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Bucciarelli V, Moscucci F, Dei Cas A, Coppi F, Angeli F, Pizzi C, Renda G, Nodari S, Maffei S, Montisci R, Pedrinelli R, Sciomer S, Perrone Filardi P, Mattioli AV, Gallina S. Maternal-fetal dyad beyond the phenomenology of pregnancy: from primordial cardiovascular prevention on out, do not miss this boat! Curr Probl Cardiol 2024; 49:102695. [PMID: 38852910 DOI: 10.1016/j.cpcardiol.2024.102695] [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: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
Pregnancy represents a stress test for every woman's cardiovascular (CV) system, and a pre-existing maternal unfavorable cardio-metabolic phenotype can uncover both adverse pregnancy outcomes and the subsequent development of cardiovascular disease (CVD) risk factors during and after pregnancy. Moreover, the maternal cardiac and extracardiac environment can affect offspring's cardiovascular health through a complex mechanism called developmental programming, in which fetal growth can be influenced by maternal conditions. This interaction continues later in life, as adverse developmental programming, along with lifestyle risk factors and genetic predisposition, can exacerbate and accelerate the development of CV risk factors and CVD in childhood and adolescence. The aim of this narrative review is to summarize the latest evidences regarding maternal-fetal dyad and its role on primordial, primary and secondary CV prevention.
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Affiliation(s)
- Valentina Bucciarelli
- Cardiovascular Sciences Department, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
| | - Federica Moscucci
- Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, Viale del Policlinico n. 155, Rome 00161, Italy
| | - Alessandra Dei Cas
- Department of Medicine and Surgery, Università di Parma, Parma, Italy; Division of Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Francesca Coppi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena 41121, Italy
| | - Francesco Angeli
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda, Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences- DIMEC, University of Bologna, Via Giuseppe Massarenti 9, Bologna 40138, Italy
| | - Carmine Pizzi
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda, Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences- DIMEC, University of Bologna, Via Giuseppe Massarenti 9, Bologna 40138, Italy
| | - Giulia Renda
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Savina Nodari
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia 25123, Italy
| | - Silvia Maffei
- Department of Cardiovascular Endocrinology and Metabolism, Gynaecological and Cardiovascular Endocrinology and Osteoporosis Unit, "Gabriele Monasterio" Foundation and Italian National Research Council (CNR) Pisa, Pisa 56124 Italy
| | - Roberta Montisci
- Clinical Cardiology, AOU Cagliari, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Susanna Sciomer
- Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, 'Sapienza', Rome University, Viale dell'Università, 37, Rome 00185, Italy
| | | | - Anna Vittoria Mattioli
- Department of Quality of Life Sciences, University of Bologna-Alma Mater Studiorum, Bologna 40126, Italy.
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
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Angeli F, Ricci F, Moscucci F, Sciomer S, Bucciarelli V, Bianco F, Mattioli AV, Pizzi C, Gallina S. Sex- and gender-related disparities in chest pain syndromes: the feminine mystique of chest pain. Curr Probl Cardiol 2024; 49:102457. [PMID: 38342350 DOI: 10.1016/j.cpcardiol.2024.102457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/13/2024]
Abstract
Chest pain syndromes encompass a wide range of different clinical conditions, being coronary artery disease one of the most important and feared aetiology. Sex and gender disparities have been reported in pathophysiology, clinical presentations, diagnostic work-up and outcomes of patients admitted for chest pain. Biological differences in sexual hormones and neurological pain procession pathways have been proposed as contributors to disparities between men and women; however, gender-related disparities in socio-economic and psychological status have emerged as additional factors involved in these conditions. A better understanding of gender- and sex-related disparities will lead to improved clinical care and management of chest pain syndromes in both men and women. In this comprehensive review, we describe the existing knowledge regarding sex and gender-based differences in management and outcomes of chest pain syndromes in order to stimulate and promote the development of a more sex- and gender-oriented approach to these conditions.
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Affiliation(s)
- Francesco Angeli
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda, Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences- DIMEC, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Federica Moscucci
- Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, Viale del Policlinico n. 155, 00161 Rome, Italy
| | - Susanna Sciomer
- Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, 'Sapienza', Rome University, Viale dell'Università, 37, 00185, Rome, Italy
| | - Valentina Bucciarelli
- Cardiovascular Sciences Department-Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
| | - Francesco Bianco
- Cardiovascular Sciences Department-Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
| | - Anna Vittoria Mattioli
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Carmine Pizzi
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda, Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences- DIMEC, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy.
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
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Mattioli AV, Moscucci F, Sciomer S, Maffei S, Nasi M, Pinti M, Bucciarelli V, Dei Cas A, Parati G, Ciccone MM, Palmiero P, Maiello M, Pedrinelli R, Pizzi C, Barillà F, Gallina S. Cardiovascular prevention in women: an update by the Italian Society of Cardiology working group on 'Prevention, hypertension and peripheral disease'. J Cardiovasc Med (Hagerstown) 2023; 24:e147-e155. [PMID: 37186565 DOI: 10.2459/jcm.0000000000001423] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The recent pandemic has substantially changed the approach to the prevention of cardiovascular diseases in women. Women have been significantly impacted by the changes that occurred during the pandemic and the quarantine adopted to prevent the spread of the disease. Changes involved prevention both through the reduction of visits and preventive screening and through social and economic changes. It is necessary to adopt new cardiovascular prevention approaches focused on returning to healthy lifestyles, reducing stress and depression also using modern tools such as telemedicine, mobile phone applications and the web. These tools convey messages in a persuasive way especially in young and adult women. There is less impact of these new tools on older women towards whom it is important to adopt a more traditional approach. This review focuses on the new approach to cardiovascular prevention in women in light of the lifestyle changes recorded during the pandemic and which led to an increase in obesity examines the effects on the cardiovascular system induced by stress and depression and analyses the new high blood pressure guidelines and indications that are specific to women.
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Affiliation(s)
- Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
| | - Federica Moscucci
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome
| | - Susanna Sciomer
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome
| | | | - Milena Nasi
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
| | - Marcello Pinti
- Department of Life Science, University of Modena and Reggio Emilia, Modena
| | - Valentina Bucciarelli
- Department of Paediatric and Congenital Cardiac Surgery and Cardiology, Azienda Ospedaliero-Universitaria Ospedali Riuniti Ancona 'Umberto I, G. M. Lancisi, G. Salesi', Ancona
| | - Alessandra Dei Cas
- Division of Nutritional and Metabolic Sciences, Azienda Ospedaliero-Universitaria di Parma, University of Parma, Parma
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, S.Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan & Department of Medicine and Surgery, University of Milano-Bicocca, Milan
| | - Marco Matteo Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University 'A. Moro' of Bari, Bari
| | | | - Maria Maiello
- ASL Brindisi, Cardiology Equipe, District of Brindisi, Brindsi
| | - Roberto Pedrinelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine-Cardiology Division, University of Pisa, Pisa
| | - Carmine Pizzi
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | | | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Italy
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Sjödahl Hammarlund C, Norlander A, Brogårdh C. Experiences of People with Cardiovascular Disease during COVID-19 in Sweden: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085588. [PMID: 37107869 PMCID: PMC10139106 DOI: 10.3390/ijerph20085588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 05/10/2023]
Abstract
Although people with cardiovascular conditions were subjected to more rigorous restrictions during the COVID-19 pandemic, there is limited knowledge of how the restrictions affected their lives and well-being. Thus, the aim of this study was to describe how people with cardiovascular conditions experienced their life situation and physical and mental health during the second wave of the pandemic in Sweden. Fifteen participants (median age 69 years; nine women) were individually interviewed, and data were analyzed with systematic text condensation. The findings revealed that some of the participants were fearful of contracting COVID-19 as their medical condition made them vulnerable. Additionally, the restrictions changed their daily routines and their ability to take part in social activities, as well as their access to specialized outpatient care (medical check-ups and physiotherapy). Although emotional and psychological distress were present, several participants found strategies that reduced their worries, such as exercising and meeting friends outdoors. However, some had adopted a more sedentary lifestyle and unhealthy diets. These findings indicate that healthcare professionals should provide individualized support to persons with cardiovascular diseases in order to find well-functioning emotion- and problem-focused strategies aimed at improving physical and mental health during crises such as pandemics.
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Affiliation(s)
- Catharina Sjödahl Hammarlund
- Department of Health Sciences, Lund University, SE-22100 Lund, Sweden; (A.N.); (C.B.)
- The PRO-CARE Group, Faculty of Health Sciences, Kristianstad University, SE-29188 Kristianstad, Sweden
- Correspondence:
| | - Anna Norlander
- Department of Health Sciences, Lund University, SE-22100 Lund, Sweden; (A.N.); (C.B.)
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, SE-22185 Lund, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, SE-22100 Lund, Sweden; (A.N.); (C.B.)
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, SE-22185 Lund, Sweden
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5
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Moscucci F, Gallina S, Bucciarelli V, Aimo A, Pelà G, Cadeddu-Dessalvi C, Nodari S, Maffei S, Meloni A, Deidda M, Mercuro G, Pedrinelli R, Penco M, Sciomer S, Mattioli AV. Impact of COVID-19 on the cardiovascular health of women: a review by the Italian Society of Cardiology Working Group on 'gender cardiovascular diseases'. J Cardiovasc Med (Hagerstown) 2023; 24:e15-e23. [PMID: 36729627 PMCID: PMC10100638 DOI: 10.2459/jcm.0000000000001398] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/02/2022] [Indexed: 02/03/2023]
Abstract
The coronavirus disease 19 (COVID-19), due to coronavirus 2 (SARS-CoV-2) infection, presents with an extremely heterogeneous spectrum of symptoms and signs. COVID-19 susceptibility and mortality show a significant sex imbalance, with men being more prone to infection and showing a higher rate of hospitalization and mortality than women. In particular, cardiovascular diseases (preexistent or arising upon infection) play a central role in COVID-19 outcomes, differently in men and women. This review will discuss the potential mechanisms accounting for sex/gender influence in vulnerability to COVID-19. Such variability can be ascribed to both sex-related biological factors and sex-related behavioural traits. Sex differences in cardiovascular disease and COVID-19 involve the endothelial dysfunction, the innate immune system and the renin-angiotensin system (RAS). Furthermore, the angiotensin-converting enzyme 2 (ACE2) is involved in disease pathogenesis in cardiovascular disease and COVID-19 and it shows hormone-dependent actions. The incidence of myocardial injury during COVID-19 is sex-dependent, predominantly in association with a greater degree of inflammation and coagulation disorders among men. Its pathogenesis is not fully elucidated, but the main theories foresee a direct role for the ACE2 receptor, the hyperimmune response and the RAS imbalance, which may also lead to isolated presentation of COVID-19-mediated myopericarditis. Moreover, the latest evidence on cardiovascular diseases and their relationship with COVID-19 during pregnancy will be discussed. Finally, authors will analyse the prevalence of the long-covid syndrome between the two sexes and its impact on the quality of life and cardiovascular health.
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Affiliation(s)
- Federica Moscucci
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome ‘Sapienza’, Policlinico Umberto I, Rome
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti
| | - Valentina Bucciarelli
- Department of Paediatric and Congenital Cardiac Surgery and Cardiology, Azienda Ospedaliero-Universitaria Ospedali Riuniti Ancona ‘Umberto I, G. M. Lancisi, G. Salesi’, Ancona
| | - Alberto Aimo
- Cardiology Division, Fondazione Toscana Gabriele Monasterio
- Scuola Superiore Sant’Anna, Pisa
| | - Giovanna Pelà
- Department of Medicine and Surgery, University of Parma
- Department of General and Specialistic Medicine, University-Hospital of Parma, Parma
| | | | - Savina Nodari
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Silvia Maffei
- Cardiovascular and Gynaecological Endocrinology Unit, Fondazione G Monasterio CNR-Regione Toscana
| | - Antonella Meloni
- Department of Radiology, Fondazione G Monasterio CNR-Regione Toscana, Pisa
| | - Martino Deidda
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari
| | - Roberto Pedrinelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa
| | - Maria Penco
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila
| | - Susanna Sciomer
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome ‘Sapienza’, Policlinico Umberto I, Rome
| | - Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
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Piccirillo G, Moscucci F, Corrao A, Carnovale M, Di Diego I, Lospinuso I, Caltabiano C, Mezzadri M, Rossi P, Magrì D. Noninvasive Hemodynamic Monitoring in Advanced Heart Failure Patients: New Approach for Target Treatments. Biomedicines 2022; 10:biomedicines10102407. [PMID: 36289669 PMCID: PMC9599112 DOI: 10.3390/biomedicines10102407] [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: 07/15/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022] Open
Abstract
Using bio-impedance to deduce some hemodynamic parameters combined with some short-term ECG temporal dispersion intervals, and measuring myocardial depolarization, intraventricular conduction, and repolarization. A total of 65 in-hospital patients (M/F:35/30) were enrolled, 39 with HFrEF and 26 HFpEF, in New York Heart Association (NYHA) class IV. Stroke volume (SVI), cardiac indexes (CI), left ventricular ejection fraction (LVEFBIO), end diastolic volume (LV-EDV), and other systolic and diastolic parameters were noninvasively obtained at enrollment and at hospital discharge. At the same time, QR, QRS, QT, ST, Tpeak-Tend (Te) interval mean, and standard deviation (SD) from 5 min ECG recordings were obtained. At baseline, HFrEF patients reported significantly lower SVI (p < 0.05), CI (p < 0.05), and LVEF (p < 0.001) than HFpEF patients; moreover, HFrEF patients also showed increased LV-EDV (p < 0.05), QR, QRS, QT, ST, and Te means (p < 0.05) and standard deviations (p < 0.05) in comparison to HFpEF subjects. Multivariable logistic regression analysis reported a significant correlation between hospital mortality and Te mean (odds ratio: 1.03, 95% confidence limit: 1.01−1.06, p: 0.01). Fifty-seven percent of patients were considered responders to optimal medical therapy and, at discharge, they had significantly reduced NT-proBNP, (p < 0.001), heart rate (p < 0.05), and TeSD (p < 0.001). LVEF, obtained by transthoracic echocardiography, and LVEFBIO were significantly related (r: 0.781, p < 0.001), but these two parameters showed a low agreement limit. Noninvasive hemodynamic and ECG-derived parameters were useful to highlight the difference between HFrEF and HFpEF and between responders and nonresponders to the optimal medical therapy. Short-period bioimpedance and electrocardiographic data should be deeply evaluated to determine possible advantages in the therapeutic and prognostic approach in severe CHF.
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Affiliation(s)
- Gianfranco Piccirillo
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Viale del Policlinico n. 155, 00186 Rome, Italy
| | - Federica Moscucci
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Viale del Policlinico n. 155, 00186 Rome, Italy
- Correspondence: ; Tel.: +39-06-4997-0118
| | - Andrea Corrao
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Viale del Policlinico n. 155, 00186 Rome, Italy
| | - Myriam Carnovale
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Viale del Policlinico n. 155, 00186 Rome, Italy
| | - Ilaria Di Diego
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Viale del Policlinico n. 155, 00186 Rome, Italy
| | - Ilaria Lospinuso
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Viale del Policlinico n. 155, 00186 Rome, Italy
| | - Cristina Caltabiano
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Viale del Policlinico n. 155, 00186 Rome, Italy
| | - Martina Mezzadri
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Viale del Policlinico n. 155, 00186 Rome, Italy
| | - Pietro Rossi
- Arrhytmology Unit, Cardiology Division, S. Giovanni Calibita, Isola Tiberina, 00186 Rome, Italy
| | - Damiano Magrì
- Department of Clinical and Molecular Medicine, S. Andrea Hospital, “Sapienza” University of Rome, 00186 Rome, Italy
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Onnis C, Cadeddu Dessalvi C, Cademartiri F, Muscogiuri G, Angius S, Contini F, Suri JS, Sironi S, Salgado R, Esposito A, Saba L. Quantitative and qualitative features of carotid and coronary atherosclerotic plaque among men and women. Front Cardiovasc Med 2022; 9:970438. [PMID: 36176995 PMCID: PMC9513059 DOI: 10.3389/fcvm.2022.970438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/25/2022] [Indexed: 11/25/2022] Open
Abstract
Cardiovascular diseases (CVDs), particularly ischemic heart disease (IHD) and stroke, present epidemiologically in a different way among sexes. The reasons of these sex-based differences should be delved into sex-specific cardiovascular (CV) risk factors and different mechanisms of atherosclerotic progression. Imaging techniques of both carotid and coronary atherosclerotic plaques represent a tool to demonstrate sex-related features which might be used to further and better assess CV risk of male and female population. The aim of this review is to evaluate current knowledge on sex-specific qualitative and quantitative plaque features of coronary and carotid atherosclerosis. We also discuss the clinical implication of a sex-based plaque phenotype, evaluated with non-invasive imaging techniques, such as CT-angiography and MRI-angiography, to stratify CV risk.
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Affiliation(s)
- Carlotta Onnis
- Department of Radiology, Azienda Ospedaliero-Universitaria (A.O.U.), di Cagliari—Polo di Monserrato, Cagliari, Italy
| | - Christian Cadeddu Dessalvi
- Department of Medical Sciences and Public Health, Università Degli Studi di Cagliari, Cagliari, Italy
- *Correspondence: Christian Cadeddu Dessalvi,
| | | | - Giuseppe Muscogiuri
- Department of Radiology, San Luca Hospital, Istituto Auxologico Italiano IRCCS, University of Milano-Bicocca, Milan, Italy
| | - Simone Angius
- Department of Medical Sciences and Public Health, Università Degli Studi di Cagliari, Cagliari, Italy
| | - Francesca Contini
- Department of Medical Sciences and Public Health, Università Degli Studi di Cagliari, Cagliari, Italy
| | - Jasjit S. Suri
- Stroke Diagnostic and Monitoring Division, AtheroPoint™, United States and Advanced Knowledge Engineering Centre, Global Biomedical Technologies Inc. (GBTI), Roseville, CA, United States
| | - Sandro Sironi
- Department of Radiology, San Luca Hospital, Istituto Auxologico Italiano IRCCS, University of Milano-Bicocca, Milan, Italy
| | - Rodrigo Salgado
- Department of Radiology, Antwerp University Hospital, Antwerp, Belgium
| | - Antonio Esposito
- Experimental Imaging Center, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero-Universitaria (A.O.U.), di Cagliari—Polo di Monserrato, Cagliari, Italy
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8
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Moscucci F, Lavalle F, Politi C, Campanale A, Baggio G, Sciomer S. Acute coronary syndrome in women: a new and specific approach is needed. Eur J Prev Cardiol 2022; 29:e305-e308. [PMID: 35881512 DOI: 10.1093/eurjpc/zwac143] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 12/20/2022]
Affiliation(s)
- Federica Moscucci
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome 'Sapienza', Rome, Italy
| | - Franco Lavalle
- OMCEO (Provincial Order Council of Surgeons and Dentists), Bari, Italy
- G.I.S.e G. (Gender and Health Italian Group), Italy
| | - Cecilia Politi
- Internal Medicine Department, Gender Medicine Area F.A.D.O.I., Isernia, Italy
| | - Antonella Campanale
- Medical Device and Pharmaceutical Service-Italian Ministry of Health, Rome, Italy
| | - Giovanella Baggio
- Department of Medicine, University of Padua, Padua, Italy
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome 'Sapienza', Rome, Italy
| | - Susanna Sciomer
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome 'Sapienza', Rome, Italy
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9
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Vigna L, Tirelli AS, Gaggini M, Di Piazza S, Tomaino L, Turolo S, Moroncini G, Chatzianagnostou K, Bamonti F, Vassalle C. Insulin resistance and cardiometabolic indexes: comparison of concordance in working-age subjects with overweight and obesity. Endocrine 2022; 77:231-241. [PMID: 35665880 DOI: 10.1007/s12020-022-03087-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/21/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The aim of the study was to evaluate indexes of insulin resistance and cardiometabolic risk in a large population of workers with overweight or obesity, in order to identify a possible efficient, cheap and simple strategy to apply in workers' health surveillance. METHODS The evaluation of IR and cardiometabolic risk indexes (HOMA, QUICKI, Ty/HDLC, TyG, insuTAG, Castelli risk indexes 1 and 2, non-HDLC, TRL-C, AIP, and VAI) was performed in a population of 1195 working-age subjects with overweight or obesity (322 males, mean age 49 ± 11 years). RESULTS The prevalence of IR and cardiometabolic risk was higher among males for all indexes. Aging, waist circumference, BMI, blood pressure, glucose, CRP, fibrinogen and uric acid were correlated more frequently with IR/cardiometabolic indexes in women, homocysteine in men. The percentage of the workers identified as insulin resistant (IR+) or at higher cardiometabolic risk greatly vary according to the different index used. CONCLUSION With a small group of biomarkers and anthropometric measures (fasting glucose and insulin, lipid profile, BMI and waist circumference) is possible to calculate a number of IR/cardiometabolic indexes, which, likely reflecting different pathophysiological aspects also related to gender, might help in a personalized evaluation of IR and cardiometabolic risk. Graphical abstract.
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Affiliation(s)
- Luisella Vigna
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico. Occupational Health Unit, Obesity and Work Center, EASO Collaborating Center for Obesity Management, Milan, Italy
| | - Amedea Silvia Tirelli
- Fondazione IRCCS Cà Grande Ospedale Maggiore Policlinico. Clinical Chemistry and Microbiology Bacteriology and Virology Units, Milan, Italy
| | - Melania Gaggini
- Cardiometabolic Risk Unit, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Salvina Di Piazza
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico. Occupational Health Unit, Obesity and Work Center, EASO Collaborating Center for Obesity Management, Milan, Italy
| | - Laura Tomaino
- Emergency Medicine Residency Program, Marche Polytechnic University, Ancona, Italy
| | - Stefano Turolo
- Fondazione IRCCS Cà Grande Ospedale Maggiore Policlinico. UOC Pediatric Nephrology, Dialysis and Transplantation, Milan, Italy
| | - Gianluca Moroncini
- Clinica Medica, Azienda Ospedali Riuniti, Department of Internal Medicine, Azienda ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy
| | | | - Fabrizia Bamonti
- Former Associate Professor of Clinical Biochemistry, Board Certify in Clinical Chemistry and Biochemistry, Università degli Studi di Milano, Milan, Italy
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10
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Sense of Coherence Predicts Physical Activity Maintenance and Health-Related Quality of Life: A 3-Year Longitudinal Study on Cardiovascular Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084700. [PMID: 35457565 PMCID: PMC9028314 DOI: 10.3390/ijerph19084700] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. A physically active lifestyle can improve the health-related quality of life (HRQoL) of people with CVD. Nevertheless, adherence to a physically active lifestyle is poor. This study examined the longitudinal (pre-event, 6-, 12-, 24-, and 36-month follow-ups) physical activity profiles in 275 patients (mean age = 57.1 years; SD = 7.87; 84% men) after the first acute coronary event. Moreover, it investigated the associations among physical activity, sense of coherence (SOC), and HRQoL. Physical activity profiles were identified through latent class growth analysis, and linear regressions were then performed to explore the association between physical activity, SOC, and HRQoL. After the cardiovascular event, 62% of patients reached adequate physical activity levels and maintained them over time (virtuous profile). The remaining 38% could not implement (23%) or maintain (15%) a healthy behavior. A strong SOC at baseline (standardized β = 0.19, p = 0.002) predicted the probability of belonging to the virtuous profile. Moreover, a strong SOC at baseline (standardized β = 0.27, p < 0.001), together with the probability of belonging to the virtuous profile (standardized β = 0.16, p = 0.031), predicted a better HRQoL at the final follow-up. Findings showed a strong relationship between SOC, the ability to adopt a physically active lifestyle stably over time, and HRQoL in patients with CVD. They suggest the importance of tailoring physical activity interventions by promoting resilience resources such as SOC to improve patients’ quality of life after an acute coronary event.
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11
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García R, Muñoz MA, Navas E, Vinyoles E, Verdú-Rotellar JM, Del Val JL. Variability in Cardiovascular Risk Factor Control in Patients with Heart Failure According to Gender and Socioeconomic Status. J Womens Health (Larchmt) 2022; 31:690-697. [PMID: 35041531 DOI: 10.1089/jwh.2021.0404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background: Despite considerable evidence concerning heart failure (HF) risk factors, there is scarce information about the effect and degree of control regarding socioeconomic and gender inequalities. Methods: Cohort study including HF patients >40 years of age attended in 53 primary health care centers in Barcelona (Spain). Socioeconomic status (SES) was determined by an aggregated deprivation index (MEDEA) according to the neighborhood of residence. Logistic multivariable regression was performed to analyze differences in cardiovascular risk factor control, stratifying by SES and sex. Results: A total of 8235 HF patients were included. Mean age was 78.1 (standard deviation 10.2) years, and 56.0% were women. The most prevalent cardiovascular risk factors were hypertension, diabetes, and dyslipidemia. Blood pressure was the worst controlled factor in both genders with the lowest SES (odds ratio [OR] 0.56 95% confidence interval [CI] 0.56-0.71) and (OR 0.52, 0.46-0.71), respectively. In women, a social gradient was observed for glycemic and body mass index control, which were worse in the most unfavorable socioeconomic position (OR 0.54, 95% CI 0.38-0.77), and (OR 0.45, 95% CI 0.32-0.64), respectively. Men presented worse control of blood pressure (OR 0.55, 95% CI 0.42-0.71) and smoking habit (OR 0.67, 95% CI 0.47-0.90) in the most deprived socioeconomic bracket. Conclusions: Patients with HF in the most disadvantaged socioeconomic levels presented the worst degree of control for cardiovascular risk factors, and this negative effect was stronger in women.
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Affiliation(s)
- Raquel García
- Institut Català de la Salut, Barcelona, Spain.,Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Department of Pediatrics, Obstetrics and Ginecology and Preventive Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Miguel-Angel Muñoz
- Institut Català de la Salut, Barcelona, Spain.,Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Department of Pediatrics, Obstetrics and Ginecology and Preventive Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Elena Navas
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Ernest Vinyoles
- Institut Català de la Salut, Barcelona, Spain.,Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Jose-Maria Verdú-Rotellar
- Institut Català de la Salut, Barcelona, Spain.,Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - José-Luis Del Val
- Institut Català de la Salut, Barcelona, Spain.,Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
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12
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Stival C, Lugo A, Bosetti C, Amerio A, Serafini G, Cavalieri d’Oro L, Odone A, Stuckler D, Iacoviello L, Bonaccio M, van den Brandt P, Zucchi A, Gallus S. COVID-19 confinement impact on weight gain and physical activity in the older adult population: data from the LOST in Lombardia study. Clin Nutr ESPEN 2022; 48:329-335. [PMID: 35331509 PMCID: PMC8802547 DOI: 10.1016/j.clnesp.2022.01.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 11/03/2022]
Abstract
Background & aims COVID-19 containment measures significantly impacted lifestyle of the general population, including physical activity. Although the older adults are particularly susceptible to the potential consequences of sedentary lifestyle and inactivity, few studies investigated pandemic effects in this segment of the population. We aimed to evaluate COVID-19 pandemic effects on weight gain and physical activity in the Italian older adults, and assess the impact of possible changes in physical activity on mental health wellbeing. Methods In November 2020, a cross-sectional survey was conducted on a representative sample of 4400 older adults (aged 65 or more) from the Lombardy region, Northern Italy. Changes in body mass index (BMI) and physical activity were assessed, compared to the previous year. Using unconditional multiple logistic models, we estimated the odds ratios (OR) and the corresponding 95% confidence intervals (CI) of a decrease in physical activity during COVID-19 pandemic and we evaluated if decreased physical activity was a determinant of a worsening in psychological wellbeing. Results Neither weight gain nor increase in obesity prevalence occurred during the pandemic. Mean time spent in physical activity significantly decreased, with 43.8% of participants reporting a decrease of 1 h/week or more during COVID-19 pandemic. A decreased physical activity was determinant of a worsening of selected mental health outcomes, such as: sleep quality (OR = 2.45; 95% CI: 1.91–3.15) and quantity (OR = 1.54; 95% CI: 1.18–2.02), anxiety (OR = 1.31; 95% CI: 1.14–1.52) and depressive symptoms (OR = 1.61; 95% CI: 1.38–1.88). Conclusion During the COVID-19 pandemic, while no major changes in BMI were observed, physical activity significantly declined in the older adults. In this population, the lack of physical activity might have contributed to the observed worsening in mental health. During emergency periods, encouraging physical activity might be effective also to preserve psychological wellbeing.
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13
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Saldarriaga-Giraldo CI, Ramirez-Ramos CF, Lopez-Santi R, Lanas F, Martín AV, Perales JLS, Juárez-Lloclla JP, Ruise M, Arcela JPC, de Espinal EHF, Gimon EDLR, Sambadaro G, Bello EG, Varleta P, Chaves DQ, Farina JM, Lopez HIAO, Peréz-Siller G, Liblik K, Baranchuk A. Gender-related differences in the impact of COVID-19 pandemic in cardiometabolic patients in Latin America: The CorCOVID LATAM Gender sub-study. Curr Probl Cardiol 2021; 47:101075. [PMID: 34871661 PMCID: PMC8639483 DOI: 10.1016/j.cpcardiol.2021.101075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 01/01/2023]
Abstract
COVID-19 pandemic and lockdown measures have disrupted lifestyle habits and self-care. Gender differences in health behavior during the pandemic have not yet been fully elucidated. The aim of this study was to evaluate gender related differences in the impact of COVID-19 pandemic on patients with cardiometabolic diseases. A cross-sectional survey was administered to cardiometabolic patients in 13 Latin American countries between June 15th and July 15th, 2020. The study included 4216 participants, of which 2147 (50.9%) were women. Women reported healthier eating habits as well as lower tobacco and alcohol consumption than men but exercised less and reported increased symptoms of depression. Low income and symptoms of depression were associated with sedentarism in women. The interplay between psychological factors and sedentarism could increase the risk of cardiovascular events in this population.
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Affiliation(s)
| | - Cristhian Felipe Ramirez-Ramos
- Department of Cardiology, Universidad Pontificia Bolivariana and Centro de Medicina del Ejercicio y Rehabilitación Cardíaca S.A CEMDE, Medellín, Colombia
| | | | - Fernando Lanas
- Department of Internal Medicine, Universidad de La Frontera, Temuco, Chile
| | - Alexander Valdés Martín
- Department of Cardiology, Instituto de Cardiología y Cirugía Cardiovascular, La Habana, Cuba
| | | | | | - Mauro Ruise
- Cardio CCV Clínica Yunes, Santiago de Estero, Argentina
| | | | | | | | | | | | - Paola Varleta
- Department of Cardiology, Unidad de Prevención Cardiovascular y Rehabilitación Cardíaca, Hospital Dipreca, Santiago de Chile, Chile
| | | | | | | | | | - Kiera Liblik
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Adrian Baranchuk
- Department of Medicine, Queen's University, Kingston, Ontario, Canada.
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14
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Thakkar A, Agarwala A, Michos ED. Secondary Prevention of Cardiovascular Disease in Women: Closing the Gap. Eur Cardiol 2021; 16:e41. [PMID: 34815749 PMCID: PMC8591616 DOI: 10.15420/ecr.2021.24] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/24/2021] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular disease (CVD) remains the leading cause of death in women globally. Younger women (<55 years of age) who experience MI are less likely to receive guideline-directed medical therapy (GDMT), have a greater likelihood of readmission and have higher rates of mortality than similarly aged men. Women have been under-represented in CVD clinical trials, which limits the generalisability of results into practice. Available evidence indicates that women derive a similar benefit as men from secondary prevention pharmacological therapies, such as statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, icosapent ethyl, antiplatelet therapy, sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists. Women are less likely to be enrolled in cardiac rehabilitation programs than men. Mitigating risk and improving outcomes is dependent on proper identification of CVD in women, using appropriate GDMT and continuing to promote lifestyle modifications. Future research directed at advancing our understanding of CVD in women will allow us to further develop and tailor CVD guidelines appropriate by sex and to close the gap between diagnoses, treatment and mortality.
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Affiliation(s)
- Aarti Thakkar
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine Baltimore, MD, US
| | - Anandita Agarwala
- Division of Cardiology, Baylor Scott and White Health Heart Hospital Baylor Plano Plano, TX, US
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine Baltimore, MD, US
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15
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Boesgaard Graversen C, Brink Valentin J, Lytken Larsen M, Riahi S, Holmberg T, Paaske Johnsen S. Non-Persistence with Medication as a Mediator for the Social Inequality in Risk of Major Adverse Cardiovascular Events in Patients with Incident Acute Coronary Syndrome: A Nationwide Cohort Study. Clin Epidemiol 2021; 13:1071-1083. [PMID: 34803405 PMCID: PMC8597923 DOI: 10.2147/clep.s335133] [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: 08/19/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022] Open
Abstract
Aim Low socioeconomic status is associated with higher risk of major adverse cardiovascular events (MACE) among patients with incident acute coronary syndrome (ACS). We examined whether non-persistence with antiplatelet and statin therapy mediated the income- and educational-related inequality in risk of MACE. Methods Using national registers, all Danish patients diagnosed with incident ACS from 2010 to 2017 were identified. The primary outcome (MACE) comprised all-cause death, cardiac death and cardiac readmission. Risk of MACE was handled by discrete time analyses using inverse probability of treatment weights. The mediator variable comprised non-persistence to a combined 2-dimensional measure of statin and antiplatelet treatment. The mediation analysis was evaluated by population average effects. Results The study population was 45,874 patients, of whom 16,958 (37.0%) were non-persistent with medication and 16,365 (35.7%) suffered MACE during the median follow-up of 3.5 years. Compared to patients with low income, the adjusted hazard ratio of MACE was lowered by 33% (HR: 0.67, 95% CI: 0.61–0.72) in men and by 34% (HR: 0.66, 95% CI: 0.61–0.72) in women with high income, respectively. Similar results were observed according to level of education. A socioeconomic difference in risk of non-persistence was found in men but not women and only in relation to income. The lower risk of non-persistence observed in high-income men mediated the lower risk of MACE by 12.6% (95% CI: 11.1–14.1%) compared with low-income men. Conclusion Non-persistence with medication mediated some of the income-related inequality in risk of MACE in men, but not women, with incident ACS.
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Affiliation(s)
| | - Jan Brink Valentin
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Mogens Lytken Larsen
- Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Sam Riahi
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Teresa Holmberg
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Søren Paaske Johnsen
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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16
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Mattioli AV, Coppi F, Manenti A, Farinetti A. Subclinical Vascular Damage: Current Insights and Future Potential. Vasc Health Risk Manag 2021; 17:729-738. [PMID: 34866906 PMCID: PMC8633547 DOI: 10.2147/vhrm.s242636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022] Open
Abstract
The cardiovascular risk assessment must be carried out during all the different phases of life because the cardiovascular risk and the related prevention actions are dynamic and constantly evolving. As patients age, they change their exposure to various risk factors and accumulate comorbidities by changing their subjective cardiovascular risk, so it is necessary to undertake personalized early and preventive diagnostic actions. The main approach to asymptomatic vascular disease is based on primary prevention with the adoption of a healthy lifestyle. Indeed, lifestyle influences most of the traditional risk factors. In recent years, important differences between the sexes regarding cardiovascular risk factors have emerged and in particular, risk factors specific for female sex have been identified. Women are more likely to be categorized into lower risk categories for cardiovascular disease and, as a result, receive less lifestyle counseling than men, as well as less intensive prevention. This narrative review aims to analyze CVD risk prevention in asymptomatic atherosclerosis with a look at new emerging factors. In the end, we quickly analyzed the effects of the recent pandemic on lifestyle and cardiovascular risk and the potential negative effects in the long term.
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Affiliation(s)
- Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Antonio Manenti
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Farinetti
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
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17
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Al Sharie S, Araydah M, Al-Azzam S, Karasneh R, Hammoudeh AJ. The participation of Arab women in randomised clinical trials for cardiovascular diseases. Int J Clin Pract 2021; 75:e14612. [PMID: 34235821 DOI: 10.1111/ijcp.14612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Women's enrolment in randomised clinical trials (RCTs) raises the attention of medical personnel and evidence-based medicine researchers to achieve the highest possible quality and transparency of conducted studies. This study aims to demonstrate various patterns and relationships of women's enrolment in cardiovascular RCTs conducted in Arab countries. MATERIALS AND METHODS Three databases (PubMed, Web of Science and Scopus) were accessed and searched for randomised clinical trials investigating cardiovascular diseases in Arab countries. Studies were screened, data were extracted and risk of bias of included studies was assessed independently by two sets of authors. The female to male ratio and the participation prevalence ratio (PPR) were calculated for each trial and the association of them with different variables were analysed. RESULTS AND DISCUSSION Of the 9071 patients enrolled in the 71 included RCTs, 38.02% were women. Various factors such as age of participants, publication year, therapeutic class, clinical indication, prevention type, and location of trial showed a significant association with the level of women enrolment in cardiovascular randomised clinical trials in Arab countries (P-value < .05). The median female to male ratio of all the trials was 0.55. The median female: male ratio varied by clinical indications (2.33 for valvular heart diseases vs 0.5 for stroke), intervention type (0.46 for surgical procedures vs 0.52 for drugs), prevention type (0.79 for secondary prevention, 0.74 for primary prevention and 0.52 for tertiary prevention), sample size (0.48 for Q1 vs 0.85 for Q2) and by age groups (0.98 for ages ≤50 years old vs 0.47 for 56-60 years old). Women were overrepresented in valvular heart disease trials (PPR = 1.37), and underrepresented in coronary artery disease, stroke and atrial fibrillation trials (PPR = 0.6, 0.63, and 0.71, respectively). CONCLUSION As a result of the huge importance of RCTs in the medical field, and to reduce biases arising from inaccurate representation of different study populations, women's enrolment in Arab cardiovascular trials should be pre-planned and based on the percentage of women among the studied disease population.
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Affiliation(s)
| | | | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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18
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Adorni R, Zanatta F, D’Addario M, Atella F, Costantino E, Iaderosa C, Petarle G, Steca P. Health-Related Lifestyle Profiles in Healthy Adults: Associations with Sociodemographic Indicators, Dispositional Optimism, and Sense of Coherence. Nutrients 2021; 13:nu13113778. [PMID: 34836035 PMCID: PMC8624048 DOI: 10.3390/nu13113778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/16/2021] [Accepted: 10/22/2021] [Indexed: 01/20/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. Promoting healthy behaviors throughout life is an essential prevention tool. This study investigated the associations among lifestyle profiles (including diet, alcohol consumption, physical activity, cigarette smoking, and cardiovascular screening), sociodemographic factors (gender, age, education, and family history of CVDs), and psychological factors (sense of coherence and dispositional optimism). In total, 676 healthy adults (mean age = 35 years; range = 19-57; 46% male) participated in an online survey. Lifestyle profiles were identified through cluster analysis, and a multinomial logistic regression was then performed to explore their association with sociodemographic and psychological variables. Results show that men were more likely than women to belong to the lifestyle profile with the highest amount of physical activity (OR = 2.40; p < 0.001) and the greatest attention to cardiovascular screening (OR = 2.09; p < 0.01). Lower dispositional optimism was associated with the profile paying the greatest attention to cardiovascular screening (OR = 0.67; p < 0.05). Sense of coherence, in terms of lower comprehensibility (OR = 0.67; p < 0.05) and higher manageability (OR = 1.43; p < 0.05), was associated with the lifestyle profile characterized by an unhealthy diet, sedentary lifestyle, and nonsmoking. This study shed light on factors associated with different co-occurring health-related behaviors that should be considered in planning effective communication strategies promoting adherence to health claims.
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19
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Association between Big Five Personality Traits and Participation in Cardiac Rehabilitation in Japanese Patients with Cardiovascular Disease: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168589. [PMID: 34444339 PMCID: PMC8392722 DOI: 10.3390/ijerph18168589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/16/2022]
Abstract
Cardiac rehabilitation (CR) remains underutilised, despite its established clinical benefit. A personality traits assessment may help promote CR implementation, as they are determinants of health-related behaviour. This study aimed to examine the association between the Big Five personality traits and outpatient CR participation in patients with cardiovascular disease (CVD) after discharge. This retrospective cohort study included 163 patients aged <80 years, who underwent inpatient CR when hospitalised for CVD. The Big Five personality traits (conscientiousness, neuroticism, openness, extraversion, and agreeableness) of each patient were evaluated at discharge, using the Japanese version of the Ten-Item Personality Inventory. We examined the relationship of each personality trait with non-participation in outpatient CR and dropout within three months, using logistic regression analysis. Out of 61 patients who initiated the outpatient CR, 29 patients dropped out, leaving us with 32 subjects. The logistic regression analysis results showed that high conscientiousness was associated with non-participation in CR. The primary reason for this was a lack of motivation. Conversely, low conscientiousness and high openness were predictors of dropout. This study suggests that the assessment of the Big Five personality traits, especially conscientiousness and openness, can help improve health communication with patients to promote outpatient CR participation after discharge.
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20
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Mattioli AV, Farinetti A. Comment on "Western Dietary Pattern Antioxidant Intakes and Oxidative Stress: Importance during the SARS-CoV-2/COVID-19 Pandemic". Adv Nutr 2021; 12:1044-1045. [PMID: 34059884 PMCID: PMC8166548 DOI: 10.1093/advances/nmab029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/08/2021] [Accepted: 02/25/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Alberto Farinetti
- From the Surgical, Medical and Dental Department of
Morphological Sciences related to Transplant, Oncology and Regenerative
Medicine, University of Modena and Reggio Emilia, Modena,
Italy
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21
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Mattioli AV, Sciomer S, Maffei S, Gallina S. Lifestyle and Stress Management in Women During COVID-19 Pandemic: Impact on Cardiovascular Risk Burden. Am J Lifestyle Med 2021; 15:356-359. [PMID: 34025328 PMCID: PMC8120604 DOI: 10.1177/1559827620981014] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
CoV-19/SARS-CoV-2 (coronavirus 2019/severe acute respiratory syndrome coronavirus 2) is a virus that has caused a pandemic with high numbers of deaths worldwide. To contain the diffusion of infection, several governments have enforced restrictions on outdoor activities on the population. Today, we are witnessing the so-called "second wave" COVID-19 (coronavirus disease 2019) with an increasing number of cases similar to the one reported at the beginning of the current year. It is plausible that further restrictions will be applied to contain the "second wave" of infections. The present commentary evaluated the effects of stress on lifestyle during the COVID-19 pandemic in women. We briefly suggest practical recommendations for women to reduce stress and recovery for a healthy lifestyle after quarantine. Quarantine is associated with stress and depression, which lead to unhealthy lifestyle, including unhealthy diet, smoking, alcohol, and reduced physical activity. Women are more likely to suffer from depression and stress and quarantine has acted as a trigger. The prolongation of the COVID-19 pandemic around the world requires decisive action to correct the unhealthy lifestyle that has developed in recent months.
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Affiliation(s)
- Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Susanna Sciomer
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University, Roma, Italy
| | - Silvia Maffei
- Cardiovascular and Gynaecological Endocrinology Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Italy
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22
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Barrett S, Rodda K, Begg S, O'Halloran PD, Kingsley MI. Exercise and COVID-19: reasons individuals sought coaching support to assist them to increase physical activity during COVID-19. Aust N Z J Public Health 2021; 45:133-137. [PMID: 33683771 PMCID: PMC8251065 DOI: 10.1111/1753-6405.13089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/01/2020] [Accepted: 01/01/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE This paper explores the experiences of individuals who reported substantially decreasing physical activity (PA) as a result of COVID-19 and sought coaching support to increase PA. METHODS A qualitative study using phenomenological analysis. Eight individuals participated in semi-structured interviews that focused on their experiences of decreasing PA as a result of physical distancing measures, and why they sought PA coaching to overcome these issues. Responses were analysed thematically. RESULTS The participants reported markedly decreasing their PA following the enactment of physical distancing measures. The inability to subsequently engage in regular PA was a source of frustration for participants. Interview analysis revealed two themes that contributed to the understanding of why these individuals felt they needed PA coaching to increase PA; namely, a desire for both listening support and PA self-regulation support. CONCLUSION The individuals who decreased PA due to COVID-19 desired an autonomy-supportive counselling style, centred on listening support and self-regulatory support. Online PA interventions were not highlighted as strategies to overcome PA barriers. Implications for public health: The effect of physical distancing measures on the determinants of overall PA is important, particularly if prolonged physical distancing is required.
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Affiliation(s)
- Stephen Barrett
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria,Health Promotion Department, Bendigo Health Care Group, Bendigo, Victoria
| | - Kane Rodda
- Outpatient Rehabilitation Services, Bendigo Health Care Group, Bendigo, Victoria
| | - Stephen Begg
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria
| | - Paul D. O'Halloran
- School of Psychology and Public Health, La Trobe University. Bundoora, Victoria
| | - Michael I. Kingsley
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria,Department of Exercise Sciences, University of Auckland, Newmarket, New Zealand,Correspondence to: Professor Michael Kingsley, Holsworth Research Initiative, La Trobe University, Victoria
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Cocchi C, Coppi F, Farinetti A, Mattioli AV. Cardiovascular disease prevention and therapy in women with Type 2 diabetes. Future Cardiol 2021; 17:487-496. [PMID: 33739145 DOI: 10.2217/fca-2021-0011] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death among men and women, although women are usually underdiagnosed and experience a delay in diagnosis. This also occurs in women with type 2 diabetes mellitus, despite the fact that diabetes is recognized as a major cardiovascular risk factor. Several factors influence the gap between diagnosis and treatment of cardiovascular disease in women: lack of perception of cardiovascular risk, effects of sex-related risk factors and the action of drugs in women. Women with Type 2 diabetes mellitus are more likely to be assigned a lower CVD risk category and to receive lifestyle counseling as well as less intensive CVD therapy compared with men. The present narrative review aims to analyze the risk of CVD in women with Type 2 diabetes mellitus and whether there is a difference between men and women in the efficacy of SGLT-2 inhibitors, new hypoglycemic drugs.
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Affiliation(s)
- Camilla Cocchi
- Istituto Nazionale per le Ricerche Cardiovascolari, University of Modena & Reggio Emilia, 41124 Modena, Italy
| | - Francesca Coppi
- Cardiology Division, Policlinico di Modena, 41124 Modena, Italy
| | - Alberto Farinetti
- Department of Medical & Surgical Sciences for Children & Adults, University of Modena & Reggio Emilia, 41124 Modena, Italy
| | - Anna Vittoria Mattioli
- Istituto Nazionale per le Ricerche Cardiovascolari, University of Modena & Reggio Emilia, 41124 Modena, Italy.,Surgical, Medical & Dental Department of Morphological Sciences Related to Transplant, Oncology & Regenerative Medicine, University of Modena & Reggio Emilia, 41124 Modena, Italy
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Ogura A, Izawa KP, Tawa H, Kureha F, Wada M, Harada N, Ikeda Y, Kimura K, Kondo N, Kanai M, Kubo I, Yoshikawa R, Matsuda Y. Impact of the COVID-19 pandemic on phase 2 cardiac rehabilitation patients in Japan. Heart Vessels 2021; 36:1184-1189. [PMID: 33512598 PMCID: PMC7844103 DOI: 10.1007/s00380-021-01783-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/08/2021] [Indexed: 11/22/2022]
Abstract
This study aimed to clarify the effects of the interruption of cardiac rehabilitation (CR) and refraining from going outside due to the COVID-19 pandemic on hemodynamic response and rating of perceived exertion (RPE) during exercise including differences by age in phase 2 CR outpatients. Among 76 outpatients participating in consecutive phase 2 CR in both periods from March to April and June to July 2020, which were before and after CR interruption, respectively, at Sanda City Hospital were enrolled. The inclusion criterion was outpatients whose CR was interrupted due to COVID-19. We compared the data of hemodynamic response and RPE during exercise on the last day before interruption and the first day after interruption when aerobic exercise was performed at the same exercise intensity in the < 75 years group and ≥ 75 years group. Fifty-three patients were enrolled in the final analysis. Post-CR interruption, peak heart rate increased significantly (p = 0.009) in the < 75 years group, whereas in the ≥ 75 years group, weight and body mass index decreased significantly (p = 0.009, 0.011, respectively) and Borg scale scores for both dyspnea and lower extremities fatigue worsened significantly (both, p < 0.001). CR interruption and refraining from going outside due to the COVID-19 pandemic affected the hemodynamic response, RPE during exercise and body weight in phase 2 CR outpatients. In particular, patients aged ≥ 75 years appeared to be placed at an increased risk of frailty.
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Affiliation(s)
- Asami Ogura
- Department of Rehabilitation, Sanda City Hospital, Sanda, Japan.,Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan.,Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
| | - Kazuhiro P Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan. .,Cardiovascular Stroke Renal Project (CRP), Kobe, Japan.
| | - Hideto Tawa
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
| | - Fumie Kureha
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
| | - Masaaki Wada
- Department of Rehabilitation, Sanda City Hospital, Sanda, Japan
| | - Nobuko Harada
- Department of Nursing, Sanda City Hospital, Sanda, Japan
| | - Yuki Ikeda
- Department of Nursing, Sanda City Hospital, Sanda, Japan
| | - Kaemi Kimura
- Department of Nursing, Sanda City Hospital, Sanda, Japan
| | - Naomi Kondo
- Department of Nursing, Sanda City Hospital, Sanda, Japan
| | - Masashi Kanai
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan.,Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
| | - Ikko Kubo
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan.,Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
| | | | - Yuichi Matsuda
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
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Nasi M, D'alisera R, Cossarizza A, Guerra E, Savino G, Mattioli AV. Sex Difference in Access to Sports: A 1-Year Retrospective Study. Am J Lifestyle Med 2020; 15:108-112. [PMID: 33456422 DOI: 10.1177/1559827620911610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose. Regular physical activity is a cornerstone in the prevention and treatment of cardiovascular disease thanks to its anti-inflammatory effects. Thus, favoring the access to sports is of importance for promoting well-being. The aim of the present study was to investigate how the practice of different sports is distributed among different age groups and between men and women, by taking a picture of the medical certificate request in 2017 for sports in the population of the province of Modena, Italy. Methods. We analyzed the difference in distribution of requested medical certificate from 18 874 males and 7625 females stratified for age (<18 years, 18-40 years, and >40 years) and for different sporting disciplines (athletics, football, bike, swimming, basketball, volleyball, tennis, other team sports, other individual sports, and disabled sports). Results. Men requested medical certificates more than women (more than 2.5 times). The distribution of requested certificates differs significantly (chi-square test P < .0001) at different ages and between males and females of same age. Certificate for men aged less than 18 years were 7550 and for women were 4131 and the difference increase with age. Conclusions. In order to decrease the imbalance between men and women access to sports, it is mandatory to promote a healthy lifestyle and reduce, as consequence, cardiovascular risks, mostly in women after 40 years.
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Affiliation(s)
- Milena Nasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
| | - Roberta D'alisera
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
| | - Andrea Cossarizza
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
| | - Emanuele Guerra
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
| | - Gustavo Savino
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
| | - Anna Vittoria Mattioli
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy (MN, AVM).,National Health Service, Unit of Sports Medicine, Department of Public Health, AUSL Modena, Modena, Italy (RD, EG, GS).,Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy (AC)
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26
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Study on the Correlation between Continuity of Care and Quality of Life for Patients with Coronary Heart Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239125. [PMID: 33297393 PMCID: PMC7730628 DOI: 10.3390/ijerph17239125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 12/16/2022]
Abstract
Background: As coronary heart disease (CHD) is a highly complex disease, complex continuity of care (CoC) service should be provided for the patients, and the quality of life (QoL) needs to be regarded as an important measuring indicator for the health-care outcome. Purpose: To understand the general situation of CHD QoL and important predictors. Method: A cross-sectional study design was adopted from August 2019 to July 2020 by structured questionnaires. A total of 163 patients were enrolled, and data were statistically analyzed using SPSS 25.0. Result: The average score of the QoL questionnaire is 56.56/80, and the CoC is 4.32. The overall regression model can explain 58.7% of the variance regarding QoL. Patients’ instrumental activities of daily living (IADLs) (26.1%), age (18.1%), living situation (7%), information transfer (4.8%), main source of income (1.8%), and risk of disability are significantly different from their overall QoL in depression (0.9%). Conclusions: In order to improve the QoL of patients, it is suggested that medical teams should assess the needs of patients immediately upon hospitalization, provide patients with individual CoC, encourage them to participate in community health promotion activities, and strengthen the function of IADL to improve the QoL of patients.
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27
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Mattioli AV, Pinti M, Farinetti A, Nasi M. Obesity risk during collective quarantine for the COVID-19 epidemic. OBESITY MEDICINE 2020; 20:100263. [PMID: 32838051 PMCID: PMC7282788 DOI: 10.1016/j.obmed.2020.100263] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 12/22/2022]
Abstract
In March 2020, when COVID-19 epidemics involved several countries, the WHO defined the infection as a pandemic. Government adopted measures to prevent the diffusion of infection; i.e. quarantine and isolation. One of the consequences of quarantine-induced stress is a change in lifestyle and eating habits leading to obesity. The present commentary briefly analyzes the effects of quarantine on obesity.
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Affiliation(s)
- Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Via Del Pozzo, 71 41124, Modena, Italy
| | - Marcello Pinti
- Department of Life Science, University of Modena and Reggio Emilia, Via Campi, 287 41124, Modena, Italy
| | - Alberto Farinetti
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Via Del Pozzo, 71 41124, Modena, Italy
| | - Milena Nasi
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Via Del Pozzo, 71 41124, Modena, Italy
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28
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Đogaš Z, Lušić Kalcina L, Pavlinac Dodig I, Demirović S, Madirazza K, Valić M, Pecotić R. The effect of COVID-19 lockdown on lifestyle and mood in Croatian general population: a cross-sectional study. Croat Med J 2020. [PMID: 32881428 PMCID: PMC7480750 DOI: 10.3325/cmj.2020.61.309] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim To investigate the effect of the coronavirus 2019 (COVID-19) lockdown on lifestyle behaviors and mood changes in the Croatian general population. Methods During ten days of the COVID-19 lockdown in Croatia, 3027 respondents (70.3% female) from the general population completed an online, self-report questionnaire. Demographic data and data on lifestyle habits and mood changes before and during the COVID-19 lockdown were collected. Results A total of 95.64% of respondents reported to follow most or all restrictions, with female sex (P < 0.001) and higher education level (P < 0.001) being associated with higher restriction compliance. Women smoked an increased number of cigarettes (P < 0.001). The proportion of respondents of both sexes who did not drink or drank 7 drinks per week or more increased (P < 0.001). Women also reported lower frequency (P = 0.001) and duration of physical exercise (P < 0.001). In total, 30.7% of respondents gained weight, with female sex (OR, 2.726) and higher BMI (OR, 1.116; both P < 0.001) being associated with an increased likelihood of gaining weight. Both men and women felt more frequently afraid (P < 0.001), discouraged (P < 0.001), and sad (P < 0.001). Conclusion Public health authorities should promote the adoption of healthy lifestyles in order to reduce long-term negative effects of the lockdown.
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Affiliation(s)
- Zoran Đogaš
- Zoran Đogaš, Department of Neuroscience, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia,
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29
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Sciomer S, Moscucci F. Menopausal hormone therapy and breast cancer risk: the cardiological point of view. J Cardiovasc Med (Hagerstown) 2020; 21:538-539. [DOI: 10.2459/jcm.0000000000000969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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30
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Oreel TH, Nieuwkerk PT, Hartog ID, Netjes JE, Vonk ABA, Lemkes J, van Laarhoven HWM, Scherer-Rath M, Sprangers MAG, Henriques JPS. Gender differences in quality of life in coronary artery disease patients with comorbidities undergoing coronary revascularization. PLoS One 2020; 15:e0234543. [PMID: 32555617 PMCID: PMC7299316 DOI: 10.1371/journal.pone.0234543] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/27/2020] [Indexed: 12/18/2022] Open
Abstract
In comparison to male patients with coronary artery disease, female patients suffer from more comorbidities, experience symptoms of coronary artery disease differently and report poorer health-related quality of life (HRQoL) after coronary revascularization. However, there is limited data on the impact of comorbidity burden on the recovery in HRQoL in female and male patients. We investigated the impact of comorbidity burden on the change in HRQoL following coronary revascularization in female patients versus male patients. 230 patients (60 female) with coronary artery disease were assessed before, and two weeks, three months and six months after coronary revascularization. Disease-specific HRQoL was measured with the Short-Form Seattle Angina Questionnaire. Physical and mental health was measured with the Short-Form Health Survey. Comorbidity burden was assessed by the total number of identified comorbidity conditions and by the Charlson comorbidity score. Linear mixed models were used to estimate the effects of time, gender and comorbidity burden on HRQoL. Whereas HRQoL improved after coronary revascularization in all patients, female patients reported poorer physical health and disease-specific HRQoL and their physical health improved more slowly than male patients. A higher comorbidity burden was related with poorer physical health and disease-specific HRQoL in male patients, but not in female patients. A higher comorbidity burden was associated with slower improvement in HRQoL for both female and male patients. Female patients reported poorer HRQoL and their physical health improved more slowly after coronary revascularization, irrespective of comorbidity burden. Higher comorbidity burden was associated with poorer physical health and disease-specific HRQoL in male patients only. Our results indicate that female and male patients recover differently after coronary revascularization. These findings highlight the importance of comorbidity- and gender-specific approaches for evaluating coronary artery disease and coronary revascularization procedures.
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Affiliation(s)
- Tom H. Oreel
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- * E-mail:
| | - Pythia T. Nieuwkerk
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Iris D. Hartog
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Faculty of Philosophy, Theology and Religious Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Justine E. Netjes
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Alexander B. A. Vonk
- Department of Cardio-thoracic Surgery, Amsterdam University Medical Centers, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jorrit Lemkes
- Department of Cardiology, Amsterdam University Medical Centers, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke W. M. van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology and Religious Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Mirjam A. G. Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - José P. S. Henriques
- Department of Cardiology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Mattioli AV, Farinetti A. Espresso coffee, caffeine and colon cancer. World J Gastrointest Oncol 2020; 12:601-603. [PMID: 32461791 PMCID: PMC7235187 DOI: 10.4251/wjgo.v12.i5.601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/10/2020] [Accepted: 05/05/2020] [Indexed: 02/05/2023] Open
Abstract
The present letter to editor is related to “Cui WQ, Wang ST, Pan D, Chang B, Sang LX. Caffeine and its main targets of colorectal cancer. World J Gastrointest Oncol 2020; 12(2): 149-172 [DOI: 10.4251/wjgo.v12.i2.149]”.
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Affiliation(s)
- Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena 41124, Italy
| | - Alberto Farinetti
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena 41124, Italy
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COVID-19 pandemic: the effects of quarantine on cardiovascular risk. Eur J Clin Nutr 2020; 74:852-855. [PMID: 32371988 PMCID: PMC7199203 DOI: 10.1038/s41430-020-0646-z] [Citation(s) in RCA: 176] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 02/06/2023]
Abstract
COVID-19 is causing a global pandemic with a high number of deaths and infected people. To contain the diffusion of COVID-19 virus, Governments have enforced restrictions on outdoor activities or even collective quarantine on the population. One important consequence of quarantine is a change in lifestyle: reduced physical activity and unhealthy diet. 2019 guidelines for primary prevention of cardiovascular disease indicate that “Adults should engage in at least 150 minute per week of accumulated moderate-intensity or 75 minute per week of vigorous-intensity aerobic physical activity (or an equivalent combination of moderate and vigorous activity) to reduce ASCVD risk.” During quarantine, strategies to further increase home-based physical activity and to follow a healthy diet should be implemented. Quarantine carries some long-term effects on cardiovascular disease, mainly related to unhealthy lifestyle and anxiety. Following quarantine a global action supporting healthy diet and physical activity is mandatory to encourage people to return to good lifestyle.
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Association between Post-Diagnosis Particulate Matter Exposure among 5-Year Cancer Survivors and Cardiovascular Disease Risk in Three Metropolitan Areas from South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082841. [PMID: 32326144 PMCID: PMC7215375 DOI: 10.3390/ijerph17082841] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022]
Abstract
Cancer survivors are at an increased risk for cardiovascular disease (CVD). However, the association between particulate matter (PM) and CVD risk among cancer survivors (alive >5 years since diagnosis) is unclear. We investigated the risk of CVD among 40,899 cancer survivors within the Korean National Health Insurance Service database. Exposure to PM was determined by assessing yearly average PM levels obtained from the Air Korea database from 2008 to 2011. PMs with sizes <2.5 (PM2.5), <10 (PM10), or 2.5-10 (PM2.5-10) μm in diameter were compared, with each PM level exposure further divided into quintiles. Patients were followed up from January 2012 to date of CVD event, death, or December 2017, whichever came earliest. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated using Cox proportional hazards regression by PM exposure levels. Compared with cancer survivors in the lowest quintile of PM2.5 exposure, those within the highest quintile had a greater risk for CVD (aHR 1.31, 95% CI 1.07-1.59). Conversely, increasing PM10 and PM2.5-10 levels were not associated with increased CVD risk (p for trend 0.078 and 0.361, respectively). Cancer survivors who reduce PM2.5 exposure may benefit from lower risk of developing CVD.
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Mattioli AV, Nasi M, Coppi F, Gelmini R, Farinetti A. Relationship between socioeconomic status and asymptomatic peripheral arterial disease: a retrospective study. J Cardiovasc Med (Hagerstown) 2020; 21:720-721. [PMID: 32251079 DOI: 10.2459/jcm.0000000000000960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Anna V Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia
| | - Milena Nasi
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia
| | | | - Roberta Gelmini
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia
| | - Alberto Farinetti
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia
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35
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Obesogenic Lifestyle and Its Influence on Adiposity in Children and Adolescents, Evidence from Mexico. Nutrients 2020; 12:nu12030819. [PMID: 32204522 PMCID: PMC7146202 DOI: 10.3390/nu12030819] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/10/2020] [Accepted: 03/13/2020] [Indexed: 12/16/2022] Open
Abstract
Overweight (OW) and obesity (OB) during childhood/adolescence are major public health problems in Mexico. Several obesogenic lifestyle (OL) risk factors have been identified, but the burden and consequences of them in Mexican children/adolescents remain unclear. The objective of this study was to estimate the prevalence of OL components and describe their relationships with adiposity, and OW/OB. A population-based cross-sectional study of Mexican children/adolescents with nutritional assessment, data collection on daily habits and adiposity as fat-mass index (FMI) by dual-energy X-ray absorptiometry was performed. Individual OL-components: “inactivity,” “excessive screen time,” “insufficient sleep,” “unhealthy-diet”, were defined according to non-adherence to previously published healthy recommendations. Results: 1449 subjects were assessed between March 2015 to April 2018. Sixteen percent of subjects had all four OL-components, 40% had three, 35% had two, 9% had one, and 0.5% had none. A cumulative OL score showed a significant dose–response effect with FMI. The combination of inactivity, excessive screen time, and insufficient sleep showed the highest risk association to OW/OB and higher values of FMI. Conclusions: The prevalence of OL-components was extremely high and associated with increased adiposity and OW/OB. Several interventions are needed to revert this major public health threat.
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Lagerweij GR, Brouwers L, De Wit GA, Moons K, Benschop L, Maas A, Franx A, Wermer M, Roeters van Lennep JE, van Rijn BB, Koffijberg H. Impact of preventive screening and lifestyle interventions in women with a history of preeclampsia: A micro-simulation study. Eur J Prev Cardiol 2020; 27:1389-1399. [PMID: 32054298 DOI: 10.1177/2047487319898021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Preeclampsia is a female-specific risk factor for the development of future cardiovascular disease. Whether early preventive cardiovascular disease risk screenings combined with risk-based lifestyle interventions in women with previous preeclampsia are beneficial and cost-effective is unknown. METHODS A micro-simulation model was developed to assess the life-long impact of preventive cardiovascular screening strategies initiated after women experienced preeclampsia during pregnancy. Screening was started at the age of 30 or 40 years and repeated every five years. Data (initial and follow-up) from women with a history of preeclampsia was used to calculate 10-year cardiovascular disease risk estimates according to Framingham Risk Score. An absolute risk threshold of 2% was evaluated for treatment selection, i.e. lifestyle interventions (e.g. increasing physical activity). Screening benefits were assessed in terms of costs and quality-adjusted-life-years, and incremental cost-effectiveness ratios compared with no screening. RESULTS Expected health outcomes for no screening are 27.35 quality-adjusted-life-years and increase to 27.43 quality-adjusted-life-years (screening at 30 years with 2% threshold). The expected costs for no screening are €9426 and around €13,881 for screening at 30 years (for a 2% threshold). Preventive screening at 40 years with a 2% threshold has the most favourable incremental cost-effectiveness ratio, i.e. €34,996/quality-adjusted-life-year, compared with other screening scenarios and no screening. CONCLUSIONS Early cardiovascular disease risk screening followed by risk-based lifestyle interventions may lead to small long-term health benefits in women with a history of preeclampsia. However, the cost-effectiveness of a lifelong cardiovascular prevention programme starting early after preeclampsia with risk-based lifestyle advice alone is relatively unfavourable. A combination of risk-based lifestyle advice plus medical therapy may be more beneficial.
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Affiliation(s)
- G R Lagerweij
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.,Netherlands Heart Institute, the Netherlands
| | - L Brouwers
- Netherlands Heart Institute, the Netherlands.,Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, the Netherlands
| | - G A De Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.,Centre for Nutrition, Prevention and Healthcare, National Institute for Public Health and the Environment, the Netherlands
| | - Kgm Moons
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - L Benschop
- Netherlands Heart Institute, the Netherlands.,Department of Obstetrics and Gynecology, Erasmus MC, the Netherlands
| | - Ahem Maas
- Department of Cardiology, Radboud University Medical Center, the Netherlands
| | - A Franx
- Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, the Netherlands
| | - Mjh Wermer
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | | | - B B van Rijn
- Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, the Netherlands
| | - H Koffijberg
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.,Department of Health Technology and Services Research, University of Twente, the Netherlands
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37
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Mattioli AV, Sciomer S, Moscucci F, Maiello M, Cugusi L, Gallina S, Dei Cas A, Lombardi C, Pengo M, Parati G, Barilla F, Ciccone MM, Palmiero P, Mercuro G, Maffei S. Cardiovascular prevention in women: a narrative review from the Italian Society of Cardiology working groups on 'Cardiovascular Prevention, Hypertension and peripheral circulation' and on 'Women Disease'. J Cardiovasc Med (Hagerstown) 2020; 20:575-583. [PMID: 31246698 DOI: 10.2459/jcm.0000000000000831] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in women.Some authors highlighted that the female risk profile consists of traditional and emerging risk factors. Despite the lower prevalence of type 2 diabetes, years of life lost owing to the disease for women are substantially higher compared with men. In addition, pregnancy complicated by gestational diabetes represents a risk factor for CVD. Women with gestational diabetes have a higher prevalence of coronary artery disease that occur at a younger age and are independent of T2DM.Hypertension is an important cardiovascular risk factor in women. Estrogens and progesterone, known to have an impact on blood pressure levels, have also been proposed to be protective against sleep-disordered breathing. It is very difficult to understand whereas obstructive sleep apnea in women is independently associated with hypertension or if many confounders acting at different stages of the woman lifespan mediate this relation.The cardioprotective effect of physical activity in women of all ages is well known. Women are generally more physically inactive than men. During and after menopause, most women tend to reduce their physical activity levels and together with the reduction in basal metabolic rate, women experience loss of skeletal muscle mass with a negative change in the ratio of fat-to-lean mass.In conclusion, sex differences in the cardiovascular system are because of dissimilarities in gene expression and sex hormones; these result in variations in prevalence and presentation of CVD and associated conditions, such as diabetes, hypertension and vascular and cardiac remodeling.Changes in lifestyle and increase in physical activity could help in prevention of cardiovascular disease in women.
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Affiliation(s)
- Anna Vittoria Mattioli
- Department of Surgical, Medical and Dental Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia
| | - Susanna Sciomer
- Department of Cardiovascular, Respiratory Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University
| | - Federica Moscucci
- Department of Cardiovascular, Respiratory Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University
| | - Maria Maiello
- ASL Brindisi, Cardiology Equipe, District of Brindisi
| | - Lucia Cugusi
- Department of Medical Sciences and Public Health, University of Cagliari
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti
| | - Alessandra Dei Cas
- Endocrinology and Metabolism, Department of Clinical and Experimental Medicine, University of Parma
| | - Carolina Lombardi
- Department of Cardiovascular, Neural and Metabolic Sciences, S.Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan
| | - Martino Pengo
- Department of Cardiovascular, Neural and Metabolic Sciences, S.Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, S.Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan
| | - Francesco Barilla
- Department of Cardiovascular, Respiratory Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University
| | - Marco Matteo Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University 'A. Moro' of Bari
| | - Pasquale Palmiero
- Department of Cardiovascular, Respiratory Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari
| | - Silvia Maffei
- Cardiovascular and Gynaecological Endocrinology Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
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38
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Nasi M, Patrizi G, Pizzi C, Landolfo M, Boriani G, Dei Cas A, Cicero AFG, Fogacci F, Rapezzi C, Sisca G, Capucci A, Vitolo M, Galiè N, Borghi C, Berrettini U, Piepoli M, Mattioli AV. The role of physical activity in individuals with cardiovascular risk factors: an opinion paper from Italian Society of Cardiology-Emilia Romagna-Marche and SIC-Sport. J Cardiovasc Med (Hagerstown) 2020; 20:631-639. [PMID: 31436678 DOI: 10.2459/jcm.0000000000000855] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
: Regular physical activity is a cornerstone in the prevention and treatment of atherosclerotic cardiovascular disease (CVD) due to its positive effects in reducing several cardiovascular risk factors. Current guidelines on CVD suggest for healthy adults to perform at least 150 min/week of moderate intensity or 75 min/week of vigorous intensity aerobic physical activity. The current review explores the effects of physical activity on some risk factors, specifically: diabetes, dyslipidemia, hypertension and hyperuricemia. Physical activity induces an improvement in insulin sensitivity and in glucose control independently of weight loss, which may further contribute to ameliorate both diabetes-associated defects. The benefits of adherence to physical activity have recently proven to extend beyond surrogate markers of metabolic syndrome and diabetes by reducing hard endpoints such as mortality. In recent years, obesity has greatly increased in all countries. Weight losses in these patients have been associated with improvements in many cardiometabolic risk factors. Strategies against obesity included caloric restriction, however greater results have been obtained with association of diet and physical activity. Similarly, the beneficial effect of training on blood pressure via its action on sympathetic activity and on other factors such as improvement of endothelial function and reduction of oxidative stress can have played a role in preventing hypertension development in active subjects. The main international guidelines on prevention of CVD suggest to encourage and to increase physical activity to improve lipid pattern, hypertension and others cardiovascular risk factor. An active action is required to the National Society of Cardiology together with the Italian Society of Sports Cardiology to improve the prescription of organized physical activity in patients with CVD and/or cardiovascular risk factors.
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Affiliation(s)
- Milena Nasi
- Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
| | | | - Carmine Pizzi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum
| | - Matteo Landolfo
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | - Giuseppe Boriani
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena
| | - Alessandra Dei Cas
- Endocrinology and Metabolism, Department of Clinical and Experimental Medicine, University of Parma, Parma
| | - Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | - Federica Fogacci
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | - Claudio Rapezzi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum
| | - Giovanbattista Sisca
- Bologna F.C.,FIFA Medical Centre of Excellence, Isokinetic Medical Group, Bologna
| | | | - Marco Vitolo
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena
| | - Nazzareno Galiè
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum
| | - Claudio Borghi
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | | | - Massimo Piepoli
- Heart Failure Unit, Cardiology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Anna V Mattioli
- Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
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Dietary and Plasma Carboxymethyl Lysine and Tumor Necrosis Factor-α as Mediators of Body Mass Index and Waist Circumference among Women in Indonesia. Nutrients 2019; 11:nu11123057. [PMID: 31847322 PMCID: PMC6950749 DOI: 10.3390/nu11123057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/26/2019] [Accepted: 12/02/2019] [Indexed: 02/02/2023] Open
Abstract
Dietary and plasma carboxymethyl lysine (dCML, pCML) and plasma tumor necrosis factor-α (pTNF-α) may be associated with obesity in affluent society. However, evidence in women from low-middle income countries with predominantly traditional diets is lacking. We investigated the mediator effects of dCML, pCML and pTNF-α on body mass index (BMI) and waist circumference (WC) among Indonesian women. A cross-sectional study was conducted among 235 non-diabetic, non-anemic and non-smoking women aged 19–50 years from selected mountainous and coastal areas of West Sumatra and West Java. Dietary CML, pCML, pTNF-α were obtained from 2 × 24-h recalls, ultra-performance liquid chromatography-tandem mass spectrometry and enzyme-linked immunosorbent assay, respectively. Between-group differences were analyzed by the Chi-square or Mann-Whitney test and mediator effects by Structural Equation Modeling. The medians and interquartile-ranges of dCML, pCML and pTNF-α were 2.2 (1.7–3.0) mg/day, 22.2 (17.2–28.2) ng/mL and 0.68 (0.52–1.00) IU/mL, respectively, and significantly higher in the WC ≥ 80 cm than in the WC < 80 cm group, but not in BMI ≥ 25 kg/m2 compared to BMI < 25 kg/m2 group. Plasma CML and pTNF-α were positively and directly related to WC (β = 0.21 [95% CI: 0.09, 0.33] and β = 0.23 [95% CI: 0.11, 0.35], respectively). Dietary CML that correlated with dry-heat processing and cereals as the highest contributions was positively related to WC (β = 0.33 [95% CI: 0.12, 0.83]). Ethnicity, level of education, intake of fat, and intake of energy contributed to dCML, pCML and pTNF-α, and subsequently affected WC, while only ethnicity contributed to BMI through dCML, pCML and pTNF-α (β = 0.07 [95% CI: 0.01, 0.14]). A positive direct effect of dCML on pCML and of pCML and pTNF-α on WC was seen among Indonesian women. Dietary CML seems to have several paths that indirectly influence the increases in WC if compared to BMI. Thus, intake of CML-rich foods should be reduced, or the foods consumed in moderate amounts to avoid the risk of central obesity in this population.
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40
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Promoting Cardiovascular Health in Midlife Women. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2019. [DOI: 10.1007/s13669-019-00275-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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41
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Chedraui P, Pérez-López FR. The metabolic syndrome and diabetes are not synonymous. Climacteric 2019; 22:425. [DOI: 10.1080/13697137.2019.1605758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Peter Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Facultad Ciencias Médicas, Universidad Católica de Guayaquil, PO BOX 09-01-4671, Guayaquil, Ecuador
| | - Faustino R. Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain
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42
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Mattioli AV, Farinetti A, Gelmini R. Aspirin Use in Patients Undergoing Preoperative Evaluation for Minor Surgery. Am J Med 2019; 132:e629. [PMID: 31400799 DOI: 10.1016/j.amjmed.2019.02.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 02/23/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Anna Vittoria Mattioli
- Department of Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Farinetti
- Department of Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Roberta Gelmini
- Department of Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
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43
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Mattioli AV, Farinetti A, Gelmini R. The beneficial effect of Mediterranean diet on colorectal cancer. Int J Cancer 2019; 145:306. [PMID: 30575957 DOI: 10.1002/ijc.32082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 12/10/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Farinetti
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Roberta Gelmini
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
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