVries
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Samantha E Dilworth
- Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, 550 16 Street, San Francisco, CA, 94158, USA
| | - Adam W Carrico
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Claudia A Martinez
- Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA.
- Department of Cardiology and Interventional Cardiology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA.
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Abstract
Accumulating evidence suggests that living in areas of high surrounding greenness or even brief exposures to areas of high greenery is conducive to cardiovascular health, which may be related to the environmental, social, psychological, and physiological benefits of greenspaces. Recent data from multiple cross-sectional, longitudinal, and cohort studies suggest that living in areas of high surrounding greenness is associated with a lower risk of all-cause and cardiovascular mortality. High levels of neighborhood greenery have been linked also to a decrease in the burden of cardiovascular disease risk factors as reflected by lower rates of hypertension, dyslipidemia, and diabetes. Those who live in greener environments report better mental health and more frequent social interactions, which can benefit cardiovascular health as well. In this narrative review, we discuss evidence linking greenspaces to cardiovascular health as well as the potential mechanisms underlying the beneficial effects of greenspaces, including the impact of vegetation on air, noise and light pollution, ambient temperature, physical activity, mental health, and biodiversity. We review literature on the beneficial effects of acute and chronic exposure to nature on cardiovascular disease risk factors, inflammation and immune function, and we highlight the potential cardiovascular effects of biogenic volatile organic compounds that are emitted by trees and shrubs. We identify current knowledge gaps in this area and underscore the need for additional population studies to understand more clearly and precisely the link between greenness and health. Such understanding is urgently needed to fully redeem the promise of greenspaces in preventing adverse environmental exposures, mitigating the effects of climate change, and creating healthier living environments.
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Affiliation(s)
- Rachel J Keith
- Christina Lee Brown Envirome Institute (R.J.K., J.L.H., A.B.)
- Department of Medicine (R.J.K., A.B.), University of Louisville
| | - Joy L Hart
- Christina Lee Brown Envirome Institute (R.J.K., J.L.H., A.B.)
- Department of Communication (J.L.H.), University of Louisville
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute (R.J.K., J.L.H., A.B.)
- Department of Medicine (R.J.K., A.B.), University of Louisville
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Cagigas ML, Twigg SM, Fontana L. Ten tips for promoting cardiometabolic health and slowing cardiovascular aging. Eur Heart J 2024; 45:1094-1097. [PMID: 38206047 DOI: 10.1093/eurheartj/ehad853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Affiliation(s)
- Maria L Cagigas
- Charles Perkins Centre, Faculty of Medicine and Health, John Hopkins Dr, Camperdown NSW 2050, Australia
| | - Stephen M Twigg
- Charles Perkins Centre, Faculty of Medicine and Health, John Hopkins Dr, Camperdown NSW 2050, Australia
- Department of Endocrinology, Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown NSW 2050, Australia
| | - Luigi Fontana
- Charles Perkins Centre, Faculty of Medicine and Health, John Hopkins Dr, Camperdown NSW 2050, Australia
- Department of Endocrinology, Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown NSW 2050, Australia
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Al-Amin NS, McBryde-Redzovic A, Gutierrez-Kapheim M, Mitchell UA. COVID-Related Stressors and Psychological Distress Among Chicago Residents: the Moderating Role of Race. J Racial Ethn Health Disparities 2024; 11:598-610. [PMID: 36877378 PMCID: PMC9987389 DOI: 10.1007/s40615-023-01544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/31/2023] [Accepted: 02/16/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Racial and ethnic minorities have been disproportionately affected by the COVID-19 pandemic and have experienced greater financial loss, housing instability, and food insecurity due to COVID-related restrictions. As a result, Black and Hispanic communities may be at greater risk of experiencing psychological distress (PD). METHODS Using data collected between October 2020 and January 2021from 906 Black (39%), White (50%), and Hispanic (11%) adults, we assessed racial/ethnic differences in the effect of three COVID-related stressors-employment stress, housing instability, and food insecurity-on PD using ordinary least square regression. RESULTS Black adults reported lower PD levels compared to White adults (β = - 0.23, P < 0.001), but Hispanic adults did not differ significantly from White adults. COVID-related housing instability (β = 0.46, P < 0.001), food insecurity (β = 0.27, P < 0.001), and employment stress (β = 0.29, P < 0.001) were associated with higher PD. Employment stress was the only stressor to differentially affect PD by race/ethnicity. Among those that reported employment stress, Black adults had lower levels of distress compared to Whites (β = - 0.54, P < 0.001) and Hispanics (β = - 0.04, P = 0.85). CONCLUSION Despite relatively high exposure to COVID-related stressors, Black respondents had lower levels of PD compared to Whites and Hispanics which may reflect differences in race-specific coping mechanisms. Future research is needed to elucidate the nuances of these relationships and identify policies and interventions that prevent and minimize the impact of employment, food, and housing-related stressors and support coping mechanisms that promote mental health among minority populations, such as policies that support easier access to mental health and financial and housing assistance.
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Affiliation(s)
- Nadia S Al-Amin
- School of Public Health, Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA.
| | - Aminah McBryde-Redzovic
- School of Public Health, Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Gutierrez-Kapheim
- School of Public Health, Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
| | - Uchechi A Mitchell
- School of Public Health, Community Health Sciences Division, University of Illinois at Chicago, Chicago, IL, USA
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Astudillo Y, Kibrom S, Pereira T, Solomon S, Krishnan S, Samsonov D. Association between anxiety and elevated blood pressure in adolescent patients: a single-center cross-sectional study. J Hypertens 2024; 42:644-649. [PMID: 38230613 PMCID: PMC10906197 DOI: 10.1097/hjh.0000000000003652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 11/16/2023] [Accepted: 12/03/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Although anxiety is known to be associated with elevated blood pressure and hypertension in adults, this has not been studied in children. The aim of this study was to determine the association between anxiety and elevated blood pressures in adolescents. METHODS Adolescents, aged 12-18 years old, referred to the nephrology clinic were eligible to participate. Elevated blood pressure was defined as either SBP or DBP measurement above the 95th percentile for age, height, and sex. Participants were evaluated for anxiety using the validated Screen for Child Anxiety Related Disorders questionnaire filled independently by the child (SCARED-C) and parent (SCARED-P) evaluating the child. RESULTS Two hundred adolescents participated in this study. Thirty-one (53%) of SCARED-P-positive participants were found to have elevated blood pressure compared with 27 (19%) of SCARED-P negative, P 0.03. Twenty-five (43%) of SCARED-P positive had elevated DBP compared with 31 (28%) of SCARED-P negative ( P 0.003). In SCARED-P positive, mean DBP (78.4 ± 9.9) was higher compared with SCARED-P negative (74.9 ± 9.2) ( P 0.03). In a subgroup of adolescents (№ 130) not treated with blood pressure medications mean DBP was higher in both SCARED-P (79.0 ± 10.1) and SCARED-C (77.1 ± 10.4) positive groups compared with SCARED-P (73.6 ± 9.3) and SCARED-C (73 ± 8.9) negative, respectively. CONCLUSION Our study demonstrates an association between anxiety and elevated DBP in adolescent children. Screening adolescents for anxiety should be a part of the routine evaluation of adolescent children.
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Affiliation(s)
- Yaritzy Astudillo
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Sara Kibrom
- Stanford University School of Medicine, Stanford Children's Health, San Francisco, California, USA
| | - Tanya Pereira
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Sonia Solomon
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Sankaran Krishnan
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Dmitry Samsonov
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
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Morte SD, Berti E, Lalli C, Modugno N, Morgante F, Schrag A, Makovac E, Ricciardi L. Compassionate mind training for people with Parkinson's disease: A pilot study and predictors of response. Eur J Neurol 2024:e16286. [PMID: 38520186 DOI: 10.1111/ene.16286] [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: 10/16/2023] [Revised: 01/25/2024] [Accepted: 03/06/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION People with Parkinson's disease (PD) often present with disabling neuropsychiatric symptoms. Compassionate mind training (CMT) is a psychological approach effective in reducing stress and promoting psychological well-being. Heart rate variability (HRV), a measure reflecting sympathovagal balance, has been associated with psychological well-being and a compassionate attitude. AIM To assess the feasibility and effectiveness of CMT in enhancing the quality of life and psychological well-being in PD patients. Additionally, we evaluated HRV as a physiomarker for assessing the CMT outcomes. METHODS Twenty-four PD patients participated in the study. A 6-week online CMT intervention was delivered on a weekly basis. At baseline and post-intervention patients completed questionnaires assessing depression, anxiety and quality of life. In a subsample of 11 patients, HRV was measured at baseline and post-intervention in three conditions: at rest, during stress and after 3 min of deep breathing. RESULTS The attendance rate was 94.3%. Quality of life and perceived stigma improved post-intervention as compared with baseline (p = 0.02 and p = 0.03 for PD Questionnaire-39 total score and Stigma subscore, respectively). After CMT, patients presented better physiological regulation to stress, as measured by higher HRV as compared with baseline (p = 0.005). Notably, patients who were more resilient to stress at baseline (less decrease in HRV during stress) experienced a more substantial reduction in anxiety and depression following CMT. CONCLUSIONS CMT is feasible and can improve quality of life and stigma in PD patients. HRV emerges as a promising physiomarker for predicting and measuring the outcomes of psychological interventions in PD.
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Affiliation(s)
| | | | | | - Nicola Modugno
- ParkinZone Onlus, Rome, Italy
- Department of Neurology, IRCCS INM Neuromed, Pozzilli, Italy
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, UCL, London, UK
| | - Elena Makovac
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Brunel University London, Uxbridge, UK
- Centre for Neuroimaging Science, Kings College London, London, UK
| | - Lucia Ricciardi
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
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Nishimori M, Hayasaka N, Otsui K, Inoue N, Asakura J, Nagao M, Toh R, Ishida T, Hirata KI, Furuyashiki T, Shinohara M. Stress-induced stenotic vascular remodeling via reduction of plasma omega-3 fatty acid metabolite 4-oxoDHA by noradrenaline. Sci Rep 2024; 14:4178. [PMID: 38378892 PMCID: PMC10879168 DOI: 10.1038/s41598-024-54867-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/17/2024] [Indexed: 02/22/2024] Open
Abstract
Stress has garnered significant attention as a prominent risk factor for inflammation-related diseases, particularly cardiovascular diseases (CVDs). However, the precise mechanisms underlying stress-driven CVDs remain elusive, thereby impeding the development of preventive and therapeutic strategies. To explore the correlation between plasma lipid metabolites and human depressive states, liquid chromatography-mass spectrometry (LC/MS) based analysis of plasma and the self-rating depression (SDS) scale questionnaire were employed. We also used a mouse model with restraint stress to study its effects on plasma lipid metabolites and stenotic vascular remodeling following carotid ligation. In vitro functional and mechanistic studies were performed using macrophages, endothelial cells, and neutrophil cells. We revealed a significant association between depressive state and reduced plasma levels of 4-oxoDHA, a specific omega-3 fatty acid metabolite biosynthesized by 5-lipoxygenase (LO), mainly in neutrophils. In mice, restraint stress decreased plasma 4-oxoDHA levels and exacerbated stenotic vascular remodeling, ameliorated by 4-oxoDHA supplementation. 4-oxoDHA enhanced Nrf2-HO-1 pathways, exerting anti-inflammatory effects on endothelial cells and macrophages. One of the stress hormones, noradrenaline, reduced 4-oxoDHA and the degraded 5-LO in neutrophils through the proteasome system, facilitated by dopamine D2-like receptor activation. Our study proposed circulating 4-oxoDHA levels as a stress biomarker and supplementation of 4-oxoDHA as a novel therapeutic approach for controlling stress-related vascular inflammation.
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Affiliation(s)
- Makoto Nishimori
- Division of Molecular Epidemiology, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan
| | - Naomi Hayasaka
- The Integrated Center for Mass Spectrometry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazunori Otsui
- Division of General Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Junko Asakura
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Manabu Nagao
- Division of Evidence-Based Laboratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryuji Toh
- Division of Evidence-Based Laboratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuro Ishida
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Nursing Practice, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoyuki Furuyashiki
- Division of Pharmacology, Kobe University Graduate School of Medicine, Kobe, Japan
- Japan Agency for Medical Research and Development, Tokyo, Japan
| | - Masakazu Shinohara
- Division of Molecular Epidemiology, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan.
- The Integrated Center for Mass Spectrometry, Kobe University Graduate School of Medicine, Kobe, Japan.
- Japan Agency for Medical Research and Development, Tokyo, Japan.
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Rees K, Takeda A, Court R, Kudrna L, Hartley L, Ernst E. Meditation for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev 2024; 2:CD013358. [PMID: 38358047 PMCID: PMC10867897 DOI: 10.1002/14651858.cd013358.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
BACKGROUND Interventions incorporating meditation to address stress, anxiety, and depression, and improve self-management, are becoming popular for many health conditions. Stress is a risk factor for cardiovascular disease (CVD) and clusters with other modifiable behavioural risk factors, such as smoking. Meditation may therefore be a useful CVD prevention strategy. OBJECTIVES To determine the effectiveness of meditation, primarily mindfulness-based interventions (MBIs) and transcendental meditation (TM), for the primary and secondary prevention of CVD. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, three other databases, and two trials registers on 14 November 2021, together with reference checking, citation searching, and contact with study authors to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) of 12 weeks or more in adults at high risk of CVD and those with established CVD. We explored four comparisons: MBIs versus active comparators (alternative interventions); MBIs versus non-active comparators (no intervention, wait list, usual care); TM versus active comparators; TM versus non-active comparators. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were CVD clinical events (e.g. cardiovascular mortality), blood pressure, measures of psychological distress and well-being, and adverse events. Secondary outcomes included other CVD risk factors (e.g. blood lipid levels), quality of life, and coping abilities. We used GRADE to assess the certainty of evidence. MAIN RESULTS We included 81 RCTs (6971 participants), with most studies at unclear risk of bias. MBIs versus active comparators (29 RCTs, 2883 participants) Systolic (SBP) and diastolic (DBP) blood pressure were reported in six trials (388 participants) where heterogeneity was considerable (SBP: MD -6.08 mmHg, 95% CI -12.79 to 0.63, I2 = 88%; DBP: MD -5.18 mmHg, 95% CI -10.65 to 0.29, I2 = 91%; both outcomes based on low-certainty evidence). There was little or no effect of MBIs on anxiety (SMD -0.06 units, 95% CI -0.25 to 0.13; I2 = 0%; 9 trials, 438 participants; moderate-certainty evidence), or depression (SMD 0.08 units, 95% CI -0.08 to 0.24; I2 = 0%; 11 trials, 595 participants; moderate-certainty evidence). Perceived stress was reduced with MBIs (SMD -0.24 units, 95% CI -0.45 to -0.03; I2 = 0%; P = 0.03; 6 trials, 357 participants; moderate-certainty evidence). There was little to no effect on well-being (SMD -0.18 units, 95% CI -0.67 to 0.32; 1 trial, 63 participants; low-certainty evidence). There was little to no effect on smoking cessation (RR 1.45, 95% CI 0.78 to 2.68; I2 = 79%; 6 trials, 1087 participants; low-certainty evidence). None of the trials reported CVD clinical events or adverse events. MBIs versus non-active comparators (38 RCTs, 2905 participants) Clinical events were reported in one trial (110 participants), providing very low-certainty evidence (RR 0.94, 95% CI 0.37 to 2.42). SBP and DBP were reduced in nine trials (379 participants) but heterogeneity was substantial (SBP: MD -6.62 mmHg, 95% CI -13.15 to -0.1, I2 = 87%; DBP: MD -3.35 mmHg, 95% CI -5.86 to -0.85, I2 = 61%; both outcomes based on low-certainty evidence). There was low-certainty evidence of reductions in anxiety (SMD -0.78 units, 95% CI -1.09 to -0.41; I2 = 61%; 9 trials, 533 participants; low-certainty evidence), depression (SMD -0.66 units, 95% CI -0.91 to -0.41; I2 = 67%; 15 trials, 912 participants; low-certainty evidence) and perceived stress (SMD -0.59 units, 95% CI -0.89 to -0.29; I2 = 70%; 11 trials, 708 participants; low-certainty evidence) but heterogeneity was substantial. Well-being increased (SMD 0.5 units, 95% CI 0.09 to 0.91; I2 = 47%; 2 trials, 198 participants; moderate-certainty evidence). There was little to no effect on smoking cessation (RR 1.36, 95% CI 0.86 to 2.13; I2 = 0%; 2 trials, 453 participants; low-certainty evidence). One small study (18 participants) reported two adverse events in the MBI group, which were not regarded as serious by the study investigators (RR 5.0, 95% CI 0.27 to 91.52; low-certainty evidence). No subgroup effects were seen for SBP, DBP, anxiety, depression, or perceived stress by primary and secondary prevention. TM versus active comparators (8 RCTs, 830 participants) Clinical events were reported in one trial (201 participants) based on low-certainty evidence (RR 0.91, 95% CI 0.56 to 1.49). SBP was reduced (MD -2.33 mmHg, 95% CI -3.99 to -0.68; I2 = 2%; 8 trials, 774 participants; moderate-certainty evidence), with an uncertain effect on DBP (MD -1.15 mmHg, 95% CI -2.85 to 0.55; I2 = 53%; low-certainty evidence). There was little or no effect on anxiety (SMD 0.06 units, 95% CI -0.22 to 0.33; I2 = 0%; 3 trials, 200 participants; low-certainty evidence), depression (SMD -0.12 units, 95% CI -0.31 to 0.07; I2 = 0%; 5 trials, 421 participants; moderate-certainty evidence), or perceived stress (SMD 0.04 units, 95% CI -0.49 to 0.57; I2 = 70%; 3 trials, 194 participants; very low-certainty evidence). None of the trials reported adverse events or smoking rates. No subgroup effects were seen for SBP or DBP by primary and secondary prevention. TM versus non-active comparators (2 RCTs, 186 participants) Two trials (139 participants) reported blood pressure, where reductions were seen in SBP (MD -6.34 mmHg, 95% CI -9.86 to -2.81; I2 = 0%; low-certainty evidence) and DBP (MD -5.13 mmHg, 95% CI -9.07 to -1.19; I2 = 18%; very low-certainty evidence). One trial (112 participants) reported anxiety and depression and found reductions in both (anxiety SMD -0.71 units, 95% CI -1.09 to -0.32; depression SMD -0.48 units, 95% CI -0.86 to -0.11; low-certainty evidence). None of the trials reported CVD clinical events, adverse events, or smoking rates. AUTHORS' CONCLUSIONS Despite the large number of studies included in the review, heterogeneity was substantial for many of the outcomes, which reduced the certainty of our findings. We attempted to address this by presenting four main comparisons of MBIs or TM versus active or inactive comparators, and by subgroup analyses according to primary or secondary prevention, where there were sufficient studies. The majority of studies were small and there was unclear risk of bias for most domains. Overall, we found very little information on the effects of meditation on CVD clinical endpoints, and limited information on blood pressure and psychological outcomes, for people at risk of or with established CVD. This is a very active area of research as shown by the large number of ongoing studies, with some having been completed at the time of writing this review. The status of all ongoing studies will be formally assessed and incorporated in further updates.
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Affiliation(s)
- Karen Rees
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Rachel Court
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Laura Kudrna
- Institute of Applied Health, University of Birmingham, Birmingham, UK
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11
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Dominguez LJ, Veronese N, Barbagallo M. The link between spirituality and longevity. Aging Clin Exp Res 2024; 36:32. [PMID: 38341843 PMCID: PMC10859326 DOI: 10.1007/s40520-023-02684-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/21/2023] [Indexed: 02/13/2024]
Abstract
We are facing an inverted demographic pyramid with continuously growing aged populations around the world. However, the advances that prolong physical life not always contemplate its psychological and social dimensions. Longevity is a complex outcome influenced by a wide range of factors, including genetics, lifestyle choices, access to healthcare, socio-economic conditions, and other environmental factors. These factors have been generally considered in the compelling research that seeks the determinants of longevity, particularly those concerning personal lifestyle choices, socioeconomic conditions, and molecular mechanisms proposed to mediate these effects. Nonetheless, fundamental aspects that can affect health and well-being, such as spirituality and religiosity, have been somehow left aside despite numerous epidemiological studies showing that higher levels of spirituality/religiosity are associated with lower risk of mortality, even after adjusting for relevant confounders. Because spirituality/religiosity are dimensions of great value for patients, overlooking them can leave them with feelings of neglect and lack of connection with the health system and with the clinicians in charge of their care. Integrating spirituality and religiosity assessment and intervention programs into clinical care can help each person obtain better and complete well-being and also allowing clinicians to achieve the highest standards of health with holistic, person-centered care. The present narrative review aims to explore the available evidence of a relationship between spirituality/religiosity and longevity and discusses the possible mechanisms that can help explain such relationship.
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Affiliation(s)
| | - Nicola Veronese
- Geriatric Unit, Department of Medicine, University of Palermo, 90127, Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Medicine, University of Palermo, 90127, Palermo, Italy.
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12
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Vassou C, Chrysohoou C, Georgousopoulou EN, Yannakoulia M, Pitsavos C, Cropley M, Panagiotakos DB. Cognitive vulnerability, anxiety, and physical well-being in relation to 10-year cardiovascular disease risk: The ATTICA epidemiological study. Appl Psychol Health Well Being 2024; 16:60-79. [PMID: 37435922 DOI: 10.1111/aphw.12469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/25/2023] [Indexed: 07/13/2023]
Abstract
This study aimed to evaluate the association between irrational beliefs and the 10-year cardiovascular disease (CVD) incidence among apparently healthy adults. The ATTICA study is a population-based, prospective cohort (2002-2012) consisting of 853 participants without evidence of CVD (453 men and 400 women) who underwent psychological evaluations. Participants completed the Irrational Beliefs Inventory (IBI, range 0-88), a self-reported measure consistent with the Ellis model of psychological disturbance. We conducted a factor analysis to develop irrational beliefs factors to evaluate the association between subcategories of irrational beliefs and CVD incidence. Demographic characteristics, detailed medical history, other psychological factors, and dietary and other lifestyle habits were also evaluated. The incidence of CVD was defined according to the International Coding Diseases (ICD)-10 criteria. The identified dominant irrational beliefs factor, "cognitive vulnerability to anxiety," consisted of demandingness, perfectionism, emotional irresponsibility, anxious overconcern, dependence on others, and overconcern for the welfare of others, was strongly associated with an increased 10-year CVD risk. Nested multi-adjusted regression analysis revealed that anxiety, as well as negative physical well-being, mediated this relationship, and subset of irrational beliefs predicted CVD risk directly and indirectly through anxiety and negative physical well-being. These findings further map the path through which irrational beliefs can contribute to CVDs and provide insights in favor of preventive healthcare.
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Affiliation(s)
- Christina Vassou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Ekavi N Georgousopoulou
- School of Medicine Sydney, University of Notre Dame, Sydney, New South Wales, Australia
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Mark Cropley
- School of Psychology, University of Surrey, Guildford, UK
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
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13
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Babygeetha A, Devineni D. Social Support and Adherence to Self-Care Behavior Among Patients With Coronary Heart Disease and Heart Failure: A Systematic Review. EUROPES JOURNAL OF PSYCHOLOGY 2024; 20:63-77. [PMID: 38487598 PMCID: PMC10936663 DOI: 10.5964/ejop.12131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/19/2023] [Indexed: 03/17/2024]
Abstract
Cardiovascular diseases stand out as the foremost cause of mortality on a global scale and encompass conditions that require long term self-care. Coronary heart disease and heart failure are two cardiovascular conditions that require significant lifestyle modifications. Adherence to self-care is a multifaceted phenomenon, and is influenced by various factors that include social, economic, disease-related and healthcare system-related factors. A key factor in adherence to self-care in chronic illnesses is social support. To explore this relationship between social support and adherence to self-care, a systematic review was carried out across Scopus, EBSCO host and ProQuest from October 2022 to February 2023 using predefined search criteria. Studies from inception to February 2023 were considered for the review, ultimately incorporating a total of 11 studies. Six studies had an adult population with coronary heart disease while the remaining five had adults with heart failure. All the studies reported a significant positive correlation between social support and adherence to self-care. Our findings revealed that social support plays a significant role in promoting self-care, emphasizing the need for a holistic understanding of self-care to develop effective interventions. Along with self-report measures, objective measures should be used to assess adherence accurately. There is a need for scales that assess all aspects of self-care, as well as the development of new interventions and teaching strategies to facilitate the individual's self-care journey. In addition, family members and trusted resources should be involved in encouraging self-care, and interventions should target both patients and their family members.
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Affiliation(s)
- Athira Babygeetha
- Department of Applied Psychology, Pondicherry University, Puducherry, India
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14
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Alsuwaidan SD, Bakhaider MA, Alsenaidy AA, Alshehri MA, Alzaid FN, Aldakhil LO, Albrahim FZ. Prevalence of depression in postmyocardial infarction patients in a tertiary care center in Riyadh. J Family Community Med 2024; 31:57-62. [PMID: 38406215 PMCID: PMC10883433 DOI: 10.4103/jfcm.jfcm_166_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND The coexistence of coronary artery disease (CAD) and depression is a growing concern, as both conditions lead to disability. Although depression is more prevalent in CAD patients than in the general population and has been associated with adverse cardiac outcomes, the underlying mechanisms linking depression and CAD are not yet fully understood. This study aims to assess the prevalence of depression in postmyocardial infarction (MI) patients as baseline data in Saudi Arabia. MATERIALS AND METHODS A cross-sectional study was conducted at King Saud Medical City, Riyadh. The study population included male and female patients who had survived MI from January 2022 to June 2022. A sample size of 323 patients was initially planned, but only 249 patients could be included on account of exclusions. The patients underwent screening for depression using Patient Health Questionnaire-2 (PHQ-2), and those who were positive on screening were further assessed using the PHQ-9 according to DSM-5 criteria. Sociodemographic data, comorbidities, and previous cardiac interventions were collected from medical records. RESULTS The mean age of the study participants was 57.15 years, and majority (76.6%) were males. The prevalence of previously diagnosed depression was 9.2%, and 5.2% of patients reported using antidepressant medication. According to the PHQ-9 scores, 33.33% had depression, 9% had moderate depression, and 2.4% had severe depression. There were significant associations between the severity of depression and previous CAD (P < 0.05), previous coronary artery bypass graft surgery (P < 0.05), and heart failure (P < 0.05). CONCLUSION This study reveals a high prevalence of depression in post-MI patients at King Saud Medical City. The findings highlight the need for comprehensive management of depression in this population to improve outcomes. Further research into the underlying mechanisms linking depression and CAD to develop effective interventions is required.
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Affiliation(s)
- Salem D. Alsuwaidan
- Department of Family Medicine, King Saud Medical City, Research Centre, Riyadh, Saudi Arabia
| | - Moaz A. Bakhaider
- Department of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | | | | | - Fahad N. Alzaid
- Department of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Lina O. Aldakhil
- Department of Family Medicine, King Saud Medical City, Research Centre, Riyadh, Saudi Arabia
| | - Fatima Z. Albrahim
- Department of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
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15
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Sirbu C. The Role of Endogenous Opioids in Cardioprotection. ADVANCES IN NEUROBIOLOGY 2024; 35:381-395. [PMID: 38874733 DOI: 10.1007/978-3-031-45493-6_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
The opioid system involves opioid receptors (OPRs) and endogenous opioid peptides.This chapter will focus on the distribution of OPRs in the cardiovascular system, the expression pattern in the heart, the activation by opioid peptides, and the effects of OPRs activation with potential relevance in cardiovascular performance. In the heart, OPRs are co-expressed with beta adrenergic receptors (β-ARs) in the G-protein-coupled receptor (GPCR) superfamily, functionally cross-talk with β-Ars and modify catecholamine-induced effects. They are involved in cardiac contractility, energy metabolism, myocyte survival or death, vascular resistance. The effects of the opioid system in the regulation of systemic circulation at both the central and peripheral level are presented. The pathways are discussed under physiological (i.e., aging) and pathological conditions (atherosclerosis, heart failure, essential hypertension, ischemic stress). Stimulation of OPRs not only inhibits cardiac excitation-contraction coupling, but also protects the heart against hypoxic and ischemic injury. An enhanced sensitivity to opioids of endocrine organs and neuronal systems is operative in hypertensive patients. The opioid system can be pharmacologically engaged to selectively mimic these responses via cardiac and nervous signaling. The clinical opportunities for the use of cardioprotective effects of opioids require future investigations to provide more specific details of the impact on cardiac performance and electrophysiological properties.
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Affiliation(s)
- Cristina Sirbu
- Department of Cardiac Surgery and Transplantation, University Hospital Nancy-Brabois, Nancy, France
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16
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Yamasaki S, Tokunou T, Maeda T, Horiuchi T. Night-Time Hot Spring Bathing Is Associated with a Lower Systolic Blood Pressure among Japanese Older Adults: A Single-Institution Retrospective Cohort Study. Geriatrics (Basel) 2023; 9:2. [PMID: 38392101 PMCID: PMC10888263 DOI: 10.3390/geriatrics9010002] [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: 08/30/2023] [Revised: 11/28/2023] [Accepted: 12/19/2023] [Indexed: 02/24/2024] Open
Abstract
Hot spring bathing is practiced to help manage hypertension. We retrospectively investigated the effects of hot spring bathing on hypertension with the aim of identifying a novel approach to prevent and manage hypertension. The study cohort comprised 99 patients aged ≥65 years admitted to Kyushu University Beppu Hospital between 1 December 2021 and 30 November 2022 who could walk by themselves and who used hot springs for ≥3 days during their hospital stay. The changes in both systolic and diastolic blood pressure were significantly decreased in the night-time bathing group (n = 21) compared with the noontime (n = 26) and afternoon (n = 52) groups. Night-time hot spring bathing was significantly associated with reduced systolic blood pressure the next morning in older adults. Although prospective randomized controlled trials on night-time hot spring bathing as a hypertension treatment are warranted to investigate whether the practice can prevent hypertension among adults aged ≥65 years, we have initiated a single-center, phase II study on the relationship between sleep quality and quality of life in hypertensive patients after night-time hot spring bathing.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu 874-0838, Japan
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan
| | - Tomotake Tokunou
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu 874-0838, Japan
- Division of Basic Medical Science and Fundamental Nursing, Department of Nursing, Fukuoka Nursing College, Fukuoka 814-0193, Japan
| | - Toyoki Maeda
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu 874-0838, Japan
| | - Takahiko Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu 874-0838, Japan
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17
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Fukumoto D, Kanda D, Takumi T, Ikeda Y, Tokushige A, Ohmure K, Sonoda T, Arikawa R, Anzaki K, Ohishi M. Living alone predicts poor prognosis among patients with acute myocardial infarction. Coron Artery Dis 2023; 34:580-588. [PMID: 37721361 PMCID: PMC10602217 DOI: 10.1097/mca.0000000000001286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/29/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Living alone as a proxy for social isolation has been considered to increase the risk of cardiovascular disease. We thus investigated the impact of living alone on mortality in acute myocardial infarction (AMI) patients. METHODS Subjects comprised 277 AMI patients who underwent percutaneous coronary intervention (PCI). Associations between all-cause and cardiac deaths after PCI and baseline characteristics including living alone and Global Registry of Acute Coronary Events (GRACE) risk score were assessed. RESULTS Eighty-three patients (30%) were living alone. Thirty patients died after PCI, including 20 cardiac deaths. Patients living alone showed higher incidences of both all-cause and cardiac deaths compared with patients not living alone (18% vs. 8%, P = 0.019 and 14% vs. 4%, P = 0.004). Multivariate Cox proportional hazards regression analysis models showed living alone [hazard ratio (HR), 2.60; 95% confidence interval (CI), 1.20-5.62; P = 0.016 and HR, 4.17; 95% CI, 1.60-10.84; P = 0.003] and GRACE risk score (HR, 1.02; 95% CI, 1.01-1.03; P = 0.003 and HR, 1.03; 95% CI, 1.01-1.04; P < 0.001) correlated significantly with all-cause and cardiac deaths. Cox proportional hazards modeling revealed that patients living alone with GRACE risk score ≥162 derived from the receiver-operating characteristic curve showed a significantly greater risk of all-cause death than patients not living alone with GRACE risk score <162 (HR 16.57; 95% CI 6.67-41.21; P < 0.001). CONCLUSION Among AMI patients, living alone represents an independent risk factor for all-cause and cardiac deaths after PCI, separate from GRACE risk score. Furthermore, AMI patients living alone with high GRACE risk scores may experience an additively increased risk of mortality after PCI.
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Affiliation(s)
- Daichi Fukumoto
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Daisuke Kanda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuro Takumi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Akihiro Tokushige
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kenta Ohmure
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takeshi Sonoda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Ryo Arikawa
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kazuhiro Anzaki
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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Bentley TGK, D’Andrea-Penna G, Rakic M, Arce N, LaFaille M, Berman R, Cooley K, Sprimont P. Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature. Brain Sci 2023; 13:1612. [PMID: 38137060 PMCID: PMC10741869 DOI: 10.3390/brainsci13121612] [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: 10/15/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 12/24/2023] Open
Abstract
Anxiety and stress plague populations worldwide. Voluntary regulated breathing practices offer a tool to address this epidemic. We examined peer-reviewed published literature to understand effective approaches to and implementation of these practices. PubMed and ScienceDirect were searched to identify clinical trials evaluating isolated breathing-based interventions with psychometric stress/anxiety outcomes. Two independent reviewers conducted all screening and data extraction. Of 2904 unique articles, 731 abstracts, and 181 full texts screened, 58 met the inclusion criteria. Fifty-four of the studies' 72 interventions were effective. Components of effective and ineffective interventions were evaluated to develop a conceptual framework of factors associated with stress/anxiety reduction effectiveness. Effective breath practices avoided fast-only breath paces and sessions <5 min, while including human-guided training, multiple sessions, and long-term practice. Population, other breath paces, session duration ≥5 min, and group versus individual or at-home practices were not associated with effectiveness. Analysis of interventions that did not fit this framework revealed that extensive standing, interruptions, involuntary diaphragmatic obstruction, and inadequate training for highly technical practices may render otherwise promising interventions ineffective. Following this evidence-based framework can help maximize the stress/anxiety reduction benefits of breathing practices. Future research is warranted to further refine this easily accessible intervention for stress/anxiety relief.
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Affiliation(s)
- Tanya G. K. Bentley
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Gina D’Andrea-Penna
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
- Neurosciences Graduate Program, University of California San Diego, La Jolla, CA 92093, USA
| | - Marina Rakic
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Nick Arce
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Michelle LaFaille
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Rachel Berman
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Katie Cooley
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Preston Sprimont
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
- Department of Kinesiology, California State University Fullerton, Fullerton, CA 92831, USA
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19
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Lally C, Maliq NN, Schreiber M, Wilson A, Tiwari T. Association of parental social support and dental caries in hispanic children. FRONTIERS IN ORAL HEALTH 2023; 4:1261111. [PMID: 38033461 PMCID: PMC10684728 DOI: 10.3389/froh.2023.1261111] [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: 07/18/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
This study describes social support of Hispanic parents and the correlation with dental caries in their children. A cross-sectional study design was utilized to assess the 157 parent-child triads recruited from the Children's Hospital Colorado Dental Clinic. The Basic Research Factors Questionnaire (BRFQ) survey was utilized to assess parents' oral health knowledge, attitudes, behavior, and other psychosocial measures with social support as the main predictor variable. Bivariate associations between the independent variables and dmfs were conducted. Independent variables with a bivariate association of p ≤ 0.2 for the outcome variable were included in the multivariable linear regression model. Dental caries in children was significantly associated with less overall parental social support (β = -10.10, p = 0.03). Overall social support was divided into four sub-categories: errand help, money help, childcare help, and transportation help. Dental caries decreased by 7.70 units for every 1-unit increase in transportation help (β = -7.70, p = 0.03). A significant association was observed between parental knowledge on dental utilization and dmfs (β = -2.70, p = 0.04). In the multivariable linear regression model, caries was significantly associated with social support (β = -11.18, p = 0.02) and knowledge on dental utilization (β = -3.84, p = 0.01). The study concludes that a higher level of social support and knowledge on dental utilization for Hispanic parents is correlated with lower rates of dental caries in their children.
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Affiliation(s)
- Casey Lally
- Children’s Hospital, University of Colorado, Aurora, CO, United States
| | | | - Madysen Schreiber
- School of Public Helath, Oregon Health and Sciences University, Portland, OR, United States
| | - Anne Wilson
- Children’s Hospital, University of Colorado, Aurora, CO, United States
- School of Dental Medicine, University of Colorado, Aurora, CO, United States
| | - Tamanna Tiwari
- School of Dental Medicine, University of Colorado, Aurora, CO, United States
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20
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Park JW, Dulin AJ, Scarpaci MM, Dionne LA, Needham BL, Sims M, Kanaya AM, Kandula NR, Loucks EB, Fava JL, Eaton CB, Howe CJ. Examining the Relationship Between Multilevel Resilience Resources and Cardiovascular Disease Incidence, Overall and by Psychosocial Risks, Among Participants in the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. Am J Epidemiol 2023; 192:1864-1881. [PMID: 37442807 PMCID: PMC11043787 DOI: 10.1093/aje/kwad159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/20/2022] [Accepted: 07/11/2023] [Indexed: 07/15/2023] Open
Abstract
We examined relationships between resilience resources (optimism, social support, and neighborhood social cohesion) and cardiovascular disease (CVD) incidence and assessed potential effect-measure modification by psychosocial risk factors (e.g., stress, depression) among adults without CVD in 3 cohort studies (2000-2018): the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. We fitted adjusted Cox models accounting for within-neighborhood clustering while censoring at dropout or non-CVD death. We assessed for effect-measure modification by psychosocial risks. In secondary analyses, we estimated standardized risk ratios using inverse-probability-weighted Aalen-Johansen estimators to account for confounding, dropout, and competing risks (non-CVD deaths) and obtained 95% confidence intervals (CIs) using cluster bootstrapping. For high and medium (versus low) optimism (n = 6,243), adjusted hazard ratios (HRs) for incident CVD were 0.94 (95% CI: 0.78, 1.13) and 0.90 (95% CI: 0.75, 1.07), respectively. Corresponding HRs were 0.88 (95% CI: 0.74, 1.04) and 0.92 (95% CI: 0.79, 1.06) for social support (n = 7,729) and 1.10 (95% CI: 0.94, 1.29) and 0.99 (95% CI: 0.85, 1.16) for social cohesion (n = 7,557), respectively. Some psychosocial risks modified CVD HRs. Secondary analyses yielded similar findings. For optimism and social support, an inverse relationship was frequently most compatible with the data, but a positive relationship was also compatible. For neighborhood social cohesion, positive and null relationships were most compatible. Thus, specific resilience resources may be potential intervention targets, especially among certain subgroups.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Chanelle J Howe
- Correspondence to Dr. Chanelle Howe, Center for Epidemiologic Research, Department of Epidemiology, School of Public Health, Brown University, Box G-S121-2, Providence, RI 02912 (e-mail: )
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Akkoca M, Kocaay AF, Tokgoz S, Er S, Duman B, Ayaz T, Kumbasar H, Gokmen D, Koç MA, Kuzu MA. Psychiatric Symptoms, Aggression, and Sexual Dysfunction Among Patients With Benign Anal Conditions. Am Surg 2023; 89:4297-4304. [PMID: 35195473 DOI: 10.1177/00031348221074225] [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: 11/16/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the incidence of general psychiatric symptoms, aggression levels, and sexual dysfunction in patients with benign anorectal diseases and compare the results with those of healthy control subjects. METHODS We prospectively enrolled consecutive adult patients who presented for treatment of benign perianal diseases and healthy control subjects between June 2017 and December 2018. All patients had either grade 3 or 4 hemorrhoidal disease or perianal fistula with active discharge who had not undergone previous anorectal surgery. We also included a control group with benign subcutaneous lumps presenting for minor surgery. We used the Symptom Checklist-90-Revised Form to evaluate general psychiatric symptoms, the Buss-Perry Aggression Questionnaire (BPAQ) to evaluate aggression levels, and the Arizona Sexual Experiences Scale to evaluate sexual dysfunction. RESULTS A total of 563 patients were assessed for eligibility; after exclusions, 94 with anal fistula, 89 with hemorrhoids, and 59 healthy control subjects were enrolled. The groups were similar with regard to age, gender, and educational level. Physical and verbal aggression, anger, and total BPAQ score were significantly higher in patients with perianal fistula than in those with hemorrhoidal disease and healthy control subjects (P < .001). CONCLUSION This study suggests that patients with perianal fistula have higher levels of aggression than healthy control subjects and those with hemorrhoidal disease. One must bear this in mind during preoperative patient evaluations and obtaining informed consent. Further studies are needed to investigate the reason for this association and potential causality.
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Affiliation(s)
- Muzaffer Akkoca
- Department of General Surgery, University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Akin Firat Kocaay
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Serhat Tokgoz
- Department of General Surgery, University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Saadettin Er
- Department of General Surgery, Bilkent City Research and Training Hospital, University of Health Sciences, Ankara, Turkey
| | - Berker Duman
- Department of Psychiatry, Division of Consultation-Liaison Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Tugba Ayaz
- Department of Psychiatry, Ege University School of Medicine, İzmir, Turkey
| | - Hakan Kumbasar
- Department of Psychiatry, Division of Consultation-Liaison Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Derya Gokmen
- Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet Ali Koç
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet Ayhan Kuzu
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
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22
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Cao Z, Hou Y, Yang H, Huang X, Wang X, Xu C. Healthy sleep patterns and common mental disorders among individuals with cardiovascular disease: A prospective cohort study. J Affect Disord 2023; 338:487-494. [PMID: 37356734 DOI: 10.1016/j.jad.2023.06.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Sleep behaviors are potentially modifiable risk factors for common mental disorders and cardiovascular disease (CVD). However, the associations between combined sleep behaviors and common mental disorders among individuals with CVD remain unclear. METHODS A total of 18,776 participants with a history of CVD from UK Biobank, who were free of depression or anxiety from 2006 to 2010 were included. A composite healthy sleep score was constructed based on five sleep behaviors (chronotype, sleep duration, insomnia, snoring, and excessive daytime sleepiness). Cox proportional hazard regression models were performed to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs) for incident depression and anxiety. RESULTS During a median follow-up of 11.8 years, 965 depression and 812 anxiety cases were recorded. The adjusted HRs for participants with a healthy sleep pattern compared with a poor sleep pattern were 0.45 (95 % CI: 0.35-0.57) for depression and 0.77 (95 % CI: 0.58-1.03) for anxiety. There was a linear dose-response association of healthy sleep score with incident depression and anxiety (HR = 0.82, 95 % CI: 0.77-0.87; HR = 0.92, 95 % CI: 0.86-0.99 per 1-score increase, respectively). Likewise, these associations were observed among individuals with coronary heart disease, stroke, heart failure and atrial fibrillation. CONCLUSIONS A healthy sleep pattern is significantly associated with a lower risk of depression among individuals with CVD, highlighting the importance of monitoring and improving sleep health in the prevention of common mental disorders among individuals with CVD.
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Affiliation(s)
- Zhi Cao
- School of Public Health, Hangzhou Normal University, Hangzhou, China; School of Public Health, Zhejiang University School of Medicine, Hangzhou, China; Hangzhou International Urbanology Research Center & Center for Urban Governance Studies, Hangzhou, China
| | - Yabing Hou
- Yanjing Medical College, Capital Medical University, Beijing, China
| | - Hongxi Yang
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Xianhong Huang
- School of Public Health, Hangzhou Normal University, Hangzhou, China; Hangzhou International Urbanology Research Center & Center for Urban Governance Studies, Hangzhou, China
| | - Xiaohe Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China; Hangzhou International Urbanology Research Center & Center for Urban Governance Studies, Hangzhou, China
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China; Hangzhou International Urbanology Research Center & Center for Urban Governance Studies, Hangzhou, China.
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23
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Bansal K, Majmundar V, Muthyala A, Arun Kumar P, Dasari M, Kasireddy TR, Yukselen Z, Singh T, Nakhla M, Anugu VR, Desai N, Ganatra S, Dani SS. Association Between Psychosocial Risk Factors and Readmissions After Acute Myocardial Infarction: Role of COVID-19 Pandemic. Curr Probl Cardiol 2023; 48:101881. [PMID: 37336310 PMCID: PMC10276487 DOI: 10.1016/j.cpcardiol.2023.101881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023]
Abstract
Psychosocial risk factors (PSRFs) are known to be associated with worse cardiovascular (CV) outcomes. However, there are limited data on the impact of PSRFs on readmissions after acute myocardial infarction (AMI) before and during the COVID-19 (Coronavirus Disease 2019) pandemic. Therefore, we aimed to examine this association and whether the effects of PSRFs were amplified during the COVID-19 pandemic. We queried the 2019 and 2020 Nationwide Readmissions Database for adult (age ≥18 years) index admissions with AMI as the primary diagnosis. They were then divided into 2 cohorts based on the presence or absence of ≥1 PSRF and compared across non-COVID-19 (2019) and COVID-19 (2020) time periods. The primary outcome was 30-day all-cause readmissions. Secondary outcomes included cause-specific readmissions (cardiac, noncardiac, AMI, heart failure). Multivariable hierarchical logistic regression was conducted to evaluate differences in outcomes. The study included 380,820 patients with index AMI, of which 214,384 (56%) had ≥1 PSRFs. Patients with PSRFs were younger, more likely to be female, and had a higher prevalence of CV risk factors. Of 30-day all-cause readmissions were higher in patients with PSRFs in both eras. Moreover, noncardiac and heart failure readmissions were also higher in patients with PSRFs admitted with AMI in 2019 and 2020. This study of a nationally representative population magnifies the association of PSRF with more unplanned readmissions after AMI in both pre-COVID-19 and COVID-19 times.
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Affiliation(s)
- Kannu Bansal
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA
| | - Vidit Majmundar
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA
| | - Anjani Muthyala
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA
| | | | - Mahati Dasari
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA
| | | | - Zeynep Yukselen
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA; School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA
| | - Tejveer Singh
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA
| | - Michael Nakhla
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA
| | | | - Nihar Desai
- Department of Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT
| | - Sarju Ganatra
- Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA
| | - Sourbha S Dani
- Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA.
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Giubilato S, Lucà F, Abrignani MG, Gatto L, Rao CM, Ingianni N, Amico F, Rossini R, Caretta G, Cornara S, Di Matteo I, Di Nora C, Favilli S, Pilleri A, Pozzi A, Temporelli PL, Zuin M, Amico AF, Riccio C, Grimaldi M, Colivicchi F, Oliva F, Gulizia MM. Management of Residual Risk in Chronic Coronary Syndromes. Clinical Pathways for a Quality-Based Secondary Prevention. J Clin Med 2023; 12:5989. [PMID: 37762932 PMCID: PMC10531720 DOI: 10.3390/jcm12185989] [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: 07/24/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Chronic coronary syndrome (CCS), which encompasses a broad spectrum of clinical presentations of coronary artery disease (CAD), is the leading cause of morbidity and mortality worldwide. Recent guidelines for the management of CCS emphasize the dynamic nature of the CAD process, replacing the term "stable" with "chronic", as this disease is never truly "stable". Despite significant advances in the treatment of CAD, patients with CCS remain at an elevated risk of major cardiovascular events (MACE) due to the so-called residual cardiovascular risk. Several pathogenetic pathways (thrombotic, inflammatory, metabolic, and procedural) may distinctly contribute to the residual risk in individual patients and represent a potential target for newer preventive treatments. Identifying the level and type of residual cardiovascular risk is essential for selecting the most appropriate diagnostic tests and follow-up procedures. In addition, new management strategies and healthcare models could further support available treatments and lead to important prognostic benefits. This review aims to provide an overview of the diagnostic and therapeutic challenges in the management of patients with CCS and to promote more effective multidisciplinary care.
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Affiliation(s)
- Simona Giubilato
- Cardiology Department, Cannizzaro Hospital, 95126 Catania, Italy;
| | - Fabiana Lucà
- Cardiology Department, Grande Ospedale Metropolitano, AO Bianchi Melacrino Morelli, 89129 Reggio Calabria, Italy; (F.L.); (C.M.R.)
| | | | - Laura Gatto
- Cardiology Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy
| | - Carmelo Massimiliano Rao
- Cardiology Department, Grande Ospedale Metropolitano, AO Bianchi Melacrino Morelli, 89129 Reggio Calabria, Italy; (F.L.); (C.M.R.)
| | - Nadia Ingianni
- ASP Trapani Cardiologist Marsala Castelvetrano Districts, 91022 Castelvetrano, Italy;
| | - Francesco Amico
- Cardiology Department, Cannizzaro Hospital, 95126 Catania, Italy;
| | - Roberta Rossini
- Cardiology Unit, Ospedale Santa Croce e Carle, 12100 Cuneo, Italy;
| | - Giorgio Caretta
- Sant’Andrea Hospital, ASL 5 Regione Liguria, 19124 La Spezia, Italy;
| | - Stefano Cornara
- Arrhytmia Unit, Division of Cardiology, Ospedale San Paolo, Azienda Sanitaria Locale 2, 17100 Savona, Italy;
| | - Irene Di Matteo
- De Gasperis Cardio Center, Niguarda Hospital, 20162 Milan, Italy; (I.D.M.); (F.O.)
| | - Concetta Di Nora
- Department of Cardiothoracic Science, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy;
| | - Silvia Favilli
- Department of Pediatric Cardiology, Meyer Hospital, 50139 Florence, Italy;
| | - Anna Pilleri
- Cardiology Unit, Brotzu Hospital, 09121 Cagliari, Italy;
| | - Andrea Pozzi
- Cardiology Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy;
| | - Pier Luigi Temporelli
- Division of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, 28013 Gattico-Veruno, Italy;
| | - Marco Zuin
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy;
- Department of Cardiology, West Vicenza Hospital, 136071 Arzignano, Italy
| | - Antonio Francesco Amico
- CCU-Cardiology Unit, Ospedale San Giuseppe da Copertino Hospital, Copertino, 73043 Lecce, Italy
| | - Carmine Riccio
- Cardiovascular Department, Sant’Anna e San Sebastiano Hospital, 81100 Caserta, Italy;
| | - Massimo Grimaldi
- Department of Cardiology, General Regional Hospital “F. Miulli”, 70021 Bari, Italy;
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, 00135 Rome, Italy;
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, 20162 Milan, Italy; (I.D.M.); (F.O.)
| | - Michele Massimo Gulizia
- Cardiology Department, Garibaldi Nesima Hospital, 95122 Catania, Italy;
- Heart Care Foundation, 50121 Florence, Italy
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Zhu C, Dreyer RP, Li F, Spatz ES, Caraballo‐Cordovez C, Mahajan S, Raparelli V, Leifheit EC, Lu Y, Krumholz HM, Spertus JA, D'Onofrio G, Pilote L, Lichtman JH. Impact of Marital Stress on 1-Year Health Outcomes Among Young Adults With Acute Myocardial Infarction. J Am Heart Assoc 2023; 12:e030031. [PMID: 37589125 PMCID: PMC10547344 DOI: 10.1161/jaha.123.030031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/10/2023] [Indexed: 08/18/2023]
Abstract
Background Stress experienced in a marriage or committed relationship may be associated with worse patient-reported outcomes after acute myocardial infarction (AMI), but little is known about this association in young adults (≤55 years) with AMI. Methods and Results We used data from VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), an observational cohort study that enrolled individuals aged 18 to 55 years with AMI (2008-2012). Marital stress was self-reported 1 month after AMI using the Stockholm Marital Stress Scale (categorized as absent/mild, moderate, and severe). Outcomes were physical/mental health (Short Form-12), generic health status (EuroQol-5 Dimensions), cardiac-specific quality of life and angina (Seattle Angina Questionnaire), depressive symptoms (Patient Health Questionnaire-9), and all-cause readmission 1 year after AMI. Regression models were sequentially adjusted for baseline health, demographics (sex, age, race or ethnicity), and socioeconomic factors (education, income, employment, and insurance). Sex and marital stress interaction was also tested. Among 1593 married/partnered participants, 576 (36.2%) reported severe marital stress, which was more common in female than male participants (39.4% versus 30.4%, P=0.001). Severe marital stress was significantly associated with worse mental health (beta=-2.13, SE=0.75, P=0.004), generic health status (beta=-3.87, SE=1.46, P=0.008), cardiac-specific quality of life (beta=-6.41, SE=1.65, P<0.001), and greater odds of angina (odds ratio [OR], 1.49 [95% CI, 1.06-2.10], P=0.023) and all-cause readmissions (OR, 1.45 [95% CI, 1.04-2.00], P=0.006), after adjusting for baseline health, demographics, and socioeconomic factors. These associations were similar across sexes (P-interaction all >0.05). Conclusions The association between marital stress and worse 1-year health outcomes was statistically significant in young patients with AMI, suggesting a need for routine screening and the creation of interventions to support patients with stress recovering from an AMI.
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Affiliation(s)
- Cenjing Zhu
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenCTUSA
| | - Rachel P. Dreyer
- Department of Emergency MedicineYale School of MedicineNew HavenCTUSA
- Department of BiostatisticsYale School of Public HealthNew HavenCTUSA
| | - Fan Li
- Department of BiostatisticsYale School of Public HealthNew HavenCTUSA
- Center for Methods in Implementation and Preventive ScienceYale UniversityNew HavenCTUSA
| | - Erica S. Spatz
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenCTUSA
- Center for Outcomes Research and EvaluationYale University School of MedicineNew HavenCTUSA
- Section of Cardiovascular Medicine, Department of Internal MedicineYale School of MedicineNew HavenCTUSA
| | - César Caraballo‐Cordovez
- Center for Outcomes Research and EvaluationYale University School of MedicineNew HavenCTUSA
- Section of Cardiovascular Medicine, Department of Internal MedicineYale School of MedicineNew HavenCTUSA
| | - Shiwani Mahajan
- Center for Outcomes Research and EvaluationYale University School of MedicineNew HavenCTUSA
| | - Valeria Raparelli
- Department of Translational MedicineUniversity of FerraraFerraraItaly
- University Center for Studies on Gender MedicineUniversity of FerraraFerraraItaly
| | - Erica C. Leifheit
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenCTUSA
| | - Yuan Lu
- Center for Outcomes Research and EvaluationYale University School of MedicineNew HavenCTUSA
- Section of Cardiovascular Medicine, Department of Internal MedicineYale School of MedicineNew HavenCTUSA
| | - Harlan M. Krumholz
- Center for Outcomes Research and EvaluationYale University School of MedicineNew HavenCTUSA
- Department of CardiologyYale School of MedicineNew HavenCTUSA
- Department of Health Policy and ManagementYale School of Public HealthNew HavenCTUSA
| | - John A. Spertus
- Healthcare Institute for Innovations in Quality, University of MissouriKansas CityMOUSA
- Saint Luke’s Cardiovascular Outcomes ResearchSaint Luke’s Mid America Heart InstituteKansas CityMOUSA
| | - Gail D'Onofrio
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenCTUSA
- Department of Emergency MedicineYale School of MedicineNew HavenCTUSA
| | - Louise Pilote
- Center for Outcomes Research and EvaluationResearch Institute, McGill University Health CentreMontrealQuebecCanada
- Research Institute of the McGill University Health CentreMontrealQuebecCanada
| | - Judith H. Lichtman
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenCTUSA
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Li J, Meng L, Wu D, Xu H, Hu X, Hu G, Chen Y, Xu J, Gong T, Liu D. Adrenal SGLT1 or SGLT2 as predictors of atherosclerosis under chronic stress based on a computer algorithm. PeerJ 2023; 11:e15647. [PMID: 37663275 PMCID: PMC10474830 DOI: 10.7717/peerj.15647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/06/2023] [Indexed: 09/05/2023] Open
Abstract
Background Chronic stress promotes the development of atherosclerosis, causing disruptions in the body's hormone levels and changes in the structural function of organs. Objective The purpose of this study was to investigate the pathological changes in the adrenal gland in a model of atherosclerosis under chronic stress and to verify the expression levels of Sodium-glucose cotransporter (SGLT) 1 and SGLT2 in the adrenal gland and their significance in the changes of adrenal gland. Methods The model mice were constructed by chronic unpredictable stress, high-fat diet, and Apoe-/- knockout, and they were tested behaviorally at 0, 4, 8 and 12 weeks. The state of the abdominal artery was examined by ultrasound, and the pathological changes of the aorta and adrenal glands were observed by histological methods, and the expression levels and distribution of SGLT1 and SGLT2 in the adrenal gland were observed and analyzed by immunofluorescence and immunohistochemistry. The predictive value of SGLT1 and SGLT2 expression levels on intima-media thickness, internal diameter and adrenal abnormalities were verified by receiver operating characteristic (ROC) curves, support vector machine (SVM) and back-propagation (BP) neural network. Results The results showed that chronic stress mice had elevated expression levels of SGLT1 and SGLT2. The model mice developed thickening intima-media and smaller internal diameter in the aorta, and edema, reticular fiber rupture, increased adrenal glycogen content in the adrenal glands. More importantly, analysis of ROC, SVM and BP showed that SGLT1 and SGLT2 expression levels in the adrenal glands could predict the above changes in the aorta and were also sensitive and specific predictors of adrenal abnormalities. Conclusion SGLT1 and SGLT2 could be potential biomarkers of adrenal injury in atherosclerosis under chronic stress.
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Affiliation(s)
- Jianyi Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lingbing Meng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dishan Wu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hongxuan Xu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xing Hu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Gaifeng Hu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuhui Chen
- Department of Neurology, Beijing Hospital, National Center of Gerontology, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiapei Xu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Tao Gong
- Department of Neurology, Beijing Hospital, National Center of Gerontology, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Deping Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Park SE, So WY, Kang YS, Yang JH. Relationship between Perceived Stress, Obesity, and Hypertension in Korean Adults and Older Adults. Healthcare (Basel) 2023; 11:2271. [PMID: 37628469 PMCID: PMC10454312 DOI: 10.3390/healthcare11162271] [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: 06/29/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Perceived stress has a significant effect on metabolic diseases, including obesity and hypertension. However, the association between stress levels, obesity, and hypertension according to age and sex is not fully understood. Therefore, this study investigated the relationship between stress levels and obesity and hypertension in Korean adults and older adults. METHODS We analyzed data from the 2015 survey of the Korea National Physical Fitness Project conducted by the Korea Institute of Sports Science and the Korea Ministry of Culture, Sports, and Tourism. Of the 3457 participants, 2829 were adults (20-64 years old) and 628 were older adults (≥65 years old). The correlation between obesity and hypertension according to the degree of perceived stress (low, medium, and high) was analyzed using the chi-square test. Binary logistic regression analysis was used to investigate the influence of perceived stress levels on obesity and hypertension. Age, body mass index (BMI), blood pressure, exercise frequency, smoking, breakfast, and sleeping hours were included as covariates. RESULTS In adult males, perceived stress levels, age, and diastolic blood pressure were found to have a significant impact on obesity rates, whereas age and breakfast had a significant effect on hypertension rates. In adult females, age and systolic blood pressure were found to significantly influence obesity rates, whereas age, BMI, and exercise frequency had a significant impact on hypertension rates. In older adult females, perceived stress levels and systolic blood pressure were found to significantly impact obesity rates, and sleep duration influenced the rates of hypertension. The effect of perceived stress level on obesity and hypertension rates was less pronounced in the elderly population than in the adult population. CONCLUSIONS This study revealed age and sex differences in the relationship between perceived stress, obesity, and hypertension among Koreans. These findings contribute to a better understanding of the complex relationship between perceived stress and metabolic disorders and emphasize the need for a deeper understanding of the specific factors involved in the prevention and management of metabolic diseases.
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Affiliation(s)
- Sung-Eun Park
- Department of Sports Science, Korea Institute of Sport Science, Seoul 01794, Republic of Korea;
| | - Wi-Young So
- Sport Medicine Major, College of Humanities and Arts, Korea National University of Transportation, Chungju-si 27469, Republic of Korea;
| | - Yun-Sun Kang
- Department of Physical Education, Graduate School of Education, Sogang University, Seoul 04107, Republic of Korea
- Goyang Dance Company, Professional Arts Organization, Goyang-si 10417, Republic of Korea
| | - Jong-Hyun Yang
- Department of Physical Education, Incheon National University, Incheon 22012, Republic of Korea
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So J, Chung KM, Seo J, Kim B, Chun H, Han SN, Chung IM. High intake of sweet foods and low life satisfaction can act as risk factors for acute coronary syndrome through synergistic interaction. Front Nutr 2023; 10:1221916. [PMID: 37609484 PMCID: PMC10440423 DOI: 10.3389/fnut.2023.1221916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/03/2023] [Indexed: 08/24/2023] Open
Abstract
Purpose Dietary and psychological status contributes to the development of coronary artery disease. However, these lifestyle factors may vary depending on ethnic and environmental background, and secondary prevention programs dealing with these factors in a specific population are not well-established. We aimed to assess dietary and psychological characteristics in Korean patients with acute coronary syndrome (ACS) and analyze their interactions as independent risk factors for ACS. Methods Ninety-two patients with ACS (29 acute myocardial infarction and 63 unstable angina) and 69 controls were subjected to dietary and psychological analyses. Dietary intake was assessed by a food frequency questionnaire. Psychological depression and perceived stress were assessed using the Patient Health Questionnaire-9 and the Perceived Stress Scale, respectively. Eight domains of life satisfaction (marital/love relationship, leisure, standard of living, job, health, family life, sex life, and self) were assessed using the Domain Satisfaction Questionnaire (DSQ). Results The ACS group had a higher consumption of sweets and fish/seafood, as well as higher levels of depressive symptoms. Additionally, they had lower DSQ scores in total, and all eight individual domains compared with the control group. In multivariate logistic regression analysis, sweet intake (OR 4.57, 95% CI: 1.94-11.40) and total DSQ scores (OR 0.34, 95% CI: 0.14-0.81) were identified as independent risk factors for ACS. Furthermore, these factors, which displayed a significant inverse correlation (ρ = -0.23, p = 0.01), were determined as having a synergistic contribution to the development of ACS. Conclusion High sweet food intake and low life satisfaction can act as risk factors for ACS through a synergistic interaction, which emphasizes a demand for a more comprehensive approach to secondary prevention of ACS. In addition, these data highlight the role of positive psychological wellbeing factors in cardiovascular health.
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Affiliation(s)
- Jisun So
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Kyong-Mee Chung
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Jihyeon Seo
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Byungmi Kim
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
| | - Hyejin Chun
- Department of Family Medicine, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Sung Nim Han
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
- Research Institute of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Ick-Mo Chung
- Division of Cardiology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea
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Liu Q, Zhang W, Li Q, Chen L, Wang X, Wang Z, Wang Y, Wang J. Risk of cerebrovascular disease after cancer diagnosis in the United States. iScience 2023; 26:107165. [PMID: 37456860 PMCID: PMC10344795 DOI: 10.1016/j.isci.2023.107165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/22/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
The risk of subsequent cerebrovascular disease among cancer patients of multiple cancers in the US is not well understood. A total of 3,843,261 cancer patients diagnosed from 1975 to 2018, were included from the surveillance, epidemiology, and end results (SEER) database. Standardized mortality ratios (SMRs) and absolute excess risks (AERs) were estimated. The overall cerebrovascular disease SMR was 1.04 (95% CI, 1.03-1.04), and the AER per 10,000 person-years at risk was 0.89. When compared with the US general population, greater cerebrovascular disease risk was correlated with certain cancer sites, American Indian/Alaska Native race, Asian or Pacific Islander race, unmarried marital status, distant metastasis, younger age, and an earlier time of cancer diagnosis. Clinically, more precision and proactive strategies for cerebrovascular disease prevention are required to subgroup of cancer patients with a greater risk of cerebrovascular disease, especially within the first two months.
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Affiliation(s)
- Qiang Liu
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wenxiang Zhang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Qi Li
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Li Chen
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xiangyu Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Zhongzhao Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yipeng Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jing Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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30
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Xue F, Suh HN, Rice KG, Ashby JS. Cumulative Trauma and Trauma Symptoms: A Three-Way Interaction. Behav Sci (Basel) 2023; 13:576. [PMID: 37504023 PMCID: PMC10376125 DOI: 10.3390/bs13070576] [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: 06/12/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023] Open
Abstract
The purpose of this study was to test if perceived social support and self-compassion will interact to reduce the magnitude of the bivariate relationship (buffering effect) between cumulative trauma and trauma symptoms after controlling for gender and age among college students. As part of a broader research project conducted between 2018 and 2019, we collected data via online surveys from a sample of 551 undergraduate students at a public university in the southern region of the US. After data cleaning, the study included 538 participants (representing 97.6% of the original dataset), ensuring a diverse representation across various ethnicities and genders. The three-way interaction model accounted for 38.61% of the variance in PTSD symptoms. In detail, with high levels of perceived social support, there was a significant difference in the buffering effects of perceived social support on the trauma-PTSD association between high and low self-compassion. Conversely, at high levels of self-compassion, perceived social support did not significantly influence the buffering effect of self-compassion. This study underscores the critical role of self-compassion in enhancing the protective effect of high-level perceived social support against PTSD symptoms following cumulative trauma.
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Affiliation(s)
- Fang Xue
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, GA 30303, USA
| | - Han Na Suh
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, GA 30303, USA
| | - Kenneth G Rice
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, GA 30303, USA
| | - Jeffrey S Ashby
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, GA 30303, USA
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31
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Elifranji ZO, Al-Ajlouni JM, Al-Saber MG, Hammad YS, Baniatta BA, Alshoubaki SN, Jabaiti MS, Alkhatib AM, Abu awad AM, Altarazi AE, Abdin AN, Al-Ani A, Alshrouf MA. Effect of Preoperative Antianxiety Medications on Blood Pressure and Blood Loss in Total Knee Arthroplasty: A Case-Control Study. Adv Orthop 2023; 2023:6355849. [PMID: 37456533 PMCID: PMC10349676 DOI: 10.1155/2023/6355849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/14/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023] Open
Abstract
Background The increasing number of canceled operations in patients undergoing total knee arthroplasty (TKA) due to high blood pressure readings has put a considerable burden on surgeons. In this study, we aim to assess the effect of giving antianxiety drugs preoperatively on maintaining blood pressure (BP) and blood loss for patients undergoing TKA surgery. Methods This retrospective case-control study included patients who underwent total knee arthroplasty and divided them into two main groups: those who had taken a 3 mg bromazepam oral tablet at the night preoperatively and the control group. The blood pressure of patients was then measured preoperatively (baseline), in the morning of surgery, in the operating room before anesthesia, and during the surgery. The percentage of measured BP was calculated by dividing the measured BP by the baseline, then multiplying by 100. Results 301 patients were included in our study: 137 received bromazepam and 164 as a control group. The ratio of systolic BP (SBP) in the morning of surgery to the baseline (percentage of morning SBP) decreased significantly in the bromazepam group compared with the controls. The ratio of SBP, in the operating room before anesthesia (percentage of preanesthesia SBP) also decreased significantly in the bromazepam group. However, the percentage of SBP in the middle of surgery did not change significantly. In addition, there was a significant difference change from the baseline in diastolic BP and mean arterial BP between the two groups in the morning of surgery, inside the theatre, and in the middle of the operation. The bromazepam group also showed a significant decrease in blood loss. Conclusion Preoperative oral antianxiety drugs (bromazepam) helps in controlling hemodynamic changes associated with anxiety, including maintaining BP in well-controlled hypertensive and healthy patients undergoing TKA, and it plays a role in decreasing the total blood loss.
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Affiliation(s)
- Zuhdi O. Elifranji
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Jihad M. Al-Ajlouni
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Munther G. Al-Saber
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Yazan S. Hammad
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Basel A. Baniatta
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Sara N. Alshoubaki
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan
| | - Mohammad S. Jabaiti
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Ahmad M. Alkhatib
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Abdelrahman M. Abu awad
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Abdelrahman E. Altarazi
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Aseel N. Abdin
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan
| | - Abdallah Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11942, Jordan
| | - Mohammad Ali Alshrouf
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan
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Sobolewska-Nowak J, Wachowska K, Nowak A, Orzechowska A, Szulc A, Płaza O, Gałecki P. Exploring the Heart-Mind Connection: Unraveling the Shared Pathways between Depression and Cardiovascular Diseases. Biomedicines 2023; 11:1903. [PMID: 37509542 PMCID: PMC10377477 DOI: 10.3390/biomedicines11071903] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 07/30/2023] Open
Abstract
Civilization diseases are defined as non-communicable diseases that affect a large part of the population. Examples of such diseases are depression and cardiovascular disease. Importantly, the World Health Organization warns against an increase in both of these. This narrative review aims to summarize the available information on measurable risk factors for CVD and depression based on the existing literature. The paper reviews the epidemiology and main risk factors for the coexistence of depression and cardiovascular disease. The authors emphasize that there is evidence of a link between depression and cardiovascular disease. Here, we highlight common risk factors for depression and cardiovascular disease, including obesity, diabetes, and physical inactivity, as well as the importance of the prevention and treatment of CVD in preventing depression and other mental disorders. Conversely, effective treatment of CVD can also help prevent depression and improve mental health outcomes. It seems advisable to introduce screening tests for depression in patients treated for cardiac reasons. Importantly, in patients treated for mood disorders, it is worth controlling CVD risk factors, for example, by checking blood pressure and pulse during routine visits. It is also worth paying attention to the mental condition of patients with CVD. This study underlines the importance of interdisciplinary co-operation.
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Affiliation(s)
| | - Katarzyna Wachowska
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Artur Nowak
- Department of Immunopathology, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Agata Orzechowska
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Agata Szulc
- Psychiatric Clinic of the Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Olga Płaza
- Psychiatric Clinic of the Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Piotr Gałecki
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
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33
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Zhou WS, Mao SJ, Zhang SK, Xu H, Li WL. Effects of aquatic exercises on physical fitness and quality of life in postmenopausal women: an updated systematic review and meta-analysis. Front Public Health 2023; 11:1126126. [PMID: 37361170 PMCID: PMC10285069 DOI: 10.3389/fpubh.2023.1126126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
Objective In the present systematic review and meta-analysis, we aimed to evaluate and update the effects of aquatic exercise on physical fitness and quality of life (QoL) in postmenopausal women. Methods The databases Cochrane Library, PubMed, Web of Science, and MEDLINE were searched for randomized controlled trials (RCTs) on the topic from inception to July 2022. The GetData software was used to extract data from the published images. RevMan5.4 software was used for statistical analysis. Data are expressed as standardized mean difference (SMD) with 95% confidence intervals (CI). I2 index was employed for heterogeneity. Egger's test was used to assess publication bias. We evaluated the methodological quality of included studies using the Physiotherapy Evidence Database scale. Results We included 594 participants in 16 RCTs (19 comparison groups). The results indicated that aquatic exercise can significantly improve lower limb strength (LLS), upper limb strength (ULS), agility, flexibility, and overall QoL. No significant effects were found on aerobic capacity. Subgroup-analysis results indicated that aquatic exercise only significantly improved LLS, ULS, agility, and flexibility in postmenopausal women < 65 years of age. However, aquatic exercise improves the overall QoL both in postmenopausal women < 65 years and ≥ 65 years. Aquatic resistance exercise significantly improves LLS, ULS, agility and flexibility. In addition, aquatic aerobic exercise can effectively increase LLS, and combined aquatic aerobic and resistance exercise can enhance the overall QoL. Conclusions Aquatic exercise can effectively improve physical fitness and overall QoL in postmenopausal women, but has limited effects on aerobic capacity; thus, it is highly recommended in postmenopausal women.
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Affiliation(s)
- Wen-Sheng Zhou
- College of Physical Education, Jiangsu Second Normal University, Nanjing, China
| | | | - Shi-Kun Zhang
- Department of Police Physical Education, Jiangsu Police Institute, Nanjing, China
| | - Hong Xu
- Department of Sport and Health Science, College of Natural Science, Sangmyung University, Seoul, South Korea
| | - Wei-Lu Li
- Nanjing Zhong-Yang Road Primary School, Nanjing, China
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34
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Park HC, Oh J. The relationship between stress and sleep quality: The mediating effect of fatigue and dizziness among patients with cardiovascular disease. Medicine (Baltimore) 2023; 102:e33837. [PMID: 37335686 DOI: 10.1097/md.0000000000033837] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Cardiovascular disease is the leading cause of non-noncommunicable disease mortality worldwide. Therefore, this study analyzes the mediating effect of dizziness and fatigue in the relationship between stress and sleep quality in patients with heart disease. This study was conducted on patients with heart disease diagnosed by a cardiologist from December 7, 2021 to August 30, 2022 at the Outpatient Department of Cardiology at Hanyang University Hospital in Guri-si, Gyeonggi-do. To verify the serial multiple mediation effect, serial multiple mediation analysis was performed using SPSS Macro Process Model 6 as the most appropriate verification method for this study. The analysis indicated that the more dizziness a participant experienced, the more severe their physical and psychological fatigue and the poorer their quality of sleep. Also, the more severe the physical fatigue, the worse the psychological fatigue and the worse the quality of sleep. In other words, the more severe the psychological fatigue, the poorer the quality of sleep. In summary, in the relationship in which stress in patients with heart disease affects sleep quality, stress is a variable that directly affects sleep quality, and this means that the stress of patients with heart disease can affect the quality of sleep through the parameters, dizziness and fatigue, sequentially; this research model can thus be considered a partial mediator model. Fatigue in patients with cardiovascular disease had a direct effect on sleep quality, and there was a mediating effect through dizziness and fatigue in the relationship between stress and sleep quality. Therefore, it is necessary to develop a sleep management program that can improve the quality of sleep in patients with cardiovascular disease as well as a nursing intervention plan that can alleviate fatigue and control stress in such patients.
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Affiliation(s)
- Hwan-Cheol Park
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri City, South Korea
| | - Jihyun Oh
- Department of Nursing, College of Nursing and Health, Kongju National University, Kongju, South Korea
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35
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Rozanski A, Blumenthal JA, Hinderliter AL, Cole S, Lavie C. Cardiology and lifestyle medicine. Prog Cardiovasc Dis 2023; 77:4-13. [PMID: 37059409 DOI: 10.1016/j.pcad.2023.04.004] [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: 04/09/2023] [Accepted: 04/09/2023] [Indexed: 04/16/2023]
Abstract
Poor lifestyle habits, such as physical inactivity and poor diets, are highly prevalent within society and even more so among patients with chronic disease. The need to stem poor lifestyle habits has led to the development of a new field of Lifestyle Medicine, whose mission is to prevent, treat, and even reverse chronic diseases through lifestyle interventions. Three fields within Cardiology relate to this mission: Cardiac Rehabilitation, Preventive Cardiology, and Behavioral Cardiology. Each of these three fields have contributed substantially to the reduction of cardiovascular disease (CVD) morbidity and mortality. The historic contributions of these three cardiac fields are reviewed as well as the challenges each of these fields has faced in optimizing the application of lifestyle medicine practices. A shared agenda between Cardiology and the American College of Lifestyle Medicine could further the utilization of behavioral interventions. This review suggests seven steps that could be shared by these organizations and other medical societies. First, there is a need to develop and promulgate the assessment of lifestyle factors as "vital signs" during patient visits. Second, developing a strong partnership between the fields of Cardiology and Physiatry could improve important aspects of cardiac care, including a potential redesign of cardiac stress testing. Third, behavioral evaluations should be optimized at patients' entrée points into medical care since these may be considered "windows of opportunity". Fourth, there is a need to broaden cardiac rehabilitation into inexpensive programs and make this program eligible for patients with risk factors but no known CVD. Fifth, lifestyle medicine education should be integrated into the core competencies for relevant specialties. Sixth, there is a need for inter-societal advocacy to promote lifestyle medicine practices. Seventh, the well-being effects of healthy lifestyle behaviors, such as their impact on one's sense of vitality, should be emphasized.
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Affiliation(s)
- Alan Rozanski
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States of America
| | - Alan L Hinderliter
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Steven Cole
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States of America; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, United States of America
| | - Carl Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the UQ School of Medicine, New Orleans, LA, United States of America
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Ma H, Wang X, Xue Q, Li X, Liang Z, Heianza Y, Franco OH, Qi L. Cardiovascular Health and Life Expectancy Among Adults in the United States. Circulation 2023; 147:1137-1146. [PMID: 37036905 PMCID: PMC10165723 DOI: 10.1161/circulationaha.122.062457] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/08/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Cardiovascular disease may be the main reason for stagnant growth in life expectancy in the United States since 2010. The American Heart Association recently released an updated algorithm for evaluating cardiovascular health (CVH)-Life's Essential 8 (LE8) score. We aimed to quantify the associations of CVH levels, estimated by the LE8 score, with life expectancy in a nationally representative sample of US adults. METHODS We included 23 003 nonpregnant, noninstitutionalized participants aged 20 to 79 years who participated in the National Health and Nutrition Examination Survey from 2005 to 2018 and whose mortality was identified through linkage to the National Death Index through December 31, 2019. The overall CVH was evaluated by the LE8 score (range, 0-100), as well as the score for each component of diet, physical activity, tobacco/nicotine exposure, sleep duration, body mass index, non-high-density lipoprotein cholesterol, blood glucose, and blood pressure. Life table method was used to estimate life expectancy by levels of the CVH. RESULTS During a median of 7.8 years of follow-up, 1359 total deaths occurred. The estimated life expectancy at age 50 years was 27.3 years (95% CI, 26.1-28.4), 32.9 years (95% CI, 32.3-33.4), and 36.2 years (95% CI, 34.2-38.2) in participants with low (LE8 score <50), moderate (50≤ LE8 score <80), and high (LE8 score ≥80) CVH, respectively. Equivalently, participants with high CVH had an average 8.9 (95% CI, 6.2-11.5) more years of life expectancy at age 50 years compared with those with low CVH. On average, 42.6% of the gained life expectancy at age 50 years from adhering to high CVH was attributable to reduced cardiovascular disease death. Similarly significant associations of CVH with life expectancy were observed in men and women, respectively. Similarly significant associations of CVH with life expectancy were observed in White participants and Black participants but not in Mexican participants. CONCLUSIONS Adhering to a high CVH, defined as the LE8 score, is related to a considerably increased life expectancy in US adults, but more research needs to be done in other races and ethnicities (eg, Hispanic and Asian).
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Affiliation(s)
- Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Xuan Wang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Qiaochu Xue
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Zhaoxia Liang
- Obstetrical Department, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Oscar H. Franco
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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Rozanski A. The pursuit of health: A vitality based perspective. Prog Cardiovasc Dis 2023; 77:14-24. [PMID: 37037404 DOI: 10.1016/j.pcad.2023.04.001] [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: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/12/2023]
Abstract
The larger number of adults who enter their senior years with a high burden of chronic diseases has led to new metrics designed to promote health pro-activity, such as the calculation of one's "healthspan". These efforts call for re-evaluation as to what is meant by "health". A large body of epidemiologic and clinical investigation identifies that good health is shaped by specific health behaviors (aerobic exercise, resistance training, sleep, and good diet quality) and four psychological determinants (positive emotions, positive mindsets, purposeful living, and social connectivity). In common, each of these determinants produce "vitality", which can be defined as having the pleasing sensation of feeling energetic. Having a strong sense of vitality produces a sense of agency, provides resilience, and serves as a leading indicator of good health. Importantly, vitality can be assessed as a single item "vital sign" in clinical practice and can be promoted by recommending simple steps to patients, such as suggesting that they initiate walking or other aerobic activities. Because health habits and psychological determinants of health are inter-related, such simple steps can initiate a "virtuous cycle" of health improvement. An emphasis on vitality can also encourage patients to become more cognizant of their level of energy and manage it through health-promoting behaviors rather than quick fix behaviors. Finally, vitality assessment and prescription can promote more successful aging. In sum, an updated and more clinically useful definition of health recognizes that it is a dynamic entity that is influenced at any time by one's engagement in physical and psychological practices that promote health. Accordingly, an updated definition of health is proposed: good health is characterized by physical and psychological well-being and is associated with vitality.
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Affiliation(s)
- Alan Rozanski
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
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38
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Vassou C, Georgousopoulou EN, Yannakoulia M, Chrysohoou C, Papageorgiou C, Pitsavos C, Cropley M, Panagiotakos DB. Exploring the Role of Irrational Beliefs, Lifestyle Behaviors, and Educational Status in 10-Year Cardiovascular Disease Risk: the ATTICA Epidemiological Study. Int J Behav Med 2023; 30:279-288. [PMID: 35474416 DOI: 10.1007/s12529-022-10091-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Irrational beliefs, maladaptive emotions, and unhealthy lifestyle behaviors can adversely affect health status. However, limited research has examined the association between irrational beliefs and cardiovascular disease (CVD). The aim of this study was to evaluate the association between irrational beliefs and the 10-year CVD incidence among apparently healthy adults, considering the potential moderating or mediating role of particular social and lifestyle factors. METHODS The ATTICA study is a population-based, prospective cohort (2002-2012), in which 853 participants without a history of CVD [453 men (aged 45 ± 13 years) and 400 women (aged 44 ± 18 years)] underwent psychological evaluations. Among other tools, participants completed the irrational beliefs inventory (IBI, range 0-88), a self-reported measure consistent with the Ellis model of psychological disturbance. Demographic characteristics, detailed medical history, dietary, and other lifestyle habits were also evaluated. Incidence of CVD (i.e., coronary heart disease, acute coronary syndromes, stroke, or other CVD) was defined according to the International Coding Diseases (ICD)-10 criteria. RESULTS Mean IBI score was 53 ± 2 in men and 53 ± 3 in women (p = 0.88). IBI score was positively associated with 10-year CVD risk (hazard ratio 1.07, 95%CI 1.04, 1.13), in both men and women, and more prominently among those with less healthy dietary habits and lower education status; specifically, higher educational status leads to lower IBI score, and in conjunction they lead to lower 10-year CVD risk (HR for interaction 0.98, 95%CI 0.97, 0.99). CONCLUSIONS The findings of this study underline the need to build new, holistic approaches in order to better understand the inter-relationships between irrational beliefs, lifestyle behaviors, social determinants, and CVD risk in individuals.
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Affiliation(s)
- Christina Vassou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Ave, 176 76, Kallithea, Athens, Greece
| | | | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Ave, 176 76, Kallithea, Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | | | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Mark Cropley
- School of Psychology, University of Surrey, Guildford, UK
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Ave, 176 76, Kallithea, Athens, Greece.
- Faculty of Health, University of Canberra, Canberra, Australia.
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Ye Z, Zhu L, Li XJ, Gao HY, Wang J, Wu SB, Wu ZJ, Gao HR. PC6 electroacupuncture reduces stress-induced autonomic and neuroendocrine responses in rats. Heliyon 2023; 9:e15291. [PMID: 37095918 PMCID: PMC10121450 DOI: 10.1016/j.heliyon.2023.e15291] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 01/25/2023] [Accepted: 03/31/2023] [Indexed: 04/26/2023] Open
Abstract
Stress can trigger cardiovascular disease. Both imbalance of autonomic nervous activity and increase of neurohormonal output are core aspects of stress responses and can lead to cardiovascular disease. PC6 as a very important acupoint is used to prevent and treat cardiovascular disease and to improve stress-related activities. We examined the influence of electroacupuncture (EA) at PC6 on stress-induced imbalance of autonomic nervous activity and increase of neurohormonal output. EA at PC6 relieved increased cardiac sympathetic nervous activity and decreased cardiac vagal nervous activity induced by immobilization stress. Also, EA at PC6 reduced immobilization stress-induced increases of plasma norepinephrine (NE) and adrenaline (E) released from sympatho-adrenal-medullary axis. Finally, EA at PC6 reduced immobilization stress-induced increases of corticotropin-releasing hormone (CRH) in paraventricular hypothalamic nucleus and plasma cortisol (CORT) released from hypothalamic-pituitary-adrenal axis. However, EA at tail had no significant effect on the stress-induced autonomic and neuroendocrine responses. The results demonstrate the role of EA at PC6 regulating the autonomic and neuroendocrine responses induced by stress and provide insight into the prevention and treatment of EA at PC6 for stress-induced cardiovascular disease by targeting autonomic and neuroendocrine systems.
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Affiliation(s)
- Zhen Ye
- School of Acupuncture and Tuina, Anhui University of Chinese Medicine, Hefei, 230038, China
| | - Li Zhu
- School of Acupuncture and Tuina, Anhui University of Chinese Medicine, Hefei, 230038, China
| | - Xiao-jia Li
- School of Acupuncture and Tuina, Anhui University of Chinese Medicine, Hefei, 230038, China
- Research Institute of Acupuncture and Meridian, Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230038, China
| | - He-yuan Gao
- Department of Pediatrics, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, China
| | - Jie Wang
- School of Acupuncture and Tuina, Anhui University of Chinese Medicine, Hefei, 230038, China
- Research Institute of Acupuncture and Meridian, Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230038, China
| | - Sheng-bing Wu
- School of Acupuncture and Tuina, Anhui University of Chinese Medicine, Hefei, 230038, China
- Research Institute of Acupuncture and Meridian, Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230038, China
- Key Laboratory of Acupuncture-Moxibustion Basis and Technology of Anhui Higher Education Institutes, Anhui University of Chinese Medicine (KLABT), Hefei, Anhui, 230038, China
- Key Laboratory of Xin'an Medicine (Anhui University of Chinese Medicine), The Ministry of Education, Hefei, Anhui, 230038, China
| | - Zi-jian Wu
- School of Acupuncture and Tuina, Anhui University of Chinese Medicine, Hefei, 230038, China
- Research Institute of Acupuncture and Meridian, Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230038, China
- Key Laboratory of Acupuncture-Moxibustion Basis and Technology of Anhui Higher Education Institutes, Anhui University of Chinese Medicine (KLABT), Hefei, Anhui, 230038, China
- Key Laboratory of Xin'an Medicine (Anhui University of Chinese Medicine), The Ministry of Education, Hefei, Anhui, 230038, China
- Corresponding author. School of Acupuncture and Tuina, Research Institute of Acupuncture and Meridian, Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230038, China.
| | - He-ren Gao
- School of Acupuncture and Tuina, Anhui University of Chinese Medicine, Hefei, 230038, China
- Research Institute of Acupuncture and Meridian, Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230038, China
- CAS Key Laboratory of Brain Function and Disease, and School of Life Sciences, University of Science Technology of China, Hefei, 230022, China
- Corresponding author. School of Acupuncture and Tuina, Research Institute of Acupuncture and Meridian, Anhui Academy of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, 230038, China.
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40
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Ganguly R, Ngoruh A, Ingty P, Yadav SK, Bhattacharjee A. Identification of an inhibitor for atherosclerotic enzyme NOX-1 to inhibit ROS production. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2023. [DOI: 10.1186/s43094-023-00474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Abstract
Background
NOX-1 overexpression has been observed in various studies, persons with diabetes or cardiovascular conditions. NOX-1 orchestrates the disease pathogenesis of various cardiovascular conditions such as atherosclerotic plaque development and is a very crucial biomarker. Therefore, this study was carried out to deduce the three-dimensional modelled structure of NOX-1 using DeepMind AlphaFold-2 to find meaningful insight into the structural biology. Extensive in silico approaches have been used to determine the active pocket, virtually screen large chemical space to identify potential inhibitors. The role of the key amino acid residues was also deduced using alanine scanning mutagenesis contributing to the catalytic process and to the overall stability of NOX-1.
Results
The modelled structure of NOX-1 protein was validated using ERRAT. The ERRAT statistics with 9 amino acids sliding window have shown a confidence score of 96.937%. According to the Ramachandran statistics, 96.60% of the residues lie within the most favoured region, and 2.80% of residues lie in the additionally allowed region, which gives an overall of 99.4% residues in the three quadrants in the plot. GKT-831 which is a referral drug in this study has shown a GOLD interaction score of 62.12 with respect to the lead molecule zinc000059139266 which has shown a higher GOLD score of 78.07. Alanine scanning mutagenesis studies has shown that Phe201, Leu98 and Leu76 are found to be the key interacting residues in hydrophobic interactions. Similarly, Tyr324, Arg287 and Cys73 are major amino acid residues in the hydrogen bond interactions.
Conclusions
NOX-1 overexpression leads to heightened ROS production resulting in catastrophic outcomes. The modelled structure of NOX-1 has a good stereochemistry with respect to Ramachandran plot. The lead molecule zinc000059139266 has shown to have a very high interaction score of 78.07 compared to the referral drug GKT-831 with a score of 62.12. There is an excellent scope for the lead molecule to progress further into in vitro and in vivo studies.
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41
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Reynolds CA, Minic Z. Chronic Pain-Associated Cardiovascular Disease: The Role of Sympathetic Nerve Activity. Int J Mol Sci 2023; 24:5378. [PMID: 36982464 PMCID: PMC10049654 DOI: 10.3390/ijms24065378] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/26/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Chronic pain affects many people world-wide, and this number is continuously increasing. There is a clear link between chronic pain and the development of cardiovascular disease through activation of the sympathetic nervous system. The purpose of this review is to provide evidence from the literature that highlights the direct relationship between sympathetic nervous system dysfunction and chronic pain. We hypothesize that maladaptive changes within a common neural network regulating the sympathetic nervous system and pain perception contribute to sympathetic overactivation and cardiovascular disease in the setting of chronic pain. We review clinical evidence and highlight the basic neurocircuitry linking the sympathetic and nociceptive networks and the overlap between the neural networks controlling the two.
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Affiliation(s)
- Christian A. Reynolds
- Department of Emergency Medicine, Wayne State University School of Medicine, 540 E Canfield St., Detroit, MI 48201, USA
- Department of Biotechnology, University of Rijeka, 51000 Rijeka, Croatia
| | - Zeljka Minic
- Department of Emergency Medicine, Wayne State University School of Medicine, 540 E Canfield St., Detroit, MI 48201, USA
- Department of Biotechnology, University of Rijeka, 51000 Rijeka, Croatia
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42
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Ingrosso DMF, Primavera M, Samvelyan S, Tagi VM, Chiarelli F. Stress and Diabetes Mellitus: Pathogenetic Mechanisms and Clinical Outcome. Horm Res Paediatr 2023; 96:34-43. [PMID: 35124671 DOI: 10.1159/000522431] [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: 10/31/2021] [Accepted: 02/01/2022] [Indexed: 11/19/2022] Open
Abstract
Evidence suggests that psychological and physical stress are relevant triggering factors for the onset of type 1 diabetes (T1D) and type 2 diabetes (T2D). The underlying mechanisms involve a complex neuroendocrine structure, involving the central nervous system and the periphery. Psychological stress leads to an increase of serum glucocorticoid concentrations and catecholamines release increasing the insulin need and the insulin resistance. According to the β-cell stress hypothesis, also causes of increased insulin demand, such as rapid growth, overweight, puberty, low physical activity, trauma, infections, and glucose overload, are potentially relevant factors in development of T1D. It has also been demonstrated that chronic stress and obesity form a vicious circle which leads to a definitive metabolic failure, increasing the risk of developing T2D. In this review, we will provide the most recent data concerning the role of stress in the outcomes of T1D and T2D, with a focus on the role of physical and psychological stress on the onset of T1D.
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Affiliation(s)
| | | | - Sona Samvelyan
- Paediatric Outpatient Department No. 122, Moscow, Russian Federation
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43
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Suwannakul B, Sangkarit N, Manoy P, Amput P, Tapanya W. Association between Stress and Physical Fitness of University Students Post-COVID-19 Pandemic. J Funct Morphol Kinesiol 2023; 8:jfmk8010033. [PMID: 36976130 PMCID: PMC10052582 DOI: 10.3390/jfmk8010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/18/2023] [Accepted: 02/28/2023] [Indexed: 03/29/2023] Open
Abstract
Post-COVID-19 pandemic, most universities changed their educational model from online courses to onsite learning, allowing students to attend regular face-to-face classes. These changes can cause stress in students, which affects physical fitness. The aim of this study was to investigate the relationship between stress levels and physical fitness in female university students. The participants were 101 female university students, 18-23 years of age. All participants completed the Suan Prung Stress Test-60 (SPST-60). The physical fitness test included body composition, cardiorespiratory fitness, as well as musculoskeletal fitness. Multiple linear regression analysis was used to determine the associations between SPST-60 scores and physical fitness. A p-value < 0.05 was considered statistically significant. We found a negative correlation between the sources of stress scores, here environment, and maximal oxygen consumption (β = -0.291; 95% CI, -0.551, -0.031). We also found that symptoms of stress scores in the parasympathetic and sympathetic nervous systems were positively associated with waist-hip circumference ratio (WHR) (β = 0.010; 95% CI, 0.002, 0.017 and β = 0.006; 95% CI, 0.000, 0.012, respectively). Moreover, the symptoms of stress, here emotion, were positively associated with the WHR (β = 0.005; 95 %CI, 0.001, 0.009) and negatively associated with upper extremity muscle strength (β = -0.005; 95% CI, -0.009, 0.000). The results of this study confirmed the associations between stress levels in the post-COVID-19 pandemic era and WHR, maximal oxygen consumption, and upper extremity muscle strength. As a result, stress reduction or prevention alternatives should be considered in order to maintain physical fitness and prevent stress disorders.
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Affiliation(s)
- Boonsita Suwannakul
- Department of Physical Therapy, School of Allied Health Science, University of Phayao, Phayao 56000, Thailand
| | - Noppharath Sangkarit
- Department of Physical Therapy, School of Allied Health Science, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
| | - Pacharee Manoy
- Department of Physical Therapy, School of Allied Health Science, University of Phayao, Phayao 56000, Thailand
| | - Patchareeya Amput
- Department of Physical Therapy, School of Allied Health Science, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
| | - Weerasak Tapanya
- Department of Physical Therapy, School of Allied Health Science, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
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44
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Gan T, Yang J, Jiang L, Gao Y. Living alone and cardiovascular outcomes: a meta-analysis of 11 cohort studies. PSYCHOL HEALTH MED 2023; 28:719-731. [PMID: 34477038 DOI: 10.1080/13548506.2021.1975784] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To explore whether living alone could increase the risk of cardiovascular outcomes. We searched PubMed, EMBASE, and Web of Science from their inception to 5 October 2020. Cohort studies evaluating the relationship between living alone and cardiovascular outcomes were included. Subgroup analyses were conducted to explore which characteristics would affect the relationship. A total of 13 effect sizes obtained from 11 studies were included and spanned from 1993 to 2019, with 424,286 participants. This study found that living alone increased the risk of cardiovascular outcomes (HR = 1.22, 95% CI: 1.10-1.36, I2 = 80.3%, P = 0.000). In subgroup analyses, living alone increased the risk of cardiovascular outcomes in patients from Europe (HR = 1.37, 95% CI: 1.17-1.61, I2 = 76.2%, P = 0.000), but not increased in Asia (HR = 1.17, 95% CI: 0.83-1.66, I2 = 76.2%, P = 0.000) and multiple regions (HR = 1.02, 95% CI: 0.96-1.08, I2 = 0.0%, P = 0.738). For different cardiovascular outcomes, living alone has statistical significance in increasing the risk of cardiovascular mortality (HR = 1.23, 95% CI: 1.05-1.46, I2 = 84.0%, P = 0.000) and myocardial infarction (HR = 1.11, 95% CI: 1.02-1.21, I2 = 29.6%, P = 0.213). The risk of cardiovascular mortality in men was higher than women (HR = 1.52, 95% CI: 1.24-1.86 vs HR = 1.01, 95% CI: 0.85-1.20; P < 0.05 for interaction). Sensitivity analysis suggested that the results of the meta-analysis were robust. In conclusion, living alone could increase the risk of cardiovascular outcomes and men were more prone to cardiovascular mortality and myocardial infarction.
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Affiliation(s)
- Ting Gan
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jingli Yang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.,College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Lili Jiang
- Institute of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
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45
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Zwack CC, McDonald R, Tursunalieva A, Vasan S, Lambert GW, Lambert EA. Stress and social isolation, and its relationship to cardiovascular risk in young adults with intellectual disability. Disabil Rehabil 2023; 45:974-985. [PMID: 35311428 DOI: 10.1080/09638288.2022.2046186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Stress produces many physiological changes, some of which may contribute to the development of cardiovascular disease (CVD). Individuals with intellectual disability (ID) are exposed to multiple and stressful challenges everyday which may put them at increased cardiovascular risk. This current study aimed to establish whether adults with ID experience higher levels of subjective stress and encounter different stressors (including social isolation) than the general population, and whether there is a relationship between stress and cardiometabolic profile in this population. METHODS Adults with ID (n = 35) aged 18-45 years completed the Subjective Stress Survey, and underwent a physiological assessment to measure blood pressure, metabolic profile and subclinical CVD risk factors, and were compared to a control group (n = 29). Multiple regression was used to investigate whether cardiometabolic parameters were predicative of SSS scores. RESULTS Findings showed adults with ID have higher perceived stress levels (total score ID: 21.3 ± 11.4 vs control: 13.9 ± 9.0, p = 0.006), which is elicited by unique stressors, when compared to people without ID. Stress was strongly associated with increased social isolation (r = -0.38, p = 0.002) and with obesity in females with mild ID (r = 0.72). Regression showed that arterial stiffness was predictive of total SSS score (p = 0.038). CONCLUSIONS Adults with ID aged 18-45 years report higher levels of perceived stress when compared to people without ID.Implications for RehabilitationReducing stress in this young population may prevent development of arterial stiffness, and consequently lower the risk of cardiometabolic morbidity and mortality.There are unique targets for stress management in young adults with intellectual disability, including supporting decision-making and improving self-efficacy.Improving community integration and reducing social isolation may decrease perceived stress in young adults with intellectual disability.
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Affiliation(s)
- Clara C Zwack
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Rachael McDonald
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Ainura Tursunalieva
- Department of Econometrics and Business Statistics, Monash University, Clayton, Australia
| | - Shradha Vasan
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Gavin W Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Elisabeth A Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
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46
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Kapoor G. Association of Physical, Psychological and Psychosocial Attributes With Arterial Stiffness in Cardiovascular Disorders: A Systematic Literature Review. J Lifestyle Med 2023; 13:27-43. [PMID: 37250275 PMCID: PMC10210964 DOI: 10.15280/jlm.2023.13.1.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/05/2023] [Accepted: 02/17/2023] [Indexed: 05/31/2023] Open
Abstract
The prevalence of cardiovascular diseases is increasing exponentially in the industrialized world. According to the World Health Organization, 17.8 million people died in 2019 as a result of cardiovascular diseases (CVD), accounting for 31.0% of all fatalities worldwide. Even though CVD is more common in low and middle-income countries, it is responsible for three-quarters of all cardiovascular-related deaths worldwide. The most common attributes for the occurrence of CVD are the physical, psychological, and psychosocial factors. Arterial stiffness, which is a precursor of CVD, is most commonly affected by said factors and serves as a predictor for CVD diagnosis, treatment, and prevention. The purpose of this article is to learn more about the relationship between arterial stiffness and the physical, psychological, and psychosocial characteristics of cardiovascular diseases. In addition to proposed ways to lower the co-morbidities following CVD. PubMed, Medline, and Web of Science were used for the present review. Only articles published between 1988 and 2022 that discussed physical, psychological, and psychosocial characteristics were considered. A narrative discussion is used to extract and review the information from the selected articles. Several factors related to arterial stiffness and cardiovascular illness have been reviewed, and data has been compiled. This review proposed recommendations and a list of linked factors for prevention and to lower morbidity of cardiovascular illness.
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Affiliation(s)
- Gaurav Kapoor
- Department of Physiotherapy, Jayoti Vidyapeeth Women’s University, Rajasthan, India
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47
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Blumenthal JA, Rozanski A. Exercise as a therapeutic modality for the prevention and treatment of depression. Prog Cardiovasc Dis 2023; 77:50-58. [PMID: 36848966 DOI: 10.1016/j.pcad.2023.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
While maintaining an active lifestyle and engaging in regular exercise are known to promote cardiovascular (CV) health, increasing evidence has emerged to indicate that these lifestyle behaviors also can promote psychological health and well-being. This has led to research to determine if exercise can serve as a potential therapeutic modality for major depressive disorder (MDD), which is a leading cause of mental-health impairment and overall disability worldwide. The strongest evidence to support this use comes from an increasing number of randomized clinical trials (RCTs) that have compared exercise to usual care, placebo controls, or established therapies in healthy adults and in various clinical populations. The relatively large number of RCTs has led to numerous reviews and meta-analyses, which generally have been concordant in indicating that exercise ameliorates depressive symptoms, improves self-esteem, and enhances various aspects of quality of life. Together, these data indicate that exercise should be considered as a therapeutic modality for improving CV health and psychological well-being. The emerging evidence also has led to a new proposed subspecialty of "lifestyle psychiatry", which promotes the use of exercise as an adjunctive treatment for patients with MDD. Indeed, some medical organizations have now endorsed lifestyle-based approaches as foundational aspects of depression management, with adoption of exercise as a treatment option for MDD. This review summarizes research in the area and provides practical suggestions for the use of exercise in clinical practice.
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Affiliation(s)
- James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Alan Rozanski
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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48
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Kaneko H, Yano Y, Lee H, Lee HH, Okada A, Suzuki Y, Itoh H, Matsuoka S, Fujiu K, Michihata N, Jo T, Takeda N, Morita H, Nishiyama A, Node K, Kim HC, Yasunaga H, Komuro I. Blood Pressure Classification Using the 2017 ACC/AHA Guideline and Heart Failure in Patients With Cancer. J Clin Oncol 2023; 41:980-990. [PMID: 36075006 DOI: 10.1200/jco.22.00083] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Despite the growing recognition of the importance of hypertension in patients with cancer, little is known about whether high blood pressure (BP) among patients with cancer is associated with incident heart failure (HF) and other cardiovascular disease (CVD) events and what BP levels are linked to these events. We examined the association of BP classification on the basis of the 2017 American College of Cardiology/American Heart Association BP guideline with the risk of HF and CVD events in patients with cancer. METHODS We studied 33,991 patients with a history of breast, colorectal, or stomach cancer (median age, 53 years; 34.1% men). Patients receiving treatment with BP-lowering medications or having a history of CVD including HF were excluded. Using BP measurements at baseline, 33,991 participants were categorized as having normal BP (n = 17,444), elevated BP (n = 4,733), stage 1 hypertension (n = 7,502), or stage 2 hypertension (n = 4,312). The primary outcome was HF. RESULTS Over a mean follow-up of 2.6 ± 2.2 years, 779 HF events were recorded. After multivariable adjustment, the hazard ratios (HRs) for HF were 1.15 (95% CI, 0.93 to 1.44) for elevated BP, 1.24 (95% CI, 1.03 to 1.49) for stage 1 hypertension, and 1.99 (95% CI, 1.63 to 2.43) for stage 2 hypertension. A stepwise increase in risk with BP categories was also observed in other CVD events. This association was observed even in patients undergoing active cancer treatment. The relationship between hypertension and the risk of developing HF in patients with cancer was confirmed in the Korean National Health Insurance Service database. CONCLUSION Medication-naïve stage 1 and 2 hypertension was associated with a greater risk of HF and other CVD events in patients with cancer. Our results suggest the importance of multidisciplinary collaboration (eg, oncologists and cardiologists) to establish the optimal management strategy for hypertension in patients with cancer.
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Affiliation(s)
- Hidehiro Kaneko
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.,The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan
| | - Yuichiro Yano
- Department of Advanced Epidemiology, NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan.,The Department of Family Medicine and Community Health, Duke University, Durham, NC
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeok-Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuta Suzuki
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.,Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Saitama, Japan
| | - Hidetaka Itoh
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Matsuoka
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuhito Fujiu
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.,The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan
| | - Nobuaki Michihata
- The Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Taisuke Jo
- The Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Norifumi Takeda
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Morita
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hideo Yasunaga
- The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
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Yan L, Ai Y, Xing Y, Wang B, Gao A, Xu Q, Li H, Chen K, Zhang J. Citalopram in the treatment of elderly chronic heart failure combined with depression: A systematic review and meta-analysis. Front Cardiovasc Med 2023; 10:1107672. [PMID: 36818339 PMCID: PMC9933506 DOI: 10.3389/fcvm.2023.1107672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/12/2023] [Indexed: 02/04/2023] Open
Abstract
Background Depression is an independent factor to predict the hospitalization and mortality in the chronic HF patients. Citalopram is known as an effective drug for depression treatment. Currently, there is no specific recommendation in the HF guidelines for the treatment of psychological comorbidity. In recent years, many studies have shown that the citalopram may be safe in treating of chronic HF with depression. Objective To evaluate the efficacy and safety of the citalopram in the treatment of elderly chronic HF combined with depression. Methods PubMed, EMBASE, Cochrane, Web of Science, CNKI, VIP, CBM, and Wanfang were searched from their inception to May 2022. In the treatment of elderly chronic HF combined with depression, randomized controlled studies of the citalopram were included. Independent screening and extraction of data information were conducted by two researchers, and the quality was assessed by the Cochrane bias risk assessment tool. Review manager 5.4.1 was employed for statistical analysis. Results The results of meta-analysis prove that the citalopram treatment for depressed patients with chronic HF has a benefit for HAMD-24 (MD: -8.51, 95% CI: -10.15 to -6.88) and LVEF (MD: 2.42, 95% CI: 0.51 to 4.33). Moreover, the score of GDS decreases, and NT-proBNP (MD: -537.78, 95% CI: -718.03 to -357.54) is improved. However, the comparison with the control group indicates that there is no good effect on HAMD-17 (MD: -5.14, 95% CI: -11.60 to 1.32), MADRS (MD: -1.57, 95% CI: -3.47 to 0.32) and LVEDD (MD: -1.45, 95% CI: -3.65 to -0.76). No obvious adverse drug reactions were observed. Conclusion Citalopram treatment for depressed patients with chronic HF has a positive effect on LVEF and NT-proBNP. It can alleviate HAMD-24 and GDS, but the relative benefits for LVEDD, HAMD-17 and MADRS still need to be verified.Systematic Review Registration: PROSPERO [CRD42021289917].
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Affiliation(s)
- Longmei Yan
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yuzhen Ai
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guizhou, China
| | - Yaxuan Xing
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Biqing Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Anran Gao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Qiwu Xu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Hongzheng Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Keji Chen
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jingchun Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,*Correspondence: Jingchun Zhang, ✉
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50
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Suzuki Y, Kaneko H, Yano Y, Okada A, Fujiu K, Matsuoka S, Michihata N, Jo T, Takeda N, Morita H, Node K, Yasunaga H, Oparil S, Komuro I. The association of BP with cardiovascular outcomes in patients with dipstick proteinuria and preserved kidney function. Hypertens Res 2023; 46:856-867. [PMID: 36658302 DOI: 10.1038/s41440-022-01146-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/12/2022] [Accepted: 10/28/2022] [Indexed: 01/20/2023]
Abstract
Little is known about the relationship between blood pressure (BP) and incident cardiovascular disease (CVD) in people with proteinuria and a preserved estimated glomerular filtration rate (eGFR). This study sought to investigate the association of BP with CVD risk in adults with proteinuria and preserved eGFR. We studied 188,837 individuals with proteinuria and preserved eGFR ≥60 mL/min/1.73 m2. We categorized individuals who were not taking BP-lowering medications into four groups based on the 2017 American College of Cardiology/American Heart Association BP guideline and categorized those who were taking BP-lowering medications using the same BP ranges. The primary outcome was a composite CVD endpoint that included myocardial infarction, angina pectoris, stroke, and heart failure. Over a mean follow-up of 1,050 days, 7,039 CVD events were identified. Compared with normal BP, stage 1 hypertension (hazard ratio [HR]: 1.30, 95% confidence interval [95% CI]: 1.21-1.40) and stage 2 hypertension (HR: 2.17, 95% CI: 2.01-2.34) were associated with an increased risk for CVD events among medication-naïve individuals. Only stage 2 hypertension range (HR: 1.19, 95% CI: 1.02-1.38) was associated with an increased CVD event risk among people taking BP-lowering medications. Restricted cubic spline analysis showed that the risk of CVD events increased monotonically with BP at an SBP/DBP > 120/80 mmHg among medication-naïve individuals, but risk increased only at an SBP/DBP > 140/90 mmHg among individuals taking BP-lowering medications. In conclusion, among people with proteinuria and preserved eGFR, stage 1 and stage 2 hypertension were associated with a greater risk of CVD among medication-naïve individuals, whereas only stage 2 hypertension was associated with an increased CVD risk among those taking BP-lowering medications.
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Affiliation(s)
- Yuta Suzuki
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.,Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Saitama, Japan
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. .,Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.
| | - Yuichiro Yano
- Department of Advanced Epidemiology, NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan.,Department of Family Medicine and Community Health, Duke University, Durham, NC, USA
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.,Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan
| | - Satoshi Matsuoka
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuaki Michihata
- Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Taisuke Jo
- Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Suzanne Oparil
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
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