1
|
Berka B, Lustigová M, Urbanová J, Krollová P, Hloch O, Romanová A, Michalec J, Taniwall A, Žejglicová K, Malinovská J, Jenšovský M, Vejtasová V, González-Rivas JP, Maranhao Neto GA, Pavlovska I, Brož J. Cascade of care for hypertension among apparently healthy and unhealthy individuals of 25-64 years in the Czech Republic. PLoS One 2024; 19:e0301202. [PMID: 38662802 PMCID: PMC11045056 DOI: 10.1371/journal.pone.0301202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/12/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Despite accessible diagnostics and treatment of hypertension, a high proportion of patients worldwide remain unaware of their diagnosis, and even more remain untreated. Several studies suggest that absence of comorbidities is a predictive factor for unawareness and consequently non-treatment of hypertension. There are only a few studies that have assessed the hypertension prevalence and management among apparently healthy individuals. OBJECTIVE The aim of the study was to assess and compare hypertension prevalence, awareness, treatment and control among apparently healthy individuals, patients with internal diseases, and patients with non-internal diseases. METHODS Data from standardised blood pressure measurements conducted during the Czech European Health Examination Survey 2014 and information on health status and health care use collected during the Czech European Health Interview Survey 2014 were analyzed. We focused on participants aged 25-64. Data were weighted on sex and age to ensure an appropriate sex and age structure of the population. The χ2-test and binary logistic regression analyses were used to compare distribution of cascade of care for hypertension between the health-status groups of respondents. RESULTS The final eligible sample consisted of 1121 participants. The prevalence of hypertension was 32.8% in the healthy group, 29.8% in the non-internal disease group and 52.4% in the internal disease group, (p < 0.001). Awareness was 54.1%, 59.1% and 85.2% respectively, (p < 0.001). Treatment was 44.2%, 52.6% and 86.4%, respectively, (p < 0.001). Among apparently healthy respondents 62.6% had their blood pressure measured by a medical professional in the last year, compared to 71.1% in the non-internal disease group and 91.7% in the internal disease group, (p < 0.001). Differences in hypertension control were not statistically significant. CONCLUSIONS Generally, our data show a discordance in hypertension management within the Czech population. Apparently healthy individuals are the least aware of their diagnosis and the highest proportion of them remain untreated.
Collapse
Affiliation(s)
- Barbora Berka
- Department of Internal Medicine University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michala Lustigová
- Department of Social Geography and Regional Development, Faculty of Science, Charles University, Prague, Czech Republic
- National Institute of Public Health, Prague, Czech Republic
| | - Jana Urbanová
- Department of Internal Medicine, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavlína Krollová
- Department of Internal Medicine University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ondřej Hloch
- Department of Internal Medicine University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alexandra Romanová
- Department of Internal Medicine University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Juraj Michalec
- Department of Internal Medicine University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Arian Taniwall
- Department of Internal Medicine, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Jana Malinovská
- Department of Internal Medicine University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michael Jenšovský
- Department of Internal Medicine University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Veronika Vejtasová
- Department of Cardiology, University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Juan P. González-Rivas
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), Brno, Czech Republic
- Departments of Global Health and Population and Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela
| | - Geraldo A. Maranhao Neto
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), Brno, Czech Republic
| | - Iuliia Pavlovska
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), Brno, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jan Brož
- Department of Internal Medicine University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| |
Collapse
|
2
|
Bartoskova Polcrova A, Nieto-Martinez R, Mechanick JI, Maranhao Neto GA, Infante-Garcia MM, Pikhart H, Bobak M, Medina-Inojosa J, Gonzalez-Rivas JP. Comparison of social gradient in cardiometabolic health in Czechia and Venezuela: a cross-sectional study. BMJ Open 2023; 13:e069077. [PMID: 36931684 PMCID: PMC10030916 DOI: 10.1136/bmjopen-2022-069077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
OBJECTIVES This study compared the relationships of social determinants with cardiometabolic risk in different socioeconomic contexts: sociopolitically unstable Venezuela (VE) and stable Czechia (CZ). DESIGN cross-sectional analysis involving two population-based studies. SETTING Brno, Czechia and 23 cities of Venezuela. PARTICIPANTS 25-64 years old subjects from CZ (2013-2014, n=1579, 56% females) and VE (2014-2017, n=1652, 70% females). MAIN OUTCOME MEASURES The composite cardiometabolic risk score (CMRS) (scaled 0-8) was calculated using eight biomarkers (body mass index, waist circumference, blood glucose, systolic and diastolic blood pressure, total and high-density lipoprotein-cholesterol, triglycerides). Social characteristics included education in both countries, income in CZ and a composite measure of social position (SP) in VE. Sex stratified ordinal regression examined the social gradient in having less favourable CMRS. RESULTS In CZ, men and women with low education and women with low income had higher odds of higher CMRS compared with those with high education and income with OR 1.45 (95% CI 1.01 to 2.21), 2.29 (95% CI 1.62 to 3.24) and 1.69 (95% CI 1.23 to 2.35). In VE, women with low education and low SP had higher odds to have higher CMRS OR 1.47 (95% CI 1.09 to 1.97) and 1.51 (95% CI 1.16 to 1.97), while men with low education and low SP had lower odds to have higher CMRS OR 0.64 (95% CI 0.41 to 1.00) and 0.61 (95% CI 0.40 to 0.97), compared with those with high education and high SP. Independently of age, sex and socioeconomic characteristics, Venezuelans had higher odds to have higher CMRS than Czechs (OR 2.70; 95% CI 2.37 to 3.08). CONCLUSIONS The results suggest that the associations of socioeconomic status indices and cardiometabolic risk differed between CZ and VE, likely reflecting differences in the social environment among countries. Further research is needed to confirm and quantify these differences.
Collapse
Affiliation(s)
- Anna Bartoskova Polcrova
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
- International Clinical Research Centre, St Anne's University Hospital, Brno, Czech Republic
| | - Ramfis Nieto-Martinez
- Departments of Global Health and Population and Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela
| | - Jeffrey I Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, and Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Maria M Infante-Garcia
- International Clinical Research Centre, St Anne's University Hospital, Brno, Czech Republic
| | - Hynek Pikhart
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Martin Bobak
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jose Medina-Inojosa
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, New York, USA
| | - Juan P Gonzalez-Rivas
- International Clinical Research Centre, St Anne's University Hospital, Brno, Czech Republic
- Departments of Global Health and Population and Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela
| |
Collapse
|
3
|
Kunzová M, Maranhao Neto GA, González-Rivas JP. Sugar-sweetened beverages and childhood abnormal adiposity in the Czech Republic - narrative literature review. Cent Eur J Public Health 2023; 31:30-37. [PMID: 37086418 DOI: 10.21101/cejph.a7479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 03/29/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVES In Czech children, the burden related to the high body-mass index is rising. In the last three decades, Western eating patterns have influenced Czech children's diet, including the high consumption of sugar-sweetened beverages. This narrative review aims to evaluate evidence of the trend of sugar-sweetened beverages consumption in Czech children and its impact on the prevalence of childhood abnormal adiposity. METHODS A comprehensive literature review in MEDLINE (PubMed) and a hand search using references in identified articles were performed. The inclusion criteria were population-based studies of randomly selected samples of children from 0 to 18 years old, data involving the Czech population, published from 1990 to 2021. The results were organized into three sections - childhood abnormal adiposity, SSBs consumption, and the association between SSBs consumption and abnormal adiposity. RESULTS The studies showed a significant increase in abnormal adiposity in both genders and all age categories. The highest prevalence of abnormal adiposity was observed in boys and younger children. On the contrary, sugar-sweetened beverages showed a significant decline in daily consumption among Czech children of both genders and all age categories. No results were found for consequences of abnormal adiposity concerning sugar-sweetened beverages consumption. CONCLUSION Findings from this review could serve public health experts to detect the areas of a gap in research and establish potential interventions in vulnerable groups. Observation of potential obesogenic contributors - including sugar-sweetened beverages - should be an integral part of effective action against the obesity pandemic.
Collapse
Affiliation(s)
- Monika Kunzová
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Geraldo A Maranhao Neto
- International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Juan P González-Rivas
- International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czech Republic
- Departments of Global Health and Population and Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela, Caracas, Venezuela
| |
Collapse
|
4
|
Maranhao Neto GA, Lattari E, Oliveira BRR, Polcrova AB, Infante-Garcia MM, Kunzova S, Stokin GB, Gonzalez-Rivas JP. Association of Self-Reported Depression Symptoms with Physical Activity Levels in Czechia. Int J Environ Res Public Health 2022; 19:14319. [PMID: 36361199 PMCID: PMC9657333 DOI: 10.3390/ijerph192114319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/24/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Worldwide, depressive disorder is one of the leading determinants of disability-adjusted life years. Although there are benefits associated with a higher physical activity (PA) level, there is a lack of information related to this relationship, especially in countries such as Czechia, where modern approaches to mental health care only recently emerged. The present study aimed to evaluate the association between the level of depression and different PA levels following the World Health Organization (WHO) PA guidelines and according to specific symptoms that indicate depression. Multivariable-adjusted Poisson regression models were used to calculate the prevalence rate (PR) in a sample of 2123 participants (45.3% men, median 48 years). Compared to subjects with insufficient PA, moderate and high PA levels were inversely associated with continuous depression scores (PR = 0.85; 95% CI: 0.75-0.97; and PR = 0.80; 95% CI: 0.70-0.92). Depressed mood and worthlessness were the symptoms associated with moderate and high PA. Tiredness, change in appetite, and concentration problems were related to high PA. The results suggest that reaching the minimum PA target according to the guidelines seems to be effective, and this could stimulate adherence. However, more specific improvements in symptomatology will require a subsequent gradual increase in PA levels.
Collapse
Affiliation(s)
- Geraldo A. Maranhao Neto
- International Clinical Research Center (ICRC), St. Anne’s University Hospital (FNUSA), 602 00 Brno, Czech Republic
| | - Eduardo Lattari
- Postgraduate Program in Physical Activity Sciences (PGCAF), Salgado de Oliveira University, Niterói 24030-060, Brazil
| | - Bruno Ribeiro Ramalho Oliveira
- Department of Physical, Education and Sports, Physical Activity, Health, and Performance Research Laboratory, Rural Federal University of Rio de Janeiro, Seropédica 23890-000, Brazil
| | - Anna Bartoskova Polcrova
- International Clinical Research Center (ICRC), St. Anne’s University Hospital (FNUSA), 602 00 Brno, Czech Republic
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 625 00 Brno, Czech Republic
| | - Maria M. Infante-Garcia
- International Clinical Research Center (ICRC), St. Anne’s University Hospital (FNUSA), 602 00 Brno, Czech Republic
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 3001, Venezuela
| | - Sarka Kunzova
- International Clinical Research Center (ICRC), St. Anne’s University Hospital (FNUSA), 602 00 Brno, Czech Republic
| | - Gorazd B. Stokin
- International Clinical Research Center (ICRC), St. Anne’s University Hospital (FNUSA), 602 00 Brno, Czech Republic
| | - Juan P. Gonzalez-Rivas
- International Clinical Research Center (ICRC), St. Anne’s University Hospital (FNUSA), 602 00 Brno, Czech Republic
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 3001, Venezuela
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| |
Collapse
|
5
|
Maranhao Neto GA, Polcrova AB, Pospisilova A, Blaha L, Klanova J, Bobak M, Gonzalez-Rivas JP. Associations between Per- and Polyfluoroalkyl Substances (PFAS) and Cardiometabolic Biomarkers in Adults of Czechia: The Kardiovize Study. Int J Environ Res Public Health 2022; 19:13898. [PMID: 36360776 PMCID: PMC9656035 DOI: 10.3390/ijerph192113898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/17/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
Even though there is evidence of decreasing trends of per- and polyfluoroalkyl substances (PFAS) in Czechia, there are still major sources of PFAS pollution. Regarding the still-inconsistent results of the relationship between cardiometabolic health and PFAS, the present study sought to determine the association between PFAS levels and the presence of cardiometabolic biomarkers, including blood pressure and dysglycemia drivers in the Czech population. A cross-sectional study with 479 subjects (56.4% women, median: 53 years, range: 25-89) was conducted. Four PFAS were measured in serum: perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluorooctane sulfonate (PFOS). The associations between natural log (ln)-transformed PFAS and cardiometabolic biomarkers were assessed through generalized additive models using linear regression and smoothing thin plate splines, adjusted for potential confounders. There were positive and significant (p < 0.05) associations between the ln-transformed PFOA and glucose (β = 0.01), systolic (β = 0.76) and diastolic blood pressure (β = 0.65); total cholesterol (β = 0.07) and LDL-c (β = 0.04); and PFOS with glucose (β = 0.03), BMI (β = 2.26), waist circumference (β = 7.89), systolic blood pressure (β = 1.18), total cholesterol (β = 0.13), and HDL-c (β = 0.04). When significant, the correlations of PFNA and PFDA were negative. Of the four PFAS, only PFOA and PFOS showed a positive association, even in serum levels not as high as the values from the literature.
Collapse
Affiliation(s)
- Geraldo A. Maranhao Neto
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 602 00 Brno, Czech Republic
| | - Anna Bartoskova Polcrova
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 602 00 Brno, Czech Republic
- Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Anna Pospisilova
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 602 00 Brno, Czech Republic
| | - Ludek Blaha
- Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Jana Klanova
- Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Martin Bobak
- Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Juan P. Gonzalez-Rivas
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 602 00 Brno, Czech Republic
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 3001, Venezuela
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| |
Collapse
|
6
|
Maranhao Neto GA, Pavlovska I, Polcrova A, Mechanick JI, Infante-Garcia MM, Medina-Inojosa J, Nieto-Martinez R, Lopez-Jimenez F, Gonzalez-Rivas JP. The Combined Effects of Television Viewing and Physical Activity on Cardiometabolic Risk Factors: The Kardiovize Study. J Clin Med 2022; 11:jcm11030545. [PMID: 35159997 PMCID: PMC8836375 DOI: 10.3390/jcm11030545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
The aim of the present study was to evaluate the association between television viewing/physical activity (TVV/PA) interactions and cardiometabolic risk in an adult European population. A total of 2155 subjects (25–64 years) (45.2% males), a random population-based sample were evaluated in Brno, Czechia. TVV was classified as low (<2 h/day), moderate (2–4), and high (≥4). PA was classified as insufficient, moderate, and high. To assess the independent association of TVV/PA categories with cardiometabolic variables, multiple linear regression was used. After adjustments, significant associations were: High TVV/insufficient PA with body mass index (BMI) (β = 2.61, SE = 0.63), waist circumference (WC) (β = 7.52, SE = 1.58), body fat percent (%BF) (β = 6.24, SE = 1.02), glucose (β = 0.25, SE = 0.12), triglycerides (β = 0.18, SE = 0.05), and high density lipoprotein (HDL-c) (β = −0.10, SE = 0.04); high TVV/moderate PA with BMI (β = 1.98, SE = 0.45), WC (β = 5.43, SE = 1.12), %BF (β = 5.15, SE = 0.72), triglycerides (β = 0.08, SE = 0.04), total cholesterol (β = 0.21, SE = 0.10), low density protein (LDL-c) (β = 0.19, SE = 0.08), and HDL-c (β = −0.07, SE = 0.03); and moderate TVV/insufficient PA with WC (β = 2.68, SE = 1.25), %BF (β = 3.80, SE = 0.81), LDL-c (β = 0.18, SE = 0.09), and HDL-c (β = −0.07, SE = 0.03). Independent of PA levels, a higher TVV was associated with higher amounts of adipose tissue. Higher blood glucose and triglycerides were present in subjects with high TVV and insufficient PA, but not in those with high PA alone. These results affirm the independent cardiometabolic risk of sedentary routines even in subjects with high-levels of PA.
Collapse
Affiliation(s)
- Geraldo A. Maranhao Neto
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 656 91 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Correspondence: ; Tel.: +4-207-345-23179
| | - Iuliia Pavlovska
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 656 91 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 601 77 Brno, Czech Republic
| | - Anna Polcrova
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 656 91 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 601 77 Brno, Czech Republic
| | - Jeffrey I. Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Maria M. Infante-Garcia
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 656 91 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 3001, Venezuela;
| | - Jose Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA; (J.M.-I.); (F.L.-J.)
| | - Ramfis Nieto-Martinez
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 3001, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02138, USA
- LifeDoc Health, Memphis, TN 38119, USA
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA; (J.M.-I.); (F.L.-J.)
| | - Juan P. Gonzalez-Rivas
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 656 91 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 3001, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| |
Collapse
|
7
|
Gonzalez‐Rivas JP, Mechanick JI, Hernandez JP, Infante‐Garcia MM, Pavlovska I, Medina‐Inojosa JR, Kunzova S, Nieto‐Martinez R, Brož J, Busetto L, Maranhao Neto GA, Lopez‐Jimenez F, Urbanová J, Stokin GB. Prevalence of adiposity-based chronic disease in middle-aged adults from Czech Republic: The Kardiovize study. Obes Sci Pract 2021; 7:535-544. [PMID: 34631132 PMCID: PMC8488447 DOI: 10.1002/osp4.496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/11/2021] [Accepted: 02/13/2021] [Indexed: 01/22/2023] Open
Abstract
AIMS/HYPOTHESIS The need for understanding obesity as a chronic disease, its stigmatization, and the lack of actionability related to it demands a new approach. The adiposity-based chronic disease (ABCD) model is based on adiposity amount, distribution, and function, with a three stage complication-centric rather than a body mass index (BMI)-centric approach. The prevalence rates and associated risk factors are presented. METHODS In total, 2159 participants were randomly selected from Czechia. ABCD was established as BMI ≥ 25 kg/m2 or high body fat percent, or abdominal obesity and then categorized by their adiposity-based complications: Stage 0: none; Stage 1: mild/moderate; Stage 2: severe. RESULTS ABCD prevalence was 62.8%. Stage 0 was 2.3%; Stage 1 was 31.4%; Stage 2 was 29.1%. Comparing with other classifiers, participants in Stage 2 were more likely to have diabetes, hypertension, and metabolic syndrome than those with overweight, obesity, abdominal obesity, and increased fat mass. ABCD showed the highest sensitivity and specificity to detect participants with peripheral artery disease, increased intima media, and vascular disease. CONCLUSION/INTERPRETATION The ABCD model provides a more sensitive approach that facilitates the early detection and stratification of participants at risk compared to traditional classifiers.
Collapse
Affiliation(s)
- Juan P. Gonzalez‐Rivas
- International Clinical Research Center (ICRC)St Anne's University Hospital (FNUSA) BrnoBrnoCzech Republic
- Department of Global Health and PopulationHarvard TH Chan School of Public HealthHarvard UniversityBostonMassachusettsUSA
| | - Jeffrey I. Mechanick
- The Marie‐Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, and Division of Endocrinology, Diabetes and Bone DiseaseIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - José Pantaleón Hernandez
- International Clinical Research Center (ICRC)St Anne's University Hospital (FNUSA) BrnoBrnoCzech Republic
| | - María M Infante‐Garcia
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN)CaracasVenezuela
| | - Iuliia Pavlovska
- International Clinical Research Center (ICRC)St Anne's University Hospital (FNUSA) BrnoBrnoCzech Republic
- Department of Public HealthFaculty of MedicineMasaryk UniversityBrnoCzech Republic
| | | | - Sarka Kunzova
- International Clinical Research Center (ICRC)St Anne's University Hospital (FNUSA) BrnoBrnoCzech Republic
| | - Ramfis Nieto‐Martinez
- Department of Global Health and PopulationHarvard TH Chan School of Public HealthHarvard UniversityBostonMassachusettsUSA
- LifeDoc Diabetes and Obesity ClinicMemphisTennesseeUSA
| | - Jan Brož
- Department of Internal MedicineSecond Faculty of MedicineCharles UniversityPrahaPrahaCzech Republic
| | - Luca Busetto
- European Association for the Study of Obesity (EASO)TeddingtonMiddlesexUK
- Department of MedicineUniversity of PadovaPadovaItaly
| | - Geraldo A Maranhao Neto
- International Clinical Research Center (ICRC)St Anne's University Hospital (FNUSA) BrnoBrnoCzech Republic
| | - Francisco Lopez‐Jimenez
- Department of Medicine 2Third Faculty of MedicineCharles University and Královské Vinohrady University HospitalPragueCzech Republic
| | - Jana Urbanová
- Department of Cardiovascular MedicineMayo ClinicRochesterMinnesotaUSA
| | - Gorazd B Stokin
- International Clinical Research Center (ICRC)St Anne's University Hospital (FNUSA) BrnoBrnoCzech Republic
| |
Collapse
|
8
|
Maranhao Neto GA, Pavlovska I, Polcrova A, Mechanick JI, Infante-Garcia MM, Hernandez JP, Araujo MA, Nieto-Martinez R, Gonzalez-Rivas JP. Prediction of Cardiorespiratory Fitness in Czech Adults: Normative Values and Association with Cardiometabolic Health. Int J Environ Res Public Health 2021; 18:10251. [PMID: 34639552 PMCID: PMC8507681 DOI: 10.3390/ijerph181910251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 11/19/2022]
Abstract
Cardiorespiratory fitness (CRF) is a strong independent predictor of morbidity and mortality. However, there is no recent information about the impact of CRF on cardiometabolic risk specifically in Central and Eastern Europe, which are characterized by different biological and social determinants of health. In this cross-sectional study normative CRF values were proposed and the association between CRF and cardiometabolic outcomes was evaluated in an adult Czechian population. In 2054 participants (54.6% females), median age 48 (IQR 19 years), the CRF was predicted from a non-exercise equation. Multivariable-adjusted logistic regressions were carried out to determine the associations. Higher CRF quartiles were associated with lower prevalence of hypertension, type 2 diabetes (T2D) and dyslipidemia. Comparing subjects within the lowest CRF, we see that those within the highest CRF had decreased chances of hypertension (odds ratio (OR) = 0.36; 95% CI: 0.22-0.60); T2D (OR = 0.16; 0.05-0.47), low HDL-c (OR = 0.32; 0.17-0.60), high low-density lipoprotein (OR = 0.33; 0.21-0.53), high triglycerides (OR = 0.13; 0.07-0.81), and high cholesterol (OR = 0.44; 0.29-0.69). There was an inverse association between CRF and cardiometabolic outcomes, supporting the adoption of a non-exercise method to estimate CRF of the Czech population. Therefore, more accurate cardiometabolic studies can be performed incorporating the valuable CRF metric.
Collapse
Affiliation(s)
- Geraldo A. Maranhao Neto
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA), 656 92 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
| | - Iuliia Pavlovska
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA), 656 92 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 656 91 Brno, Czech Republic
| | - Anna Polcrova
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA), 656 92 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 656 91 Brno, Czech Republic
| | - Jeffrey I. Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maria M. Infante-Garcia
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA), 656 92 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 1060, Venezuela;
| | | | - Miguel A. Araujo
- Department of Physical Education, School of Education, University of Los Andes, Mérida 5101, Venezuela;
| | - Ramfis Nieto-Martinez
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 1060, Venezuela;
- Department of Global Health and Population. Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
- LifeDoc Health, Memphis, TN 38119, USA
| | - Juan P. Gonzalez-Rivas
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA), 656 92 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 1060, Venezuela;
- Department of Global Health and Population. Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| |
Collapse
|
9
|
Pavlovska I, Polcrova A, Mechanick JI, Brož J, Infante-Garcia MM, Nieto-Martínez R, Maranhao Neto GA, Kunzova S, Skladana M, Novotny JS, Pikhart H, Urbanová J, Stokin GB, Medina-Inojosa JR, Vysoky R, González-Rivas JP. Dysglycemia and Abnormal Adiposity Drivers of Cardiometabolic-Based Chronic Disease in the Czech Population: Biological, Behavioral, and Cultural/Social Determinants of Health. Nutrients 2021; 13:nu13072338. [PMID: 34371848 PMCID: PMC8308692 DOI: 10.3390/nu13072338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/28/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022] Open
Abstract
In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.
Collapse
Affiliation(s)
- Iuliia Pavlovska
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Correspondence: ; Tel.: +4-207-770-90433
| | - Anna Polcrova
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic;
| | - Jeffrey I. Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jan Brož
- Department of Internal Medicine, Charles University Second Faculty of Medicine, 10506 Prague, Czech Republic;
| | - Maria M. Infante-Garcia
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
| | - Ramfis Nieto-Martínez
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
- LifeDoc Health, Memphis, TN 38119, USA
| | - Geraldo A. Maranhao Neto
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Sarka Kunzova
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Maria Skladana
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Second Department of Internal Medicine, St. Anne’s University Hospital in Brno and Faculty of Medicine, Masaryk University, 65691 Brno, Czech Republic
| | - Jan S. Novotny
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Hynek Pikhart
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic;
- Department of Epidemiology and Public Health, University College London, London WC1E6BT, UK
| | - Jana Urbanová
- Center for Research in Diabetes, Metabolism and Nutrition, Second Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, 10000 Prague, Czech Republic;
| | - Gorazd B. Stokin
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Jose R. Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA;
- Marriott Heart Disease Research Program, Mayo Clinic, Rochester, MN 55905, USA
| | - Robert Vysoky
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Department of Health Support, Faculty of Sport Studies, Masaryk University, 62500 Brno, Czech Republic
| | - Juan P. González-Rivas
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| |
Collapse
|
10
|
Pavlovska I, Mechanick JI, Maranhao Neto GA, Infante-Garcia MM, Nieto-Martinez R, Kunzova S, Polcrova A, Vysoky R, Medina-Inojosa JR, Lopez-Jimenez F, Stokin GB, González-Rivas JP. Arterial Stiffness and Cardiometabolic-Based Chronic Disease: The Kardiovize Study. Endocr Pract 2021; 27:571-578. [PMID: 33722731 DOI: 10.1016/j.eprac.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Arterial stiffness (ArSt) describes a loss of arterial wall elasticity and is an independent predictor of cardiovascular events. A cardiometabolic-based chronic disease model integrates concepts of adiposity-based chronic disease (ABCD), dysglycemia-based chronic disease (DBCD), and cardiovascular disease. We assessed if ABCD and DBCD models detect more people with high ArSt compared with traditional adiposity and dysglycemia classifiers using the cardio-ankle vascular index (CAVI). METHODS We evaluated 2070 subjects aged 25 to 64 years from a random population-based sample. Those with type 1 diabetes were excluded. ABCD and DBCD were defined, and ArSt risk was stratified based on the American Association of Clinical Endocrinologists criteria. RESULTS The highest prevalence of a high CAVI was in stage 2 ABCD (18.5%) and stage 4 DBCD (31.8%), and the lowest prevalence was in stage 0 ABCD (2.2%). In univariate analysis, stage 2 ABCD and all DBCD stages increased the risk of having a high CAVI compared with traditional classifiers. After adjusting for age and gender, only an inverse association between obesity (body mass index ≥30 kg/m2) and CAVI remained significant. Nevertheless, body mass index was responsible for only 0.3% of CAVI variability. CONCLUSION The ABCD and DBCD models showed better performance than traditional classifiers to detect subjects with ArSt; however, the variables were not independently associated with age and gender, which might be explained by the complexity and multifactoriality of the relationship of CAVI with the ABCD and DBCD models, mediated by insulin resistance.
Collapse
Affiliation(s)
- Iuliia Pavlovska
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic; Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Jeffrey I Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Geraldo A Maranhao Neto
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic
| | - Maria M Infante-Garcia
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela
| | - Ramfis Nieto-Martinez
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela; Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts; LifeDoc Health, Memphis, Tennessee
| | - Sarka Kunzova
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic
| | - Anna Polcrova
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic; Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic
| | - Robert Vysoky
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Faculty of Sport Studies - Department of Health Support, Masaryk University, Brno, Czech Republic
| | - Jose R Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Minnesota
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Minnesota
| | - Gorazd B Stokin
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic
| | - Juan P González-Rivas
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic; Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela; Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts
| |
Collapse
|
11
|
Maranhao Neto GA, Oliveira AJ, Pedreiro R, Marques Neto S, Luz LG, Silva HC, Farinatti PTV. Prediction of cardiorespiratory fitness from self-reported data in elderly. Rev Bras Cineantropom Desempenho Hum 2017. [DOI: 10.5007/1980-0037.2017v19n5p545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Cardiorespiratory fitness (CRF) is associated with several health outcomes. Some non-exercise equations are available for CRF estimation. However, little is known about the validation of these equations among elderly. The aim of this study was to exam the validity of non-exercise equations with self-reported information in elderly. Participants (n= 93) aged 60 to 91 years measured CRF using maximal cardiopulmonary exercise test. Five non-exercise equations were selected. Data included in the equations (age, sex, weight, height, body mass index, physical activity and smoking) were self-reported. Coefficient of determination (R2) of linear regressions with laboratory-measured VO2 peak ranged from 0.04 to 0.64. The Bland-Altman plots showed higher agreement between achieved and predicted CRF obtained by Jackson and colleagues, and Wier and colleagues equations. On the other hand, the other equations showed lower agreement and overestimation. Our findings provide evidences that two non-exercise equations, previously developed, could be used on the prediction of CRF among elderly.
Collapse
|
12
|
Maranhao Neto GA, Oliveira RB, Myers JN, Farinatti PTV. Prediction of peak oxygen pulse (O2Ppeak) without exercise testing in older adults. Arch Gerontol Geriatr 2014; 59:562-7. [PMID: 25085231 DOI: 10.1016/j.archger.2014.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/27/2014] [Accepted: 07/10/2014] [Indexed: 10/25/2022]
Abstract
Peak oxygen pulse has been considered a surrogate of cardiovascular function and an independent predictor of all cause mortality. However, O2P(peak) depends on maximal volitional effort which may limit its utility in older subjects. The aim of this study was to develop a model to estimate O2P(peak) without exercise in an elderly sample. This cross-sectional study enrolled 67 community-dwelling older adults (69.4±7.1 years; 41 men) for the non-exercise model development and 30 community-dwelling older adults (67.7±6.4 years; n=30; 17 men) for cross-validation. The non-exercise model was derived through hierarchical regression model and cross-validated by means of PRESS statistics and comparison against an independent sample. Classification accuracy of the model for tertiles of estimated and actual O2P(peak) was tested by gamma (γ) nonparametric correlation. The following prediction equation was generated: -3.416+0.137 × weight (kg)+1.226 × Veterans Specific Activity Questionnaire (VSAQ) (metabolic equivalents, METs)+1.987 × gender (0=women, 1=men)-2.045 × β-Blockers use (0=no, 1=yes)-0.044 × resting heart rate (HR) (R(2)=0.83; standard error of estimate (SEE)=1.68 mL beat(-1)). Correlation in cross-validation group was 0.80 (P<0.001). A high probability was observed for the model to rank the values in the same tertile in validation and cross-validation groups (γ=0.98; γ=0.92, respectively, P<0.05). In conclusion, O2P(peak) can be estimated with reasonable precision without exercise testing, providing an alternative for elder subjects not capable to perform maximal effort.
Collapse
Affiliation(s)
| | | | | | - Paulo T V Farinatti
- Salgado de Oliveira University, Niteroi, RJ, Brazil; Rio de Janeiro State University, RJ, Brazil.
| |
Collapse
|