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Nedeljkovic M, Mihajlovic M, Mujovic N, Lip GYH, Potpara TS. Assessment of patient-reported treatment burden in patients with coronary artery disease. Arch Med Sci 2024; 20:1006-1010. [PMID: 39050177 PMCID: PMC11264058 DOI: 10.5114/aoms/187104] [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: 02/02/2024] [Accepted: 04/13/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction Patient-reported treatment burden (TBN) refers to the patient's time and effort invested in the management of their chronic health conditions. The aim of this research was to explore TBN in patients with coronary artery disease (CAD). Methods Consecutive patients with chronic medical condition(s) were invited to complete the study questionnaires (TBN and EQ-5D). Results Of 514 enrolled patients, 116 (22.6%) patients had CAD. The mean TBN score for CAD vs. non-CAD was 40.49 ±21.54 and 46.17 ±21.44 (p = 0.023), respectively. Conclusions Patients with CAD could have a lower TBN in comparison to patients with other chronic medical conditions.
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Affiliation(s)
- Milan Nedeljkovic
- School of Medicine, Belgrade University, Belgrade, Serbia
- Cardiology Clinic, University Clinical Centre of Serbia, Belgrade, Serbia
| | | | - Nebojsa Mujovic
- School of Medicine, Belgrade University, Belgrade, Serbia
- Cardiology Clinic, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Gregory Y. H. Lip
- School of Medicine, Belgrade University, Belgrade, Serbia
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Tatjana S. Potpara
- School of Medicine, Belgrade University, Belgrade, Serbia
- Cardiology Clinic, University Clinical Centre of Serbia, Belgrade, Serbia
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Comparison of Blood Pressure Variability between 24 h Ambulatory Monitoring and Office Blood Pressure in Diabetics and Nondiabetic Patients: A Cross-Sectional Study. Int J Hypertens 2022; 2022:1022044. [PMID: 35774421 PMCID: PMC9239826 DOI: 10.1155/2022/1022044] [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: 07/19/2021] [Revised: 01/23/2022] [Accepted: 05/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background. Evidence regarding blood pressure (BP) variability (BPV) and its independent association with adverse outcomes has grown. Diabetic patients might have increased BPV, but there is still an evidence gap regarding relation between BPV and type 2 diabetes beyond mean values of BP. Objective. To examine the relationship between 24 h ambulatory BP monitoring (ABPM, short-term variability) and visit-to-visit in-office BPV (OBP, long-term variability), in diabetics (D) and nondiabetics (ND), and to explore BPV relation with estimated glomerular filtration rate (eGFR), and pulse wave velocity (PWV) as indicators of target organ lesion. Materials and Methods. We conducted a single-center cross-sectional study in an outpatient BP unit, including adult patients consecutively admitted from 1999 to 2019. Multivariate was performed to compare BPV between D and ND adjusted for clinical variables. Pearson’s correlation was performed to evaluate relation of BPV with eGFR and PWV. Results. A total of 1123 patients with ABPM and OBP measurements were included. Values of eGFR and PWV were worse in D than in ND. Measurements of OBPV did not differ between groups. Of ABPM BPV, the coefficient of variation and standard deviation for daytime systolic BP were higher in D compared to ND, but only in ND did BPV correlated with both eGFR and PWV. Conclusion. We found that diabetes is associated with higher variability of daytime BP than nondiabetics along with worse damage of vascular and renal function. However, in contrast to nondiabetics, in diabetics eGFR and PWV may not be dependent on BP variability, suggesting that other mechanisms might explain more rigorously the greater damage of target organ lesion markers.
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Nansseu JRN, Moor VJA, Nouaga MED, Zing-Awona B, Tchanana G, Ketcha A. Atherogenic index of plasma and risk of cardiovascular disease among Cameroonian postmenopausal women. Lipids Health Dis 2016; 15:49. [PMID: 26957313 PMCID: PMC4784375 DOI: 10.1186/s12944-016-0222-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 03/04/2016] [Indexed: 11/30/2022] Open
Abstract
Background The paucity of data regarding the relationship between atherogenic index of plasma (AIP) and risk of cardiovascular disease (CVD) in postmenopausal women living in sub-Saharan Africa prompted us to conduct this study which aimed at assessing the interplay between AIP and risk of CVD among Cameroonian postmenopausal women. Methods This was a cross-sectional study conducted among 108 postmenopausal women in Yaoundé, Cameroon. Risk of CVD was calculated using the Framingham risk score, (FRS), and the AIP was derived as log (triglycerides/high-density lipoproteins cholesterol). Results Mean age of participants equaled 56.4 ± 6.9 years. AIP values ranged from -0.40 to 0.85 with a mean of 0.21 ± 0.27. There was a positive and significant correlation between AIP and body mass index (r = 0.234; p = 0.015), systolic blood pressure (r = 0.350; p < 0.001), diastolic blood pressure (r = 0.365; p < 0.001), fasting plasma glucose (r = 0.314; p = 0.001), uric acid (r = 0.374; p < 0.001), and total cholesterol (r = 0.374; p < 0.001), but not with age (r = -0.104; p = 0.284). The FRS varied between 1.2 % and >30 % with a mean of 13.4 ± 8.7 %. In univariable model, AIP significantly influenced the risk of CVD (β = 11.94; p < 0.001; R2 = 0.136). But in the multivariable model, after adjusting for confounders, AIP did not impact the risk of CVD anymore (adjusted β = 1.98; p = 0.487; R2 = 0.486). Conclusion AIP may not be an independent factor impacting the risk of CVD among Cameroonian postmenopausal women. More studies are needed to better elucidate the interaction between AIP and risk of CVD in our setting.
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Affiliation(s)
- Jobert Richie N Nansseu
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, PO Box 1364, Yaoundé, Cameroon. .,Sickle Cell Disease Unit, Mother and Child Centre, Chantal Biya Foundation, Yaoundé, Cameroon.
| | - Vicky Jocelyne Ama Moor
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon. .,Laboratory of Biochemistry, Yaoundé University Teaching Hospital, Yaoundé, Cameroon. .,Department of Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
| | | | - Bertrand Zing-Awona
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, PO Box 1364, Yaoundé, Cameroon. .,Mathematical Engineering and Information System Laboratory, National Advanced School of Engineering, University of Yaoundé I, Yaoundé, Cameroon. .,African Center of Excellence in Information and Communication Technologies, Yaoundé, Cameroon.
| | - Gladys Tchanana
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.
| | - Arthur Ketcha
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.
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Kolovou GD, Mavrogeni S. Menopause Status and Percutaneous Coronary Intervention. Angiology 2015; 67:309-10. [PMID: 26032850 DOI: 10.1177/0003319715589521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Genovefa D Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center Athens, Athens, Greece
| | - Sophie Mavrogeni
- Cardiology Department, Onassis Cardiac Surgery Center Athens, Athens, Greece
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Krzysztoszek J, Koligat D, Ratajczak P, Bryl W, Cymerys M, Hoffmann K, Wierzejska E, Kleka P. Economic aspects of hypertension treatment in Poland. Arch Med Sci 2014; 10:607-17. [PMID: 25097594 PMCID: PMC4107239 DOI: 10.5114/aoms.2013.32853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 05/16/2012] [Accepted: 09/26/2012] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The aim of this study was to assess the costs associated with mild hypertension (HTN) in Poland and to compare the costs of 3-year ambulatory care for those diagnosed with mild HTN (group A) and those diagnosed with mild HTN and comorbidities (group B). MATERIAL AND METHODS The researchers undertook a retrospective study of a group of 120 patients treated for 3 years (2006-2008) (60%, n = 72 women and 40%, n = 48 men), taking into account the broadest possible social perspective. Medical and non-medical direct costs as well as indirect costs were calculated. RESULTS The total costs of the 3-year pharmacotherapy in group A equalled 49,985.65 EUR, or 833.09 EUR per patient, whereas in group B the costs were twice as high: 105,691.55 EUR in total or 1,761.53 EUR per patient. Indirect costs for group A patients totalled 3,468.80 EUR (578.13 EUR per patient) and 4,579.20 EUR for group B patients (572.40 EUR per patient). Total direct costs (medical and non-medical) and indirect costs for group B patients were much higher, amounting to 130,228.14 EUR and 2,666.55 EUR per patient, which was double the costs in group A, where costs were 74,184.96 EUR and 1,756.73 EUR per patient. CONCLUSIONS The costs of HTN treatment in Poland are very high and are growing, like in other countries. Potential solutions include developing better patientdoctor communication to improve compliance, and increasing the chances of more effective and less expensive therapy by prescribing cheaper generic drugs, limiting polypharmacy and improving availability of novel therapeutic methods.
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Affiliation(s)
- Jana Krzysztoszek
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
| | - Dorota Koligat
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Ratajczak
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
| | - Wiesław Bryl
- Department of Internal Medicine, Metabolic Disorders and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Cymerys
- Department of Internal Medicine, Metabolic Disorders and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Karolina Hoffmann
- Department of Internal Medicine, Metabolic Disorders and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewelina Wierzejska
- Laboratory of International Health, Department of Preventive Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Paweł Kleka
- Institute of Psychology, Adam Mickiewicz University, Poznan, Poland
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Kasznicki J, Drzewoski J. Heart failure in the diabetic population - pathophysiology, diagnosis and management. Arch Med Sci 2014; 10:546-56. [PMID: 25097587 PMCID: PMC4107260 DOI: 10.5114/aoms.2014.43748] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 10/14/2013] [Accepted: 11/04/2013] [Indexed: 01/08/2023] Open
Abstract
Evidence from clinical trials repeatedly confirms the association of diabetes with heart failure, independent of hypertension, atherosclerosis, coronary artery disease and valvular heart disease. However, the importance of coexistence of diabetes and heart failure is not universally recognized, despite the fact that it may significantly contribute to morbidity and mortality of the diabetic population. It seems that prevention of heart failure, early diagnosis, and appropriate management could improve the outcome. Unfortunately, the etiology of heart failure in diabetic patients is still to be elucidated. It is multifactorial in nature and several cellular, molecular and metabolic factors are implicated. Additionally, there are still no definite guidelines on either the diagnosis and treatment of heart failure in diabetic patients or on the therapy of diabetes in subjects with heart failure. This review focuses on the pathophysiology, diagnosis, and prevention of heart failure in the diabetic population as well as management of both comorbidities.
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Affiliation(s)
- Jacek Kasznicki
- Department of Internal Disease, Diabetology and Clinical Pharmacology, Medical University of Lodz, Poland
| | - Jozef Drzewoski
- Department of Internal Disease, Diabetology and Clinical Pharmacology, Medical University of Lodz, Poland
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Guirado GN, Damatto RL, Matsubara BB, Roscani MG, Fusco DR, Cicchetto LAF, Seki MM, Teixeira AS, Valle AP, Okoshi K, Okoshi MP. Combined exercise training in asymptomatic elderly with controlled hypertension: effects on functional capacity and cardiac diastolic function. Med Sci Monit 2012; 18:CR461-5. [PMID: 22739737 PMCID: PMC3560779 DOI: 10.12659/msm.883215] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Aging is associated with changes in cardiac structure and function that are associated with left ventricular diastolic dysfunction. Whether diastolic functional alterations during senescence are manifestations of the intrinsic aging process or related to cardiac adaptations to a more sedentary lifestyle is still unsettled. This was a prospective study evaluating the effects of a 6-month combined exercise training period on functional capacity and diastolic function in sedentary elderly patients with controlled arterial hypertension. Material/Methods Functional capacity was assessed by exercise stress test and muscle strength was evaluated by the one-repetition maximum test. Cardiac structures and function were analyzed by transthoracic echocardiography. Results Fifteen patients, 68±8 years old, completed the training program. Exercise training significantly improved physical capacity (distance walked: 551±92 vs. 630±153 m, P<0.05; work load: 7.2±1.7 vs. 8.5±3.0 METs, P<0.05) and upper and lower extremity muscle strength (P<0.001). Arterial blood pressure significantly decreased after training (systolic blood pressure: 134±9 vs. 128±8 mmHg; diastolic blood pressure: 82±7 vs. 77±6 mmHg; P<0.05). Cardiac structures and left and right systolic and diastolic function did not change after combined training (P>0.05). Conclusions Combined and supervised training for a 6-month period increases physical capacity and muscle strength in elderly patients with controlled arterial hypertension without changing resting left ventricular diastolic function.
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Affiliation(s)
- Gabriel N Guirado
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, SP, Brazil
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Athyros VG, Gossios TD, Katsiki N, Karagiannis A, Mikhailidis DP. The clinical benefit of implementing guidelines in cardiovascular disease prevention in real world settings. Arch Med Sci 2012; 8:6-10. [PMID: 22457666 PMCID: PMC3309428 DOI: 10.5114/aoms.2012.27272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Revised: 02/04/2012] [Accepted: 02/04/2012] [Indexed: 01/13/2023] Open
Affiliation(s)
- Vasilios G. Athyros
- 2 Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Thomas D. Gossios
- 1 Cardiology Clinic, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Niki Katsiki
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinic) and Department of Surgery, Royal Free Campus, University College London Medical School, University College London (UCL), London, United Kingdom
| | - Asterios Karagiannis
- 2 Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinic) and Department of Surgery, Royal Free Campus, University College London Medical School, University College London (UCL), London, United Kingdom
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