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Guo P, Fang Q, Wang Y. Associations between varicose veins and heart failure: A genetic correlation and mendelian randomization study. Medicine (Baltimore) 2024; 103:e38175. [PMID: 38758877 PMCID: PMC11098184 DOI: 10.1097/md.0000000000038175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/17/2024] [Indexed: 05/19/2024] Open
Abstract
Varicose veins and heart failure (HF) are increasingly prevalent. Although numbers of observational studies have indicated that varicose veins might contribute to the risk of HF, the causal relationship between them remains unclear due to the uncontrolled confounding factors and reverse causation bias. Therefore, this study aimed to explore the potential causal relationship between varicose veins and HF. Based on publicly released genome-wide association studies (GWAS), gene correlation was assessed using linkage disequilibrium score (LDSC) regression, and we conducted a two-sample Mendelian randomization (TSMR) analysis to infer the causal relationship. We performed the Inverse variance weighted (IVW) method as the primary analysis, and used Weighted median, MR-Egger, weighted mode, simple mode, and MR-pleiotropy residual sum and outlier (MR-PRESSO) methods to detect and correct for horizontal pleiotropy. LDSC revealed there was a positive genetic correlation between varicose veins and HF (rg = 0.1726184, Se = 0.04511803, P = .0001). The results of the IVW method indicated that genetically predicted varicose veins were associated with an increased risk of HF (odds ratio (OR) = 1.03; 95% confidence interval (CI): 1.01-1.06; P = .009). Our findings illustrated the significant causal effect of varicose veins on HF, suggesting that people with varicose veins might have a higher risk of HF. The results provided a novel and important perspective into the development mechanism of HF.
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Affiliation(s)
- Ping Guo
- Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Qin Fang
- Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Yan Wang
- Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
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Jayo-Montoya JA, Jurio-Iriarte B, Aispuru GR, Villar-Zabala B, Blanco-Guzman S, Maldonado-Martin S. Impact of Aerobic High-Intensity Interval Training Intervention and Mediterranean Diet Recommendations on Health-Related Quality of Life and Lifestyle Modification in Post-Myocardial Infarction Patients: Results From the INTERFARCT Surveys. Am J Lifestyle Med 2024; 18:389-402. [PMID: 38737886 PMCID: PMC11082858 DOI: 10.1177/15598276221087628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
This study aims to determine the impact of 2 (low vs high volume) high-intensity interval training (HIIT) programs with Mediterranean diet (MedDiet) recommendations on health-related quality of life (HRQoL) and lifestyle modification, and to examine the relationships between the changes in anxiety and depression with HRQoL and lifestyle variables after myocardial infarction (MI). Participants (n = 80) were randomized to attention control or one of the two supervised HIIT groups (2 d/weeks). Surveys before and after intervention (16 weeks): HRQoL (SF-36), anxiety and depression (HADS), MedDiet adherence (MEDAS), and physical activity (PA) and sedentary behavior (SB) levels. After intervention, there were improvements (P < .05) in HRQoL, HADS scores, and MedDiet adherence, with higher PA level in both HIIT groups with no between-HIIT group differences. The HADS score decline correlated (P < .05) with both the increase in physical component of SF-36 (r = .42), the overall metabolic expenditure (r = .26), and adherence to the MedDiet (r = .24), and the reduction in the SB (r = .35). HIIT exercise intervention with MedDiet recommendations improved HRQoL, along with reduced anxiety and depression symptoms, and a healthier lifestyle after MI. Better mental health was related to higher values of PA and MedDiet adherence.
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Affiliation(s)
- Jon A. Jayo-Montoya
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
| | - Borja Jurio-Iriarte
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
| | - Gualberto R. Aispuru
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
| | - Beatriz Villar-Zabala
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
| | - Sonia Blanco-Guzman
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
| | - Sara Maldonado-Martin
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
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Bernal-Jiménez MÁ, Calle G, Gutiérrez Barrios A, Gheorghe LL, Cruz-Cobo C, Trujillo-Garrido N, Rodríguez-Martín A, Tur JA, Vázquez-García R, Santi-Cano MJ. Effectiveness of an Interactive mHealth App (EVITE) in Improving Lifestyle After a Coronary Event: Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e48756. [PMID: 38648103 PMCID: PMC11074898 DOI: 10.2196/48756] [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: 05/06/2023] [Revised: 10/27/2023] [Accepted: 01/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Coronary heart disease is one of the leading causes of mortality worldwide. Secondary prevention is essential, as it reduces the risk of further coronary events. Mobile health (mHealth) technology could become a useful tool to improve lifestyles. OBJECTIVE This study aimed to evaluate the effect of an mHealth intervention on people with coronary heart disease who received percutaneous coronary intervention. Improvements in lifestyle regarding diet, physical activity, and smoking; level of knowledge of a healthy lifestyle and the control of cardiovascular risk factors (CVRFs); and therapeutic adherence and quality of life were analyzed. METHODS This was a randomized controlled trial with a parallel group design assigned 1:1 to either an intervention involving a smartphone app (mHealth group) or to standard health care (control group). The app was used for setting aims, the self-monitoring of lifestyle and CVRFs using measurements and records, educating people with access to information on their screens about healthy lifestyles and adhering to treatment, and giving motivation through feedback about achievements and aspects to improve. Both groups were assessed after 9 months. The primary outcome variables were adherence to the Mediterranean diet, frequency of food consumed, patient-reported physical activity, smoking, knowledge of healthy lifestyles and the control of CVRFs, adherence to treatment, quality of life, well-being, and satisfaction. RESULTS The study analyzed 128 patients, 67 in the mHealth group and 61 in the control group; most were male (92/128, 71.9%), with a mean age of 59.49 (SD 8.97) years. Significant improvements were observed in the mHealth group compared with the control group regarding adherence to the Mediterranean diet (mean 11.83, SD 1.74 points vs mean 10.14, SD 2.02 points; P<.001), frequency of food consumption, patient-reported physical activity (mean 619.14, SD 318.21 min/week vs mean 471.70, SD 261.43 min/week; P=.007), giving up smoking (25/67, 75% vs 11/61, 42%; P=.01), level of knowledge of healthy lifestyles and the control of CVRFs (mean 118.70, SD 2.65 points vs mean 111.25, SD 9.05 points; P<.001), and the physical component of the quality of life 12-item Short Form survey (SF-12; mean 45.80, SD 10.79 points vs mean 41.40, SD 10.78 points; P=.02). Overall satisfaction was higher in the mHealth group (mean 48.22, SD 3.89 vs mean 46.00, SD 4.82 points; P=.002) and app satisfaction and usability were high (mean 44.38, SD 6.18 out of 50 points and mean 95.22, SD 7.37 out of 100). CONCLUSIONS The EVITE app was effective in improving the lifestyle of patients in terms of adherence to the Mediterranean diet, frequency of healthy food consumption, physical activity, giving up smoking, knowledge of healthy lifestyles and controlling CVRFs, quality of life, and overall satisfaction. The app satisfaction and usability were excellent. TRIAL REGISTRATION Clinicaltrials.gov NCT04118504; https://clinicaltrials.gov/study/NCT04118504.
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Affiliation(s)
- María Ángeles Bernal-Jiménez
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - German Calle
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - Alejandro Gutiérrez Barrios
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - Livia Luciana Gheorghe
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - Celia Cruz-Cobo
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - Nuria Trujillo-Garrido
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - Amelia Rodríguez-Martín
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Biomedicine, Biotechnology and Public Health Department, University of Cádiz, Cádiz, Spain
| | - Josep A Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
- Network Biomedical Research Center "Pathophysiology of Obesity and Nutrition", Carlos III Health Institute, Madrid, Spain
| | - Rafael Vázquez-García
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - María José Santi-Cano
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
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Darabi P, Gharibzadeh S, Khalili D, Bagherpour-Kalo M, Janani L. Optimizing cardiovascular disease mortality prediction: a super learner approach in the tehran lipid and glucose study. BMC Med Inform Decis Mak 2024; 24:97. [PMID: 38627734 PMCID: PMC11020797 DOI: 10.1186/s12911-024-02489-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/22/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND & AIM Cardiovascular disease (CVD) is the most important cause of death in the world and has a potential impact on health care costs, this study aimed to evaluate the performance of machine learning survival models and determine the optimum model for predicting CVD-related mortality. METHOD In this study, the research population was all participants in Tehran Lipid and Glucose Study (TLGS) aged over 30 years. We used the Gradient Boosting model (GBM), Support Vector Machine (SVM), Super Learner (SL), and Cox proportional hazard (Cox-PH) models to predict the CVD-related mortality using 26 features. The dataset was randomly divided into training (80%) and testing (20%). To evaluate the performance of the methods, we used the Brier Score (BS), Prediction Error (PE), Concordance Index (C-index), and time-dependent Area Under the Curve (TD-AUC) criteria. Four different clinical models were also performed to improve the performance of the methods. RESULTS Out of 9258 participants with a mean age of (SD; range) 43.74 (15.51; 20-91), 56.60% were female. The CVD death proportion was 2.5% (228 participants). The death proportion was significantly higher in men (67.98% M, 32.02% F). Based on predefined selection criteria, the SL method has the best performance in predicting CVD-related mortality (TD-AUC > 93.50%). Among the machine learning (ML) methods, The SVM has the worst performance (TD-AUC = 90.13%). According to the relative effect, age, fasting blood sugar, systolic blood pressure, smoking, taking aspirin, diastolic blood pressure, Type 2 diabetes mellitus, hip circumference, body mss index (BMI), and triglyceride were identified as the most influential variables in predicting CVD-related mortality. CONCLUSION According to the results of our study, compared to the Cox-PH model, Machine Learning models showed promising and sometimes better performance in predicting CVD-related mortality. This finding is based on the analysis of a large and diverse urban population from Tehran, Iran.
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Affiliation(s)
- Parvaneh Darabi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran.
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrdad Bagherpour-Kalo
- Department of Epidemiology and Biostatistics, School of Public health, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK.
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Höld E, Chmelar S, Aubram T, Leitner G, Nehrer S, Neubauer O, Wagner KH, Wondrasch B. Nutrition and movement to improve quality of life in patients with knee osteoarthritis: the NUMOQUA study protocol for a randomised controlled trial. Trials 2024; 25:245. [PMID: 38594710 PMCID: PMC11005166 DOI: 10.1186/s13063-024-08048-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Osteoarthritis (OA) has long been considered as a degenerative disease of cartilage tissue resulting from bodily wear and tear. However, there is accumulating evidence that inflammation plays a key role in the pathogenesis of OA. In knee OA, the most common form of OA, exercise therapy as an effective component of early treatment addresses functional deficits, pain and inflammation. Since inflammation is critical for the development and progress of OA, anti-inflammatory therapies must be combined strategically. In the course of the NUMOQUA project, an anti-inflammatory therapeutic diet named 'Austrian Osteoarthritis Cuisine' was developed. It is based on the framework of the New Nordic Diet combined with the food-based dietary guidelines of Austria, the guidelines for OA, the Austrian food culture and the principles of a sustainable diet. The present study examines the implementation of the 'Austrian OA Cuisine' combined with the evidence-based training programme GLA:D® (Good Life with osteoArthritis in Denmark) in Austrian patients with knee OA and the effects on quality of life, nutritional and inflammatory status, as well as oxidative stress parameters. METHODS A total of 60 participants aged 50 to 75 with knee OA will be included and randomly assigned either to the intervention group or the control group. All participants will undergo the GLA:D® programme in the first 6 weeks. Additionally, the intervention group will receive nutritional group training and individual nutritional counselling on the 'Austrian OA Cuisine' over 9 months. The control group will receive general information about a healthy lifestyle. Measurements at baseline and at 4 follow-up dates include nutritional, inflammatory and oxidative stress markers. Furthermore, anthropometric, behavioural and clinical data will be obtained. The recruitment process lasted from autumn 2022 to January 2024, followed by the intervention until October 2024. DISCUSSION The prevalence of OA is expected to increase in the future due to ongoing demographic changes and rising obesity rates. The expected results will provide important evidence on whether this interdisciplinary therapeutic approach could be a new, cost-effective and sustainable strategy to address the disease process of OA without negative side effects. TRIAL REGISTRATION ClinicalTrials.gov NCT05955300. Date of registration: 23rd of October 2023.
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Affiliation(s)
- Elisabeth Höld
- Department of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria.
| | - Sabine Chmelar
- Department of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
- Vienna Doctoral School of Pharmaceutical, Nutritional and Sport Science (PhaNuSpo), University of Vienna, Vienna, Austria
| | - Tatjana Aubram
- Institute for Innovation Systems, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Gabriele Leitner
- Department of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Stefan Nehrer
- Faculty of Health and Medicine, University for Continuing Education Krems, Krems, Austria
| | - Oliver Neubauer
- Faculty of Health and Medicine, University for Continuing Education Krems, Krems, Austria
- Research Platform Active Ageing, University of Vienna, Vienna, Austria
| | - Karl-Heinz Wagner
- Research Platform Active Ageing, University of Vienna, Vienna, Austria
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Barbara Wondrasch
- Department of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
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Regan-Moriarty J, Hardcastle S, McCallion M, Youell A, Collery A, McCarren A, Moyna N, Kehoe B. 'The illness isn't the end of the road'-Patient perspectives on the initiation of and early participation in a multi-disease, community-based exercise programme. PLoS One 2024; 19:e0291700. [PMID: 38551937 PMCID: PMC10980187 DOI: 10.1371/journal.pone.0291700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/14/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Exercise is the cornerstone of cardiac rehabilitation (CR). Hospital-based CR exercise programmes are a routine part of clinical care and are typically 6-12 weeks in duration. Following completion, physical activity levels of patients decline. Multi-disease, community-based exercise programmes (MCEP) are an efficient model that could play an important role in the long-term maintenance of positive health behaviours in individuals with cardiovascular disease (CVD) following their medically supervised programme. AIM To explore patients experiences of the initiation and early participation in a MCEP programme and the dimensions that facilitate and hinder physical activity engagement. METHODS Individuals with established CVD who had completed hospital-based CR were referred to a MCEP. The programme consisted of twice weekly group exercise classes supervised by clinical exercise professionals. Those that completed (n = 31) an initial 10 weeks of the programme were invited to attend a focus group to discuss their experience. Focus groups were transcribed and analysed using reflexive thematic analysis. RESULTS Twenty-four (63% male, 65.5±6.12yrs) patients attended one of four focus groups. The main themes identified were 'Moving from fear to confidence', 'Drivers of engagement,' and 'Challenges to keeping it (exercise) up'. CONCLUSION Participation in a MCEP by individuals with CVD could be viewed as a double-edged sword. Whilst the programme clearly provided an important transition from the clinical to the community setting, there were signs it may breed dependency and not effectively promote independent exercise. Another novel finding was the use of social comparison that provided favourable valuations of performance and increased exercise confidence.
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Affiliation(s)
- Joanne Regan-Moriarty
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland
| | - Sarah Hardcastle
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, United Kingdom
| | - Maire McCallion
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland
| | - Azura Youell
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland
| | | | - Andrew McCarren
- School of Computing, Dublin City University, Dublin, Ireland
| | - Niall Moyna
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Brona Kehoe
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
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Tigges-Limmer K, Brocks Y, Winkler Y, Stock Gissendanner S, Gummert J. Clinical experience with medical hypnosis as an adjunctive therapy in heart surgery. Front Psychol 2024; 15:1356392. [PMID: 38440236 PMCID: PMC10910116 DOI: 10.3389/fpsyg.2024.1356392] [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: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
Heart surgery patients are at high risk for psychological trauma and comorbid psychological disorders. Depression, anxiety, and post-traumatic stress disorders in this patient group are predictors of outcomes after cardiac surgery. Medical hypnosis is effective for non-pharmacologic prevention and treatment of psychological disorders and has been associated with improved health-related quality of life and better cardiovascular outcomes. This contribution makes note of evidence of the effectiveness of medical hypnosis in a discussion of the clinical experience with specific hypnotherapeutic tools and interventions from the perspective of the mental health team in one large cardiac center in Germany. Based on our experience, we encourage heart centers to educate their heart surgery care teams about the core concepts of medical hypnosis and to make hypnotherapeutic techniques available as an adjunctive therapy.
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Affiliation(s)
- Katharina Tigges-Limmer
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
| | - Yvonne Brocks
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
| | - Yvonne Winkler
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
| | | | - Jan Gummert
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
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Aragão VC, Maximo GJ. Thermophysical properties of blends composed of Amazonian fats and soybean oil. Food Res Int 2024; 177:113911. [PMID: 38225148 DOI: 10.1016/j.foodres.2023.113911] [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: 08/30/2023] [Revised: 12/14/2023] [Accepted: 12/21/2023] [Indexed: 01/17/2024]
Abstract
Thermophysical properties of blends composed of soybean oil and fats obtained from fruits and seeds from Brazilian Amazonian region (Murumuru, Tucuma, and Bacuri) were investigated, looking for more sustainable alternatives to the mostly used industrial fats, for applications in product formulation. Fatty acid (FA) and triacylglycerol composition, nutritional indexes, solid fat content (SFC), compatibility, consistency, melting, and crystallization profiles were determined. Soybean oil increased blends' unsaturated FA profile, leading to lower SFC, but higher nutritional quality. Fats' melting profiles were significantly altered with soybean oil addition: temperatures decreased with the increase in oil content. Iso-solids diagrams showed that lipids were compatible, which is a technological advantage. SFC and consistency profiles suggested that tucuma and murumuru fats could be used as hardstocks for lipid products, and bacuri fat could be applied in products such as margarine and spreads. Blends could improve fats' spreadability and other technological properties, which is promising for applications in products formulation.
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Affiliation(s)
- Vitor C Aragão
- Universidade Estadual de Campinas (UNICAMP), Faculty of Food Engineering (FEA), 13083-862, Campinas, Brazil
| | - Guilherme J Maximo
- Universidade Estadual de Campinas (UNICAMP), Faculty of Food Engineering (FEA), 13083-862, Campinas, Brazil.
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9
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Kitjanukit S, Kuanprasert S, Suwannasom P, Phrommintikul A, Wongyikul P, Phinyo P. Coronary artery calcium (CAC) score for cardiovascular risk stratification in a Thai clinical cohort: A comparison of absolute scores and age-sex-specific percentiles. Heliyon 2024; 10:e23901. [PMID: 38226260 PMCID: PMC10788496 DOI: 10.1016/j.heliyon.2023.e23901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/17/2024] Open
Abstract
Purposes Coronary artery calcium (CAC) score provides a quantification of atherosclerotic plaque within the coronary arteries. This study aimed to examine the prevalence and CAC score distribution and to evaluate the association of each CAC score classifications with major adverse cardiovascular events (MACE) in a Thai clinical cohort. Methods This study was a retrospective observational cohort. We included patients aged above 35 years who underwent CAC score testing. The absolute and age-sex specific percentile classifications were categorized as 0, 1 to 10, 11 to 100, 101 to 400, and >400 and 0, <75th, 75th - 90th, and >90th, respectively. The endpoint was MACE, including cardiovascular death, myocardial infarction, heart failure hospitalization, coronary artery revascularization procedure, and stroke. Multivariable Cox regression was used to estimate the hazard ratios. The discriminative performance between classifications were compared using Harrell's C-statistics. The agreement was assessed via Cohen's Kappa. Results This study included 440 patients, with approximately 70% of Thai patients exhibiting a CAC score. CAC score distributed higher in male than female and increased with age. Both CAC score classification demonstrated the acceptable predictive performance. However, fair agreement was observed between classifications (Cohen's kappa 0.51, 95%CI 0.42-0.59). Within the absolute classification, a higher CAC score was associated with increased hazard ratios for MACE across stratified age-sex-specific percentile levels. In contrast, the hazard ratios for MACE did not consistently rise with higher age-sex-specific percentile CAC score when stratified by absolute CAC score levels. Conclusions Both absolute and age-sex-specific percentile CAC score demonstrated acceptable performance in predicting MACE. However, the absolute CAC score classification may be more suitable for risk stratification within the Thai clinical cohort. Our findings offer supportive information that could inform future recommendations for CAC score testing criteria within national clinical practice guidelines.
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Affiliation(s)
- Supitcha Kitjanukit
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Srun Kuanprasert
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pannipa Suwannasom
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Arintaya Phrommintikul
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pakpoom Wongyikul
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phichayut Phinyo
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Musculoskeletal Science and Translational Research, Chiang Mai University, Chiang Mai, Thailand
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10
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Kallistratos M, Konstantinidis D, Dimitriadis K, Sanidas E, Katsi V, Androulakis E, Vlachopoulos C, Toutouzas K, Kanakakis J, Sideris S, Kafkas N, Mavrogianni AD, Papadopoulos CH, Stefanidis A, Patsourakos N, Kachrimanidis I, Papaioannou N, Tsioufis C, Kochiadakis G, Marketou M. Exercise and cardiac rehabilitation in hypertensive patients with heart failure with preserved ejection fraction: A position statement on behalf of the Working Group of Arterial Hypertension of the Hellenic Society of Cardiology. Hellenic J Cardiol 2024; 75:82-92. [PMID: 37619947 DOI: 10.1016/j.hjc.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023] Open
Abstract
Arterial hypertension is a major cause of cardiovascular morbidity and mortality and the most common cause of comorbidity in heart failure (HF) with preserved ejection fraction (HFpEF). As an adjunct to medication, healthy lifestyle modifications with emphasis on regular exercise are strongly recommended by both the hypertension and the HF guidelines of the European Society of Cardiology. Several long-term studies have shown that exercise is associated with a reduction in all-cause mortality, a favorable cardiac and metabolic risk profile, mental health, and other non-cardiovascular benefits, as well as an improvement in overall quality of life. However, the instructions for the prescriptive or recommended exercise in hypertensive patients and, more specifically, in those with HFpEF are not well defined. Moreover, the evidence is based on observational or small randomized studies, while well-designed clinical trials are lacking. Despite the proven benefit and the guidelines' recommendations, exercise programs and cardiac rehabilitation in patients with hypertensive heart disease and HFpEF are grossly underutilized. This position statement provides a general framework for exercise and exercise-based rehabilitation in patients with hypertension and HFpEF, guides clinicians' rehabilitation strategies, and facilitates clinical practice. It has been endorsed by the Working Group of Arterial Hypertension of the Hellenic Society of Cardiology and is focused on the Health Care System in Greece.
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Affiliation(s)
| | - Dimitriοs Konstantinidis
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Kyriakos Dimitriadis
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Elias Sanidas
- Cardiology Department, LAIKO General Hospital, Athens, Greece
| | - Vasiliki Katsi
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | | | - Charalambos Vlachopoulos
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Konstantinos Toutouzas
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - John Kanakakis
- Department of Clinical Therapeutics, University of Athens Medical School, 11528 Athens, Greece
| | - Skevos Sideris
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | | | | | | | | | - Nikolaos Patsourakos
- Department of Cardiology, "Tzaneio" General Hospital of Piraeus, Piraeus, Greece
| | - Ioannis Kachrimanidis
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Nikolaos Papaioannou
- Department of Cardiology, Asklepeion General Hospital Cardiology, Athens, Greece
| | - Costas Tsioufis
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - George Kochiadakis
- Cardiology Department, Heraklion University General Hospital, Crete, Greece
| | - Maria Marketou
- Cardiology Department, Heraklion University General Hospital, Crete, Greece.
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11
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Hafskjold I, Rangul V, Ringvoll H, Kolberg M, Haug EB, Blomhoff R, Henriksen HB, Horn J. Postpartum Lifestyle Behaviors among Women with Hypertensive Disorders of Pregnancy: Data from the HUNT Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7025. [PMID: 37947581 PMCID: PMC10648747 DOI: 10.3390/ijerph20217025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/22/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
Hypertensive disorders of pregnancy (HDP) are associated with an increased risk of cardiovascular disease later in life. Clinical guidelines for postpartum follow-up after HDP often recommend lifestyle counseling to reduce this risk. However, knowledge about lifestyle behaviors and perceptions among women with a history of HDP is limited. We linked data from the fourth survey of the population-based Trøndelag Health Study (HUNT4) with data from the Medical Birth Registry of Norway. The associations between HDP and postpartum lifestyle behaviors and perceptions were examined using multivariable logistic regression. In a secondary analysis, HUNT4 participants with a recent history of pre-eclampsia were compared with women with a recent history of pre-eclampsia participating in a postpartum pilot intervention study. Lifestyle behaviors and perceptions were self-reported and included diet (intake frequency of fruits, vegetables, meat, fish, and sugar-sweetened beverages), alcohol intake, physical activity, sleep, smoking, lifestyle satisfaction, and the importance of a healthy lifestyle. Among 7551 parous HUNT4 participants, 610 had a history of HDP. We found no differences in lifestyle behaviors between women with and without a history of HDP. However, women with HDP had higher odds of being unsatisfied with their lifestyle. Women with pre-eclampsia participating in a postpartum lifestyle intervention study tended to have a healthier lifestyle at baseline than women participating in HUNT4. Future studies should explore how lifestyle intervention programs could be adapted to the needs of women who have experienced HDP or other pregnancy complications that are associated with an increased risk of CVD.
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Affiliation(s)
- Ingrid Hafskjold
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Vegar Rangul
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
- Faculty of Nursing and Health Sciences, Nord University, 7600 Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, 7600 Levanger, Norway
| | - Hanne Ringvoll
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Marit Kolberg
- Center for Oral Health Services and Research Mid-Norway (TkMidt), 7030 Trondheim, Norway
| | - Eirin B. Haug
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, 0316 Oslo, Norway
- Department of Clinic Service, Division of Cancer Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, 0316 Oslo, Norway
| | - Julie Horn
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
- Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, 7600 Levanger, Norway
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12
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Ramezankhani A, Azizi F, Hadaegh F. Lifetime risk of cardiovascular disease stratified by traditional risk factors: Findings from the cohort of Tehran lipid and glucose study. Hellenic J Cardiol 2023; 73:36-46. [PMID: 36914096 DOI: 10.1016/j.hjc.2023.03.003] [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: 08/21/2022] [Revised: 03/04/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND We aimed to estimate the lifetime risk (LTR) of cardiovascular disease (CVD) in the Iranian population, stratified by sex and traditional risk factors including high body mass index (BMI), hypertension, diabetes, smoking, and hypercholesterolemia. METHODS We included 10222 (4430 men) participants aged ≥20 years without CVD at baseline. LTRs at index ages 20 and 40 years and number of years lived without CVD was estimated. We further assessed the effect of traditional risk factors on the LTR of CVD and the number of years lived without CVD, stratified by sex and index ages. RESULTS During a median follow-up of 18 years, 1326 participants (774 men) developed CVD and 430 (238 men) died from non-cardiovascular causes. At age 20, the remaining LTR for CVD was 66.7% (95% CI 62.9-70.4) in men and 52.0% (47.6-56.8) in women, with similar LTRs at age 40 for both men and women. The LTRs at both index ages for those with ≥3 risk factors were about 30% and 55% higher in men and women, respectively, than those without any of the five risk factors. At the age of 20, men with ≥3 risk factors lived 24.1 fewer years without CVD compared with men with no risk factors; the corresponding value was 8 years in their female counterparts. CONCLUSIONS Our findings suggest that both sexes may benefit from effective prevention strategies early in the life course, despite the observed differences between men and women in LTR for CVD and number of years lived without CVD.
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Affiliation(s)
- Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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13
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Chávez Fernández JA, Ramírez Mendoza M, Kassck Ipinaa H, Sánchez Ángeles LA, González Chávez A, Escobedo G, Méndez-García LA. The cardiovascular polypill as baseline treatment improves lipid profile and blood pressure regardless of body mass index in patients with cardiovascular disease. The Bacus study. PLoS One 2023; 18:e0290544. [PMID: 37624820 PMCID: PMC10456133 DOI: 10.1371/journal.pone.0290544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Pharmacological treatment with lipid-lowering and antihypertensive drugs has been proposed as a strategy to improve excess cardiovascular (CV) risk among obese individuals. The present study aimed to assess whether the CV polypill (Sincronium®) could be an effective strategy to help improve CV risk factor control in obese/overweight individuals requiring secondary prevention. METHODS This was an observational, retrospective study reviewing the hospital medical records of 479 patients with established CV disease who initiated treatment with the CV polypill between 2013 and 2019 at a general hospital in Mexico. Patients were grouped as normal weight, overweight or obese according to their initial body mass index (BMI). We collected blood pressure (BP), lipid profile, and vascular age at the last visit recorded during the period following treatment. RESULTS At the end of the study, all assessed lipid parameters improved compared to baseline regardless of the initial BMI category (all p<0.001). There was an increase from baseline regarding the proportion of patients with at target low-density lipoprotein cholesterol after treatment (2.3% vs. 30.1%; p<0.001), more than 80% of patients achieved triglyceride levels <200 mg/dL (p<0.001), and more than 80% achieved target BP levels in all BMI subgroups (p<0.001). The subanalyses in the elderly population yielded similar results, with a significant overall improvement in lipid and BP control after initiating the CV polypill strategy. CONCLUSIONS The use of the CV polypill as baseline therapy for secondary prevention seems to be a reasonable strategy that enhances CV risk factor control regardless of the patient's BMI.
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Affiliation(s)
- José Alejandro Chávez Fernández
- Clínica de Enfermedad Coronaria e Insuficiencia Cardiaca, Servicio de Cardiología, Hospital General de México, Dr. Eduardo Liceaga, Mexico City, Mexico
| | - Marcelo Ramírez Mendoza
- Servicio de Cardiología, Hospital General de México, Dr. Eduardo Liceaga, Mexico City, Mexico
| | | | | | - Antonio González Chávez
- Servicio de Medicina Interna, Hospital General de México, Dr. Eduardo Liceaga, Mexico City, Mexico
| | - Galileo Escobedo
- Departamento de Proteómica y Metabolismo, Hospital General de México, Dr. Eduardo Liceaga, Mexico City, Mexico
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14
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Ellis T, Cheng S, Zecchin R, Zwack C, Hyun K, Zhang L, Gallagher R, Clark R, Redfern J. Effect of an avatar-based discharge education application on knowledge and behaviour in people after acute coronary syndrome: protocol for a pragmatic prospective randomised controlled trial. BMJ Open 2023; 13:e073621. [PMID: 37604633 PMCID: PMC10445362 DOI: 10.1136/bmjopen-2023-073621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/08/2023] [Indexed: 08/23/2023] Open
Abstract
INTRODUCTION Many hospital presentations for acute coronary syndrome (ACS) occur in people previously hospitalised with coronary heart disease (CHD), leading to increased costs and health burden. Secondary prevention education including a prehospital discharge plan is recommended for all individuals to reduce the risk of recurrence. However, many clinicians lack the time or support to provide education, and patients' uptake of secondary prevention programmes is limited. An avatar-based education app is a novel and engaging way to provide self-delivered, evidence-based secondary prevention information during the hospital admission and remains accessible after discharge. This protocol aims to evaluate the effect of an avatar-based education app on individuals with ACS. METHODS AND ANALYSIS This protocol describes a prospective, randomised controlled trial with 3-month follow-up and blinded assessment of 72 participants. Intervention group participants will download the app onto their own device during the hospital admission and independently complete six interactive education modules based on the National Heart Foundation's six steps to cardiac recovery. All participants will receive a text message reminder of the study after 3 weeks. Both groups will receive usual care consisting of bedside education and a pamphlet about cardiac rehabilitation. The primary outcome is knowledge of CHD, assessed using the Coronary Artery Disease Education Questionnaire II. Secondary outcomes include quality of life, response to heart attack symptoms, cardiac-related readmissions and mortality and modifiable cardiac risk factors. Engagement with the app will be evaluated objectively. Intention-to-treat analysis will be conducted, with between-group comparisons and 95% CIs of the primary outcome analysed using analysis of covariance, adjusting for baseline values. ETHICS AND DISSEMINATION This study protocol has been approved by the Western Sydney Local Health District Human Research Ethics Committee. The results of this study will be disseminated via a peer-reviewed journal and research thesis. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12622001436763).
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Affiliation(s)
- Tiffany Ellis
- Department of Physiotherapy, Westmead Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sonia Cheng
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Robert Zecchin
- Cardiac Rehabilitation Services, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Clara Zwack
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Karice Hyun
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ling Zhang
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Robyn Gallagher
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Robyn Clark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Julie Redfern
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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15
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Martín-Rioboó E, Brotons-Cuixart C, Ruiz García A, Villafañe Sanz F, Frías Vargas M, Moyá Amengual A, Divisón Garrote JA, Seoane Vicente MC, Banegas JR, Pallarés Carratalá V. [Luces y sombras de la Guía Europea esc-2021 de Prevención de la Enfermedad Cardiovascular en la Práctica Clínica.]. Rev Esp Salud Publica 2023; 97:e202308064. [PMID: 37921403 PMCID: PMC10541257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/01/2023] [Indexed: 11/04/2023] Open
Abstract
General practitioners see in their consultation a a significant number of patients at high vascular risk (VR). The European Guidelines for Cardiovascular Disease Prevention (2021) recommend a new risk classification and intervention strategies on on vascular risk factors (RF), with the aim of providing a shared decision-making recommendations between professionals and patients. In this document we present a critical analysis of these guidelines, offering possible solutions that can be implemented in Primary Care. It should be noted that there are positive aspects (lights) such as that the SCORE2 (from forty to sixty-nine years) and SCORE2-OP models (from seventy to eighty-nine years) are based on more current cohorts and measure cardiovascular risk in a more accurately manner. In addition, it is proposed to differentiate different risk thresholds according to age-groups. For sake of practicality, cardiovascular risk can be estimated using different websites with the new computer models. However, among the negative aspects (shadows), it seems to be add complexity implementing nine subgroups of subjects according to their age or level of risk, with a defined thresholds that could cause a substantial increase in the potential number of subjects susceptible to treatment without a clear evidence that supports it. In addition, two-step RF interventions could delay achievement of therapeutic goals, especially in very high-risk patients, diabetics, or patients with cardiovascular disease. Given these limitations, in this document we propose practical recommendations in order to simplify and facilitate the implementation of the guideline in primary care.
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Affiliation(s)
- Enrique Martín-Rioboó
- Médico de Familia; Unidad de Gestión Clínica Poniente; Distrito Universitario Córdoba-Guadalquivir; Departamento de Medicina; Universidad de Córdoba. / IMIBIC; Hospital Reina Sofía. Córdoba. España
| | - Carlos Brotons-Cuixart
- Médico de familia; Instituto de Investigaciones Biomédicas Sant Pau; Equipo de Atención Primaria Sardenya. Barcelona. España
| | - Antonio Ruiz García
- Médico de familia; Universidad Europea de Madrid. / Director del Centro de Salud Universitario Pinto; Unidad de Lípidos y Prevención Cardiovascular. Pinto (Madrid). España
| | - Fátima Villafañe Sanz
- Médico especialista en Medicina familiar y comunitaria.Centro de Salud Pisuerga. Arroyo de la Encomienda (Valladolid). España
| | - Manuel Frías Vargas
- Médico de Familia; Centro de Salud San Andrés. / Departamento de Medicina; Facultad de Medicina; Universidad Complutense de Madrid. Madrid. España
| | - Ana Moyá Amengual
- Médico del trabajo; Centro de Salud Sta. Catalina. Palma de Mallorca. España
| | - Juan Antonio Divisón Garrote
- Médico de Atención Primaria; Centro de Salud de Casas Ibáñez. Albacete. España
- Facultad de Medicina; Universidad Católica de Murcia (UCAM). Murcia. España
| | | | - José R Banegas
- Departamento de Medicina Preventiva y Salud Pública, y Microbiología; Universidad Autónoma de Madrid. / CIBERESP. Madrid. España
| | - Vicente Pallarés Carratalá
- Médico de familia; Unidad de Vigilancia de la Salud; Unión de Mutuas. / Departamento de Medicina; Facultad de Ciencias de la Salud; Universitat Jaume I. Castellón. España
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16
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Gaebel R, Lang C, Vasudevan P, Lührs L, de Carvalho KAT, Abdelwahid E, David R. New Approaches in Heart Research: Prevention Instead of Cardiomyoplasty? Int J Mol Sci 2023; 24:ijms24109017. [PMID: 37240361 DOI: 10.3390/ijms24109017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/10/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Cardiovascular diseases are the leading cause of death in industrialized nations. Due to the high number of patients and expensive treatments, according to the Federal Statistical Office (2017) in Germany, cardiovascular diseases account for around 15% of total health costs. Advanced coronary artery disease is mainly the result of chronic disorders such as high blood pressure, diabetes, and dyslipidemia. In the modern obesogenic environment, many people are at greater risk of being overweight or obese. The hemodynamic load on the heart is influenced by extreme obesity, which often leads to myocardial infarction (MI), cardiac arrhythmias, and heart failure. In addition, obesity leads to a chronic inflammatory state and negatively affects the wound-healing process. It has been known for many years that lifestyle interventions such as exercise, healthy nutrition, and smoking cessation drastically reduce cardiovascular risk and have a preventive effect against disorders in the healing process. However, little is known about the underlying mechanisms, and there is significantly less high-quality evidence compared to pharmacological intervention studies. Due to the immense potential of prevention in heart research, the cardiologic societies are calling for research work to be intensified, from basic understanding to clinical application. The topicality and high relevance of this research area are also evident from the fact that in March 2018, a one-week conference on this topic with contributions from top international scientists took place as part of the renowned "Keystone Symposia" ("New Insights into the Biology of Exercise"). Consistent with the link between obesity, exercise, and cardiovascular disease, this review attempts to draw lessons from stem-cell transplantation and preventive exercise. The application of state-of-the-art techniques for transcriptome analysis has opened new avenues for tailoring targeted interventions to very individual risk factors.
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Affiliation(s)
- Ralf Gaebel
- Department of Cardiac Surgery, Rostock University Medical Center, 18057 Rostock, Germany
- Department of Life, Light & Matter, Interdisciplinary Faculty, Rostock University, 18059 Rostock, Germany
| | - Cajetan Lang
- Department of Cardiac Surgery, Rostock University Medical Center, 18057 Rostock, Germany
- Department of Life, Light & Matter, Interdisciplinary Faculty, Rostock University, 18059 Rostock, Germany
| | - Praveen Vasudevan
- Department of Cardiac Surgery, Rostock University Medical Center, 18057 Rostock, Germany
- Department of Life, Light & Matter, Interdisciplinary Faculty, Rostock University, 18059 Rostock, Germany
| | - Larissa Lührs
- Advanced Therapy and Cellular Biotechnology in Regenerative Medicine Department, Pelé Pequeno Prίncipe Research Institute & Pequeno Prίncipe Faculties, Ave. Silva Jardim, P.O. Box 80240-020, Curitiba 1632, Brazil
| | - Katherine Athayde Teixeira de Carvalho
- Advanced Therapy and Cellular Biotechnology in Regenerative Medicine Department, Pelé Pequeno Prίncipe Research Institute & Pequeno Prίncipe Faculties, Ave. Silva Jardim, P.O. Box 80240-020, Curitiba 1632, Brazil
| | - Eltyeb Abdelwahid
- Feinberg School of Medicine, Feinberg Cardiovascular Research Institute, Northwestern University, Chicago, IL 60611, USA
| | - Robert David
- Department of Cardiac Surgery, Rostock University Medical Center, 18057 Rostock, Germany
- Department of Life, Light & Matter, Interdisciplinary Faculty, Rostock University, 18059 Rostock, Germany
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17
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Brotons C, Camafort M, Castellanos MDM, Clarà A, Cortés O, Diaz Rodríguez Á, Elosua R, Gorostidi M, Hernández AM, Herranz M, Justo S, Lahoz C, Niño P, Pallarés-Carratalá V, Pedro-Botet J, Pérez Pérez A, Royo-Bordonada MÁ, Santamaría R, Tresserras R, Zamora A, Zuza I, Armario P. Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention. Nefrologia 2023; 43:360-369. [PMID: 37635013 DOI: 10.1016/j.nefroe.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/17/2022] [Indexed: 08/29/2023] Open
Abstract
We present the Spanish adaptation of the 2021 European Guidelines on Cardiovascular Disease (CVD) prevention in clinical practice. The current guidelines besides the individual approach greatly emphasize on the importance of population level approaches to the prevention of cardiovascular diseases. Systematic global CVD risk assessment is recommended in individuals with any major vascular risk factor. Regarding LDL-Cholesterol, blood pressure, and glycemic control in patients with diabetes mellitus, goals and targets remain as recommended in previous guidelines. However, it is proposed a new, stepwise approach (Step 1 and 2) to treatment intensification as a tool to help physicians and patients pursue these targets in a way that fits patient profile. After Step 1, considering proceeding to the intensified goals of Step 2 is mandatory, and this intensification will be based on 10-year CVD risk, lifetime CVD risk and treatment benefit, comorbidities and patient preferences. The updated SCORE algorithm-SCORE2, SCORE-OP- is recommended in these guidelines, which estimates an individual's 10-year risk of fatal and non-fatal CVD events (myocardial infarction, stroke) in healthy men and women aged 40-89 years. Another new and important recommendation is the use of different categories of risk according different age groups (< 50, 50-69, ≥70 years). Different flow charts of CVD risk and risk factor treatment in apparently healthy persons, in patients with established atherosclerotic CVD, and in diabetic patients are recommended. Patients with chronic kidney disease are considered high risk or very high-risk patients according to the levels of glomerular filtration rate and albumin-to-creatinine ratio. New lifestyle recommendations adapted to the ones published by the Spanish Ministry of Health as well as recommendations focused on the management of lipids, blood pressure, diabetes and chronic renal failure are included.
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Affiliation(s)
- Carlos Brotons
- Sociedad Española de Medicina de Familia y Comunitaria (semFYC), Barcelona, Spain.
| | | | | | - Albert Clarà
- Sociedad Española de Angiología y Cirugía Vascular, Madrid, Spain
| | - Olga Cortés
- Asociación Española de Pediatría de Atención Primaria, Madrid, Spain
| | | | | | | | | | - María Herranz
- Federación de Asociaciones de Enfermería Comunitaria y Atención Primaria (FAECAP), Madrid, Spain
| | | | - Carlos Lahoz
- Sociedad Española de Medicina Interna, Madrid, Spain
| | - Pilar Niño
- Sociedad Española de Medicina y Seguridad del Trabajo, Madrid, Spain
| | | | | | | | | | | | - Ricard Tresserras
- Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS), Barcelona, Spain
| | | | - Inés Zuza
- Ministerio de Sanidad, Madrid, Spain
| | - Pedro Armario
- Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial, Madrid, Spain
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18
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Rosolová H. Preventive cardiology: Quo vadis? VNITŘNÍ LÉKAŘSTVÍ 2023; 69:76-81. [PMID: 37072265 DOI: 10.36290/vnl.2023.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Reflections of preventive cardiology history, it´s development and look to the future are mentioned. The main problems of primary and secondary prevention for atherosclerotic cardiovascular diseases are presented. New ways to the prevention improvement are sketched in the field of physician care, inside the whole society and throught the new technologies.
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19
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Heitkamp HC. [Current aspects on nutrition in hypercholesterolemia]. Wien Med Wochenschr 2023; 173:90-96. [PMID: 35377094 DOI: 10.1007/s10354-022-00916-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND New European and American guidelines for nutrition in hypercholesterolemia coincided with a lowered target value for LDL(Low density lipoprotein)-cholesterol. METHODS Guidelines, their development and supporting meta-analyses were searched in Medline/PubMed and Cochrane database and analyzed for the influence of fat, carbohydrates and protein on reduction of LDL-cholesterol as well as the differences between European and American guidelines. RESULTS In contrast to European guidelines, American guidelines increasingly refrain from controlling fat in nutrition, based on studies on the influence of nutrition on LDL-cholesterol and saturated fat; instead, monosaccharides and disaccharides are to be reduced from 15% to 10% of total calories for avoidance of high LDL-cholesterol and a non-alcoholic fatty liver. In predisposed persons the ratio of triglycerides to HDL-cholesterol should be checked when controlling LDL-cholesterol, an early indicator of type 2 diabetes mellitus and non-alcoholic fatty liver disease. Substituting animal fat with plant fat hardly influences LDL-cholesterol. Whole fat milk should be consumed as a source of protein. The nutritional pattern is more important than single components. CONCLUSION Fat content in nutrition is increasingly less important in hypercholesterolemia but the reduction of monosaccharides and disaccharides gains importance.
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Affiliation(s)
- Hans-Christian Heitkamp
- Institut für Sportmedizin, Fakultät Naturwissenschaften, Universität Paderborn, Warburgerstr. 100, 33098, Paderborn, Deutschland.
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20
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Brotons C. The challenge of therapy adherence in clinical practice. Eur J Prev Cardiol 2023; 30:147-148. [PMID: 36062950 DOI: 10.1093/eurjpc/zwac197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Carlos Brotons
- Biomedical Research Institute Sant Pau, Sardenya Primary Health Care Center, Sardenya 466, 08025 Barcelona, Spain
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21
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Havelkova A, Dvorak P, Siegelova J, Dobsak P, Filipensky P, Cornelissen G. Possibilities of Interpreting the Night-to-Day Ratio Specified by 24-Hour Blood Pressure Monitoring. Int J Clin Pract 2023; 2023:6530295. [PMID: 36793927 PMCID: PMC9908340 DOI: 10.1155/2023/6530295] [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: 09/12/2022] [Revised: 11/29/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
AIM Specify the risk rate of incorrect patient classification based on the night-to-day ratio specification from singular 24-h ABPM in comparison to the results of 7-day ABPM monitoring. MATERIALS AND METHODS 1197 24 h cycles were enrolled in 171 subjects in the study and divided into 4 groups: group 1 (40 healthy men and women without exercise), group 2 (40 healthy exercise-training men and women), group 3 (40 patients with ischemic coronary artery disease without exercise), and group 4 (51 patients with ischemic coronary artery disease following cardiovascular rehabilitation). The subject of the evaluation was the percentage rate of incorrect subject classification (dipper, nondipper, extreme dipper, and riser) based on the mean blood pressure values for 7 days and from seven independent 24-hour cycles (the mean value mode). RESULTS In the case of the individuals included in the monitored groups, the mean night-to-day ratio-based (mode for the 7 days versus the individual days of 24-hour monitoring) classification accordance ranged between 59% and 62%. Only in singular cases did the accordance reach 0% or 100%. The accordance size was not dependent on the health or cardiovascular disease (p < 0.594; 56% vs. 54%) or physical activity (p < 0.833; 55% vs. 54%) of the monitored individuals. CONCLUSION The specification of the night-to-day ratio of each individual for each day of the 7-day ABPM monitoring would be the most convenient option. In many patients, diagnosing could thus be based on the most frequently occurring values (mode specification).
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Affiliation(s)
- Alena Havelkova
- Department of Physiotherapy, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- St. Anne's Teaching Hospital, Brno, Czech Republic
| | - Petr Dvorak
- Department of Biology, Faculty of Veterinary Hygiene and Ecology, University of Veterinary Sciences, Brno, Czech Republic
| | - Jarmila Siegelova
- Department of Physiotherapy, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- St. Anne's Teaching Hospital, Brno, Czech Republic
| | - Petr Dobsak
- Department of Physiotherapy, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- St. Anne's Teaching Hospital, Brno, Czech Republic
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22
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Peretto G, Maranta F, Cianfanelli L, Sala S, Cianflone D. Outcomes of inflammatory cardiomyopathy following cardiac rehabilitation. J Cardiovasc Med (Hagerstown) 2023; 24:59-61. [PMID: 36574301 DOI: 10.2459/jcm.0000000000001388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Giovanni Peretto
- Myocarditis Disease Unit.,Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute.,San Raffaele Vita-Salute University
| | - Francesco Maranta
- San Raffaele Vita-Salute University.,Department of Cardiac Rehabilitation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Cianfanelli
- Department of Cardiac Rehabilitation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Simone Sala
- Myocarditis Disease Unit.,Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute
| | - Domenico Cianflone
- San Raffaele Vita-Salute University.,Department of Cardiac Rehabilitation, IRCCS San Raffaele Scientific Institute, Milan, Italy
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23
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Haskiah F, Jbara R, Minha S, Assali A, Sela Y, Pereg D. The impact of COVID-19 pandemic on cardiac rehabilitation of patients following acute coronary syndrome. PLoS One 2022; 17:e0276106. [PMID: 36454912 PMCID: PMC9714801 DOI: 10.1371/journal.pone.0276106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/29/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cardiac rehabilitation improves prognosis and symptoms in cardiac patients. In 2020, due to the COVID-19 pandemic, cardiac rehabilitation services were temporarily suspended between April and August. We aimed to investigate the effect of cardiac rehabilitation suspension during the COVID-19 pandemic on patients' exercise capacity and metabolic parameters. METHODS Included were patients undergoing cardiac rehabilitation following hospital admission for ACS. Exercise capacity, weight and body fat percentage were compared between baseline, pre- and post-lockdown visits. RESULTS A total of 281 patients participated in the cardiac rehabilitation program prior to its suspension. Of them, only 198 (70%) patients returned to the program on its renewal and were included in the analysis. Exercise capacity improved significantly in the pre-lockdown stress test compared to baseline. However, there was a significant decrease in exercise capacity in the post compared to pre-lockdown test (8.1±6.3 and 7.1±2.1 METs in pre- and post-lockdown measurements, respectively, p<0.001). Of the 99 (50%) of patients that demonstrated at least 10% improvement in exercise capacity in the pre-lockdown test, 48(48.5%) patients returned to their baseline values in the post-lockdown test. Post-lockdown assessment demonstrated a significant weight gain (80.3 and 81.1kg, in pre- and post-lockdown measurements, respectively, p<0.001) as well as an increase in visceral fat level and body fat percentage. CONCLUSIONS Cardiac rehabilitation suspension for 4 months during COVID-19 pandemic caused a significant reduction in exercise capacity and increased weight and body fat percent. These findings highlight the importance of remote cardiac rehabilitation services that can continue uninterrupted in times of pandemic.
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Affiliation(s)
- Feras Haskiah
- Department of Internal Medicine D, Meir Medical Center, Kfar Saba, Israel
| | - Rana Jbara
- Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Saar Minha
- Interventional Cardiology, Shamir Medical Center, Be’er-Yaakov, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Abid Assali
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Department of Cardiology, Meir Medical Center, Kfar Saba, Israel
| | - Yaron Sela
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
| | - David Pereg
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Department of Cardiology, Meir Medical Center, Kfar Saba, Israel
- * E-mail:
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24
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Cunillera-Puértolas O, Vizcaya D, Cerain-Herrero MJ, Gil-Terrón N, Cobo-Guerrero S, Salvador-González B. Cardiovascular events and mortality in chronic kidney disease in primary care patients with previous type 2 diabetes and/or hypertension. A population-based epidemiological study (KIDNEES). BMC Nephrol 2022; 23:376. [PMID: 36585634 PMCID: PMC9805248 DOI: 10.1186/s12882-022-02966-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/07/2022] [Accepted: 10/06/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Chronic Kidney Disease (CKD), Type 2 Diabetes (T2D) and Hypertension (HTN) are frequently associated with adverse outcomes. We aimed to estimate the impact of a prior diagnosis of T2D and/or HTN on clinical characteristics, cardiovascular events (CVE) and all-cause mortality (ACM) of patients with CKD. METHODS We conducted a retrospective cohort study based on primary care electronic health records of people without atherosclerotic cardiovascular disease, aged 18-90 years with incident CKD between January 1, 2007, and December 31, 2017. The association between CKD groups classified according to prior diagnosis of T2D and/or HTN and risk of ACM and CVE at follow-up was evaluated with Cox and Fine-Gray regression models, respectively. RESULTS 398,477 patients were included. Median age was 74 years and 55.2% were women. Individuals were classified as CKD with HTN (51.9%), CKD with T2D (3.87%), CKD with HTN/T2D (31.4%) and CKD without HTN/T2D (12.9%). In the multivariate analysis, with the CKD without HTN/T2D group as reference, the ACM Hazard Ratio (HR) was 0.74 (95%CI 0.72-0.75) for the CKD with HTN group, 0.81 (95%CI 0.79-0.83) for CKD with HTN/T2D and 1.14 (95%CI 1.10-1.19) for the CKD with T2D group. The sub distribution HRs for CVE were 1.40 (95%CI 1.34-1.47), 1.70 (95%CI 1.61-1.80) and 1.37 (95%CI 1.26-1.48), respectively. CONCLUSION In patients with CKD, the risk of ACM and CVE differed in patients with previous HTN and/or T2D. These comorbidities can help identify individuals at higher risk of adverse outcomes and improve the management of patients with CKD in primary care.
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Affiliation(s)
- Oriol Cunillera-Puértolas
- grid.452479.9Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Cornellà de Llobregat, Barcelona, Spain ,Costa Ponent Primary Care Cardiovascular and Kidney Disease Research Group (MACAP), L’Hospitalet de Llobregat, Barcelona, Spain
| | - David Vizcaya
- Bayer Pharmaceuticals, Sant Joan Despí, Barcelona, Spain
| | - M. Jesús Cerain-Herrero
- grid.452479.9Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Cornellà de Llobregat, Barcelona, Spain ,Costa Ponent Primary Care Cardiovascular and Kidney Disease Research Group (MACAP), L’Hospitalet de Llobregat, Barcelona, Spain ,grid.22061.370000 0000 9127 6969Primary Care Management Costa Ponent, Primary Care Centre Can Vidalet, Institut Català de la Salut, Esplugues de Llobregat, Barcelona, Spain
| | - Neus Gil-Terrón
- grid.452479.9Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Cornellà de Llobregat, Barcelona, Spain ,Costa Ponent Primary Care Cardiovascular and Kidney Disease Research Group (MACAP), L’Hospitalet de Llobregat, Barcelona, Spain ,grid.22061.370000 0000 9127 6969Primary Care Centre El Pla, Primary Care Management Costa Ponent, Catalan Institute of Health, Sant Feliu de Llobregat, Barcelona, Spain
| | - Silvia Cobo-Guerrero
- grid.452479.9Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Cornellà de Llobregat, Barcelona, Spain ,Costa Ponent Primary Care Cardiovascular and Kidney Disease Research Group (MACAP), L’Hospitalet de Llobregat, Barcelona, Spain ,grid.22061.370000 0000 9127 6969Primary Care Centre Gavarra, Primary Care Management Costa Ponent, Catalan Institute of Health, Cornellà de Llobregat, Barcelona, Spain
| | - Betlem Salvador-González
- grid.452479.9Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Cornellà de Llobregat, Barcelona, Spain ,Costa Ponent Primary Care Cardiovascular and Kidney Disease Research Group (MACAP), L’Hospitalet de Llobregat, Barcelona, Spain ,grid.22061.370000 0000 9127 6969Research Support Unit Costa Ponent, Primary Care Management Costa Ponent, Catalan Institute of Health, Cornellà de Llobregat, Barcelona, Spain
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25
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Pylev VY, Agdzhoyan AT, Gorin IO, Petrushenko VS, Pocheshkhova EA, Mirzaev KB, Balanovskaya EV. Population biobank as a basis for determining spatial variation of clinically relevant pharmacogenetic biomarkers of cardiovascular diseases. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The introduction of pharmacogenetic tests among the Russian population faces a fundamental limitation — pronounced genetic differences between populations. The genetic geography of pharmacogenetic markers of deoxyribonucleic acid (DNA) helps to remove these limitations.Aim. To reveal the spatial variation of the gene pools of the indigenous European Russian population in terms of DNA markers that are significant for the pharmacotherapy of cardiovascular diseases (CVDs) using the population biobank collections.Material and methods. A total of 3170 samples from 61 populations of the Biobank of Northern Eurasia, which represents the gene pools of the indigenous Eastern Europe population, were studied using two pharmacogenetic DNA marker arrays as follows: 60 most significant markers and 24 markers associated with CVDs. Using the multivariate statistics and genetic geography, a comparison of gene pool variation was made.Results. A cartographic atlas has been created that includes maps of the distribution among the Eastern Europe population of 24 pharmacogenetic CVD markers. These cartographic models allow various specialists to analyze patterns in the distribution of pharmacogenetic markers. General patterns are supplemented by regional studies in the North Caucasus, the Cisurals and the Russian Plain, which identify population groups with similar pharmacogenetic status. For each region, a comparison of gene pool variation for two arrays of above-mentioned DNA markers was made.Conclusion. The created atlas is the basis for the development of pharmacogenetic studies conducted by genetic geography methods using a single panel of markers and representative samples provided by population biobanks. The reliability of the results is ensured by a detailed genealogical and population annotation of each biobank sample and representative samples from the populations.
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Affiliation(s)
- V. Yu. Pylev
- Bochkov Medical Genetics Research Center;
Biobank of Northern Eurasia
| | - A. T. Agdzhoyan
- Bochkov Medical Genetics Research Center;
Biobank of Northern Eurasia
| | | | | | | | - K. B. Mirzaev
- Bochkov Medical Genetics Research Center;
Russian Medical Academy of Continuous Professional Education
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26
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Halasz G, Piepoli MF. Focus on cardiovascular risk factor control. Eur J Prev Cardiol 2022; 29:1715-1717. [DOI: 10.1093/eurjpc/zwac209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Geza Halasz
- Deputy Editor, EJPC, Cardiac Unit, G. da Saliceto Hospital , AUSL Piacenza , Italy
| | - Massimo F Piepoli
- Clinical Cardiology, Policlinico San Donato, University of Milan , Italy
- Department of Preventive Cardiology, Wroclaw Medical University , Wroclaw , Poland
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27
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Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2022; 23:S1-S259. [PMID: 36238954 PMCID: PMC9553112 DOI: 10.1080/26895269.2022.2100644] [Citation(s) in RCA: 561] [Impact Index Per Article: 280.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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Affiliation(s)
- E Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A E Radix
- Callen-Lorde Community Health Center, New York, NY, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - W P Bouman
- Nottingham Centre for Transgender Health, Nottingham, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - G R Brown
- James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
- James H. Quillen VAMC, Johnson City, TN, USA
| | - A L C de Vries
- Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M B Deutsch
- Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA
- UCSF Gender Affirming Health Program, San Francisco, CA, USA
| | - R Ettner
- New Health Foundation Worldwide, Evanston, IL, USA
- Weiss Memorial Hospital, Chicago, IL, USA
| | - L Fraser
- Independent Practice, San Francisco, CA, USA
| | - M Goodman
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - J Green
- Independent Scholar, Vancouver, WA, USA
| | - A B Hancock
- The George Washington University, Washington, DC, USA
| | - T W Johnson
- Department of Anthropology, California State University, Chico, CA, USA
| | - D H Karasic
- University of California San Francisco, San Francisco, CA, USA
- Independent Practice at dankarasic.com
| | - G A Knudson
- University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - S F Leibowitz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - H F L Meyer-Bahlburg
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - J Motmans
- Transgender Infopunt, Ghent University Hospital, Gent, Belgium
- Centre for Research on Culture and Gender, Ghent University, Gent, Belgium
| | - L Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - T O Nieder
- University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany
| | - S L Reisner
- Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - C Richards
- Regents University London, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - V Tangpricha
- Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - A C Tishelman
- Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA
| | - M A A Van Trotsenburg
- Bureau GenderPRO, Vienna, Austria
- University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria
| | - S Winter
- School of Population Health, Curtin University, Perth, WA, Australia
| | - K Ducheny
- Howard Brown Health, Chicago, IL, USA
| | - N J Adams
- University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada
- Transgender Professional Association for Transgender Health (TPATH)
| | - T M Adrián
- Asamblea Nacional de Venezuela, Caracas, Venezuela
- Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela
| | - L R Allen
- University of Nevada, Las Vegas, NV, USA
| | - D Azul
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - H Bagga
- Monash Health Gender Clinic, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - K Başar
- Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - D S Bathory
- Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA
| | - J J Belinky
- Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina
| | - D R Berg
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J U Berli
- Oregon Health & Science University, Portland, OR, USA
| | - R O Bluebond-Langner
- NYU Langone Health, New York, NY, USA
- Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA
| | - M-B Bouman
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - M L Bowers
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - P J Brassard
- GrS Montreal, Complexe CMC, Montreal, Quebec, Canada
- Université de Montreal, Quebec, Canada
| | - J Byrne
- University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - L Capitán
- The Facialteam Group, Marbella International Hospital, Marbella, Spain
| | | | - J M Carswell
- Harvard Medical School, Boston, MA, USA
- Boston's Children's Hospital, Boston, MA, USA
| | - S C Chang
- Independent Practice, Oakland, CA, USA
| | - G Chelvakumar
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University, College of Medicine, Columbus, OH, USA
| | - T Corneil
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | - K B Dalke
- Penn State Health, PA, USA
- Penn State College of Medicine, Hershey, PA, USA
| | - G De Cuypere
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
| | - E de Vries
- Nelson Mandela University, Gqeberha, South Africa
- University of Cape Town, Cape Town, South Africa
| | - M Den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - A H Devor
- University of Victoria, Victoria, BC, Canada
| | - C Dhejne
- ANOVA, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - A D'Marco
- UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas
- D M A R C O Organization, Nassau, The Bahamas
| | - E K Edmiston
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Edwards-Leeper
- Pacific University, Hillsboro, OR, USA
- Independent Practice, Beaverton, OR, USA
| | - R Ehrbar
- Whitman Walker Health, Washington, DC, USA
- Independent Practice, Maryland, USA
| | - D Ehrensaft
- University of California San Francisco, San Francisco, CA, USA
| | - J Eisfeld
- Transvisie, Utrecht, The Netherlands
| | - E Elaut
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium
| | - L Erickson-Schroth
- The Jed Foundation, New York, NY, USA
- Hetrick-Martin Institute, New York, NY, USA
| | - J L Feldman
- Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A D Fisher
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | - M M Garcia
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA
| | - L Gijs
- Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - B P Hall
- Duke University Medical Center, Durham, NC, USA
- Duke Adult Gender Medicine Clinic, Durham, NC, USA
| | - T L D Hardy
- Alberta Health Services, Edmonton, Alberta, Canada
- MacEwan University, Edmonton, Alberta, Canada
| | - M S Irwig
- Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - A C Janssen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - K Johnson
- RMIT University, Melbourne, Australia
- University of Brighton, Brighton, UK
| | - D T Klink
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium
- Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
| | - B P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - L E Kuper
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA
- Department of Endocrinology, Children's Health, Dallas, TX, USA
| | - E J Kvach
- Denver Health, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - M A Malouf
- Malouf Counseling and Consulting, Baltimore, MD, USA
| | - R Massey
- WPATH Global Education Institute
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - T Mazur
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - C McLachlan
- Professional Association for Transgender Health, South Africa
- Gender DynamiX, Cape Town, South Africa
| | - S D Morrison
- Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
| | - S W Mosser
- Gender Confirmation Center, San Francisco, CA, USA
- Saint Francis Memorial Hospital, San Francisco, CA, USA
| | - P M Neira
- Johns Hopkins Center for Transgender Health, Baltimore, MD, USA
- Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA
| | - U Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - J M Oates
- La Trobe University, Melbourne, Australia
- Melbourne Voice Analysis Centre, East Melbourne, Australia
| | - J Obedin-Maliver
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - G Pagkalos
- Independent PracticeThessaloniki, Greece
- Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece
| | - J Patton
- Talkspace, New York, NY, USA
- CytiPsychological LLC, San Diego, CA, USA
| | - N Phanuphak
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - K Rachlin
- Independent Practice, New York, NY, USA
| | - T Reed
- Gender Identity Research and Education Society, Leatherhead, UK
| | - G N Rider
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Ristori
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | | | - S A Roberts
- Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA
| | - K A Rodriguez-Wallberg
- Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S M Rosenthal
- Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA
- UCSF Child and Adolescent Gender Center
| | - K Sabir
- FtM Phoenix Group, Krasnodar Krai, Russia
| | - J D Safer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA
| | - A I Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - L J Seal
- Tavistock and Portman NHS Foundation Trust, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - K Spencer
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C St Amand
- University of Houston, Houston, TX, USA
- Mayo Clinic, Rochester, MN, USA
| | - T D Steensma
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - J F Strang
- Children's National Hospital, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
| | - G B Taylor
- Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA
| | - K Tilleman
- Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - G G T'Sjoen
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
| | - L N Vala
- Independent Practice, Campbell, CA, USA
| | - N M Van Mello
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - J F Veale
- School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - J A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - B Vincent
- Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK
| | - L M Wesp
- College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA
- Health Connections Inc., Glendale, WI, USA
| | - M A West
- North Memorial Health Hospital, Robbinsdale, MN, USA
- University of Minnesota, Minneapolis, MN, USA
| | - J Arcelus
- School of Medicine, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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Higher pulse wave velocity in young adult offspring of mothers with type 1 diabetes: a case-control study. Cardiovasc Diabetol 2022; 21:178. [PMID: 36068528 PMCID: PMC9450321 DOI: 10.1186/s12933-022-01612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Offspring of mothers with type 1 diabetes have an increased risk for acquiring early onset cardiovascular disease (CVD). Arterial stiffness, measured as pulse wave velocity (PWV), is a non-invasive biomarker for CVD risk assessment. Our aim is to determine whether PWV is increased in young adult offspring of mothers with type 1 diabetes. METHODS This is a case-control study carried out in the hospital district of Helsinki and Uusimaa, Finland. 75 offspring of mothers with type 1 diabetes (cases) and 84 offspring of mothers without diabetes (controls), aged 18-23 years, were enrolled in this study. All participants attended clinical assessments, including questionnaires and laboratory tests. Carotid-femoral PWV (cfPWV), carotid-radial PWV (crPWV), and PWV ratio were measured from each participant using the Complior Analyse mechanotransducer (Alam Medical, France). Student's t-test and chi-squared test were used to assess differences between the groups. Stata 17.0, StataCorp LP (College Station, TX, USA) statistical package was used for the analysis. RESULTS We did not observe any differences in conventional CVD risk factors: systolic blood pressure, LDL, HbA1c, and smoking between cases and controls. We detected higher cfPWV in cases 6.5 (SD ± 1.2) m/s than in controls 6.2 (SD ± 0.7) m/s, p = 0.049, after adjustments for BMI, smoking, mean arterial pressure, height, and pulse rate was made. We did not observe any difference between cases and controls regarding crPWV or PWV ratio. Additionally, we detected no sex differences. CONCLUSIONS We report a novel finding of signs of increased arterial stiffness already in young adult offspring of mothers with type 1 diabetes compared to matched offspring of mothers without diabetes. Our finding suggests that exposure to an adverse intrauterine environment of type 1 diabetes mothers may affect the vascular health of offspring already in young adulthood. Additional research within this topic is warranted.
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Vorobeľová L, Falbová D, Candráková Čerňanová V. Contribution of environmental factors and female reproductive history to hypertension and obesity incidence in later life. Ann Hum Biol 2022; 49:236-247. [PMID: 35867530 DOI: 10.1080/03014460.2022.2105398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Hypertension (HT) and obesity, which are important risk factors for cardiovascular diseases, are complex traits determined by multiple biological and behavioural factors. However, the role of female reproductive history in evaluating HT and obesity is still unclear. AIM To investigate the long-term effects of reproductive factors on the probability of obesity and HT in later life after adjusting for socio-demographic and lifestyle behaviour factors. SUBJECTS AND METHODS A total of 503 women (39 - 65 years) were recruited from different localities in Slovakia. Multivariable logistic regression analyses were performed to test the associations. RESULTS Early menarche age of 11 years and under was associated with twice higher probability of obesity at midlife, independent of environmental confounders (OR = 2.27, CI = 1.35 - 3.81, p = 0.002). Breastfeeding (Bf) women had a lower likelihood of obesity in later life than non-Bf parous women, independent of environmental confounders (OR = 0.35, CI = 0.17 - 0.72, p = 0.004). Finally, age at menarche was associated with obesity-associated HT. CONCLUSION Reproductive factors are significantly associated with obesity and obesity-associated HT in later life. The age at menarche and Bf can be risk factors for early identification of women with increased likelihood of adult cardiovascular risk.
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Affiliation(s)
- Lenka Vorobeľová
- Department of Anthropology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - Darina Falbová
- Department of Anthropology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
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30
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Rapelli G, Donato S, Parise M, Pagani AF, Castelnuovo G, Pietrabissa G, Giusti E, Bertoni A. Yes, I can (with you)! Dyadic coping and self-management outcomes in cardiovascular disease: The mediating role of health self-efficacy. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2604-e2617. [PMID: 34985787 DOI: 10.1111/hsc.13704] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/18/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Cardiac patients show alarming levels of nonadherence to medications. It is important to consider also patient activation levels. Furthermore, the partner could have a supporting role in these processes. The aim of this study was to investigate the mediating role of patient health self-efficacy (HSE) in the link between dyadic coping (DC) and two self-management outcomes (i.e. medication adherence and patient activation) across the first 6 months of cardiac disease. One hundred couples completed two self-report questionnaires during the hospitalisation for cardiac disease and 6 months after discharge. A longitudinal and dyadic research design was adopted. Cross-sectional analyses at T0 revealed that patient-provided and perceived positive DC and common DC are positively associated with HSE, which in turn is positively associated with medication adherence. HSE mediated the association between patient positive and common DC styles, with the only exception of Patient-provided positive DC, and patient activation. Conversely, patient-provided and perceived negative DC are negatively associated with HSE, which in turns is positively associated with medication adherence and patient activation. Prospective analyses showed that only patient-perceived negative DC at discharge is negatively associated with HSE at T1, which in turns is positively associated with patient activation over time. These results suggest to consider patient perceived and provided DC as antecedents of self-management outcomes via patient HSE. Furthermore, our results recommend to pay particular attention to negative DC, whose negative consequences are manifested also over time, planning interventions targeting partners' awareness of their own DC style.
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Affiliation(s)
- Giada Rapelli
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Silvia Donato
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Family Studies and Research University Centre, Università Cattolica del Sacro Cuore -Milano, Largo Gemelli, 1, 20123, Milan, Italy
| | - Miriam Parise
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Family Studies and Research University Centre, Università Cattolica del Sacro Cuore -Milano, Largo Gemelli, 1, 20123, Milan, Italy
| | - Ariela F Pagani
- Department of Humanities, University of Urbino, Via Saffi, 15 - 61019 Urbino, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Emanuele Giusti
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Anna Bertoni
- Department of Psychology, Università Cattolica del Sacro Cuore - Milano, Milan, Italy
- Family Studies and Research University Centre, Università Cattolica del Sacro Cuore -Milano, Largo Gemelli, 1, 20123, Milan, Italy
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Utilidad de una aplicación web interactiva en la mejora del control de los factores de riesgo cardiovascular. Proyecto Control-RCV. Semergen 2022; 48:411-422. [DOI: 10.1016/j.semerg.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/11/2022] [Accepted: 04/23/2022] [Indexed: 11/22/2022]
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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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Halasz G, Piepoli MF. Issue 29.11 focus on biomarkers. Eur J Prev Cardiol 2022; 29:1491-1493. [PMID: 35950482 DOI: 10.1093/eurjpc/zwac151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Geza Halasz
- Cardiac Unit, G. da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | - Massimo F Piepoli
- Clinical Cardiology, Policlinico San Donato, University of Milan, Milan, Italy
- Department of Preventive Cardiology, Wroclaw Medical University, Wroclaw, Poland
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Segan L, Prabhu S, Kalman JM, Kistler PM. Atrial Fibrillation and Stress: A 2-Way Street? JACC Clin Electrophysiol 2022; 8:1051-1059. [PMID: 35981797 DOI: 10.1016/j.jacep.2021.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 02/05/2023]
Abstract
The accumulating literature linking stress with negative health outcomes, including cardiovascular disease (CVD), is extensively reported yet poorly defined. Stress is associated with a higher risk of hypertension, acute myocardial infarction, arrhythmogenesis, and heart failure. Stress mediates its effect through direct neuronal, endocrine, autonomic, and immune processes and indirectly by modifying lifestyle behaviors that promote CVD progression. Stress occurs when an individual perceives that internal or external demands exceed the capacity for an adaptive response. Psychologic stress is increasingly recognized in the atrial fibrillation (AF) population, although the pathophysiology remains unclear. There appears to be a bidirectional relationship between AF and stress with a complex interplay between the 2 entities. Stress modulates the immune and autonomic nervous systems, key drivers in AF initiation and potentiation. AF leads to increasing anxiety, psychologic distress, and suicidal ideation. Recently, lifestyle modification has emerged as the fourth pillar of AF management, with stress reduction a potential reversible risk factor and future target for intervention. This review examines proposed mechanisms linking AF and stress and explores stress reduction as an adjunct to the AF management armamentarium.
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Affiliation(s)
- Louise Segan
- The Alfred Hospital, Melbourne, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - Sandeep Prabhu
- The Alfred Hospital, Melbourne, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - Jonathan M Kalman
- University of Melbourne, Melbourne, Australia; Royal Melbourne Hospital, Melbourne, Australia
| | - Peter M Kistler
- The Alfred Hospital, Melbourne, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Monash University, Melbourne, Australia.
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35
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Effects of Exercise on Heart Failure with Preserved Ejection Fraction: An Updated Review of Literature. J Cardiovasc Dev Dis 2022; 9:jcdd9080241. [PMID: 36005405 PMCID: PMC9409671 DOI: 10.3390/jcdd9080241] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/17/2022] [Accepted: 07/20/2022] [Indexed: 12/12/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) represents the most common HF phenotype of patients aged > 65 years, with an incidence and a prevalence that are constantly growing. The HFpEF cardinal symptom is exercise intolerance (EI), defined as the impaired ability to perform physical activity and to reach the predicted age-related level of exercise duration in the absence of symptoms—such as fatigue or dyspnea—and is associated with a poor quality of life, a higher number of hospitalizations, and poor outcomes. The evidence of the protective effect between exercise and adverse cardiovascular outcomes is numerous and long-established. Regular exercise is known to reduce cardiovascular events and overall mortality both in apparently healthy individuals and in patients with established cardiovascular disease, representing a cornerstone in the prevention and treatment of many cardio-metabolic conditions. Several studies have investigated the role of exercise in HFpEF patients. The present review aims to dwell upon the effects of exercise on HFpEF. For this purpose, the relevant data from a literature search (PubMed, EMBASE, and Medline) were reviewed. The analysis of these studies underlines the fact that exercise training programs improve the cardiorespiratory performance of HFpEF patients in terms of the increase in peak oxygen uptake, the 6 min walk test distance, and the ventilatory threshold; on the other hand, diastolic or systolic functions are generally unchanged or only partially modified by exercise, suggesting that multiple mechanisms contribute to the improvement of exercise tolerance in HFpEF patients. In conclusion, considering that exercise training programs are able to improve the cardiorespiratory performance of HFpEF patients, the prescription of exercise training programs should be encouraged in stable HFpEF patients, and further research is needed to better elucidate the pathophysiological mechanisms underpinning the beneficial effects described.
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Brotons C, Camafort M, Castellanos MDM, Clarà A, Cortés O, Diaz Rodriguez A, Elosua R, Gorostidi M, Hernández AM, Herranz M, Justo S, Lahoz C, Niño P, Pallarés-Carratalá V, Pedro-Botet J, Pérez Pérez A, Royo-Bordonada MA, Santamaria R, Tresserras R, Zamora A, Zuza I, Armario P. Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2022; 34:219-228. [PMID: 35906022 DOI: 10.1016/j.arteri.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 06/15/2023]
Abstract
We present the Spanish adaptation of the 2021 European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. The current guidelines besides the individual approach greatly emphasize on the importance of population level approaches to the prevention of cardiovascular diseases. Systematic global cardiovascular disease risk assessment is recommended in individuals with any major vascular risk factor. Regarding LDL-cholesterol, blood pressure, and glycemic control in patients with diabetes mellitus, goals and targets remain as recommended in previous guidelines. However, it is proposed a new, stepwise approach (steps 1 and 2) to treatment intensification as a tool to help physicians and patients pursue these targets in a way that fits patient profile. After step 1, considering proceeding to the intensified goals of step 2 is mandatory, and this intensification will be based on 10-year cardiovascular disease risk, lifetime cardiovascular disease risk and treatment benefit, comorbidities and patient preferences. The updated SCORE algorithm ?SCORE2, SCORE2-OP? is recommended in these guidelines, which estimates an individual's 10-year risk of fatal and non-fatal cardiovascular disease events (myocardial infarction, stroke) in healthy men and women aged 40-89 years. Another new and important recommendation is the use of different categories of risk according to different age groups (<50, 50-69, ≥70 years). Different flow charts of cardiovascular disease risk and risk factor treatment in apparently healthy persons, in patients with established atherosclerotic cardiovascular disease, and in diabetic patients are recommended. Patients with chronic kidney disease are considered high risk or very high-risk patients according to the levels of glomerular filtration rate and albumin-to-creatinine ratio. New lifestyle recommendations adapted to the ones published by the Spanish Ministry of Health as well as recommendations focused on the management of lipids, blood pressure, diabetes and chronic renal failure are included.
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Affiliation(s)
- Carlos Brotons
- Sociedad Española de Medicina de Familia y Comunitaria (semFYC), Barcelona, España.
| | | | | | - Albert Clarà
- Sociedad Española de Angiología y Cirugía Vascular, Madrid, España
| | - Olga Cortés
- Asociación Española de Pediatría de Atención Primaria, Madrid, España
| | | | | | | | | | - María Herranz
- Federación de Asociaciones de Enfermería Comunitaria y Atención Primaria (FAECAP), Madrid, España
| | | | - Carlos Lahoz
- Sociedad Española de Medicina Interna, Madrid, España
| | - Pilar Niño
- Sociedad Española de Medicina y Seguridad del Trabajo, Madrid, España
| | | | | | | | | | | | - Ricard Tresserras
- Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS), Barcelona, España
| | - Alberto Zamora
- Sociedad Española de Arteriosclerosis, Barcelona, España
| | - Inés Zuza
- Ministerio de Sanidad, Madrid, España
| | - Pedro Armario
- Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial, Madrid, España
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Brotons C, Camafort M, Castellanos MDM, Clarà A, Cortés O, Díaz Rodríguez Á, Elosua R, Gorostidi M, Hernández AM, Herranz M, Justo S, Lahoz C, Niño P, Pallarés-Carratalá V, Pedro-Botet J, Pérez A, Royo-Bordonda MÁ, Santamaría R, Tresserras R, Zamora A, Zuza I, Armario P. Comentario del CEPIV a las nuevas guías europeas de prevención cardiovascular 2021. REVISTA CLÍNICA DE MEDICINA DE FAMILIA 2022. [DOI: 10.55783/rcmf.150207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Se presenta la adaptación española de las Guías Europeas de Prevención Cardiovascular 2021. En esta actualización, además del abordaje individual, se pone mucho más énfasis en las políticas sanitarias como estrategia de prevención poblacional. Se recomienda el cálculo del riesgo vascular de manera sistemática a todas las personas adultas con algún factor de riesgo vascular. Los objetivos terapéuticos para el colesterol LDL, la presión arterial y la glucemia no han cambiado respecto a las anteriores guías, pero se recomienda alcanzar estos objetivos de forma escalonada (etapas 1 y 2). Se recomienda llegar siempre hasta la etapa 2, y la intensificación del tratamiento dependerá del riesgo a los 10 años y de por vida, del beneficio del tratamiento, de las comorbilidades, de la fragilidad y de las preferencias de los pacientes. Las guías presentan por primera vez un nuevo modelo para calcular el riesgo —SCORE2 y SCORE2-OP— de morbimortalidad vascular en los próximos 10 años (infarto de miocardio, ictus y mortalidad vascular) en hombres y mujeres entre 40 y 89 años. Otra de las novedades sustanciales es el establecimiento de diferentes umbrales de riesgo dependiendo de la edad (< 50, 50-69, ≥ 70 años).
Se presentan diferentes algoritmos de cálculo del riesgo vascular y tratamiento de los factores de riesgo vascular para personas aparentemente sanas, pacientes con diabetes y aquellos con enfermedad vascular aterosclerótica. Los pacientes con enfermedad renal crónica se considerarán de riesgo alto o muy alto, según la tasa del filtrado glomerular y el cociente albúmina/creatinina. Se incluyen innovaciones en las recomendaciones sobre los estilos de vida, adaptadas a las recomendaciones del Ministerio de Sanidad, así como aspectos novedosos relacionados con el control de los lípidos, la presión arterial, la diabetes y la insuficiencia renal crónica.
Palabras clave: prevención y control, enfermedades vasculares, guías de práctica clínica, dieta saludable, hipertensión arterial, diabetes, control de lípidos, tabaco, riesgo cardiovascular.
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Affiliation(s)
- Carlos Brotons
- Sociedad Española de Medicina de Familia y Comunitaria-semFYC. Barcelona (España)
| | | | | | - Albert Clarà
- Sociedad Española de Angiología y Cirugía Vascular. Madrid (España)
| | - Olga Cortés
- Asociación Española de Pediatría de Atención Primaria. Madrid (España)
| | | | | | | | | | - María Herranz
- Federación de Asociaciones de Enfermería Comunitaria y Atención Primaria-FAECAP. Madrid (España)
| | | | - Carlos Lahoz
- Sociedad Española de Medicina Interna. Madrid (España)
| | - Pilar Niño
- Sociedad Española de Medicina y Seguridad del Trabajo. Madrid (España)
| | | | | | | | | | | | - Ricard Tresserras
- Sociedad Española de Salud Pública y Administración Sanitaria-SESPAS. Barcelona (España)
| | - Alberto Zamora
- Sociedad Española de Arteriosclerosis. Barcelona (España)
| | - Inés Zuza
- Ministerio de Sanidad. Madrid (España)
| | - Pedro Armario
- Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial. Madrid (España)
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Comentario del CEIPV a las nuevas Guías Europeas de Prevención Cardiovascular 2021. Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Chagué F, Boulin M, Eicher JC, Bichat F, Saint-Jalmes M, Cransac A, Soudry A, Danchin N, Laurent G, Cottin Y, Zeller M. Smoking in Patients With Chronic Cardiovascular Disease During COVID-19 Lockdown. Front Cardiovasc Med 2022; 9:845439. [PMID: 35557527 PMCID: PMC9086588 DOI: 10.3389/fcvm.2022.845439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/14/2022] [Indexed: 01/04/2023] Open
Abstract
Objectives This cross-sectional study aims to investigate health-related behaviors including tobacco consumption among patients with cardiovascular diseases (CVD), during the first COVID-19-related lockdown. Methods After 5 weeks of COVID-19 lockdown, 220 patients with chronic coronary syndromes (CCS) and 124 with congestive heart failure (CHF) answered a phone questionnaire. Results Among these 344 patients, 43 (12.5%) were current smokers, and none had quit during the lockdown. When compared with non-smokers, smokers were 15 years younger, more often diabetic, more likely to live in an urban than a rural lockdown location, and more often in the CCS cohort (p = 0.011). Smokers described greater psychological impairment, but their rates of decrease in physical activity and of increase in screen time were similar to non-smokers. More than one-third (13/43) increased their tobacco consumption, which was mainly related to stress or boredom, but not driven by media messages on a protective effect of nicotine. Conclusions During the first COVID-19 lockdown, we found a decrease in favorable lifestyle behaviors among patients with CVD. Strikingly, one-third of smokers with CCS or CHF increased their tobacco consumption. Given the major impact of persistent smoking in patients with CVD, this highlights the need for targeted prevention strategies, in particular during such periods.
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Affiliation(s)
- Frédéric Chagué
- Service de Cardiologie, Centre Hospitalier Universitaire, Dijon, France.,Réseau Français d'Excellence de Recherche sur le tabac, la nicotine et les produits connexes, Paris, France
| | - Mathieu Boulin
- Département de Pharmacie, Centre Hospitalier Universitaire, Dijon, France
| | | | - Florence Bichat
- Service de Cardiologie, Centre Hospitalier Universitaire, Dijon, France
| | | | - Amélie Cransac
- Département de Pharmacie, Centre Hospitalier Universitaire, Dijon, France
| | - Agnès Soudry
- Département de Recherche Clinique, Centre Hospitalier Universitaire, Dijon, France
| | - Nicolas Danchin
- Service de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Gabriel Laurent
- Service de Cardiologie, Centre Hospitalier Universitaire, Dijon, France
| | - Yves Cottin
- Service de Cardiologie, Centre Hospitalier Universitaire, Dijon, France
| | - Marianne Zeller
- Réseau Français d'Excellence de Recherche sur le tabac, la nicotine et les produits connexes, Paris, France.,PEC2, EA 7460, Université Bourgogne Franche-Comté, Dijon, France
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40
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Almarzooq ZI. The cost of coronary heart disease and the promise of prevention. Eur J Prev Cardiol 2022; 29:e213-e215. [DOI: 10.1093/eurjpc/zwaa056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Zaid I Almarzooq
- Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
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41
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Ruiz-García A, Pallarés-Carratalá V, Serrano-Cumplido A, Escobar-Cervantes C, Barquilla-García A, Divisón-Garrote J, Turégano-Yedro M, Prieto-Díaz M, Cinza-Sanjurjo S, Alonso-Moreno F, Beato-Fernández P, García-Matarín L, Rey-Aldana D, Martín-Rioboó E, Moyá-Amengual A, Crespo-Sabarís R, Piera-Carbonell A, Romero-Vigara J, Carrasco-Carrasco E, Velilla-Zancada S, Seoane-Vicente M, Górriz-Teruel J, Polo-García J, Barrios V. Evaluation of prophylaxis in primary prevention with acetylsalicylic acid in people with diabetes: A scoping review. Semergen 2022; 48:275-292. [DOI: 10.1016/j.semerg.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/07/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
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42
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Meireles-Brandão JA, Meireles-Brandão LR, Coelho R, Rocha-Gonçalves F. Long-term outcomes of primary cardiovascular prevention: A retrospective study at a referral center in Portugal. Rev Port Cardiol 2022; 41:681-688. [DOI: 10.1016/j.repc.2021.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/25/2021] [Indexed: 11/26/2022] Open
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43
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44
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Brotons C, Camafort M, Del Mar Castellanos M, Clarà A, Cortés O, Diaz Rodriguez A, Elosua R, Gorostidi M, Hernández AM, Herranz M, Justo S, Lahoz C, Niño P, Pallarés-Carratalá V, Pedro-Botet J, Pérez Pérez A, Royo-Bordonada MA, Santamaria R, Tresserras R, Zamora A, Zuza I, Armario P. [Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention]. HIPERTENSION Y RIESGO VASCULAR 2022; 39:69-78. [PMID: 35331672 DOI: 10.1016/j.hipert.2022.02.003] [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: 02/11/2022] [Accepted: 02/21/2022] [Indexed: 10/18/2022]
Abstract
Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention. We present the Spanish adaptation of the 2021 European Guidelines on Cardiovascular Disease (CVD) prevention in clinical practice. The current guidelines besides the individual approach greatly emphasize on the importance of population level approaches to the prevention of cardiovascular diseases. Systematic global CVD risk assessment is recommended in individuals with any major vascular risk factor. Regarding LDL-Cholesterol, blood pressure, and glycemic control in patients with diabetes mellitus, goals and targets remain as recommended in previous guidelines. However, it is proposed a new, stepwise approach (Step 1 and 2) to treatment intensification as a tool to help physicians and patients pursue these targets in a way that fits patient profile. After Step 1, considering proceeding to the intensified goals of Step 2 is mandatory, and this intensification will be based on 10-year CVD risk, lifetime CVD risk and treatment benefit, comorbidities and patient preferences. The updated SCORE algorithm-SCORE2, SCORE-OP- is recommended in these guidelines, which estimates an individual's 10-year risk of fatal and non-fatal CVD events (myocardial infarction, stroke) in healthy men and women aged 40-89 years. Another new and important recommendation is the use of different categories of risk according different age groups (< 50, 50-69 ≥ 70 years). Different flow charts of CVD risk and risk factor treatment in apparently healthy persons, in patients with established atherosclerotic CVD, and in diabetic patients are recommended. Patients with chronic kidney disease are considered high risk or very high-risk patients according to the levels of glomerular filtration rate and albumin-to-creatinine ratio. New lifestyle recommendations adapted to the ones published by the Spanish Ministry of Health as well as recommendations focused on the management of lipids, blood pressure, diabetes and chronic renal failure are included.
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Affiliation(s)
- C Brotons
- Sociedad Española de Medicina de Familia y Comunitaria-semFYC, Barcelona, España.
| | - M Camafort
- Sociedad Española de Medicina Interna, Barcelona, España
| | | | - A Clarà
- Sociedad Española de Angiología y Cirugía Vascular, Madrid, España
| | - O Cortés
- Asociación Española Pediatría de Atención Primaria, Madrid, España
| | - A Diaz Rodriguez
- Sociedad Española de Médicos de Atención Primaria-SEMERGEN, Madrid, España
| | - R Elosua
- Sociedad Española de Epidemiología, Barcelona, España
| | - M Gorostidi
- Sociedad Española de Nefrología, Santander, España
| | | | - M Herranz
- Federación de Asociaciones de Enfermería Comunitaria y Atención Primaria-FAECAP, Madrid, España
| | - S Justo
- Ministerio de Sanidad, Madrid, España
| | - C Lahoz
- Sociedad Española de Medicina Interna, Barcelona, España
| | - P Niño
- Sociedad Española de Medicina y Seguridad del Trabajo, España
| | | | - J Pedro-Botet
- Sociedad Española de Arteriosclerosis, Barcelona, España
| | | | | | - R Santamaria
- Sociedad Española de Nefrología, Santander, España
| | - R Tresserras
- Sociedad Española de Salud Pública y Administración Sanitaria-SESPAS, Barcelona, España
| | - A Zamora
- Sociedad Española de Arteriosclerosis, Barcelona, España
| | - I Zuza
- Ministerio de Sanidad, Madrid, España
| | - P Armario
- Sociedad Española-Liga Española para la Lucha contra la Hipertensión Arterial, Madrid, España
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Staszewsky L, Baviera M, Tettamanti M, Colacioppo P, Robusto F, D'Ettorre A, Lepore V, Fortino I, Bisceglia L, Attolini E, Graps EA, Caldo G, Roncaglioni MC, Garattini S, Latini R. Insulin treatment in patients with diabetes mellitus and heart failure in the era of new antidiabetic medications. BMJ Open Diabetes Res Care 2022; 10:10/2/e002708. [PMID: 35351688 PMCID: PMC8966566 DOI: 10.1136/bmjdrc-2021-002708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/27/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Coexistent heart failure (HF) and diabetes mellitus (DM) are associated with marked morbidity and mortality. Optimizing treatment strategies can reduce the number and severity of events. Insulin is frequently used in these patients, but its benefit/risk ratio is still not clear, particularly since new antidiabetic drugs that reduce major adverse cardiac events (MACEs) and renal failure have recently come into use. Our aim is to compare the clinical effects of insulin in a real-world setting of first-time users, with sodium-glucose cotransporter-2 inhibitor (SGLT-2i), glucagon-like peptide-1 receptor agonist (GLP-1RA) and the other antihyperglycemic agents (other-AHAs). METHODS We used the administrative databases of two Italian regions, during the years 2010-2018. Outcomes in whole and propensity-matched cohorts were examined using Cox models. A meta-analysis was also conducted combining the data from both regions. RESULTS We identified 34 376 individuals ≥50 years old with DM and HF; 42.0% were aged >80 years and 46.7% were women. SGLT-2i and GLP-1RA significantly reduced MACE compared with insulin and particularly death from any cause (SGLT-2i, hazard ratio (95% CI) 0.29 (0.23 to 0.36); GLP-1RA, 0.482 (0.51 to 0.42)) and first hospitalization for HF (0.57 (0.40 to 0.81) and 0.67 (0.59 to 0.76)). CONCLUSIONS In patients with DM and HF, SGLT-2i and GLP-1RA significantly reduced MACE compared with insulin, and particularly any cause of death and first hospitalization for HF. These groups of medications had high safety profiles compared with other-AHAs and particularly with insulin. The inadequate optimization of HF and DM cotreatment in the insulin cohort is noteworthy.
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Affiliation(s)
- Lidia Staszewsky
- Department of Cardiovascular Medicine, Laboratory of Cardiovascular Clinical Pharmacology, Mario Negri Institute for Pharmacological Research IRCCS, Milano, Italy
| | - Marta Baviera
- Department of Cardiovascular Medicine, Laboratory of Cardiovascular Prevention, Mario Negri Institute for Pharmacological Research IRCCS, Milano, Italy
| | - Mauro Tettamanti
- Department of Health Policy, Laboratory of Geriatric Epidemiology, Mario Negri Institute for Pharmacological Research IRCCS, Milano, Italy
| | - Pierluca Colacioppo
- Department of Cardiovascular Medicine, Laboratory of Cardiovascular Prevention, Mario Negri Institute for Pharmacological Research IRCCS, Milano, Italy
| | - Fabio Robusto
- Medonline-Statte, ASL-TA, Taranto, Puglia Health System, Bari, Italy
| | - Antonio D'Ettorre
- Agenzia Regionale Strategica per la Salute ed il Sociale - AReSS Puglia, Area Epidemiologia e Care Intelligence, Puglia Health System, Bari, Italy
| | - Vito Lepore
- Department of Public Health, Laboratory of Medical Research and Consumer Involvement, Mario Negri Institute for Pharmacological Research, Milano, Italy
| | - Ida Fortino
- Region Health Ministry, Lombardy Region, Milano, Italy
| | - Lucia Bisceglia
- Agenzia Regionale Strategica per la Salute ed il Sociale - AReSS Puglia, Area Epidemiologia e Care Intelligence, Puglia Health System, Bari, Italy
| | - Ettore Attolini
- Agenzia Regionale Strategica per la Salute ed il Sociale - AReSS Puglia, Area Innovazione Sociale, Sanitaria e di Sistema-CRSS, Puglia Health System, Bari, Italy
| | - Elisabetta Anna Graps
- Agenzia Regionale Strategica per la Salute ed il Sociale - AReSS Puglia, Area Valutazione e Ricerca, Puglia Health System, Bari, Italy
| | - Gianluca Caldo
- Department of Cardiovascular Medicine, Laboratory of Cardiovascular Prevention, Mario Negri Institute for Pharmacological Research IRCCS, Milano, Italy
| | - Maria Carla Roncaglioni
- Department of Cardiovascular Medicine, Laboratory of Cardiovascular Prevention, Mario Negri Institute for Pharmacological Research IRCCS, Milano, Italy
| | - Silvio Garattini
- Mario Negri Institute for Pharmacological Research IRCCS, Milano, Italy
| | - Roberto Latini
- Department of Cardiovascular Medicine, Laboratory of Cardiovascular Clinical Pharmacology, Mario Negri Institute for Pharmacological Research IRCCS, Milano, Italy
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Leitão L, Marocolo M, de Souza HLR, Arriel RA, Campos Y, Mazini M, Junior RP, Figueiredo T, Louro H, Pereira A. Three-Month vs. One-Year Detraining Effects after Multicomponent Exercise Program in Hypertensive Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052871. [PMID: 35270564 PMCID: PMC8910620 DOI: 10.3390/ijerph19052871] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/08/2022] [Accepted: 02/24/2022] [Indexed: 01/01/2023]
Abstract
Background: Chronic diseases are the leading causes of death and disability in older women. Physical exercise training programs promote beneficial effects for health and quality of life. However, exercise interruption periods may be detrimental for the hemodynamic and lipidic profiles of hypertensive older women with dyslipidemia. Methods: Nineteen hypertensive older women with dyslipidemia (exercise group: 67.5 ± 5.4 years, 1.53 ± 3.42 m, 71.84 ± 7.45 kg) performed a supervised multicomponent exercise training program (METP) during nine months, followed by a one-year detraining period (DT), while fourteen hypertensive older women (control group: 66.4 ± 5.2 years, 1.56 ± 3.10 m, 69.38 ± 5.24 kg) with dyslipidemia kept their continued daily routine without exercise. For both groups, hemodynamic and lipidic profiles and functional capacities (FCs) were assessed four times: before and after the METP and after 3 and 12 months of DT (no exercise was carried out). Results: The METP improved hemodynamic and lipidic profiles (p < 0.05), while three months of DT decreased all (p < 0.05) parameters, with the exception of diastolic blood pressure (DBP). One year of DT significantly (p < 0.01) decreased systolic blood pressure (7.85%), DBP (2.29%), resting heart rate (7.95%), blood glucose (19.14%), total cholesterol (10.27%), triglycerides (6.92%) and FC—agility (4.24%), lower- (−12.75%) and upper-body strength (−12.17%), cardiorespiratory capacity (−4.81%) and lower- (−16.16%) and upper-body flexibility (−11.11%). Conclusion: Nine months of the exercise program significantly improved the hemodynamic and lipid profiles as well as the functional capacities of hypertensive older women with dyslipidemia. Although a detraining period is detrimental to these benefits, it seems that the first three months are more prominent in these alterations.
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Affiliation(s)
- Luis Leitão
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
- Correspondence:
| | - Moacir Marocolo
- Department of Physiology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil; (M.M.); (H.L.R.d.S.); (R.A.A.)
| | - Hiago L. R. de Souza
- Department of Physiology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil; (M.M.); (H.L.R.d.S.); (R.A.A.)
| | - Rhai André Arriel
- Department of Physiology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil; (M.M.); (H.L.R.d.S.); (R.A.A.)
| | - Yuri Campos
- Post Graduate Program in Physical Education, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil;
- Studies Research Group in Neuromuscular Responses, Federal University of Lavras, Lavras 37200-900, Brazil
| | - Mauro Mazini
- Graduate Program in Physical Education—Sudamerica Faculty, Cataguases 36774-552, Brazil;
| | - Ricardo Pace Junior
- Graduate Program of Physical Education of Fasar—Santa Rita Faculty, Conselheiro Lafaiete 36400-000, Brazil;
| | - Teresa Figueiredo
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Hugo Louro
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal;
- Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-801 Vila Real, Portugal
| | - Ana Pereira
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
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Dose-related Meta-Analysis for Omega-3 Fatty Acids Supplementation on Major Adverse Cardiovascular Events. Clin Nutr 2022; 41:923-930. [DOI: 10.1016/j.clnu.2022.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/16/2021] [Accepted: 02/28/2022] [Indexed: 11/18/2022]
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48
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Parati G, Piepoli MF. Editorial comments. FOCUS ON ISCHAEMIC HEART DISEASE. Eur J Prev Cardiol 2022; 29:301-303. [PMID: 35199144 DOI: 10.1093/eurjpc/zwac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Gianfranco Parati
- Chairman Elect, Council on Hypertension, European Society of Cardiology, University of Milano-Bicocca and IRCCS, Istituto Auxologico Italiano, Milan, Italy, Associate Editor for Hypertension, EJPC
| | - Massimo F Piepoli
- Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy. Editor in Chief, EJPC
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Li Y, Lu Y, Hurwitz EL, Wu Y. Gender Disparities of Heart Disease and the Association with Smoking and Drinking Behavior among Middle-Aged and Older Adults, a Cross-Sectional Study of Data from the US Health and Retirement Study and the China Health and Retirement Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042188. [PMID: 35206380 PMCID: PMC8872153 DOI: 10.3390/ijerph19042188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/27/2022] [Accepted: 02/03/2022] [Indexed: 12/13/2022]
Abstract
Heart disease remains the leading cause of death globally by gender and region. Smoking and alcohol drinking are known modifiable health behaviors of heart disease. Utilizing data from the US Health and Retirement Study and the China Health and Retirement Longitudinal Study, this study examines heart disease disparities and the association with smoking and drinking behavior among men and women in the US and China. Smoking and drinking behavior were combined to neither, smoke-only, drink-only, and both. In the US, the prevalence was higher in men (24.5%, 95% CI: 22.5-26.6%) than in women (20.6%, 95% CI: 19.3-22.1%) and a higher prevalence was found in the smoke-only group for both genders. In contrast, women in China had higher prevalence (22.9%, 95% CI: 21.7-24.1%) than men (16.1%, 95% CI: 15.1-17.2%), and the prevalence for women who smoked or engaged in both behaviors were ~1.5 times (95% CI: 1.3-1.8, p < 0.001) those who did not smoke or drink, but no statistical difference were found in men. The findings might be due to differences in smoking and drinking patterns and cultures by gender in the two countries and gender inequality among older adults in China. Culturally tailored health promotion strategies will help reduce the burden of heart disease.
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Affiliation(s)
- Yifei Li
- Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA; (Y.L.); (Y.L.); (E.L.H.)
- Department of Disease Control and Prevention, Tang Du Hospital, Air Force Medical University, Xi’an 710038, China
| | - Yuanan Lu
- Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA; (Y.L.); (Y.L.); (E.L.H.)
| | - Eric L. Hurwitz
- Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA; (Y.L.); (Y.L.); (E.L.H.)
| | - Yanyan Wu
- Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA; (Y.L.); (Y.L.); (E.L.H.)
- Correspondence:
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Gender differences in cardiovascular risk factor awareness: Results from the ESC EORP EUROASPIRE V Registry. Int J Cardiol 2022; 352:152-157. [PMID: 35122913 DOI: 10.1016/j.ijcard.2022.01.059] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/18/2022] [Accepted: 01/28/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Patient risk factor awareness is essential to decrease the risk of recurrent coronary events. The aim of this study was to provide up-to-date evidence on existing gender differences in the patients' knowledge of risk factors and information provided by healthcare professionals. METHODS Analyses were based on the cross-sectional ESC EORP EUROASPIRE V survey, including data on CHD patients across 27 European countries. Consecutive patients (18-80 years), hospitalized for a coronary event or surgical procedure, were retrospectively identified. Information on risk factor awareness was collected from medical records, medical examination, and structured questionnaires during the study visit (six months to two years after hospitalization). RESULTS Patient information was available for 8261 patients, of which 25.8% were women. Although women with obesity were significantly less aware about their actual (OR = 0.66, CI = 0.52-0.85) and target weight levels (OR = 0.66, CI = 0.54-0.81), no significant gender differences in risk factor awareness were found in disfavour of women. Remarkably, women with hypertension and women with raised low-density lipoprotein cholesterol (LDL-C) levels were even more aware about their target blood pressure levels (OR = 1.21, CI = 1.01-1.46) and actual cholesterol levels (OR = 1.18, CI = 1.02-1.36), respectively. Moreover, there is some indication that women were more informed by a healthcare professional if they had raised CHD risk factor levels. CONCLUSIONS Our study showed only few gender differences in disfavour of women in terms of risk factor awareness and information provided by a healthcare professional. Nevertheless, previous EUROASPIRE V findings demonstrated that women still have a poorer risk factor control in secondary CHD prevention.
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