Charlotta Eriksson; Nilsson, Mats E.; Saskia M Willers; Lars Gidhagen; Tom Bellander; Göran Pershagen
Long-term exposure to traffic noise has been suggested to increase the risk of cardiovascular diseases (CVD). However, few studies have been performed in the general population and on railway noise. This study aimed to investigate the cardiovascular effects of living near noisy roads and railways. This cross-sectional study comprised 25,851 men and women, aged 18-80 years, who had resided in Sweden for at least 5 years. All subjects participated in a National Environmental Health Survey, perf...
Wennerstad, Karin Modig
Aim: A first aim of this thesis was to examine the relationship between intelligence in early adulthood and health outcomes, mainly cardiovascular morbidity and mortality, CVD, later in life using register-based data on Swedish men. A second aim was to increase understanding of the pathways between intelligence and CVD morbidity/mortality by studying the association between intelligence and smoking habits and nicotine dependence, who might act as mediators of the associat...
Carmichael, Owen T.; Kuller, L.H.; Lopez, O L.; Thompson, P.M.; Dutton, R A; Lu, A.; Lee, S. E.; Lee, J.Y.; Aizenstein, H.J.; Meltzer, C.C.; Liu, Y. X.; Toga, A.W.; Becker, J.T.
Elevated cerebral ventricular volume may be associated with dementia risk and progression. A fully-automated technique that agreed highly with radiological readings was used to estimate lateral ventricle volume on MR scans done at baseline in 1997-99 of 377 subjects in the Cardiovascular Health Study (CHS) from the Pittsburgh Center. 327 subjects were normal or diagnosed with mild cognitive impairment (MCI) at baseline and were evaluated 4 years later. Baseline ventric...
Full Text Available Long-term exposure to traffic noise has been suggested to increase the risk of cardiovascular diseases (CVD. However, few studies have been performed in the general population and on railway noise. This study aimed to investigate the cardiovascular effects of living near noisy roads and railways. This cross-sectional study comprised 25,851 men and women, aged 18-80 years, who had resided in Sweden for at least 5 years. All subjects participated in a National Environmental Health Survey, performed in 2007, in which they reported on health, annoyance reactions and environmental factors. Questionnaire data on self-reported doctor′s diagnosis of hypertension and/or CVD were used as outcomes. Exposure was assessed as Traffic Load (millions of vehicle kilometres per year within 500 m around each participant′s residential address. For a sub-population (n = 2498, we also assessed road traffic and railway noise in L den at the dwelling façade. Multiple logistic regression models were used to assess Prevalence Odds Ratios (POR and 95% Confidence Intervals (CI. No statistically significant associations were found between Traffic Load and self-reported hypertension or CVD. In the sub-population, there was no association between road traffic noise and the outcomes; however, an increased risk of CVD was suggested among subjects exposed to railway noise ≥50 dB(A; POR 1.55 (95% CI 1.00-2.40. Neither Traffic Load nor road traffic noise was, in this study, associated with self-reported cardiovascular outcomes. However, there was a borderline-significant association between railway noise and CVD. The lack of association for road traffic may be due to methodological limitations.
Schulz, Richard; Beach, Scott R.; Hebert, Randy S.; Martire, Lynn M.; Monin, Joan K.; Tompkins, Connie A.; Albert, Steven M.
Objectives To assess the effects of suffering in a spouse on prevalent and incident psychiatric (depression) and physical morbidity (cardiovascular disease, CVD) in their partner, controlling for known risk factors for depression and CVD. Design Descriptive longitudinal study. Participants 1330 older married couples enrolled in the Cardiovascular Health Study (CHS), a large epidemiologic study of the elderly. Measurements Predictor variables were physical, psychological, and existential/spiritual indicators of suffering. Primary outcomes were prevalent and incident depression and CVD. Results Controlling for known risk factors for depression, we found a dose-response relationship between suffering in a spouse and concurrent depression in their partner as well as a relationship between suffering and the partner’s future risk for depression. With respect to CVD, and controlling for sub-clinical CVD at baseline, husbands whose wives reported high levels of suffering also had higher rates of prevalent CVD, but there were not significant associations between wives suffering and husbands incident CVD. There were no associations between husbands’ suffering and wives’ prevalent or incident CVD. Conclusion Exposure to spousal suffering is an independent and unique source of distress in married couples that contributes to psychiatric and physical morbidity. More attention should be paid to the interpersonal effects of suffering in married couples, and to its role in contributing to morbidity. PMID:19454851
Suglia, Shakira F.; Sapra, Katherine J.; Koenen, Karestan C.
Context Violence, experienced in either childhood or adulthood, has been associated with physical health outcomes including cardiovascular disease. However, the consistency of the existing literature has not been evaluated. Evidence acquisition In 2013, the authors conducted a PubMed and Web of Science review of peer reviewed articles published prior to August 2013 on the relation between violence exposure, experienced in either childhood or adulthood, and cardiovascular outcomes. To meet inclusion criteria, articles had to present estimates for the relation between violence exposure and cardiovascular outcomes (hypertension, blood pressure, stroke, coronary disease, or myocardial infarction) adjusted for demographic factors. Articles focusing on violence from TV, video games, natural disasters, terrorism, or war were excluded. Evidence synthesis The initial search yielded 2,273 articles; after removing duplicates and applying inclusion and exclusion criteria, 30 articles were selected for review. A consistent positive relation was noted on the association between violence experienced during childhood and cardiovascular outcomes in adulthood (i.e., hypertension, coronary heart disease, and myocardial infarction). Associations across genders with varying types of violence exposure were also noted. By contrast, findings were mixed on the relation between adult violence exposure and cardiovascular outcome. Conclusions Despite varying definitions of violence exposure and cardiovascular endpoints, a consistent relation exists between childhood violence exposure, largely assessed retrospectively, and cardiovascular endpoints. Findings are mixed for the adult violence–cardiovascular health relation. The cross-sectional nature of most adult studies and the reliance of self-reported outcomes can potentially be attributed to the lack of findings among adult violence exposure studies. PMID:25599905
Georgina E Crichton
Full Text Available Recently attention has been drawn to the health impacts of time spent engaging in sedentary behaviors. No studies have examined sedentary behaviors in relation to the newly defined construct of ideal cardiovascular health, which incorporates three health factors (blood pressure, total cholesterol, fasting plasma glucose and four behaviors (physical activity, smoking, body mass index, diet. The purpose of this study was to examine associations between sedentary behaviors, including sitting time, and time spent viewing television and in front of a computer, with cardiovascular health, in a representative sample of adults from Luxembourg.A cross-sectional analysis of 1262 participants in the Observation of Cardiovascular Risk Factors in Luxembourg study was conducted, who underwent objective cardiovascular health assessments and completed the International Physical Activity Questionnaire. A Cardiovascular Health Score was calculated based on the number of health factors and behaviors at ideal levels. Sitting time on a weekday, television time, and computer time (both on a workday and a day off, were related to the Cardiovascular Health Score.Higher weekday sitting time was significantly associated with a poorer Cardiovascular Health Score (p = 0.002 for linear trend, after full adjustment for age, gender, education, income and occupation. Television time was inversely associated with the Cardiovascular Health Score, on both a workday and a day off (p = 0.002 for both. A similar inverse relationship was observed between the Cardiovascular Health Score and computer time, only on a day off (p = 0.04.Higher time spent sitting, viewing television, and using a computer during a day off may be unfavorably associated with ideal cardiovascular health.
Georgina E Crichton
Full Text Available BACKGROUND: Smoking, physical inactivity, and poor diet, along with obesity, fasting glucose and blood pressure have been independently associated with poorer cognitive performance. Few studies have related scales representing a combination of these variables to multiple domains of cognitive performance. The aim of this study was to investigate the association between overall cardiovascular health, incorporating seven components, and cognitive function. METHODS: A cross-sectional analysis employing 972 participants, from the Maine-Syracuse Longitudinal Study was undertaken. Four health behaviors (body mass index, physical activity, diet, smoking and three health factors (total cholesterol, blood pressure, and fasting plasma glucose were measured. Each was categorized according to the American Heart Association definitions for ideal cardiovascular health, except diet, for which two food scores were calculated. A Cardiovascular Health Score was determined by summing the number of cardiovascular metrics at ideal levels. Cognitive function was assessed using a thorough neuropsychological test battery. RESULTS: Cardiovascular Health Score was positively associated with seven out of eight measures of cognitive function, with adjustment for age, education, and gender. With further adjustment for cardiovascular and psychological variables, these associations remained significant for Visual-Spatial Memory, Working Memory, Scanning and Tracking, Executive Function and the Global Composite score (p<0.05 for all. Ideal levels of a number of health factors and behaviors were positively associated with global cognitive performance. CONCLUSION: Increasing cardiovascular health, indexed by a higher number of metrics at ideal levels, is associated with greater cognitive performance. Smoking, physical activity, and diet are important components of cardiovascular health that impact upon cognition.
Stahl, Sarah T.; Schulz, Richard
This prospective study examined the effect of widowhood on physical activity by comparing widowed elders to health status-, age-, and sex-matched married controls. Participants included 396 married controls and 396 widows/widowers age 64 to 91 (M age = 72.7 years) who experienced the death of their spouse while participating in the Cardiovascular Health Study (CHS). Compared to married controls, widowed men, but not women, were more likely to increase their physical activity...
Win, Sithu; Parakh, Kapil; Eze-Nliam, Chete M; Gottdiener, John S.; Kop, Willem J.; Ziegelstein, Roy C.
Background Depressed older individuals have a higher mortality than older persons without depression. Depression is associated with physical inactivity, and low levels of physical activity have been shown in some cohorts to be a partial mediator of the relationship between depression and cardiovascular events and mortality. Methods A cohort of 5888 individuals (mean 72.8±5.6 years, 58% female, 16% African-American) from four US communities was followed for an average of 10.3 years. Self-repor...
Stephen Thielke; Paula Diehr
Introduction. Successful aging has many dimensions, which may manifest differently in men and women at different ages. Methods. We characterized one-year transitions among health states in 12 measures of successful aging among adults in the Cardiovascular Health Study. The measures included self-rated health, ADLs, IADLs, depression, cognition, timed walk, number of days spent in bed, number of blocks walked, extremity strength, recent hospitalizations, feelings about life as a whole, and lif...
Zhao, Yaling; Yan, Hong; Yang, Ruihai; Li, Qiang; Dang, Shaonong; Liu, Ruru; Pei, Leilei; Cao, Lei; Marshall, Roger J; Wang, Duolao
The aim of this study was to assess the status of cardiovascular health among a rural population in Northwest China and to determine the associated factors for cardiovascular health.A population-based cross-sectional study was conducted in the rural areas of Hanzhong in Northwest China. Interview, physical examination, and fasting blood glucose and lipid measurements were completed for 2693 adults. The construct of cardiovascular health and the definitions of cardiovascular health metrics proposed by the American Heart Association were used to assess cardiovascular health. The proportions of subjects with cardiovascular health metrics were calculated, adjusting for age and sex. The multiple logistic regression model was used to evaluate the association between ideal cardiovascular health and its associated factors.Only 0.5% (0.0% in men vs 0.9% in women, P = 0.002) of the participants had ideal cardiovascular health, whereas 33.8% (18.0% in men vs 50.0% in women, P health, respectively. The prevalence of poor cardiovascular health increased with increasing age (P health metrics. Also, 22.2% of the participants presented with 3 or fewer ideal metrics. Only 19.4% of the participants presented with 6 or more ideal metrics. 24.1% of the participants had all 4 ideal health factors, but only 1.1% of the participants had all 4 ideal health behaviors. Women were more likely to have ideal cardiovascular health, whereas adults aged 35 years or over and those who had a family history of hypertension were less likely to have ideal cardiovascular health.The prevalence of ideal cardiovascular health was extremely low among the rural population in Northwest China. Most adults, especially men and the elderly, had a poor cardiovascular health status. To improve cardiovascular health among the rural population, efforts, especially lifestyle improvements, education and interventions to make healthier food choices, reduce salt intake, increase physical activities, and cease
Barnes, Deborah E.; Haight, Thaddeus J; Mehta, Kala M.; Carlson, Michelle C.; Kuller, Lewis H; Tager, Ira B.
Recent studies have found that smoking is associated with an increased risk of dementia, but the effects of secondhand smoke (SHS) on dementia risk are not known to have previously been studied. The authors used Cox proportional hazards marginal structural models to examine the association between self-reported lifetime household SHS exposure and risk of incident dementia over 6 years among 970 US participants in the Cardiovascular Health Cognition Study (performed from 1991 to 1999) who were...
R. Gaillard (Romy)
markdownabstract__Abstract__ Cardiovascular disease is a major public health problem in the general adult population. 1 Cardiovascular disease leads to over 17.3 million deaths per year and is the leading cause of death and disability worldwide.1 In the Netherlands, cardiovascular disease accounts
Crichton, Georgina E; Elias, Merrill F.; Davey, Adam; Alkerwi, Ala'a
Background Smoking, physical inactivity, and poor diet, along with obesity, fasting glucose and blood pressure have been independently associated with poorer cognitive performance. Few studies have related scales representing a combination of these variables to multiple domains of cognitive performance. The aim of this study was to investigate the association between overall cardiovascular health, incorporating seven components, and cognitive function. Methods A cross-sectional analysis emplo...
Michal, Matthias; Wiltink, Jörg; Kirschner, Yvonne; Schneider, Astrid; Wild, Philipp S.; Münzel, Thomas; Blettner, Maria; Schulz, Andreas; Lackner, Karl; Pfeiffer, Norbert; Blankenberg, Stefan; Tschan, Regine; Tuin, Inka; Beutel, Manfred E.
Background Despite their high prevalence, sleep disorders often remain unrecognized and untreated because of barriers to assessment and management. The aims of the present study were to examine associations of complaints of sleep disturbances with cardiovascular disease, related risk factors, and inflammation in the community and to determine the contribution of sleep disturbances to self-perceived physical health. Method The sample consists of n = 10.000 participants, aged 35 to 74 years of a population based community sample in Germany. Cross-sectional associations of complaints of sleep disturbances with cardiovascular risk factors and disease, biomarkers of inflammation, depression, anxiety, and physical health status were analyzed. Results 19% of our sample endorsed clinically significant sleep disturbances. In the unadjusted analyses severity of sleep disturbances increased with female sex, low socioeconomic status, living without a partnership, cardiovascular disease, depression, anxiety, poor physical health, increased levels of C-reactive protein and fibrinogen. After multivariate adjustment robust associations with coronary heart disease, myocardial infarction and dyslipidemia remained. Complaints of sleep disturbances were strong and independent contributors to self-perceived poor physical health beyond depression, anxiety and medical disease burden. Conclusions Given the high prevalence of complaints of sleep disturbances and their strong impact on health status, increased efforts should be undertaken for their identification and treatment. PMID:25093413
Bartone, Paul T; Valdes, James J; Sandvik, Asle
Many, but not all people experience diminished health, performance and well-being as a function of exposure to stress. However, the underlying neurophysiological processes which characterize hardy or resilient people are not well understood. This study examines psychological hardiness and several indicators of cardiovascular health, including body mass index (BMI) and blood cholesterol markers in a sample of 338 middle-aged adults enrolled in a national security education program. Hierarchical regression analyses reveal that after controlling for the influence of age and sex, high hardiness is related to higher HDL - high density lipoprotein and less body fat (BMI). Lower hardiness is associated with greater total cholesterol to HDL ratio, a cardiovascular disease risk factor. These results suggest that psychological hardiness confers resilience in part through an influence on cholesterol production and metabolism. PMID:26652199
Yu, Edward; Rimm, Eric; Qi, Lu; Rexrode, Kathryn; Albert, Christine M.; Sun, Qi; Willett, Walter C.; Manson, JoAnn E.
Objectives. To review the contributions of the Nurses’ Health Studies (NHSs) to the understanding of cardiovascular disease etiology in women. Methods. We performed a narrative review of the publications of the NHS and NHS II between 1976 and 2016. Results. Diets low in trans fat, saturated fat, refined carbohydrates, and sugar-sweetened beverages and rich in fruits and vegetables, whole grains, and sources of unsaturated fats are associated with reduced risk of cardiovascular disease. Healthy lifestyle choices include smoking avoidance, regular physical activity, maintaining a normal body mass index, and moderate alcohol consumption. Adherence to a combination of these healthy diet and lifestyle behaviors may prevent most vascular events. Studies also covered oral contraceptive use, postmenopausal hormone therapy, shift work, sleep duration, psychosocial factors, and various biomarkers and genetic factors. Findings, such as the association of trans fat with cardiovascular disease, have helped shaped medical guidelines and government policies. Conclusions. The NHS has provided compelling evidence that the majority of vascular events may be prevented by avoiding smoking, participating in regular physical activity, maintaining normal body mass index, and eating a healthy diet. PMID:27459449
Full Text Available Abstract Background Despite the remarkable technological progress in health care and treatment, cardiovascular disease remains the leading cause of premature death, prolonged hospitalization and disability in most European countries. In the population of the Greater Region (Grand-Duchy of Luxembourg, Wallonia in Belgium, and Lorraine in France, the prevalence of cardiovascular risk factors and disease is among the highest in Europe, warranting the need for a better understanding of factors contributing to this pattern. In this context, the cross-border "Nutrition, Environment and Cardiovascular Health-NESCAV" project is initiated by an inter-regional multi-disciplinary consortium and supported by the INTERREG IV A program "Greater Region", 2007-2013, to fight synergically and harmoniously against this major public health problem. Methods/design The objectives of the three-year planned project are to assess, in a representative sample of 3000 randomly selected individuals living at the Greater Region, 1 the cardiovascular health and risk profile, 2 the association between the dietary habits and the cardiovascular risk, 3 the association of occupational and environmental pollution markers with the cardiovascular risk, 4 the knowledge, awareness and level of control of cardiovascular risk factors, 5 the potential gaps in the current primary prevention, and finally, to address evidence-based recommendations enabling the development of inter-regional guidance to help policy-makers and health care workers for the prevention of cardiovascular disease. Discussion The findings will provide tools that may enable the Greater Region's decision-makers and health professionals to implement targeted and cost-effective prevention strategies.
Stahl, Sarah T.; Schulz, Richard
This prospective study examined the effect of widowhood on physical activity by comparing widowed elders to health status-, age-, and sex-matched married controls. Participants included 396 married controls and 396 widows/widowers age 64 to 91 (M age = 72.7 years) who experienced the death of their spouse while participating in the Cardiovascular Health Study (CHS). Compared to married controls, widowed men, but not women, were more likely to increase their physical activity following the death of their spouse. However, this increased level of activity was not sustained and declines as time since spousal death passes. Moreover, during the year before spousal death, soon-to-be widowed men, but not women, increase their physical activity. Our results suggest that widowed men experience significant changes in physical activity and that the transition to widowhood contribute to these changes. PMID:23975417
Hjerpsted, Julie Bousgaard
Cardiovascular diseases (CVDs) are the number one cause of mortality worldwide. Low-density lipoprotein (LDL) cholesterol is a well-known risk factor of CVD which increases after the intake of saturated fatty acids (SFA). Cheese is a dietary product commonly consumed in Western countries and known...
Haan Mary N
Full Text Available Abstract Background We investigated if personal socioeconomic position (SEP factors and neighborhood characteristics were associated with incident mobility impairment in the elderly. Methods We used data from the Cardiovascular Health Study, a longitudinal, population-based examination of coronary heart disease and stroke among persons aged 65 and older in the United States. Results Among 3,684 persons without baseline mobility impairment, lower baseline SEP was associated with increased risk of incident mobility disability during the 10-year follow-up period, although the strengths of these associations varied by socioeconomic indicator and race/sex group. Conclusion Among independent-living elderly, SEP affected development of mobility impairment into later life. Particular effort should be made to prevent or delay its onset among the elderly with low income, education, and/or who live in economically disadvantaged neighborhoods.
Nair, Uma S; Jordan, Jeremy S; Funk, Daniel; Gavin, Kristin; Tibbetts, Erica; Collins, Bradley N
Female inmate populations in the United States tend to be overweight, physically inactive, experience high stress, and have a history of nicotine and other drug dependence. Thus, they bear an elevated risk of cardiovascular (CV) disease than the general population. However, few evidence-based health interventions exist for this population. This study will test proof of concept, feasibility, and potential efficacy of a multiple health behavior change intervention that integrates CV-health promotion education delivered during a physical activity (PA) program (indoor cycling) tailored to this population. This study uses a quasi-experimental 2-group design with two measurement time-points: baseline and 8-week end of treatment. N=120 incarcerated women (18-59years of age) who are medically cleared for participation in PA will be enrolled. Indoor cycling instructors will be trained to deliver five health education topics over an 8-week period during twice-weekly cycling classes. Topics match the American Heart Association recommendations for CV health: (a) nutrition, (b) PA promotion, (c) weight management, (d) stress management, and (e) smoking cessation and relapse prevention. Modes of intervention include instructor advice, written materials and audio/video clips reviewed during class. CV-related and mental health measures will be assessed at both time-points. Results will guide a full scale efficacy study. Future research in this area has potential to impact the health of female inmates, a high-risk population. Moreover, this multiple health behavior change intervention model represents a community approach to health promotion that could generalize to other underserved populations who may benefit most from similar intervention efforts. PMID:27020419
Barbosa Filho Valter; de Campos Wagner; Bozza Rodrigo; Lopes Adair da
Abstract Background The adoption of health-related behaviors is an important part of adolescence. This study examined the prevalence and correlates of the isolated and simultaneous presence of behavioral risk factors for cardiovascular health (BRFCH) among adolescents in Curitiba, Southern Brazil. Methods A cross-sectional study was performed with 1,628 adolescents (aged 11-17.9 years, 52.5% males) that were randomly selected from 44 public schools. Self-report instruments were used to assess...
Mocumbi, Ana Olga; Sliwa, Karen
The predominant pattern of cardiovascular diseases in sub-Saharan Africa is that of poverty-related conditions (rheumatic heart valve disease, untreated congenital heart disease, tuberculous pericarditis) and diseases of unclear aetiology with a higher prevalence in this part of the world (peripartum cardiomyopathy, endomyocardial fibrosis). However, the prevalence of the traditional risk factors for cardiovascular diseases such as hypertension and marked obesity is high in a number of sub-Saharan settings, although they vary considerably among countries, urban/rural locations and specific subpopulations. In urban settings, hypertensive heart disease with systolic and diastolic function contributes substantially to morbidity. Awareness of the general public and health workers about the burden of cardiovascular diseases in women must be increased, and risk factor control programmes must be included in the health research agenda on the African continent. Improvement in health services with coordination of maternal health services and non-communicable diseases is also needed. This review focuses on the current knowledge of cardiovascular healthcare of women in sub-Saharan Africa, particularly their propensity for various forms of heart disease, access to healthcare, treatment received within the respective healthcare system, response to therapy and mortality. It highlights the gaps in knowledge and the paucity of data in most of these aspects. PMID:22350029
Raji, Cyrus A.; Merrill, David A.; Eyre, Harris; Mallam, Sravya; Torosyan, Nare; Erickson, Kirk I.; Lopez, Oscar L.; Becker, James T.; Carmichael, Owen T.; Gach, H. Michael; Thompson, Paul M.; Longstreth, W.T.; Kuller, Lewis H.
Background: Physical activity (PA) can be neuroprotective and reduce the risk for Alzheimer’s disease (AD). In assessing physical activity, caloric expenditure is a proxy marker reflecting the sum total of multiple physical activity types conducted by an individual. Objective:To assess caloric expenditure, as a proxy marker of PA, as a predictive measure of gray matter (GM) volumes in the normal and cognitively impaired elderly persons. Methods: All subjects in this study were recruited from the Institutional Review Board approved Cardiovascular Health Study (CHS), a multisite population-based longitudinal study in persons aged 65 and older. We analyzed a sub-sample of CHS participants 876 subjects (mean age 78.3, 57.5% F, 42.5% M) who had i) energy output assessed as kilocalories (kcal) per week using the standardized Minnesota Leisure-Time Activities questionnaire, ii) cognitive assessments for clinical classification of normal cognition, mild cognitive impairment (MCI), and AD, and iii) volumetric MR imaging of the brain. Voxel-based morphometry modeled the relationship between kcal/week and GM volumes while accounting for standard covariates including head size, age, sex, white matter hyperintensity lesions, MCI or AD status, and site. Multiple comparisons were controlled using a False Discovery Rate of 5 percent. Results: Higher energy output, from a variety of physical activity types, was associated with larger GM volumes in frontal, temporal, and parietal lobes, as well as hippocampus, thalamus, and basal ganglia. High levels of caloric expenditure moderated neurodegeneration-associated volume loss in the precuneus, posterior cingulate, and cerebellar vermis. Conclusion:Increasing energy output from a variety of physical activities is related to larger gray matter volumes in the elderly, regardless of cognitive status. PMID:26967227
Chambers, Earle C.; Rosenbaum, Emily
Studies have shown that households subsidized with vouchers live in higher quality units and exhibit fewer physical, mental, and social problems than do their peers living in public housing. However, none of these studies have included cardiovascular outcomes. The objective of this study was to assess if use/type of rental assistance is independently associated with poor cardiovascular health among Latino adults (ages ≥18) who are eligible for federal low-income rental assistance and living i...
Xuemei Sui; Hongjuan Li; Jiajia Zhang; Li Chen; Ling Zhu; Blair, Steven N.
Purpose. We assessed the effects of the four newly defined American Heart Association (AHA) lifestyle factors on mortality by examining the associated population attributable fractions (PAFs) of these factors. Methods. Slightly modified AHA cardiovascular health factors (smoking, body mass index, cardiorespiratory fitness, and diet) were measured among 11,240 (24% women) participants from the Aerobics Center Longitudinal Study between 1987 and 1999. The cohort was followed to December 31, 200...
Chow, Clara K; Ariyarathna, Nilshan; Islam, Sheikh Mohammed Shariful; Thiagalingam, Aravinda; Redfern, Julie
Mobile health (mHealth) has been defined as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices and personal digital assistants. Cardiovascular mHealth is, arguably, leading the mHealth space, through innovation, research and implementation, and especially in the areas of prevention, cardiac rehabilitation and education. mHealth includes simple strategies, such as the use of short message service (SMS) or text messages in successful short-term smoking-cessation, weight loss and diabetes management programs. The recent Australian Tobacco, Exercise and Diet Messages (TEXT ME) randomised clinical trial addressed multiple cardiovascular risk factors. mHealth can also involve more complex strategies, such as smart phone applications (apps), global positioning systems (GPS) and Bluetooth technologies. Although many apps could be considered suitable for primary prevention, they are largely unregulated and most are not evidence-based. Some have been well-developed, such as the Food Switch app and an iPhone electrocardiogram (ECG) system. The "explosion" of apps has driven initiatives such as the Mobile Applications Rating Scale (MARS). More recently, the use of sensors to monitor and provide feedback to patients and healthcare providers is being explored. With almost two billion people currently owning a Smartphone, and 50% of adults (globally) predicted to own one by 2018, mHealth provides the prospect of delivering efficient, affordable healthcare services to widespread populations both locally and globally. In particular, it has the potential to reduce socioeconomic disparity and alleviate the burden of cardiovascular disease. There is now a need to rethink traditional health service structures and bioengineering capacity, to ensure mHealth systems are also safe, secure and robust. PMID:27262389
Labarthe, Darwin R; Kubzansky, Laura D; Boehm, Julia K; Lloyd-Jones, Donald M; Berry, Jarett D; Seligman, Martin E P
Two concepts, positive health and cardiovascular health, have emerged recently from the respective fields of positive psychology and preventive cardiology. These parallel constructs are converging to foster positive cardiovascular health and a growing collaboration between psychologists and cardiovascular scientists to achieve significant improvements in both individual and population cardiovascular health. We explore these 2 concepts and note close similarities in the measures that define them, the health states that they aim to produce, and their intended long-term clinical and public health outcomes. We especially examine subjective health assets, such as optimism, that are a core focus of positive psychology, but have largely been neglected in preventive cardiology. We identify research to date on positive cardiovascular health, discuss its strengths and limitations thus far, and outline directions for further engagement of cardiovascular scientists with colleagues in positive psychology to advance this new field. PMID:27539179
Tully, Phillip J; Turnbull, Deborah A; Horowitz, John D; Beltrame, John F.; Selkow, Terina; Baune, Bernhard T; Markwick, Elizabeth; Sauer-Zavala, Shannon; Baumeister, Harald; Cosh, Suzanne; Gary A Wittert
Background Previous psychological and pharmacological interventions have primarily focused on depression disorders in populations with cardiovascular diseases (CVDs) and the efficacy of anxiety disorder interventions is only more recently being explored. Transdiagnostic interventions address common emotional processes and the full range of anxiety and depression disorders often observed in populations with CVDs. The aim of CHAMPS is to evaluate the feasibility of a unified protocol (UP) for t...
Chou, Li-Ping; Tsai, Chiang-Chin; Li, Chung-Yi; Hu, Susan C
Objectives To explore the prevalence and associated factors of cardiovascular health as defined by the AHA among different job categories in health settings. Methods This is a cross-sectional and hospital-based survey. A total of 1329 medical professionals with a mean age of 38 years in a regional hospital in Taiwan were recruited. Information for seven combined indicators including blood pressure, fasting sugar, blood cholesterol, body mass index, time of physical activity, dietary pattern and smoking status was obtained from the employees' health profiles and questionnaires. Degree of job strain was evaluated by the Chinese version of the Job Content Questionnaire, which was derived from Karasek's demand-control model. Three types of cardiovascular health were identified as poor, intermediate and ideal. Results Prevalence of cardiovascular health in this study's population was ideal in 0.2% of the sample, intermediate in 20.6% and poor in 79.2%. There was a significantly higher percentage of poor health in workers with high strain (85.1%), and in the professions of nurse (85.3%) and physician assistant (83.1%). In the multivariate analysis, the only significant factor correlated with job strain was physical inactivity. After being adjusted, workers with high strain exhibit a higher prevalence of physical inactivity compared to those with low strain (OR 1.9, 95% CI 1.38 to −2.81). Conclusions Physical inactivity is the only significant factor correlated with job strain and is associated with a work situation characterised by high strain and the professions of nurse and physician assistant. Strategies for workplace health promotion should focus on employee health literacy and motivation to exercise regularly. PMID:27044581
Colkesen, Ersen; Ferket, Bart; Tijssen, Jan; Kraaijenhagen, Roderik; Kalken, Coenraad; Peters, Ron
textabstractIntroduction: A large proportion of the cardiovascular disease (CVD) burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web- based health risk assessment (HRA) with tailored feedback for individual health promotion is a promising strategy. We evaluated the effect on CVD risk of such a program among employees of a Dutch worksite. Methods: We conducted a prospective follow-up study among 368 employees who voluntarily participat...
Moon, J. Robin; Glymour, M. Maria; Subramanian, S V; Avendaño, Mauricio; Kawachi, Ichiro
Transitioning from work to retirement could be either beneficial or harmful for health. We investigated the association between transition to retirement and risk of stroke and myocardial infarction (MI). We followed US Health and Retirement Study participants age 50+ working full-time for pay and free of major cardiovascular disease (n=5,422) in 1998 up to 10 years for transition to full retirement and self- or proxy-report of either stroke or MI (CVD; 665 events). We used discrete-time survi...
Sánchez-Muniz, F J
Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in developed countries. CVD is an inflammatory disease associated with risk factors that include hypercholesterolemia and hypertension. Furthermore, the evolution of this disease depends on the amount of modified lipoproteins (e.g. oxidized) present in the arterial subendothelium. Diet is considered the cornerstone for CVD treatment, as it can lower not only atherogenic lipoprotein levels and degree of oxidation, but also blood pressure, thrombogenesis and concentrations of some relevant factors (e.g. homocystein).Among different diets, the Mediterranean diet stands out due to their benefits on several health benefits, in particular with regard to CVD. Rich in vegetable foods, this diet contributes both quantitatively and qualitatively to essential fibre compounds (cellulose, hemicellulose, gums, mucilages, pectins, oligosaccharides, lignins, etc.). The present paper analyzes the effects of fibre consumption on a) cholesterol and lipoprotein levels; b) systolic and diastolic blood pressures; and c) antioxidant availability and profile. Some studies and meta-analysis are revised, as the possible mechanisms by which fibre may decrease plasma total cholesterol and LDL-cholesterol and blood pressure and to act as antioxidant, as well. In addition, author's own publications regarding the effect of fibre matrix (e.g. seaweeds) on arylesterase and the gene expression of some key antioxidant enzymes are reviewed. The paper also includes data concerning the possible interaction between fibre and some hypolipemic drugs, which may make it possible to attain similar hypolipemic effects with lower dosages, with the consequent decrease in possible side effects. The review concludes with a summary of nutritional objectives related to the consumption of carbohydrates and fibre supplements. PMID:22566302
Temporelli, Pier Luigi
It is well known that regular moderate physical activity, in the context of a healthy lifestyle, significantly reduces the likelihood of cardiovascular events, both in primary and secondary prevention. In addition, it is scientifically proven that exercise can reduce the incidence of diabetes, osteoporosis, depression, breast cancer and colon cancer. Despite this strong evidence, sedentary lifestyle remains a widespread habit in the western world. Even in Italy the adult population has a poor attitude to regular physical activity. It is therefore necessary, as continuously recommended by the World Health Organization, to motivate people to "move" since the transition from inactivity to regular light to moderate physical activity has a huge impact on health, resulting in significant savings of resources. We do not need to be athletes to exercise - it should be part of all our daily routines. PMID:27029874
Liu, Xiaoxue; Shi, Jihong; Wang, Anxin; Song, Qiaofeng; Huang, Zhe; Zhu, Chenrui; Du, Xin; Zhang, Ying; Chen, Shuohua; Wang, Xizhu; Wu, Shouling
The aim of the present study was to investigate the association between the altered ideal cardiovascular health status (ΔCHS) and the risk of developing diabetes mellitus in the Kailuan population of China.We included 50,656 Chinese adults aged 18 years or older (11,704 men and 38,952 women) without baseline diabetes mellitus in this study. Information about 7 individual components of the cardiovascular health metrics during 2006 to 2008 was collected. A ΔCHS score was defined as the changes of ideal cardiovascular health status (CHS) from the year 2006 to 2008. New-onset diabetes was identified based on the history of diabetes, currently treated with insulin or oral hypoglycemic agents, or having a fasting blood glucose concentration ≥7.0 mmol/L during the 2010 to 2011 and 2012 to 2013 surveys. After a mean follow-up period of 3.80 years, a total of 3071 (6.06%) participants developed diabetes mellitus. Cox proportional hazards regression was used to calculate the hazard ratios and 95% confidence intervals for the CHS change and new-onset diabetes.A strong inverse association between the positive CHS changes and lower risks of developing diabetes mellitus was observed. After adjusting for age, sex, alcohol consumption, and other potential confounders, the hazard ratios for new-onset diabetes were 0.73, 0.59, 0.49, and 0.42 (95% confidence interval: 0.37-0.82; P trend diabetes mellitus in this investigated Chinese population. PMID:27559955
Thurston, Rebecca C.; Chang, Yuefang; Derby, Carol A.; Bromberger, Joyce T.; Harlow, Sioban D.; Janssen, Imke; Matthews, Karen A.
Background and Purpose Some evidence suggests that abuse may be related to CVD risk among women. However, this relation has largely been addressed using self-reported measures of CVD. We tested whether a history of abuse was related to subclinical cardiovascular disease (CVD) among midlife women without clinical CVD. Methods The Study of Women’s Health Across the Nation (SWAN) is a longitudinal cohort study of women transitioning through the menopause. 1402 Caucasian, African American, Hispanic, and Chinese SWAN participants completed measures of childhood and adult physical and sexual abuse, underwent a blood draw, completed physical measures, and underwent a carotid artery ultrasound at SWAN study visit 12. Associations between abuse and IMT and plaque were tested in linear and multinomial logistic regression models controlling for age, site, race/ethnicity, financial strain, education, body mass index, lipids, blood pressure, measures of insulin resistance, smoking, alcohol use, physical activity, and medication use. Results Findings indicated that a history of childhood sexual abuse was associated with higher IMT controlling for standard CVD risk factors and other confounders (beta (standard error)=0.022 (0.010), p<0.05; adjusted means, childhood sexual abuse: 0.800 mm vs. no childhood sexual abuse: 0.782 mm). Conclusions Childhood sexual abuse was associated with higher IMT controlling for CVD risk factors and other confounders. These findings indicate the importance of considering the potential impact of early life stressors on women’s later cardiovascular health. PMID:25034715
Banack, Hailey R.; Grover, Samuel; Kaouche, Mohammed; Marchand, Sylvie; Lowensteyn, Ilka
Background: Hypertension is a major risk factor for cardiovascular morbidity and mortality. Despite this fact and the development of effective antihypertensive drug therapy, hypertension is often poorly controlled. Community pharmacies are an ideal site for the management of hypertension and other modifiable cardiovascular risk factors. The purpose of the current study was to develop and assess a pharmacy-based cardiovascular risk screening program implemented by graduate students.
Christopher N. Blesso
Full Text Available Eggs are a major source of phospholipids (PL in the Western diet. Dietary PL have emerged as a potential source of bioactive lipids that may have widespread effects on pathways related to inflammation, cholesterol metabolism, and high-density lipoprotein (HDL function. Based on pre-clinical studies, egg phosphatidylcholine (PC and sphingomyelin appear to regulate cholesterol absorption and inflammation. In clinical studies, egg PL intake is associated with beneficial changes in biomarkers related to HDL reverse cholesterol transport. Recently, egg PC was shown to be a substrate for the generation of trimethylamine N-oxide (TMAO, a gut microbe-dependent metabolite associated with increased cardiovascular disease (CVD risk. More research is warranted to examine potential serum TMAO responses with chronic egg ingestion and in different populations, such as diabetics. In this review, the recent basic science, clinical, and epidemiological findings examining egg PL intake and risk of CVD are summarized.
Ouyang, Pamela; Wenger, Nanette K.; Taylor, Doris; Rich-Edwards, Janet W.; Steiner, Meir; Shaw, Leslee J.; Berga, Sarah L.; Miller, Virginia M.; Merz, Noel Bairey
Background In 2001, the Institute of Medicine’s (IOM) report, “Exploring the Biological Contributions to Human Health: Does Sex Matter?” advocated for better understanding of the differences in human diseases between the sexes, with translation of these differences into clinical practice. Sex differences are well documented in the prevalence of cardiovascular (CV) risk factors, the clinical manifestation and incidence of cardiovascular disease (CVD), and the impact of risk factors on outcomes...
Maria Alessandra Gammone
Full Text Available Carotenoids are a class of natural, fat-soluble pigments found principally in plants. They have potential antioxidant biological properties because of their chemical structure and interaction with biological membranes. Epidemiologic studies supported the hypothesis that antioxidants could be used as an inexpensive means of both primary and secondary cardiovascular disease (CVD prevention. In fact, the oxidation of low-density lipoproteins (LDL in the vessels plays a key role in the development of atherosclerotic lesions. The resistance of LDL to oxidation is increased by high dietary antioxidant intake, so that carotenoids, as part of food patterns such as the Mediterranean diet, may have beneficial effects on cardiovascular health too. Further properties of carotenoids leading to a potential reduction of cardiovascular risk are represented by lowering of blood pressure, reduction of pro-inflammatory cytokines and markers of inflammation (such as C-reactive protein, and improvement of insulin sensitivity in muscle, liver, and adipose tissues. In addition, recent nutrigenomics studies have focused on the exceptional ability of carotenoids in modulating the expression of specific genes involved in cell metabolism. The aim of this review is to focus attention to this effect of some carotenoids to prevent CVD.
Karas, Maria G; Yee, Laura M; Biggs, Mary L; Djoussé, Luc; Mukamal, Kenneth J; Ix, Joachim H; Zieman, Susan J; Siscovick, David S; Gottdiener, John S; Rosenberg, Michael A; Kronmal, Richard A; Heckbert, Susan R; Kizer, Jorge R
Various anthropometric measures, including height, have been associated with atrial fibrillation (AF). This raises questions about the appropriateness of using ratio measures such as body mass index (BMI), which contains height squared in its denominator, in the evaluation of AF risk. Among older adults, the optimal anthropometric approach to risk stratification of AF remains uncertain. Anthropometric and bioelectrical impedance measures were obtained from 4,276 participants (mean age = 72.4 years) free of cardiovascular disease in the Cardiovascular Health Study. During follow-up (1989-2008), 1,050 cases of AF occurred. BMI showed a U-shaped association, whereas height, weight, waist circumference, hip circumference, fat mass, and fat-free mass were linearly related to incident AF. The strongest adjusted association occurred for height (per each 1-standard-deviation increment, hazard ratio = 1.38, 95% confidence interval: 1.25, 1.51), which exceeded all other measures, including weight (hazard ratio = 1.21, 95% confidence interval: 1.13, 1.29). Combined assessment of log-transformed weight and height showed regression coefficients that departed from the 1 to -2 ratio inherent in BMI, indicating a loss of predictive information. Risk estimates for AF tended to be stronger for hip circumference than for waist circumference and for fat-free mass than for fat mass, which was explained largely by height. These findings highlight the prominent role of body size and the inadequacy of BMI as determinants of AF in older adults. PMID:27188936
Smith, Rebecca; Menon, Jaideep; Rajeev, Jaya G; Feinberg, Leo; Kumar, Raman Krishan; Banerjee, Amitava
Objectives To assess the potential for using mHealth in cardiovascular disease (CVD) management in Kerala by exploring: (1) experiences and challenges of current CVD management; (2) current mobile phone use; (3) expectations of and barriers to mobile phone use in CVD management. Design Qualitative, semistructured, individual interviews. Setting 5 primary health centres in Ernakulam district, Kerala, India. Participants 15 participants in total from 3 stakeholder groups: 5 patients with CVD an...
Monique S. White
Full Text Available Even though some medications have the potential to slow the progress of atherosclerosis and development of CVD, there are many at-risk individuals who continue to resist the benefits that are available by not following the advice of medical professionals. Non-adherence to prescribed drug regimens is a pervasive medical problem that negatively affects treatment outcomes. Information from standardized interviews of 5301 African Americans participating in the Jackson Heart Study was examined to determine the association between demographic parameters, behavior including adherence to prescribed medical regimens, and health outcomes. Data were also collected at Annual Follow-Up and Surveillance visits. During the two weeks prior to the examination visit, almost 52% of the participants reported taking blood pressure medication, 14% took cholesterol medication, 16% took medication for diabetes, and 19% took blood thinning medication. Of those who did not take the prescribed medications, the reasons given were the following: 47% were in a hurry, too busy, or forgot to take medications; 23% were trying to do without medications; 18% had no money to purchase medications; 19% indicated that the medications made them feel bad; 17% felt that they could not carry out daily functions when taking medications. The African American population can benefit from heightened awareness of the risk factors that are associated with CVD and the benefits of following a prescribed treatment regimen. Unacceptable secondary effects of prescribed medication comprised an important cause of non-compliance. Encouragement of this population to communicate with their healthcare providers to ensure that medication regimens are better tolerated could increase compliance and improve health outcomes.
Delgado, Graciela E; Siekmeier, Rüdiger; März, Winfried; Kleber, Marcus E
Cardiovascular diseases (CVD) are an important cause of morbidity and mortality worldwide. A decreased concentration of adiponectin has been reported in smokers. The aim of this study was to analyze the effect of cigarette smoking on the concentration of adiponectin and potassium in active smokers (AS) and life-time non-smokers (NS) of the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study, and the use of these two markers for risk prediction. Smoking status was assessed by a questionnaire and measurement of plasma cotinine concentration. The serum concentration of adiponectin was measured by ELISA. Adiponectin was binned into tertiles separately for AS and NS and the Cox regression was used to assess the effect on mortality. There were 777 AS and 1178 NS among the LURIC patients. Within 10 years (median) of follow-up 221 AS and 302 NS died. In unadjusted analyses, AS had lower concentrations of adiponectin. However, after adjustment for age and gender there was no significant difference in adiponectin concentration between AS and NS. In the Cox regression model adjusted for age and gender, adiponectin was significantly associated with mortality in AS, but not in NS, with hazard ratio (95 % CI) of 1.60 (1.14-2.24) comparing the third with first tertile. In a model further adjusted for the risk factors, such as diabetes mellitus, hypertension, coronary artery disease, body mass index, LDL-cholesterol and HDL-cholesterol, adiponectin was significantly associated with mortality with hazard ratio of 1.83 (1.28-2.62) and 1.56 (1.15-2.11) for AS and NS, respectively. We conclude that increased adiponectin is a strong and independent predictor of mortality in both AS and NS. The determination of adiponectin concentration could be used to identify individuals at increased mortality risk. PMID:27358181
E.B. Colkesen (Ersen); B.S. Ferket (Bart); J.G.P. Tijssen (Jan); R.A. Kraaijenhagen (Roderik); C.K. Kalken (Coenraad); R.J. Peters (Ron)
textabstractIntroduction: A large proportion of the cardiovascular disease (CVD) burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web- based health risk assessment (HRA) with tailored feedback for individual health promotion is a promising st
Ersen B Colkesen
Full Text Available Ersen B Colkesen1,2, Bart S Ferket2,3, Jan GP Tijssen1, Roderik A Kraaijenhagen2, Coenraad K van Kalken2, Ron JG Peters11Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 2NDDO Institute for Prevention and Early Diagnostics (NIPED, Amsterdam, the Netherlands; 3Department of Epidemiology, Erasmus Medical Center, Rotterdam, the NetherlandsIntroduction: A large proportion of the cardiovascular disease (CVD burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web-based health risk assessment (HRA with tailored feedback for individual health promotion is a promising strategy. We evaluated the effect on CVD risk of such a program among employees of a Dutch worksite.Methods: We conducted a prospective follow-up study among 368 employees who voluntarily participated in a Web-based HRA program at a single Dutch worksite in 2008. The program included a multicomponent HRA through a Web-based electronic questionnaire, biometrics, and laboratory evaluation. The results were combined with health behavior change theory to generate tailored motivational and educational health advice. On request, a health counseling session with the program physician was available. Follow-up data on CVD risk were collected 1 year after initial participation. The primary outcome was a change in Framingham CVD risk at 6 months relative to baseline. We checked for a possible background effect of an increased health consciousness as a consequence of program introduction at the worksite by comparing baseline measurements of early program participants with baseline measurements of participants who completed the program 6 months later.Results: A total of 176 employees completed follow-up measurements after a mean of 7 months. There was a graded relation between CVD risk changes and baseline risk, with a relative reduction of 17.9% (P = 0.001 in the high-risk category (baseline
Gunaratne Padma S
Full Text Available Abstract Background The feasibility of conducting a large-scale Polypill clinical trial in developing countries remains unclear. More information is needed regarding the efficacy in reducing the risk factors of cardiovascular disease (CVD, side effects, improvement in adherence and physician/patient "acceptability" of the Polypill. Methods We conducted an open-label, parallel-group, randomized clinical trial involving three sites in Sri Lanka that enrolled a total of 216 patients without established CVD. The trial compared a Polypill (75 mg aspirin, 20 mg simvastatin, 10 mg lisinopril and 12.5 mg hydrochlorothiazide to Standard Practice. After randomization, patients were followed monthly for three months. Pre-specified primary outcomes included reduction in systolic blood pressure, total cholesterol and estimated 10-year CVD risk. We also evaluated the recruitment process and acceptability of the Polypill by both physicians and patients. Results Patients were recruited in a six-month period as planned. Two hundred three patients (94.0% completed the treatment program and returned for their three-month follow-up visits. No safety concerns were reported. These findings suggest a high rate of patient acceptability, a finding that is bolstered by the majority of patients completing the trial (90% indicating that they would take the Polypill "for life" if proven to be effective in reducing CVD risk. Approximately 86% of the physicians surveyed agreed with and supported use of the Polypill for primary prevention and 93% for secondary prevention of CVD. Both the Polypill and Standard Practice resulted in marked reductions in systolic blood pressure, total cholesterol and 10-year risk of CVD. However, the differences between the treatment groups were not statistically significant. Conclusions We successfully completed a Polypill feasibility trial in Sri Lanka. We were able to document high acceptability of the Polypill to patients and physicians. We
Bondonno, Catherine P; Croft, Kevin D; Hodgson, Jonathan M
Emerging evidence strongly suggests that dietary nitrate, derived in the diet primarily from vegetables, could contribute to cardiovascular health via effects on nitric oxide (NO) status. NO plays an essential role in cardiovascular health. It is produced via the classical L-arginine-NO-synthase pathway and the recently discovered enterosalivary nitrate-nitrite-NO pathway. The discovery of this alternate pathway has highlighted dietary nitrate as a candidate for the cardioprotective effect of a diet rich in fruit and vegetables. Clinical trials with dietary nitrate have observed improvements in blood pressure, endothelial function, ischemia-reperfusion injury, arterial stiffness, platelet function, and exercise performance with a concomitant augmentation of markers of NO status. While these results are indicative of cardiovascular benefits with dietary nitrate intake, there is still a lingering concern about nitrate in relation to methemoglobinemia, cancer, and cardiovascular disease. It is the purpose of this review to present an overview of NO and its critical role in cardiovascular health; to detail the observed vascular benefits of dietary nitrate intake through effects on NO status as well as to discuss the controversy surrounding the possible toxic effects of nitrate. PMID:25976309
Rooks, Ronica N.; Simonsick, Eleanor M.; Harris, Tamara B.; Klesges, Lisa M; Newman, Anne B; Ayonayon, Hilsa
Black adults consistently exhibit higher rates and poorer outcomes of cardiovascular disease (CVD) relative to other racial groups, even after accounting for differences in socioeconomic status (SES). Whether factors related to health care access can further explain racial disparities in CVD have not been thoroughly examined. Using logistic regression we examined racial and health care [i.e. health insurance and access to care] associations with CVD indicators [i.e. hypertension, low ankle-ar...
Shen, Zheni; Ye, Cunqi; McCain, Keanna; Greenberg, Miriam L
Cardiolipin (CL), the signature phospholipid of mitochondrial membranes, is crucial for both mitochondrial function and cellular processes outside of the mitochondria. The importance of CL in cardiovascular health is underscored by the life-threatening genetic disorder Barth syndrome (BTHS), which manifests clinically as cardiomyopathy, skeletal myopathy, neutropenia, and growth retardation. BTHS is caused by mutations in the gene encoding tafazzin, the transacylase that carries out the second CL remodeling step. In addition to BTHS, CL is linked to other cardiovascular diseases (CVDs), including cardiomyopathy, atherosclerosis, myocardial ischemia-reperfusion injury, heart failure, and Tangier disease. The link between CL and CVD may possibly be explained by the physiological roles of CL in pathways that are cardioprotective, including mitochondrial bioenergetics, autophagy/mitophagy, and mitogen activated protein kinase (MAPK) pathways. In this review, we focus on the role of CL in the pathogenesis of CVD as well as the molecular mechanisms that may link CL functions to cardiovascular health. PMID:26301254
Full Text Available Cardiolipin (CL, the signature phospholipid of mitochondrial membranes, is crucial for both mitochondrial function and cellular processes outside of the mitochondria. The importance of CL in cardiovascular health is underscored by the life-threatening genetic disorder Barth syndrome (BTHS, which manifests clinically as cardiomyopathy, skeletal myopathy, neutropenia, and growth retardation. BTHS is caused by mutations in the gene encoding tafazzin, the transacylase that carries out the second CL remodeling step. In addition to BTHS, CL is linked to other cardiovascular diseases (CVDs, including cardiomyopathy, atherosclerosis, myocardial ischemia-reperfusion injury, heart failure, and Tangier disease. The link between CL and CVD may possibly be explained by the physiological roles of CL in pathways that are cardioprotective, including mitochondrial bioenergetics, autophagy/mitophagy, and mitogen activated protein kinase (MAPK pathways. In this review, we focus on the role of CL in the pathogenesis of CVD as well as the molecular mechanisms that may link CL functions to cardiovascular health.
Full Text Available Purpose. We assessed the effects of the four newly defined American Heart Association (AHA lifestyle factors on mortality by examining the associated population attributable fractions (PAFs of these factors. Methods. Slightly modified AHA cardiovascular health factors (smoking, body mass index, cardiorespiratory fitness, and diet were measured among 11,240 (24% women participants from the Aerobics Center Longitudinal Study between 1987 and 1999. The cohort was followed to December 31, 2003, or death. PAFs were calculated as the proportionate reduction in death attributable to identified risk factors. Results. During an average 12 years of followup, 268 deaths occurred. Low fitness had the highest PAFs at the 5th, 10th, and 15th year of followup, respectively: 6.6%, 6.4%, and 5.5%. Current smokers had the second highest PAFs at the 5th, 10th, and 15th year of followup, respectively: 5.4%, 5.2%, and 5.0%. Additional adjusting for other confounders in the model did not change the above associations. The PAFs for overweight or obesity and unhealthy diet were not significant in the current analyses. Conclusions. Assuming a causal relationship between smoking, low fitness, and mortality, avoidance of both would have prevented 13% of the deaths in the current population. Preventive interventions to increase physical activity and stop smoking would most likely promote longevity.
Full Text Available Pomegranate is a source of some very potent antioxidants (tannins, anthocyanins which are considered to be also potent anti-atherogenic agents. The combination of the above unique various types of pomegranate polyphenols provides a much wider spectrum of action against several types of free radicals. Indeed, pomegranate is superior in comparison to other antioxidants in protecting low-density lipoprotein (LDL, “the bad cholesterol” and high-density lipoprotein (HDL, “the good cholesterol” from oxidation, and as a result it attenuates atherosclerosis development and its consequent cardiovascular events. Pomegranate antioxidants are not free, but are attached to the pomegranate sugars, and hence were shown to be beneficial even in diabetic patients. Furthermore, pomegranate antioxidants are unique in their ability to increase the activity of the HDL-associated paraoxonase 1 (PON1, which breaks down harmful oxidized lipids in lipoproteins, in macrophages, and in atherosclerotic plaques. Finally, unique pomegranate antioxidants beneficially decrease blood pressure. All the above beneficial characteristics make the pomegranate a uniquely healthy fruit.
Suneet Mittal, MD
Retrospective case-control studies and case series of younger athletes and middle-aged adults have suggested an adverse association between physical activity and development of atrial fibrillation. However, these studies have evaluated subjects engaged in either vigorous exertion or endurance training. On the other hand, habitual physical activity might be expected through salutatory effects on blood pressure, vascular compliance, coronary disease, and heart failure to reduce the incidence of...
Versteeg, Henneke; Spek, Viola; Pedersen, Susanne S.;
in patient-reported physical and mental health status among cardiovascular patients. Methods: A computerized search of the literature through PUBMED and PsychINFO (from 1995 to May 2011) was performed and prospective studies were selected that analysed the association between Type D personality and...... health status in cardiovascular patients. Two separate meta-analyses were performed for the association of Type D personality with physical and mental health status, respectively. Results: Of all identified studies, ten studies met the selection criteria. The meta-analyses showed that Type D was...... associated with a two-fold increased odds for impaired physical health status (3035 patients, OR 1.94, 95% CI 1.49-2.52) and a 2.5-fold increased odds for impaired mental health status (2213 patients, OR 2.55, 95% CI 1.57-4.16). There was no significant heterogeneity between the studies on physical health...
Lee, M; Gardin, J M; Lynch, J C; Smith, V E; Tracy, R P; Savage, P J; Szklo, M; Ward, B J
This report describes the relation among diabetes, blood pressure, and prevalent cardiovascular disease, and echocardiographically measured left ventricular mass and filling (transmitral valve flow) velocities in the Cardiovascular Health Study, a cohort of 5201 men and women > or = 65 years of age. Ventricular septal and left posterior wall thicknesses were greater in diabetic than in nondiabetic subjects, showing a significant linear trend (p = 0.025 for ventricular septal thickness in both sexes combined, p = 0.002 for posterior wall thickness) with increased duration of diabetes. Increased wall thickness of the ventricular septum or the left posterior wall was not associated with prevalent coronary heart disease (CHD) in the cohort. Increased left ventricular mass was associated with diabetic persons not reporting CHD and with all subjects with CHD regardless of glucose tolerance status. After adjusting for body weight, blood pressure, heart rate, and prevalent coronary or cerebrovascular disease, diabetes (as measured by glucose level, insulin use, oral hypoglycemic use, and a positive history of diabetes before baseline examination) remained an independent predictor of increased left ventricular mass among men and women (174.2 gm in diabetic men vs 169.8 gm in normal men, 138.2 gm in diabetic women vs 134.0 gm in normal women, p = 0.043 for both sexes combined). Both early and late diastolic transmitral peak flow velocities were higher with increased duration of diabetes, but the calculated ratio of the early peak flow velocity to the late velocity (E/A ratio) did not differ significantly between subjects with historical diabetes and those with normal fasting glucose (both genders combined, p = 0.190). Glucose level, insulin use, oral hypoglycemic use, and a positive history of diabetes before baseline examination were significant independent predictors of the late transmitral peak flow velocity and its integrated flow-velocity curve but not for the integral
Barbosa Filho Valter
Full Text Available Abstract Background The adoption of health-related behaviors is an important part of adolescence. This study examined the prevalence and correlates of the isolated and simultaneous presence of behavioral risk factors for cardiovascular health (BRFCH among adolescents in Curitiba, Southern Brazil. Methods A cross-sectional study was performed with 1,628 adolescents (aged 11-17.9 years, 52.5% males that were randomly selected from 44 public schools. Self-report instruments were used to assess the variables. Six BRFCH were analyzed: insufficiently active, excessive TV watching, current alcohol and tobacco use, daily soft drinks consumption and inadequate fruit and vegetable consumption. Sociodemographic and behavioral variables were studied as possible correlates of the presence of BRFCH. Results The BRFCH with the highest prevalence were insufficiently active (50.5%, 95% confidence interval [95% CI]: 48.0-52.9 and daily soft drinks consumption (47.6%, 95% CI: 45.1-50.0. Approximately 30% of the adolescents presented three or more BRFCH simultaneously. Girls, adolescents who did not participate in organized physical activity, and who used computer/video games daily were the main high-risk subgroups for insufficiently active. Boys and those who used computer/video games daily were the high-risk subgroups for daily soft drinks consumption. For excessive TV watching, we identified to be at risk those who were from a high economic class, unemployed, and who used computer/video games daily. For current alcohol use, we identified older adolescents, who were from a high economic class and who worked to be at risk. Older adolescents, who worked and who spent little active time during a physical education class were the high-risk subgroups for current tobacco use. For inadequate fruit and vegetable consumption, we identified those who did not participate in organized physical activity to be at risk. Older adolescents, who were from a high economic class
Madamanchi, Nageswara R.; Runge, Marschall S.
Spatiotemporal regulation of the activity of a vast array of intracellular proteins and signaling pathways by reactive oxygen species (ROS) governs normal cardiovascular function. However, data from experimental and animal studies strongly support that dysregulated redox signaling, resulting from hyper-activation of various cellular oxidases or mitochondrial dysfunction, is integral to the pathogenesis and progression of cardiovascular disease (CVD). In this review, we address how redox signa...
Full Text Available BACKGROUND: Besides its well-established role in nerve cell survival and adaptive plasticity, brain-derived neurotrophic factor (BDNF is also involved in energy homeostasis and cardiovascular regulation. Although BDNF is present in the systemic circulation, it is unknown whether plasma BDNF correlates with circulating markers of dysregulated metabolism and an adverse cardiovascular profile. METHODOLOGY/PRINCIPAL FINDINGS: To determine whether circulating BDNF correlates with indices of metabolic and cardiovascular health, we measured plasma BDNF levels in 496 middle-age and elderly subjects (mean age approximately 70, in the Baltimore Longitudinal Study of Aging. Linear regression analysis revealed that plasma BDNF is associated with risk factors for cardiovascular disease and metabolic syndrome, regardless of age. In females, BDNF was positively correlated with BMI, fat mass, diastolic blood pressure, total cholesterol, and LDL-cholesterol, and inversely correlated with folate. In males, BDNF was positively correlated with diastolic blood pressure, triglycerides, free thiiodo-thyronine (FT3, and bioavailable testosterone, and inversely correlated with sex-hormone binding globulin, and adiponectin. CONCLUSION/SIGNIFICANCE: Plasma BDNF significantly correlates with multiple risk factors for metabolic syndrome and cardiovascular dysfunction. Whether BDNF contributes to the pathogenesis of these disorders or functions in adaptive responses to cellular stress (as occurs in the brain remains to be determined.
Dhutia, Harshil; Sharma, Sanjay
Regular physical activity controls acquired cardiovascular risk factors such as obesity, diabetes mellitus, hypertension and hyperlipidaemia. Exercise is generally associated with a 50% reduction in adverse events from coronary artery disease (CAD). The benefits of exercise extend well beyond the cardiovascular system. Recent evidence suggests that exercise prevents cell senescence, and active individuals are at lower risk of developing certain malignancies including cancer of the prostate and the colon, osteoporosis, depression and dementia. Individuals who exercise regularly extend their life expectancy by three to seven years. Healthy individuals should engage in 150 minutes of moderate-intensity, aerobic exercise per week. Recent studies have demonstrated that even lower volumes of exercise below these recommendations confer health benefits, which is highly relevant to individuals with established cardiac disease including heart failure. Sudden cardiac death in athletes under 35 is rare with.estimates ranging from 1 in 50,000 to 1 in 200,000. Hereditary and congenital abnormalities of the heart are the most common cause of nontraumatic death during sport in young athletes. In middle-aged recreational athletes more than 90% of sudden cardiac deaths occur in males and more than 90% are caused by atherosclerotic CAD. The AHA and the ESC advocate pre-participation screening of young athletes. The ECG has the ability to detect congenital accessory pathways and ion channelopathies, and is frequently abnormal in individuals with cardiomyopathy. Screening with a 12-lead ECG in older athletes is of limited value given the overwhelming contribution of atherosclerotic CAD to sudden cardiac death. PMID:26738247
Yingling, Leah R; Brooks, Alyssa T; Wallen, Gwenyth R; Peters-Lawrence, Marlene; McClurkin, Michael; Cooper-McCann, Rebecca; Wiley Jr, Kenneth L; Mitchell, Valerie; Saygbe, Johnetta N; Johnson, Twanda D; Curry, Rev. Kendrick E; Johnson, Allan A; Graham, Avis P; Graham, Lennox A
Background Resource-limited communities in Washington, D.C. have high rates of obesity-related cardiovascular disease in addition to inadequate physical activity (PA) facilities and limited Internet access. Engaging community members in the design and implementation of studies to address these health disparities is essential to the success of community-based PA interventions. Objective The objective of the study was to use qualitative and quantitative methods to evaluate the feasibility and acceptability of PA-monitoring wristbands and Web-based technology by predominantly African American, church-based populations in resource-limited Washington, D.C. neighborhoods. Methods To address cardiovascular health in at-risk populations in Washington, D.C., we joined community leaders to establish a community advisory board, the D.C. Cardiovascular Health and Obesity Collaborative (D.C. CHOC). As their first initiative, the Washington, D.C. Cardiovascular Health and Needs Assessment intends to evaluate cardiovascular health, social determinants of health, and PA-monitoring technologies. At the recommendation of D.C. CHOC members, we conducted a focus group and piloted the proposed PA-monitoring system with community members representing churches that would be targeted by the Cardiovascular Health and Needs Assessment. Participants (n=8) agreed to wear a PA-monitoring wristband for two weeks and to log cardiovascular health factors on a secure Internet account. Wristbands collected accelerometer-based data that participants uploaded to a wireless hub at their church. Participants agreed to return after two weeks to participate in a moderated focus group to share experiences using this technology. Feasibility was measured by Internet account usage, wristband utilization, and objective PA data. Acceptability was evaluated through thematic analysis of verbatim focus group transcripts. Results Study participants (5 males, 3 females) were African American and age 28-70 years
Zheni Shen; Cunqi Ye; Keanna McCain; Greenberg, Miriam L.
Cardiolipin (CL), the signature phospholipid of mitochondrial membranes, is crucial for both mitochondrial function and cellular processes outside of the mitochondria. The importance of CL in cardiovascular health is underscored by the life-threatening genetic disorder Barth syndrome (BTHS), which manifests clinically as cardiomyopathy, skeletal myopathy, neutropenia, and growth retardation. BTHS is caused by mutations in the gene encoding tafazzin, the transacylase that carries out the secon...
Robert G. Fassett
Full Text Available Oxidative stress and inflammation are established processes contributing to cardiovascular disease caused by atherosclerosis. However, antioxidant therapies tested in cardiovascular disease such as vitamin E, C and β-carotene have proved unsuccessful at reducing cardiovascular events and mortality. Although these outcomes may reflect limitations in trial design, new, more potent antioxidant therapies are being pursued. Astaxanthin, a carotenoid found in microalgae, fungi, complex plants, seafood, flamingos and quail is one such agent. It has antioxidant and anti-inflammatory effects. Limited, short duration and small sample size studies have assessed the effects of astaxanthin on oxidative stress and inflammation biomarkers and have investigated bioavailability and safety. So far no significant adverse events have been observed and biomarkers of oxidative stress and inflammation are attenuated with astaxanthin supplementation. Experimental investigations in a range of species using a cardiac ischaemia-reperfusion model demonstrated cardiac muscle preservation when astaxanthin is administered either orally or intravenously prior to the induction of ischaemia. Human clinical cardiovascular studies using astaxanthin therapy have not yet been reported. On the basis of the promising results of experimental cardiovascular studies and the physicochemical and antioxidant properties and safety profile of astaxanthin, clinical trials should be undertaken.
Smith, Rebecca; Menon, Jaideep; Rajeev, Jaya G; Feinberg, Leo; Kumar, Raman Krishan; Banerjee, Amitava
Objectives To assess the potential for using mHealth in cardiovascular disease (CVD) management in Kerala by exploring: (1) experiences and challenges of current CVD management; (2) current mobile phone use; (3) expectations of and barriers to mobile phone use in CVD management. Design Qualitative, semistructured, individual interviews. Setting 5 primary health centres in Ernakulam district, Kerala, India. Participants 15 participants in total from 3 stakeholder groups: 5 patients with CVD and/or its risk factors, 5 physicians treating CVD and 5 Accredited Social Health Activists (ASHAs). Patients were sampled for maximum variation on the basis of age, sex, CVD diagnoses and risk factors. All participants had access to a mobile phone. Results The main themes identified relating to the current challenges of CVD were poor patient disease knowledge, difficulties in implementing primary prevention and poor patient lifestyles. Participants noted phone calls as the main function of current mobile phone use. The expectations of mHealth use are to: improve accessibility to healthcare knowledge; provide reminders of appointments, medication and lifestyle changes; save time, money and travel; and improve ASHA job efficacy. All perceived barriers to mHealth were noted within physician interviews. These included fears of mobile phones negatively affecting physicians’ roles, the usability of mobile phones, radiation and the need for physical consultations. Conclusions There are three main potential uses of mHealth in this population: (1) as an educational tool, to improve health education and lifestyle behaviours; (2) to optimise the use of limited resources, by overcoming geographical barriers and financial constraints; (3) to improve use of healthcare, by providing appointment and treatment reminders in order to improve disease prevention and management. Successful mHealth design, which takes barriers into account, may complement current practice and optimise use of limited
Foraker, Randi E; Shoben, Abigail B; Kelley, Marjorie M; Lai, Albert M; Lopetegui, Marcelo A; Jackson, Rebecca D; Langan, Michael A; Payne, Philip R O
risk assessment, visualization, and decision-making tool that automatically populates with electronic health record (EHR) data during the encounter in order to encourage patient-centered CVH discussions among at-risk, yet under-treated, populations. We quantified five of the seven CVH behaviors and factors that were available in The Ohio State University Wexner Medical Center's EHR at baseline (May-July 2013) and compared values to those ascertained at one-year (May-July 2014) among intervention (n = 109) and control (n = 42) patients. The CVH of women in the intervention clinic improved relative to the metrics of body mass index (16% to 21% ideal) and diabetes (62% to 68% ideal), but not for smoking, total cholesterol, or blood pressure. Meanwhile, the CVH of women in the control clinic either held constant or worsened slightly as measured using those same metrics. Providers need easy-to-use tools at the point-of-care to help patients improve CVH. We demonstrated that the EHR could deliver such a tool using an existing American Heart Association framework, and we noted small improvements in CVH in our patient population. Future work is needed to assess how to best harness the potential of such tools in order to have the greatest impact on the CVH of a larger patient population. PMID:27486559
Kenney, W Larry; Craighead, Daniel H; Alexander, Lacy M
This brief review is based on a President's Lecture presented at the Annual Meeting of the American College of Sports Medicine in 2013. The purpose of this review was to assess the effects of climate change and consequent increases in environmental heat stress on the aging cardiovascular system. The earth's average global temperature is slowly but consistently increasing, and along with mean temperature changes come increases in heat wave frequency and severity. Extreme passive thermal stress resulting from prolonged elevations in ambient temperature and prolonged physical activity in hot environments creates a high demand on the left ventricle to pump blood to the skin to dissipate heat. Even healthy aging is accompanied by altered cardiovascular function, which limits the extent to which older individuals can maintain stroke volume, increase cardiac output, and increase skin blood flow when exposed to environmental extremes. In the elderly, the increased cardiovascular demand during heat waves is often fatal because of increased strain on an already compromised left ventricle. Not surprisingly, excess deaths during heat waves 1) occur predominantly in older individuals and 2) are overwhelmingly cardiovascular in origin. Increasing frequency and severity of heat waves coupled with a rapidly growing at-risk population dramatically increase the extent of future untoward health outcomes. PMID:24598696
Mogoşanu, George Dan; Biţă, Andrei; Bejenaru, Ludovic Everard; Bejenaru, Cornelia; Croitoru, Octavian; Rău, Gabriela; Rogoveanu, Otilia-Constantina; Florescu, Dan Nicolae; Neamţu, Johny; Scorei, Iulia Daria; Scorei, Romulus Ion
Calcium fructoborate (CF), a natural sugar-borate ester found in fresh fruits and vegetables, is a source of soluble boron. CF contains three forms of borate (diester, monoester, and boric acid) and all are biologically active, both at the intracellular (as free boric acid) and extracellular level (as fructose-borate diester and monoester). At the cellular and molecular level, CF is superior to the boric acid/borate, exhibiting a complex "protective" effect against inflammatory response. CF is commercially available in the USA as a "nature-identical" complex, an active compound for dietary supplements. It provides effective and safe support against the discomfort and lack of flexibility associated with osteoarticular conditions (arthritis and joint degeneration), and improves Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and McGill indexes. In addition, orally administered CF is effective in ameliorating symptoms of physiological response to stress, including inflammation of the mucous membranes, discomfort associated with osteoarthritis disorders, and bone loss, and also for supporting cardiovascular health. Clinical studies have exhibited the ability of CF to significantly modulate molecular markers associated with inflammatory mechanisms, mainly on the elevated serum levels of C-reactive protein (CRP). PMID:26686846
Gómez Juaristi, Miren; L. González-Torres; Bravo, Laura; Vaquero, M. Pilar; Bastida, Sara; Sánchez-Muniz, F. J.
Since ancient times, numerous health beneficial effects have been attributed to chocolate, closing up its consumption to a therapeutic use. The present study reviews some relevant studies about chocolate (and its bioactive compounds) on some cardiovascular risk factors and stresses the need of future studies. The consumption of cocoa/ chocolate (i) increases plasma antioxidant capacity, (ii) diminishes platelet function and inflammation, and (iii) decreases diastolic and systolic arterial pre...
Ian M Kronish
Full Text Available BACKGROUND: Depressive symptoms are associated with increased incident and recurrent cardiovascular events. In 2010, the American Heart Association published the Life's Simple 7, a metric for assessing cardiovascular health as measured by 4 health behaviors (smoking, physical activity, body mass index, diet and 3 biological measures (cholesterol, blood pressure, glucose. The association between depressive symptoms and the Life's Simple 7 has not yet been explored. METHODS: Data from 20,093 participants ≥45 years of age who enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS study between 2003 and 2007 and who had complete data available on Life's Simple 7 components were used for these analyses. The prevalence of ideal, intermediate, and poor health on each Life's Simple 7 component and total Life's Simple 7 scores were compared between participants with and without depressive symptoms. Depressive symptoms were measured using the 4-item Centers for Epidemiologic Studies of Depression scale. RESULTS: Participants with depressive symptoms were more likely to have poor levels on each of the Life's Simple 7 components other than cholesterol [adjusted prevalence ratios (95% CI: smoking 1.41 (1.29-1.55; physical activity 1.38 (1.31-1.46; body mass index 1.09 (1.04-1.15; diet 1.08 (1.06-1.10; blood pressure 1.11 (1.02-1.21; glucose 1.24 (1.09-1.41]. There was a graded association between increasing depressive symptoms and lower total Life's Simple 7 score. CONCLUSION: Depressive symptoms are associated with worse cardiovascular health on the overall Life's Simple 7 and on individual components representing both health behaviors and biological factors.
Steven van de Vijver
Full Text Available Introduction: Cardiovascular disease (CVD is a leading cause of death in sub-Saharan Africa (SSA, with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlements where access to formal healthcare and resources is limited. Objective: To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches. Study design: Two non-profit organizations that conduct public health research, Amsterdam Institute for Global Health and Development (AIGHD and African Population and Health Research Center (APHRC, collaborated with private-sector Boston Consulting Group (BCG to develop a service delivery package for CVD prevention in slum settings. A theoretic model was designed based on the integration of public and private sector approaches with the focus on costs and feasibility. Results: The final model includes components that aim to improve community awareness, a home-based screening service, patient and provider incentives to seek and deliver treatment specifically for hypertension, and adherence support. The expected outcomes projected by this model could prove potentially cost effective and affordable (1 USD/person/year. The model is currently being implemented in a Nairobi slum and is closely followed by key stakeholders in Kenya including the Ministry of Health, the World Health Organization (WHO, and leading non-governmental organizations (NGOs. Conclusion: Through the collaboration of public health and private sectors, a theoretically cost-effective model was developed for the prevention of CVD and is currently being implemented in the slums of Nairobi. If results are in line with the theoretical projections and first impressions on the ground, scale-up of the service delivery package could be planned in other poor urban areas in Kenya by
Li, Ziru; Zhang, Xusheng
To explore the assessing technique which could objectively reflect the characteristics of Chinese medicine in the prevention of cardiovascular and cerebrovascular diseases, four balance features of infrared thermal images (ITI) corresponding to the up and down, left and right, proximal and distal balance of blood circulation of human body were studied. First, the ITI features of the middle-aged and elderly people with lipid abnormality history were compared with those of the healthy youth. It was found that the balance state of the youth was significantly better than that of the middle-aged and elderly, Ppathology basis of the influences of Shengyi on the four balance features and its relationship with the clinical outcome deserves further study. So the prospect of infrared thermal imaging is indicated as the suitable evaluation technique which could objectively reflect the whole balance regulation advantage of Chinese medicinal compounds.
Vijver, Steven; Oti, Samuel; Cohen Tervaert, Thijs; Hankins, Catherine; Kyobutungi, Catherine; Gomez, Gabriela G; Brewster, Lizzy; Agyemang, Charles; Lange, Joep
Introduction: Cardiovascular disease (CVD) is a leading cause of death in sub-Saharan Africa (SSA), with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlementswhere access to formal healthcare and resources is limited.Objective: To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sec...
Full Text Available In Poland like in other European countries a favorable trend towards reducing morbidity and mortality from cardiovascular disease has been observed. Nevertheless they are still one of the most important health problems in the population, responsible for nearly half of all deaths, including premature deaths. They also affect the quality of life in terms of health and socio-economic development, limiting the possibility of taking and/or continuing employment. Nowadays, cardiovascular diseases have become more common among young, professionally active people. Their professional activity, work organization and exposure to a broad range of occupational factors and environmental conditions may significantly influence the development and course of the cardiovascular disease. The aim of the study was to present the relationship between occupation and some rarer diseases and cardiovascular pathologies, as well as those in which this relationship has not as yet been fully evidenced, however, they may play an important role in workers’ health care. In this paper tako-tsubo cardiomyopathy, aortic aneurysm, aortic dissection, pericardial tamponade, Brugada syndrome and sudden cardiac death are discussed. In addition, the authors indicate new issues emerging along with the development of modern diagnostic and therapeutic techniques in cardiology, such as the care of patients with implanted pace-maker and the use of automated external defibrillators. These issues are presented in the context of their relationship with the occupation, taking into account the activities possibly to be undertaken under preventive care programs. Med Pr 2014;65(6:847–856
markdownabstract__Abstract__ Cardiovascular disease is a major health problem in the adult general population. Epidemiological studies strongly suggest that early life events have an important role for the susceptibility to develop cardiovascular disease in later life. In the 1980’s, Barker and Osmond showed that areas of Britain with the highest neonatal mortality rates early in the 20th century also had the highest incidence of cardiovascular disease in adults, many decades later1. Birth we...
Bansilal, Sameer; Vedanthan, Rajesh; Woodward, Mark; Iyengar, Rupa; Hunn, Marilyn; Lewis, Marcelle; Francis, Lesley; Charney, Alexander; Graves, Claire; Farkouh, Michael E.; Fuster, Valentin
OBJECTIVE The Grenada Heart Project aims to study the clinical, biological, and psychosocial determinants of the cardiovascular health in Grenada in order to develop and implement a nationwide cardiovascular health promotion program. METHODS We recruited 2,827 adults randomly selected from the national electronic voter list. The main outcome measures were self-reported cardiovascular disease and behavioral risk factors, anthropometric measures, blood pressure, point-of-care testing for glucose and lipids, and ankle-brachial index. Risk factors were also compared with the U.S. National Health and Nutritional Survey data. RESULTS Prevalence of cardiovascular disease risk factors were: overweight and obesity—57.7% of the population, physical inactivity—23.4%, diabetes—13.3%, hypertension—29.7%, hypercholesterolemia—8.6%, and smoking—7%. Subjects who were physically active had a significantly lower 10-year Framingham risk score (p < 0.001). Compared with the U.S. National Health and Nutrition Survey data, Grenadian women had higher rates of adiposity, diabetes, hypertension, and elevated low-density lipoprotein cholesterol, whereas Grenadian men had a higher rate of diabetes, a similar rate of hypertension, and lower rates of the other risk factors. Prevalence of peripheral arterial disease was 7.6%; stroke and coronary heart disease were equally prevalent at ~2%. CONCLUSION This randomly selected adult sample in Grenada reveals prevalence rates of obesity, hypertension, and diabetes significantly exceeding those seen in the United States. The contrasting, paradoxically low levels of prevalent cardiovascular disease support the concept that Grenada is experiencing an obesity-related “risk transition.” These data form the basis for the implementation of a pilot intervention program based on the Institute of Medicine recommendations and may serve as a model for other low- and middle-income countries. PMID:25691303
Ms. V Luximon-Ramma
Full Text Available Current hypotheses favour the concept that lowering oxidative stress can have a health benefit. Free radicals can be overproduced or the natural antioxidant system defenses weakened, first resulting in oxidative stress, and then leading to oxidative injury and disease. Cardiovascular disease is one example of this process. This disorder continues to be the major cause of premature death worldwide. Oxidation of human low-density lipoproteins is considered an early step in the progression and eventual development of atherosclerosis, one of the leading causes to cardiovascular dysfunction. Compelling support for the involvement of free radicals in disease development originates from epidemiological studies showing that an enhanced antioxidant status is associated with reduced risk of several diseases. Dietary nutraceuticals such as vitamins C, E and polyphenolics and reduction of cardiovascular disease incidence are a notable example. This paper reviews the biology of ROS/RNS, their pathways through which they relate to the pathology of cardiovascular disease and discusses the putative roles that antioxidants, including phenolics, may play in controlling oxidative stress and reduce the incidence of cardiovascular disease.
Full Text Available Abstract Background The objective of this clinical study was to assess the potential benefit of a dietary supplement, NP 06-1, on cardiovascular protective properties in overweight and normal weight adults diagnosed with osteoarthritis of the knee. Methods An 8-week, placebo-controlled, randomized, double-blind study was conducted with four groups, comparing the effects of NP 06-1 to placebo in overweight and normal weight subjects diagnosed with primary osteoarthritis of the knee. NP 06-1 (a combination of two botanical extracts; Phellodendron amurense bark and Citrus sinensis peel or matching placebo was given in a dose of two capsules (370 mg each twice daily. The outcome measures reported are lipid levels, weight, BMI, blood pressure and fasting glucose. Analyses of variance were used to compare changes of physiological measures over the trial period and between groups. Results Eighty (80 subjects were enrolled and 45 subjects completed the study. No serious adverse events were reported. NP 06-1 administration was associated with a general improvement in lipid levels. Both the overweight and normal weight treatment groups had significant reductions in triglycerides and LDL-cholesterol, as well as a significant increase in HDL-cholesterol compared to their respective control groups. Overall there were decreases in blood pressure in both overweight and normal weight treatment groups compared to respective placebo groups. There was also a significant decrease in fasting glucose levels in the overweight treatment group compared to the start of the study and to the overweight placebo group. There was no change in fasting blood sugar for the normal weight groups. Both overweight and normal weight treatment groups lost a significant amount of weight compared to their respective placebo groups. The overweight treatment group lost an average of 5% body weight after 8 weeks, which was associated with a significant loss in BMI over time. Conclusion In
Kershaw, Kiarri N; Giacinto, Rebeca Espinoza; Gonzalez, Franklyn; Isasi, Carmen R; Salgado, Hugo; Stamler, Jeremiah; Talavera, Gregory A; Tarraf, Wassim; Van Horn, Linda; Wu, Donghong; Daviglus, Martha L
Individuals with favorable levels of all readily measured major CVD risk factors (low CV risk) during middle age incur lower cardiovascular morbidity and mortality, lower all-cause mortality, and lower Medicare costs at older ages compared to adults with one or more unfavorable CVD risk factors. Studies on predictors of low CV risk in Hispanics/Latinos have focused solely on Mexican-Americans. The objective of this study was to use data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; enrolled 2008 to 2011) to assess relationships of nativity and length of residence in the US, a commonly used proxy for acculturation, with low CV risk (not currently smoking; no diabetes; untreated total cholesterol women, and Hispanic/Latino men and women identifying as other or >1 heritage. We also tested whether associations varied by Hispanic/Latino background. Women living in the USwomen after adjusting for sociodemographic characteristics, diet, physical activity, and self-reported experiences of ethnic discrimination. Findings varied in men by Hispanic/Latino background, but length of residence was largely unrelated to low CV risk. These findings highlight the role acculturative processes play in shaping cardiovascular health in Hispanics/Latinos. PMID:27196144
Smith, Scott R; Kushalnagar, Poorna; Hauser, Peter C
Deaf individuals have more cardiovascular risks than the general population that are believed to be related to their cardiovascular health knowledge disparities. This phenomenological study describes where 20 deaf sign language-using adolescents from Rochester, New York, many who possess many positive characteristics to support their health literacy, learn cardiovascular health information and their lived experiences accessing health information. The goal is to ultimately use this information to improve the delivery of cardiovascular health education to this population and other deaf adolescents at a higher risk for weak health literacy. Deaf bilingual researchers interviewed deaf adolescents, transcribed and coded the data, and described the findings. Five major sources of cardiovascular health information were identified including family, health education teachers, healthcare providers, printed materials, and informal sources. Despite possessing advantageous characteristics contributing to stronger health literacy, study participants described significant challenges with accessing health information from each source. They also demonstrated inconsistencies in their cardiovascular health knowledge, especially regarding heart attack, stroke, and cholesterol. These findings suggest a great need for additional public funding to research deaf adolescents' informal health-related learning, develop accessible and culturally appropriate health surveys and health education programming, improve interpreter education, and disseminate information through social media. PMID:26048900
Helm, Laura; Macdonald, Ian A
studies that they are associated with an increased risk of developing type 2 diabetes. The mechanism of this latter association has not been explained. In conclusion, there is a substantial amount of epidemiological evidence for benefits of tea and cocoa in relation to cardiovascular health. There is a growing literature describing randomized controlled trials, but more evidence is needed. Potential cardiovascular and metabolic health benefits of milk and orange juice needs further investigation. The associations of higher alcohol intakes and consumption of beverages sweetened with sugars and their increased health risks are of concern, and more attention should be focused on this area. PMID:26290297
Marilia Sá Carvalho
Full Text Available The most common modeling approaches to understanding incidence, prevalence and control of chronic diseases in populations, such as statistical regression models, are limited when it comes to dealing with the complexity of those problems. Those complex adaptive systems have characteristics such as emerging properties, self-organization and feedbacks, which structure the system stability and resistance to changes. Recently, system science approaches have been proposed to deal with the range, complexity, and multifactor nature of those public health problems. In this paper we applied a multilevel systemic approach to create an integrated, coherent, and increasingly precise conceptual framework, capable of aggregating different partial or specialized studies, based on the challenges of the Longitudinal Study of Adult Health - ELSA-Brasil. The failure to control blood pressure found in several of the study's subjects was discussed, based on the proposed model, analyzing different loops, time lags, and feedback that influence this outcome in a population with high educational level, with reasonably good health services access. We were able to identify the internal circularities and cycles that generate the system's resistance to change. We believe that this study can contribute to propose some new possibilities of the research agenda and to the discussion of integrated actions in the field of public health.
Carvalho, Marilia Sá; Coeli, Claudia Medina; Chor, Dóra; Pinheiro, Rejane Sobrino; Fonseca, Maria de Jesus Mendes da; Sá Carvalho, Luiz Carlos de
The most common modeling approaches to understanding incidence, prevalence and control of chronic diseases in populations, such as statistical regression models, are limited when it comes to dealing with the complexity of those problems. Those complex adaptive systems have characteristics such as emerging properties, self-organization and feedbacks, which structure the system stability and resistance to changes. Recently, system science approaches have been proposed to deal with the range, complexity, and multifactor nature of those public health problems. In this paper we applied a multilevel systemic approach to create an integrated, coherent, and increasingly precise conceptual framework, capable of aggregating different partial or specialized studies, based on the challenges of the Longitudinal Study of Adult Health - ELSA-Brasil. The failure to control blood pressure found in several of the study's subjects was discussed, based on the proposed model, analyzing different loops, time lags, and feedback that influence this outcome in a population with high educational level, with reasonably good health services access. We were able to identify the internal circularities and cycles that generate the system's resistance to change. We believe that this study can contribute to propose some new possibilities of the research agenda and to the discussion of integrated actions in the field of public health. PMID:26171854
Luciano, Michelle; Batty, G. David; McGilchrist, Mark; Linksted, Pamela; Fitzpatrick, Bridie; Jackson, Cathy; Pattie, Alison; Dominiczak, Anna F.; Morris, Andrew D.; Smith, Blair H.; Porteous, David; Deary, Ian J.
People with higher general cognitive ability in early life have more favourable levels of cardiovascular disease (CVD) risk factors in adulthood and CVD itself. The mechanism of these associations is not known. Here we examine whether general cognitive ability and CVD risk factors share genetic and/or environmental aetiology. In this large,…
Fassett, Robert G; Coombes, Jeff S
Oxidative stress and inflammation are established processes contributing to cardiovascular disease caused by atherosclerosis. However, antioxidant therapies tested in cardiovascular disease such as vitamin E, C and β-carotene have proved unsuccessful at reducing cardiovascular events and mortality. Although these outcomes may reflect limitations in trial design, new, more potent antioxidant therapies are being pursued. Astaxanthin, a carotenoid found in microalgae, fungi, complex plants, seaf...
Park, Song-Young; Son, Won-Mok; Kwon, Oh-Sung
Whole body vibration training (WBVT) has been used as a supplement to conventional exercise training such as resistance exercise training to improve skeletal muscle strength, specifically, in rehabilitation field. Recently, this exercise modality has been utilized by cardiovascular studies to examine whether WBVT can be a useful exercise modality to improve cardiovascular health. These studies reported that WBVT has not only beneficial effects on muscular strength but also cardiovascular heal...
Asthana, Sheena; Gibson, Alex; Bailey, Trevor; Moon, Graham; Hewson, Paul; Dibben, Chris
Background: A strong policy emphasis on the need to reduce both health inequalities and unmet need in deprived areas has resulted in the substantial redistribution of English NHS funding towards deprived areas. This raises the question of whether or not socioeconomically disadvantaged people continue to be disadvantaged in their access to and utilisation of health care. Objectives: To generate estimates of the prevalence of cardiovascular disease (CVD) and common mental health disorders (...
Full Text Available Abstract Background Recent guidelines recommend assessment and treatment of the overall risk for cardiovascular disease (CVD through management of multiple risk factors in patients at high absolute risk. The aim of our study was to assess the level of cardiovascular risk in patients with known risk factors for CVD by applying the SCORE risk function and to study the implications of European guidelines on the use of treatment and goal attainment for blood pressure (BP and lipids in the primary care of Cyprus. Methods Retrospective chart review of 1101 randomly selected patients with type 2 diabetes mellitus (DM2, or hypertension or hyperlipidemia in four primary care health centres. The SCORE risk function for high-risk regions was used to calculate 10-year risk of cardiovascular fatal event. Most recent values of BP and lipids were used to assess goal attainment to international standards. Most updated medications lists were used to compare proportions of current with recommended antihypertensive and lipid-lowering drug (LLD users according to European guidelines. Results Implementation of the SCORE risk model labelled overall 39.7% (53.6% of men, 31.3% of women of the study population as high risk individuals (CVD, DM2 or SCORE ≥5%. The SCORE risk chart was not applicable in 563 patients (51.1% due to missing data in the patient records, mostly on smoking habits. The LDL-C goal was achieved in 28.6%, 19.5% and 20.9% of patients with established CVD, DM2 (no CVD and SCORE ≥5%, respectively. BP targets were achieved in 55.4%, 5.6% and 41.9% respectively for the above groups. There was under prescription of antihypertensive drugs, LLD and aspirin for all three high risk groups. Conclusion This study demonstrated suboptimal control and under-treatment of patients with cardiovascular risk factors in the primary care in Cyprus. Improvement of documentation of clinical information in the medical records as well as GPs training for implementation
Full Text Available Desde la antigüedad se ha atribuido al chocolate propiedades saludables que lo han aproximado más hacia un uso terapéutico que alimentario. El presente trabajo revisa algunos estudios relevantes de los efectos del chocolate (y sus componentes activos sobre diferentes factores de riesgo cardiovascular y señala la necesidad de futuros estudios. El consumo de cacao/chocolate (i incrementa la actividad antioxidante, (ii modula la función plaquetaria e inflamación y (iii disminuye la presión arterial sistólica y diastólica. Aunque no existe consenso sobre la cantidad óptima a consumir, puede sugerirse que el consumo diario de chocolate rico en cacao (y polifenoles es una buena elección para reducir, al menos parcialmente, el riesgo cardiovascular. No obstante, son necesarios más estudios que profundicen sobre la biodisponibilidad y mecanismos de acción de los componentes activos del chocolate. El estudio de la interacción del chocolate y sus componentes con genes candidatos aportará información fundamental de los individuos "diana" que podrían beneficiarse del potencial efecto saludable del chocolate en el tratamiento cardiovascular.Since ancient times, numerous health beneficial effects have been attributed to chocolate, closing up its consumption to a therapeutic use. The present study reviews some relevant studies about chocolate (and its bioactive compounds on some cardiovascular risk factors and stresses the need of future studies. The consumption of cocoa/ chocolate (i increases plasma antioxidant capacity, (ii diminishes platelet function and inflammation, and (iii decreases diastolic and systolic arterial pressures. Data currently available indicate that daily consumption of cocoa-rich chocolate (rich in polyphenols may at least partially lower cardiovascular disease risk. Further studies are required in order to establish the bioavailability and mechanisms of action of bioactive compounds in chocolate. The study of the
Full Text Available Giuseppe Lippi1, Massimo Franchini2, Gian Cesare Guidi31U.O. di Diagnostica Ematochimica, 2Servizio di Immunoematologia e Trasfusione, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero, Universitaria di Parma, Parma, Italy; 3Sezione di Chimica Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Verona, ItalyAbstract: The healthful and nutritive properties of wine have been acknowledged for thousands of years, but the observation that moderate consumption of red wine on a regular basis may be preventative against coronary disease is recent. Dr Renaud, a scientist working at the Bordeaux University in France, suggested wine consumption explains the “French Paradox”, the low incidence of heart attacks in France regardless of a remarkable dietary intake of saturated fats and alcohol. After nearly 20 years of research, there is now mounting evidence that light to moderate wine intake is beneficial for the cardiovascular health, acting through a variety of mechanisms that target all the crucial steps of atherosclerosis, from early formation of the atherosclerotic plaque to its life-threatening complications (ulceration, thrombosis, vessel occlusion and infarction. These effects are attributable to the synergic properties of several biochemical components of wine (alcohol, resveratrol, and especially polyphenolic compounds, particularly the red varieties. This article reviews the leading clinical observations and the hypothesized biological mechanisms that strongly support the cardiovascular benefits of moderate red wine consumption on cardiovascular health and that would make red wine a promising therapeutic supplement to prevent and even perhaps treat coronary artery disease.Keywords: wine, cardiovascular disease, coronary disease, atherosclerosis
Jay, Kenneth; Frisch, Dennis; Hansen, Klaus;
/shoulders decreased 2.1 points [95% confidence interval (95% CI) -3.7- -0.4] and pain intensity of the low back decreased 1.4 points (95% CI -2.7- -0.02) in the training group. Compared with the control group, the training group increased muscle strength of the trunk extensors (P<0.001), but not of the trunk flexors......OBJECTIVE: The aim of this trial was to investigate the effectiveness of a worksite intervention using kettlebell training to improve musculoskeletal and cardiovascular health. METHODS: This single-blind randomized controlled trial involved 40 adults from occupations with a high prevalence of...... reported musculoskeletal pain symptoms (mean age 44 years, body mass index 23 kg/m², 85% women, with pain intensity of the neck/shoulders 3.5 and of the low back 2.8 on a scale of 0-10). A blinded assessor took measures at baseline and follow-up. Participants were randomly assigned to training...
Tamosiunas, Abdonas; Luksiene, Dalia; Baceviciene, Migle; Bernotiene, Gailute; Radisauskas, Ricardas; Malinauskiene, Vilija; Kranciukaite-Butylkiniene, Daina; Virviciute, Dalia; Peasey, Anne; Bobak, Martin
Aims This study investigated the trends and levels of the prevalence of health factors, and the association of all-cause and cardiovascular (CVD) mortality with healthy levels of combined risk factors among Lithuanian urban population. Methods Data from five general population surveys in Kaunas, Lithuania, conducted between 1983 and 2008 were used. Healthy factors measured at baseline include non-smoking, normal weight, normal arterial blood pressure, normal level of total serum cholesterol, normal physical activity and normal level of fasting glucose. Among 9,209 men and women aged 45–64 (7,648 were free from coronary heart disease (CHD) and stroke at baseline), 1,219 death cases from any cause, 589 deaths from CVD, and 342 deaths from CHD occurred during follow up. Cox proportional hazards regression was used to estimate the association between health factors and mortality from all causes, CVD and CHD. Results Between 1983 and 2008, the proportion of subjects with 6 healthy levels of risk factors was higher in 2006–2008 than in 1983–1984 (0.6% vs. 0.2%; p = 0.09), although there was a significant increase in fasting glucose and a decline in intermediate physical activity. Men and women with normal or intermediate levels of risk factors had significantly lower all-cause, CVD and CHD mortality risk than persons with high levels of risk factors. Subjects with 5–6 healthy factors had hazard ratio (HR) of CVD mortality 0.35 (95% confidence interval (CI) 0.15–0.83) compared to average risk in the whole population. The hazard ratio for CVD mortality risk was significant in men (HR 0.34, 95% CI 0.12–0.97) but not in women (HR 0.38, 95% CI 0.09–1.67). Conclusions An inverse association of most healthy levels of cardiovascular risk factors with risk of all-cause and CVD mortality was observed in this urban population-based cohort. A greater number of cardiovascular health factors were related with significantly lower risk of CVD mortality, particularly
Full Text Available AIMS: This study investigated the trends and levels of the prevalence of health factors, and the association of all-cause and cardiovascular (CVD mortality with healthy levels of combined risk factors among Lithuanian urban population. METHODS: Data from five general population surveys in Kaunas, Lithuania, conducted between 1983 and 2008 were used. Healthy factors measured at baseline include non-smoking, normal weight, normal arterial blood pressure, normal level of total serum cholesterol, normal physical activity and normal level of fasting glucose. Among 9,209 men and women aged 45-64 (7,648 were free from coronary heart disease (CHD and stroke at baseline, 1,219 death cases from any cause, 589 deaths from CVD, and 342 deaths from CHD occurred during follow up. Cox proportional hazards regression was used to estimate the association between health factors and mortality from all causes, CVD and CHD. RESULTS: Between 1983 and 2008, the proportion of subjects with 6 healthy levels of risk factors was higher in 2006-2008 than in 1983-1984 (0.6% vs. 0.2%; p = 0.09, although there was a significant increase in fasting glucose and a decline in intermediate physical activity. Men and women with normal or intermediate levels of risk factors had significantly lower all-cause, CVD and CHD mortality risk than persons with high levels of risk factors. Subjects with 5-6 healthy factors had hazard ratio (HR of CVD mortality 0.35 (95% confidence interval (CI 0.15-0.83 compared to average risk in the whole population. The hazard ratio for CVD mortality risk was significant in men (HR 0.34, 95% CI 0.12-0.97 but not in women (HR 0.38, 95% CI 0.09-1.67. CONCLUSIONS: An inverse association of most healthy levels of cardiovascular risk factors with risk of all-cause and CVD mortality was observed in this urban population-based cohort. A greater number of cardiovascular health factors were related with significantly lower risk of CVD mortality, particularly among
Full Text Available Numerous studies have demonstrated the importance of naturally occurring dietary polyphenols in promoting cardiovascular health and emphasized the significant role these compounds play in limiting the effects of cellular aging. Polyphenols such as resveratrol, epigallocatechin gallate (EGCG, and curcumin have been acknowledged for having beneficial effects on cardiovascular health, while some have also been shown to be protective in aging. This review highlights the literature surrounding this topic on the prominently studied and documented polyphenols as pertaining to cardiovascular health and aging.
Barrows, Jennifer L; Fleury, Julie
The benefits of physical activity are well established, yet few older adults engage in adequate physical activity to optimize health. While yoga may reduce the risk of cardiovascular disease, few studies have focused on the efficacy of yoga-based physical activity to promote cardiovascular health in older adults. The objective of this review is to provide an evaluation of yoga interventions to reduce cardiovascular risk in older adults. Four databases were searched for randomized controlled trials of yoga interventions in older adults. Studies with cardiovascular outcomes were included. Literature searches identified nine articles eligible for review. Significant health benefits were reported, including favorable changes in blood pressure, body composition, glucose, and lipids. Yoga practices, participant characteristics, and outcome measures were variable. There was limited use of theory. Yoga is safe and feasible in older adults; additional research is warranted to examine the specific components of yoga interventions essential to reducing cardiovascular risk. PMID:26689218
Smith, Scott R.; Kushalnagar, Poorna; Hauser, Peter C.
Deaf individuals have more cardiovascular risks than the general population that are believed to be related to their cardiovascular health knowledge disparities. This phenomenological study describes where 20 deaf sign language-using adolescents from Rochester, New York, many who possess many positive characteristics to support their health…
Arsenic exposure is associated with cardiovascular and other health effects. The study objectives were to investigate the mode of action and to assess dose-response relationships of arsenic on cardiovascular, diabetic and carcinogenic effects in Ba Men, Inner Mongolia. Ba Men res...
Mastrangelo, Giuseppe; Marangi, Gianluca; Bontadi, Danilo; Fadda, Emanuela; Cegolon, Luca; Bortolotto, Melania; Fedeli, Ugo; Marchiori, Luciano
Background Despite the substantial amount of knowledge on effectiveness of worksite health promotion (WHP) in reducing cardiovascular disease (CVD) risk, WHP programs are not systematically applied in Italy. The aim was to design an intervention easy to integrate within the Italian organization of workplace health surveillance. Methods We used the “pretest-posttest design”. Workers were employed in multiple occupations and resident in Veneto region, Italy. Occupational physicians (OPs) perfor...
This commentary provides a brief overview of theory and research that supports the idea that sexism may be related to the disproportionate negative cardiovascular health outcomes in women. It describes the sexism as a stressor and outlines its association with a variety of health outcomes as evidence for why sex disparities should be examined within the context of pervasive inequities. To date, population-based studies have not explicitly examined the relationship between sexism and CVD but s...
Delgado, Graciela E; Siekmeier, Rüdiger; Krämer, Bernhard K; Grübler, Martin; Tomaschitz, Andreas; März, Winfried; Kleber, Marcus E
High concentrations of renin and aldosterone are risk factors for cardiovascular diseases (CVD) which are the leading cause of morbidity and mortality worldwide. Enhanced activation of the renin-angiotensin-aldosterone system (RAAS) by cigarette smoking has been reported. The aim of our study was to analyze the effect of cigarette smoking on parameters of the RAAS in active smokers (AS) and life-time non-smokers (NS) of the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study as well as the utility of RAAS parameter for risk prediction. We determined the concentration of aldosterone, renin, angiotensin-I and angiotensin-II in participants of the LURIC study. Smoking status was assessed by a questionnaire and the measurement of plasma cotinine concentration. Parameters were log transformed before entering analyses, where appropriate. We used a multivariate Cox regression analysis to assess the effect of parameters on mortality. From the 3316 LURIC participants 777 were AS and 1178 NS. Within a median observation period of 10 years 221 (28.4 %) AS and 302 (25.6 %) NS died. After adjustment for age, gender, and the use of anti-hypertensive medication, only angiotensin-I was significantly different in AS compared to NS with an estimated marginal mean (95 % CI) of 1607 (1541-1673) ng/L and 1719 (1667-1772) ng/L, respectively. For both NS and AS renin and angiotensin-II were directly associated with mortality in the multivariate Cox regression analysis. Angiotensin-I was only associated with increased risk for mortality in NS (HR (95 % CI) of 0.69 (0.53-0.89)). We conclude that increased renin and angiotensin-II are independent predictors of mortality in AS and NS, while angiotensin-I was associated with reduced risk of death in NS only. PMID:27334735
Depressive Symptoms and Risk of New Cardiovascular Events or Death in Patients with Myocardial Infarction: A Population-Based Longitudinal Study Examining Health Behaviors and Health Care Interventions
Larsen, Karen Kjær; Christensen, Bo; Søndergaard, Jens; Vestergaard, Mogens
bruges til at skærpe opmærksomheden over for denne patientgruppe hos de praktiserende læger, hvor op mod 90 % af alle patienter med depression bliver diagnosticeret og behandlet. Background: Depressive symptoms is associated with adverse cardiovascular outcomes in patients with myocardial infarction (MI......), but the underlying mechanisms are unclear and it remains unknown whether subgroups of patients are at a particularly high relative risk of adverse outcomes. We examined the risk of new cardiovascular events and/or death in patients with depressive symptoms following first-time MI taking into account...... 2009 and 31 December 2009, and followed up until 31 July 2012. Depressive symptoms were found in 18.6% using the Hospital Anxiety and Depression Scale (HADS-D$8). A total of 239 new cardiovascular events, 95 deaths, and 288 composite events (239 new cardiovascular events and 49 deaths) occurred during...
Roizen, Michael F; Mladen Golubic; Kristin Kirkpatrick; Bernstein, Adam M.; Brigid Titgemeier
Numerous studies reveal the cardiovascular benefits of consuming dietary fiber and, especially, cereal fiber. Cereal fiber is associated with cardiovascular risk reduction through multiple mechanisms and consuming a variety of cereal fiber sources offers health benefits specific to the source. Certain cereal fibers have been studied more extensively than others and provide greater support for their incorporation into a healthful diet. β-glucan from oats or barley, or a combination of whole oa...
A.A.A. Bak (Annette)
textabstractThis thesis comprises several studies on the effect of coffee and caffeine on cardiovascular risk in general, and the effect on serum lipids, blood pressure and selected hemostatic variables in particular. The association between coffee use and cardiovascular morbidity and mortality was
Yan, Yu X.; Dong, Jing; Liu, You Q.; Yang, Xing H.; Li, Man; Shia, Gilbert; Wang, Wei
Suboptimal health status (SHS) has become a new public health challenge in urban China. Despite indications that SHS may be associated with progression or development of chronic diseases such as cardiovascular and metabolic diseases, there are few reports on SHS investigations. To explore the relationship between SHS and traditional cardiovascular risk factors, a cross-sectional study was conducted in a sample of 4,881 workers employed in 21 companies in urban Beijing. Blood pressure, glucose...
Ostovar, Afshin; Nabipour, Iraj; Larijani, Bagher; Heshmat, Ramin; Darabi, Hossein; Vahdat, Katayoun; Ravanipour, Maryam; Mehrdad, Neda; Raeisi, Alireza; Heidari, Gholamreza; Shafiee, Gita; Haeri, Mohammadjavad; Pourbehi, Mohammadreza; Sharifi, Farshad; Noroozi, Azita; Tahmasebi, Rahim; Aghaei Meybodi, Hamidreza; Assadi, Majid; Farrokhi, Shokrollah; Nemati, Reza; Amini, Mohammad Reza; Barekat, Maryam; Amini, Abdullatif; Salimipour, Houman; Dobaradaran, Sina; Moshtaghi, Darab
Purpose The main objective of the Bushehr Elderly Health Programme, in its first phase, is to investigate the prevalence of cardiovascular risk factors and their association with major adverse cardiovascular events. Participants Between March 2013 and October 2014, a total of 3000 men and women aged ≥60 years, residing in Bushehr, Iran, participated in this prospective cohort study (participation rate=90.2%). Findings to date Baseline data on risk factors, including demographic and socioeconomic status, smoking and medical history, were collected through a modified WHO MONICA questionnaire. Vital signs and anthropometric measures, including systolic and diastolic blood pressure, weight, height, and waist and hip circumference, were also measured. 12-lead electrocardiography and echocardiography were conducted on all participants, and total of 10 cc venous blood was taken, and sera was separated and stored at –80°C for possible future use. Preliminary data analyses showed a noticeably higher prevalence of risk factors among older women compared to that in men. Future plans Risk factor assessments will be repeated every 5 years, and the participants will be followed during the study to measure the occurrence of major adverse cardiac events. Moreover, the second phase, which includes investigation of bone health and cognition in the elderly, was started in September 2015. Data are available at the Persian Gulf Biomedical Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran, for any collaboration. PMID:26674503
Warburton, Darren E.R.; Eng, Janice J.; Krassioukov, Andrei; Sproule, Shannon
There appears to be an increased prevalence and earlier onset of cardiovascular disease (CVD) in persons with SCI. Physical inactivity is thought to be a key factor in the increased risk for CVD. Physical inactivity is highly prevalent in persons with SCI and it appears that activities of daily living are not sufficient to maintain cardiovascular fitness and health. This systematic review examines the current literature regarding the risk for CVD and the effectiveness of varied exercise rehab...
M.M. Martínez-Delgado; C. Ramírez-López
Objective: To promote awareness of healthy lifestyles, to help decrease the risk factors that cause cardiovascular disease, obesity, diabetes, hypertension and hyperlipidemia, through Health Education (HE). Material and Methods: Between November and December 2014 in the prison of Soria, HE intervention in cardiovascular diseases was performed. Participation was offered to 160 inmates at the Prison. The intervention consisted of individual interviews with anthropometric assessment and review o...
Lotufo, Paulo A; Baena, Cristina P; Santos, Itamar S; Bensenor, Isabela M
The association between serum uric acid (SUA) and prehypertension was evaluated in a racially admixed sample of civil servants aged 35 to 74 years, enrolled (2008-2010) in the Brazilian Longitudinal Study of Health (ELSA-Brasil). Of the 15 105 patients who enrolled in the study, we analyzed 3412 after excluding those who reported previous cardiovascular diseases, diabetes, or hypertension; were heavy drinkers; or had a body mass index (BMI) ≥ 35 kg/m(2). Among the men, logistic regression, adjusted for age, race, income, birth weight, salt intake, insulin resistance, BMI, and renal function revealed odds ratios (ORs) and 95% confidence intervals (CIs) of prehypertension from the bottom quartile (referent) to the top quartile of SUA levels as follows: 0.84 (95% CI, 0.61-1.38), 0.97 (0.71-1.34) and 1.44 (1.04-2.0; P for trend .01). Analyzing for 1-standard deviation of change in SUA, the ORs were 1.19 (1.06-1.32). This association persisted in the subgroup analysis consisting of patients who were white, overweight, with a high salt intake but with normal renal function, and without metabolic syndrome. No association was found among women. In conclusion, SUA levels were associated with prehypertension among men. PMID:25972396
Kenney, W. Larry; Craighead, Daniel H.; Alexander, Lacy M.
This brief review is based on a President’s Lecture presented at the Annual Meeting of the American College of Sports Medicine in 2013. The purpose of this review is to assess the effects of climate change and consequent increases in environmental heat stress on the aging cardiovascular system. The earth’s average global temperature is slowly but consistently increasing, and along with mean temperature changes come increases in heat wave frequency and severity. Extreme passive thermal stress ...
Ong, Sang-Bing; Andrew R. Hall; Hausenloy, Derek J
Significance: Mitochondria are dynamic organelles capable of changing their shape and distribution by undergoing either fission or fusion. Changes in mitochondrial dynamics, which is under the control of specific mitochondrial fission and fusion proteins, have been implicated in cell division, embryonic development, apoptosis, autophagy, and metabolism. Although the machinery for modulating mitochondrial dynamics is present in the cardiovascular system, its function there has only recently be...
Colkesen, Ersen B; Ferket, Bart S; Jan GP Tijssen; et al.
Ersen B Colkesen1,2, Bart S Ferket2,3, Jan GP Tijssen1, Roderik A Kraaijenhagen2, Coenraad K van Kalken2, Ron JG Peters11Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 2NDDO Institute for Prevention and Early Diagnostics (NIPED), Amsterdam, the Netherlands; 3Department of Epidemiology, Erasmus Medical Center, Rotterdam, the NetherlandsIntroduction: A large proportion of the cardiovascular disease (CVD) burden can potentially be prevente...
Finnegan, J R; Viswanath, K; Hertog, J
Mass media roles in promoting cardiovascular health in the context of lessons learned from major U.S. community studies, changing media technology, and emergent models of media-community partnerships are discussed. Three principal issues are explored: (1) implications of the current expansion, convergence, and harmonization of mass media technology;(2) recent trends in media coverage of heart disease and population practices; and (3) implications for the future relationship between the media and public health in cardiovascular health promotion. It is concluded that classic campaign models focusing on individual-level change have evolved to recognize environmental-level influences on behavior. Emergent public health campaign models have moved toward "agenda-building," in which the focus is on a more unified approach to influencing public and community agendas for social, behavioral, and policy change. Recent developments among the commercial mass media may offer new opportunities for public health partnerships to promote cardiovascular health. PMID:10641818
Wang, Qing; Shen, Jay J
Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons' early life, are expected to be effective and successful. PMID:27275829
Full Text Available Cardiovascular diseases (CVDs are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS, a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons’ early life, are expected to be effective and successful.
de Heer, Hendrik Dirk; Balcazar, Hector G; Lee Rosenthal, E.; Cardenas, Victor M; Schulz, Leslie O.
This study addressed the association between items from the General Acculturation Index (GAI) and cardiovascular health. Specifically, we assessed whether ethnic pride was associated with health outcomes after controlling for items regarding language, place where the childhood was spent, and ethnic interaction. The study was a cross-sectional…
R Jay Widmer
Full Text Available Cardiovascular disease (CVD is the leading cause of morbidity and mortality in the US. Emerging employer-sponsored work health programs (WHP and Digital Health Intervention (DHI provide monitoring and guidance based on participants' health risk assessments, but with uncertain success. DHI-mobile technology including online and smartphone interventions-has previously been found to be beneficial in reducing CVD outcomes and risk factors, however its use and efficacy in a large, multisite, primary prevention cohort has not been described to date. We analyzed usage of DHI and change in intermediate markers of CVD over the course of one year in 30,974 participants of a WHP across 81 organizations in 42 states between 2011 and 2014, stratified by participation log-ins categorized as no (n = 14,173, very low (<12/yr, n = 12,260, monthly (n = 3,360, weekly (n = 651, or semi-weekly (at least twice per week. We assessed changes in weight, waist circumference, body mass index (BMI, blood pressure, lipids, and glucose at one year, as a function of participation level. We utilized a Poisson regression model to analyze variables associated with increased participation. Those with the highest level of participation were slightly, but significantly (p<0.0001, older (48.3±11.2 yrs than non-participants (47.7±12.2 yr and more likely to be females (63.7% vs 37.3% p<0.0001. Significant improvements in weight loss were demonstrated with every increasing level of DHI usage with the largest being in the semi-weekly group (-3.39±1.06 lbs; p = 0.0013 for difference from weekly. Regression analyses demonstrated that greater participation in the DHI (measured by log-ins was significantly associated with older age (p<0.001, female sex (p<0.001, and Hispanic ethnicity (p<0.001. The current study demonstrates the success of DHI in a large, community cohort to modestly reduce CVD risk factors in individuals with high participation rate. Furthermore, participants previously
Meng Yuan-Xiang; Chen Zhimin; Coverson Dorothy L; Din-Dzietham Rebecca; Bidulescu Aurelian; Buxbaum Sarah G; Gibbons Gary H; Welch Verna L
Abstract Background Compared with whites, sleep disturbance and sleep deprivation appear more prevalent in African Americans (AA). Long-term sleep deprivation may increase the risk of obesity through multiple metabolic and endocrine alterations. Previous studies have reported contradictory results on the association between habitual sleep duration and obesity. Accordingly, we aimed to assess whether sleep quality and duration are inversely associated with body mass index (BMI) and obesity and...
Full Text Available Abstract Background Compared with whites, sleep disturbance and sleep deprivation appear more prevalent in African Americans (AA. Long-term sleep deprivation may increase the risk of obesity through multiple metabolic and endocrine alterations. Previous studies have reported contradictory results on the association between habitual sleep duration and obesity. Accordingly, we aimed to assess whether sleep quality and duration are inversely associated with body mass index (BMI and obesity and test whether these associations are modified by psychosocial stress, known to influence sleep quality. Methods A sample of 1,515 AA residents of metropolitan Atlanta, aged 30-65 years, was recruited by a random-digit-dialing method in 2007-08. The outcome obesity was defined by BMI (kg/m2 continuously and categorically (BMI ≥ 30 versus BMI Results The mean (standard deviation age was 47.5 (17.0 years, and 1,096 (72% were women. GSQ score categorized into tertiles was associated with BMI. Among women, after multivariable adjustment that included age, gender, physical activity, smoking status, education, total family income, financial stress and history of hypertension, hypercholesterolemia, diabetes and myocardial infarction, obesity was associated with sleep quality as assessed by GSQ continuous score, [odds ratio, OR (95% C.I.: 1.08 (1.03 - 1.12], and with a worse sleep disturbance subcomponent score [OR (95% C.I.: 1.48 (1.16 - 1.89]. Among all participants, stress modified the association between obesity and sleep quality; there was an increased likelihood of obesity in the medium stress category, OR (95% C.I.: 1.09 (1.02 - 1.17. Conclusion Sleep quality was associated with obesity in women. The association of sleep quality with obesity was modified by perceived stress. Our results indicate the need for simultaneous assessment of sleep and stress.
Karaye, KM; Okeahialam, BN; Wali, SS
Background In most developed countries, risk factors for cardiovascular diseases (CVD) are more prevalent in low socio-economic classes. However, the pattern in developing countries appears to be different. This study sought to evaluate and compare risk factors for CVD as well as absolute CVD risk in hypertensive subjects grouped by income in Kano, Nigeria. Methods The study was cross-sectional in design and carried out in Aminu Kano Teaching Hospital, Kano, Nigeria. Seventy treatment-naïve h...
Trekking includes downhill walking and enhances lower limb strength. Muscle fitness is a predictor of mortality and is associated with cardiovascular risk factors in adults. The purpose of this study was to investigate the effects of trekking on cardiovascular health and fitness in older obese women. The participants were randomly assigned to an exercise group (EG, n= 32) and a control group (CG, n= 48). The EG participated in the trekking program for 12 weeks, 3 times per week, and 90 min pe...
Calverley, Peter M A; Anderson, Julie A; Celli, Bartolome; Ferguson, Gary T; Jenkins, Christine; Jones, Paul W; Crim, Courtney; Willits, Lisa R; Yates, Julie C; Vestbo, Jørgen; NN, NN
BACKGROUND: Previous studies have suggested that long-term use of beta agonists to treat chronic obstructive pulmonary disease (COPD) may increase the risk of cardiovascular adverse events. In this post hoc analysis, data from the TOwards a Revolution in COPD Health (TORCH) study were used to...... investigate whether use of the long-acting beta(2) agonist salmeterol over 3 years increased the risk of cardiovascular adverse events in patients with moderate to severe COPD. METHODS: TORCH was a randomised, double-blind, placebo controlled study conducted at 444 centres in 42 countries. Patients (n=6184...... showed that salmeterol alone or in combination (SFC) did not increase the risk of cardiovascular events in patients with moderate to severe COPD....
Alice Ravera; Valentina Carubelli; Edoardo Sciatti; Ivano Bonadei; Elio Gorga; Dario Cani; Enrico Vizzardi; Marco Metra; Carlo Lombardi
The increasing burden of cardiovascular disease (CVD) despite the progress in management entails the need of more effective preventive and curative strategies. As dietary-associated risk is the most important behavioral factor influencing global health, it appears the best target in the challenge against CVD. Although for many years, since the formulation of the cholesterol hypothesis, a nutrient-based approach was attempted for CVD prevention and treatment, in recent years a dietary-based ap...
Dujic, Zeljko; Breskovic, Toni
Human underwater breath-hold diving is a fascinating example of applied environmental physiology. In combination with swimming, it is one of the most popular forms of summer outdoor physical activities. It is performed by a variety of individuals ranging from elite breath-hold divers, underwater hockey and rugby players, synchronized and sprint swimmers, spear fishermen, sponge harvesters and up to recreational swimmers. Very few data currently exist concerning the influence of regular breath holding on possible health risks such as cerebrovascular, cardiovascular and respiratory diseases. A literature search of the PubMed electronic search engine using keywords 'breath-hold diving' and 'apnoea diving' was performed. This review focuses on recent advances in knowledge regarding possibly harmful physiological changes and/or potential health risks associated with breath-hold diving. Available evidence indicates that deep breath-hold dives can be very dangerous and can cause serious acute health problems such a collapse of the lungs, barotrauma at descent and ascent, pulmonary oedema and alveolar haemorrhage, cardiac arrest, blackouts, nitrogen narcosis, decompression sickness and death. Moreover, even shallow apnoea dives, which are far more frequent, can present a significant health risk. The state of affairs is disturbing as athletes, as well as recreational individuals, practice voluntary apnoea on a regular basis. Long-term health risks of frequent maximal breath holds are at present unknown, but should be addressed in future research. Clearly, further studies are needed to better understand the mechanisms related to the possible development or worsening of different clinical disorders in recreational or competitive breath holding and to determine the potential changes in training/competition regimens in order to prevent these adverse events. PMID:22574634
Qing Wang; Jay J. Shen
Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between chil...
Fuster, Valentin; Kelly, Bridget B; Vedanthan, Rajesh
Cardiovascular disease (CVD) is the leading cause of mortality worldwide, with more than 80% of CVD deaths occurring in low- and middle-income countries (LMICs). There have been several calls for action to address the global burden of CVD, but there remains insufficient investment in and implementation of CVD prevention and disease management efforts in LMICs. To catalyze the action needed to control global CVD, the Institute of Medicine recently produced a report, Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health. This paper presents a commentary of the Institute of Medicine's report, focusing specifically on the intersectoral nature of intervention approaches required to promote global cardiovascular health. We describe 3 primary domains of intervention to control global CVD: 1) policy approaches; 2) health communication programs; and 3) healthcare delivery interventions. We argue that the intersectoral nature of global CVD interventions should ideally occur at 2 levels: first, all 3 domains of intervention must be activated and engaged simultaneously, rather than only 1 domain at a time; and second, within each domain, a synergistic combination of interventions must be implemented. A diversity of public and private sector actors, representing multiple sectors such as health, agriculture, urban planning, transportation, finance, broadcasting, education, and the food and pharmaceutical industries, will be required to collaborate for policies, programs, and interventions to be optimally aligned. Improved control of global CVD is eminently possible but requires an intersectoral approach involving a diversity of actors and stakeholders. PMID:21903051
Soare, Andreea; Weiss, Edward P; Holloszy, John O; Fontana, Luigi
Dietary supplements are widely used for health purposes. However, little is known about the metabolic and cardiovascular effects of combinations of popular over-the-counter supplements, each of which has been shown to have anti-oxidant, anti-inflammatory and pro-longevity properties in cell culture or animal studies. This study was a 6-month randomized, single-blind controlled trial, in which 56 non-obese (BMI 21.0-29.9 kg/m2) men and women, aged 38 to 55 yr, were assigned to a dietary supplement (SUP) group or control (CON) group, with a 6-month follow-up. The SUP group took 10 dietary supplements each day (100 mg of resveratrol, a complex of 800 mg each of green, black, and white tea extract, 250 mg of pomegranate extract, 650 mg of quercetin, 500 mg of acetyl-l-carnitine, 600 mg of lipoic acid, 900 mg of curcumin, 1 g of sesamin, 1.7 g of cinnamon bark extract, and 1.0 g fish oil). Both the SUP and CON groups took a daily multivitamin/mineral supplement. The main outcome measures were arterial stiffness, endothelial function, biomarkers of inflammation and oxidative stress, and cardiometabolic risk factors. Twenty-four weeks of daily supplementation with 10 dietary supplements did not affect arterial stiffness or endothelial function in nonobese individuals. These compounds also did not alter body fat measured by DEXA, blood pressure, plasma lipids, glucose, insulin, IGF-1, and markers of inflammation and oxidative stress. In summary, supplementation with a combination of popular dietary supplements has no cardiovascular or metabolic effects in non-obese relatively healthy individuals. PMID:24036417
Shockey, Taylor M; Sussell, Aaron L; Odom, Erika C
Cardiovascular disease (CVD) accounts for one of every three deaths in the United States, making it the leading cause of mortality in the country (1). The American Heart Association established seven ideal cardiovascular health behaviors or modifiable factors to improve CVD outcomes in the United States. These cardiovascular health metrics (CHMs) are 1) not smoking, 2) being physically active, 3) having normal blood pressure, 4) having normal blood glucose, 5) being of normal weight, 6) having normal cholesterol levels, and 7) eating a healthy diet (2). Meeting six or all seven CHMs is associated with a lower risk for all-cause, CVD, and ischemic heart disease mortalities compared with the risk to persons who meet none or only one CHM (3). Fewer than 2% of U.S. adults meet all seven of the American Heart Association's CHMs (4). Cardiovascular morbidity and mortality account for an estimated annual $120 billion in lost productivity in the workplace; thus, workplaces are viable settings for effective health promotion programs (5). With over 130 million employed persons in the United States, accounting for about 55% of all U.S. adults, the working population is an important demographic group to evaluate with regard to cardiovascular health status. To determine if an association between occupation and CHM score exists, CDC analyzed data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS) industry and occupation module, which was implemented in 21 states. Among all occupational groups, community and social services employees (14.6%), transportation and material moving employees (14.3%), and architecture and engineering employees (11.6%) had the highest adjusted prevalence of meeting two or fewer CHMs. Transportation and material moving employees also had the highest prevalence of "not ideal" ("0" [i.e., no CHMs met]) scores for three of the seven CHMs: physical activity (54.1%), blood pressure (31.9%), and weight (body mass index [BMI]; 75.5%). Disparities
Claire Friedemann Smith
Full Text Available Obesity in childhood impacts on many areas of the child's current and future health, including their cardiovascular health. To date many attempts have been made to design interventions to tackle excess childhood weight but with limited success. We aimed to establish the components common to interventions in children that improve cardiovascular health parameters.We searched the following databases: EMBASE 1974-week 3 November 2014, Ovid Medline 1946 Present, and PsychINFO 1967-Present for studies reporting interventions in healthy young people under the age of 18. Included interventions had to contain an education component and have been carried out in a community, school, or clinical setting. Papers had to report on at least one of the pre-specified CVD risk parameters and at least one non-biological outcome from knowledge, attitudes or behaviours.We retrieved 2451 papers, from which 12 studies (18 papers of 3046 participants were included. From the selected papers we identified four component themes; Health Behaviours, Self-Concept, Practical and Cognitive Tools, and Intervention Characteristics. The subcomponents that made up these themes were fairly consistent across the studies analysed although the studies varied in their duration, settings and children with which they were carried out. Nine of the studies were able to bring about positive change in at least one biological and one non-biological aspect of child cardiovascular health.The component themes identified here were common to intervention studies that had success in improving parameters of cardiovascular health. We suggest that the focus of childhood health interventions be moved from weight onto cardiovascular health parameters and that future interventions use the lessons learned by their predecessors to incorporate those components that are associated with successful interventions.
Vanhees, L; Geladas, N; Hansen, D;
In a previous paper, as the first of a series of three on the importance of characteristics and modalities of physical activity (PA) and exercise in the management of cardiovascular health within the general population, we concluded that, in the population at large, PA and aerobic exercise capacity...... clearly are inversely associated with increased cardiovascular disease risk and all-cause and cardiovascular mortality and that a dose–response curve on cardiovascular outcome has been demonstrated in most studies. More and more evidence is accumulated that engaging in regular PA and exercise...... interventions are essential components for reducing the severity of cardiovascular risk factors, such as obesity and abdominal fat, high BP, metabolic risk factors, and systemic inflammation. However, it is less clear whether and which type of PA and exercise intervention (aerobic exercise, dynamic resistive...
Guilherme Oliveira de Arruda
Full Text Available OBJECTIVE To assess the association of sociodemographic and self-rated health in the presence of cardiovascular diseases and the association of this perception with the type of disease. METHODS A cross-sectional population survey study carried out with 1,232 individuals aged between 20 and 59 years of both genders living in the metropolitan region of Maringá-PR. Data were analyzed using multiple and simple logistic regression. RESULTS In multivariate analysis, the age range and self-rated health were associated with cardiovascular disease, and in the univariate analysis self-rated regular health was associated with arterial hypertension, while self-rated poor health was associated to heart failure, stroke, and to acute myocardial infarction (heart attack. CONCLUSION The differences in association of self-rated health with these diseases can indicate how individuals with certain characteristics cope with the disease, allowing for more individualized and specific health care.
Ms. V Luximon-Ramma; Mr. MA Soobrattee; Dr. T Bahorun; Prof. OI Aruoma
Current hypotheses favour the concept that lowering oxidative stress can have a health benefit. Free radicals can be overproduced or the natural antioxidant system defenses weakened, first resulting in oxidative stress, and then leading to oxidative injury and disease. Cardiovascular disease is one example of this process. This disorder continues to be the major cause of premature death worldwide. Oxidation of human low-density lipoproteins is considered an early step in the progression and e...
Mensink, G. B. M.
The relationship of leisure-time physical activity with cardiovascular risk factors and mortality was determined using data from the German Cardiovascular Prevention Study, conducted from 1984-1991. Three nationally representative crosssectional samples, with a total of 7 689 men and 7 747 women, ages 25-69, were part of this study, originally designed to estimate the impact of community intervention on cardiovascular health. Additionally we analyzed regional cross-sectional and follow-up sam...
Full Text Available Objective: To promote awareness of healthy lifestyles, to help decrease the risk factors that cause cardiovascular disease, obesity, diabetes, hypertension and hyperlipidemia, through Health Education (HE. Material and Methods: Between November and December 2014 in the prison of Soria, HE intervention in cardiovascular diseases was performed. Participation was offered to 160 inmates at the Prison. The intervention consisted of individual interviews with anthropometric assessment and review of medical records and three group sessions with theoretical and practical content of these diseases, as well as dietary recommendations, Mediterranean diet and exercise. Knowledge gained from surveys conducted for that purpose was evaluated. Results: A total of 33 (21% of 160. Average age 38.2 (35.2 to 41.3. Prevalence: Normal weight (BMI 18 to 24.9 18 (54.5%, overweight BMI (25.0 to 29.9 11 (33.3%, obesity (IBMI from 30 4 (12. 1%. Cardiovascular risk (CVR as ICC (waist hip ratio 10 (30% high risk, REGICOR 4 (12.1% moderate risk. Relative risk of comorbidity in 2 (6.0% had a slightly increased risk, 4 (12.1% had increased risk. Conclusions: HE interventions are necessary and effective in modifying lifestyles. The calculation of CVT should serve to implement preventive measures to reduce the factors of cardiovascular risk.
Lovegrove, Julie A; Hobbs, Ditte A
CVD are the leading cause of mortality and morbidity worldwide. One of the key dietary recommendations for CVD prevention is reduction of saturated fat intake. Yet, despite milk and dairy foods contributing on average 27 % of saturated fat intake in the UK diet, evidence from prospective cohort studies does not support a detrimental effect of milk and dairy foods on risk of CVD. The present paper provides a brief overview of the role of milk and dairy products in the diets of UK adults, and will summarise the evidence in relation to the effects of milk and dairy consumption on CVD risk factors and mortality. The majority of prospective studies and meta-analyses examining the relationship between milk and dairy product consumption and risk of CVD show that milk and dairy products, excluding butter, are not associated with detrimental effects on CVD mortality or risk biomarkers that include serum LDL-cholesterol. In addition, there is increasing evidence that milk and dairy products are associated with lower blood pressure and arterial stiffness. These apparent benefits of milk and dairy foods have been attributed to their unique nutritional composition, and suggest that the elimination of milk and dairy may not be the optimum strategy for CVD risk reduction. PMID:26907978
Full Text Available Most cardiovascular diseases are caused by atherosclerosis, which is a result of interactions between risk factors such as gender, age, blood lipid concentrations, blood pressure, glucose tolerance, adiposity, physical activity and cigarette smoking. Identification of risk factors is the first step in cardiovascular disease prevention. As health workers contribute significantly to cardiovascular morbidity, the aim of our study was to analyze prevalence of cardiovascular risk factors and to assess the level of mentioned risk in health workers employed in Health Centre Beočin. The study group consisted of 50 health workers. Obesity was evaluated according to BMI and body fat (BF% values, while central obesity was defined using waist circumference. Serum lipid concentrations and glycaemia were used in metabolic profile definition. The level of physical activity was assessed using IPAQ, and information about smoking status and family history of cardiovascular diseases was obtained from self-report. Framingham point-scoring system was used to predict the risk for development of coronary heart disease in the 10-year period. Overweight was found in 36%, and obesity in 18% subjects. 42% of examined subjects had higher fat mass, while 24% of them had obesity. Central fat accumulation was observed in 50% subjects. We registered 56% smokers, 70% subjects with positive family history, 28% subjects with hypertension, and 56% subjects with dyslipidemia. According to IPAQ results 20% of exanimate subjects were minimally active and 70% were insufficiently active. Estimated risk of coronary heart disease was 7.38%, and 10% subjects had risk over 20%. In spite of lower cardiovascular risk level, our results showed high prevalence of overweight, smoking and physical inactivity in health workers, which suggests the importance of their own lifestyle modification. It should be the first step in increasing motivation of their patients.
Leila Pfaeffli Dale; Robyn Whittaker; Helen Eyles; Cliona Ni Mhurchu; Kylie Ball; Natasha Smith; Ralph Maddison
Cardiac rehabilitation (CR) is crucial in the management of cardiovascular disease (CVD), yet attendance is poor. Mobile technology (mHealth) offers a potential solution to increase reach of CR. This paper presents two development studies to determine mobile phone usage in adults with CVD and to evaluate the acceptability of an mHealth healthy eating CR program. Methods: CR attendees were surveyed to determine mobile phone usage rates. A second single-subject pilot study investigated percepti...
Full Text Available Background: Cardiovascular diseases (CVDs are one of the most common causes of morbidity and mortality. Most of the risk factors of CVDs develop early in childhood. Schools immensely influence the thinking pattern of students and can thus shape their behavior. However, no amount of knowledge and awareness can change health behaviours of students until they get support from enabling environment in the schools. The Ottawa charter has also emphasized on building healthy public policy and creating supportive environments for health promotion in schools. Materials and Methods: The present study was conducted in 10 schools in Delhi, India. School policies, environment, community participation and approach of school health agency were assessed by interviewing authorities, review of related documents and direct observation in schools. Results: It was found that none of the schools had any written health policy. Environment in most of the schools was not conducive for cardiovascular health promotion. Conclusion: The study highlights that the schools lack health policies and environment for cardiovascular health and also points out the approach of school health agency, focusing on medical check-ups and treatment of minor illnesses.
Piette, John D; List, Justin; Rana, Gurpreet K; Townsend, Whitney; Striplin, Dana; Heisler, Michele
We examined evidence on whether mobile health (mHealth) tools, including interactive voice response calls, short message service, or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and gray literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries. Interactive voice response and short message service interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. Interactive voice response and short message service-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multimodal interventions including Web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in >30 low- and middle-income countries, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next-generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients' unique and changing needs
M Behnam Moghadam; A Behnam Moghadam; S Yarian; Hosseini SM; S. Mohammad Hosseini
Backgrounds & aim: nowadays measuring the quality of life in the health care system is imperative. The purpose of this study was to predict the quality of life according to public health, social support and self-efficacy in patients with cardiovascular disease. Methods: the present descriptive cross-sectional study was performed on 70 individuals with cardiovascular disease referred to medical centers and Yasuj clinics selected by purposeful sampling. The Research instruments included th...
Ansary, A.; Azuma, A; Komatireddy, R.; Barrett, P.M.
The technologies of cardiovascular connected health stand to dramatically alter the management and prevention of cardiovascular disease, a worldwide leading cause of death. The American Heart Association has outlined seven key health metrics including physical activity, adequate blood pressure control, weight and a healthy diet, which lie at the core of cardiovascular disease management. Controlling these metrics has been demonstrated to result in substantial reductions in cardiovascular mort...
Since the leading cause of morbidity and mortality is cardiovascular diseases, every individual should think regularly about possessing and maintaining cardiovascular health. In reality, this self-processing is delayed until the occurrence of complications related to cardiovascular inefficiency manifested as chest pain and/or dyspnea. However, people should be trained to think about their cardiovascular health issues as a vital need from early childhood. This goal is achievable by understandi...
Kleber, Marcus E; Delgado, Graciela; Grammer, Tanja B; Silbernagel, Günther; Huang, Jie; Krämer, Bernhard K; Ritz, Eberhard; März, Winfried
Obesity and diets rich in uric acid-raising components appear to account for the increased prevalence of hyperuricemia in Westernized populations. Prevalence rates of hypertension, diabetes mellitus, CKD, and cardiovascular disease are also increasing. We used Mendelian randomization to examine whether uric acid is an independent and causal cardiovascular risk factor. Serum uric acid was measured in 3315 patients of the Ludwigshafen Risk and Cardiovascular Health Study. We calculated a weighted genetic risk score (GRS) for uric acid concentration based on eight uric acid-regulating single nucleotide polymorphisms. Causal odds ratios and causal hazard ratios (HRs) were calculated using a two-stage regression estimate with the GRS as the instrumental variable to examine associations with cardiometabolic phenotypes (cross-sectional) and mortality (prospectively) by logistic regression and Cox regression, respectively. Our GRS was not consistently associated with any biochemical marker except for uric acid, arguing against pleiotropy. Uric acid was associated with a range of prevalent diseases, including coronary artery disease. Uric acid and the GRS were both associated with cardiovascular death and sudden cardiac death. In a multivariate model adjusted for factors including medication, causal HRs corresponding to each 1-mg/dl increase in genetically predicted uric acid concentration were significant for cardiovascular death (HR, 1.77; 95% confidence interval, 1.12 to 2.81) and sudden cardiac death (HR, 2.41; 95% confidence interval, 1.16 to 5.00). These results suggest that high uric acid is causally related to adverse cardiovascular outcomes, especially sudden cardiac death. PMID:25788527
Stafford, M.; Soljak, M.; Pledge, V.; Mindell, J.
Background: Those responsible for planning and commissioning health services require a method of assessing the benefits and costs of interventions. Quality-adjusted life years, based on health-related quality of life (HRQoL) estimates, can be used as part of this commissioning process. The purpose of this study was to generate nationally representative HRQoL estimates for cardiovascular disease (heart attack, angina and stroke) and predisposing conditions (diabetes, hypertension and obesity) ...
Calvo, Mona S; Uribarri, Jaime
This review explores the potential adverse impact of the increasing phosphorus content in the American diet on renal, cardiovascular, and bone health of the general population. Increasingly, studies show that phosphorus intakes in excess of the nutrient needs of a healthy population may significantly disrupt the hormonal regulation of phosphate, calcium, and vitamin D, which contributes to disordered mineral metabolism, vascular calcification, impaired kidney function, and bone loss. Moreover, large epidemiologic studies suggest that mild elevations of serum phosphate within the normal range are associated with cardiovascular disease (CVD) risk in healthy populations without evidence of kidney disease. However, few studies linked high dietary phosphorus intake to mild changes in serum phosphate because of the nature of the study design and inaccuracies in the nutrient composition databases. Although phosphorus is an essential nutrient, in excess it could be linked to tissue damage by a variety of mechanisms involved in the endocrine regulation of extracellular phosphate, specifically the secretion and action of fibroblast growth factor 23 and parathyroid hormone. Disordered regulation of these hormones by high dietary phosphorus may be key factors contributing to renal failure, CVD, and osteoporosis. Although systematically underestimated in national surveys, phosphorus intake seemingly continues to increase as a result of the growing consumption of highly processed foods, especially restaurant meals, fast foods, and convenience foods. The increased cumulative use of ingredients containing phosphorus in food processing merits further study given what is now being shown about the potential toxicity of phosphorus intake when it exceeds nutrient needs. PMID:23719553
Rajagopalan, Sanjay; Brook, Robert D.
Current understanding of the association between household air-pollution (HAP) and cardiovascular disease is primarily derived from outdoor air-pollution studies. The lack of accurate information on the contribution of HAP to cardiovascular events has prevented inclusion of such data in global burden of disease estimates with consequences in terms of health care allocation and national/international priorities. Understanding the health risks, exposure characterization, epidemiology and econom...
Giorgini, Paolo; Rubenfire, Melvyn; Bard, Robert L; Jackson, Elizabeth A; Ferri, Claudio; Brook, Robert D
Although regular aerobic exercise improves overall health, increased physical activity can lead to heightened exposures to a variety of air pollutants. As such, the cardiovascular health benefits of exercise may be abrogated to some degree by the harmful actions of inhaled pollutants. This review aims to provide an up-to-date summary for health professionals of the cardiovascular responses as well as the risks of exercising in air pollution. Aerobic exercise augments the overall inhaled air pollution dose, potentiates the diffusion of pollutants into circulating blood, and augments oxidative stress and inflammation. The inhalation of particulate matter during exercise can raise blood pressure, impair vascular function, and unfavorably affect autonomic balance. Several studies suggest that air pollutants can increase ischemic symptoms and signs during exercise and can even be capable of impairing exercise performance in some scenarios. The overall evidence supports that the risk-to-benefit ratio generally favors that health care providers continue to strongly encourage their patients to perform regular aerobic exercise. Nevertheless, a greater effort should be made to educate patients about the risks of air pollutant exposures during exercise, particularly those at heightened cardiovascular risk. Although no strategy has been directly tested to reduce morbidity and mortality rate, several prudent actions can be taken to lessen the degree of exposures during exercise which may thereby help mitigate the adverse effects of air pollutants on exercise performance and cardiovascular risk. PMID:26378494
O perfil de saúde cardiovascular dos idosos brasileiros precisa melhorar: estudo de base populacional The profile of cardiovascular health of elderly brazilian people needs to improve: a population-based study
Janaina Caldeira Pereira
cardiovascular diseases in the elderly is scarce. OBJECTIVE: To estimate the prevalence and clustering of risk factors and investigate their association with ischemic heart disease (IHD in elderly people. METHODS: All subjects >60 years of age participating in the "Inquérito domiciliar sobre comportamentos de risco e morbidade referida de doenças e agravos não transmissíveis" (Household Survey on Risk Behaviors and Reported Morbidity of Non Transmissible Diseases and Health Conditions carried out by the Ministry of Health, in 2002/2003 in 15 capitals and the Federal District were included. The prevalence of risk factors (smoking, alcohol consumption, lack of physical activity, inappropriate diet, and obesity and reported morbidity (hypertension, hypercholesterolemia, and diabetes was assessed, as well as the association between IHD and clustering of these factors using the Poisson regression model. RESULTS: Elderly individuals represented 13.4% (3,142/23,457, 59.4% women and 40.6% men. The mean age of the participants was 69.5 years. Approximately 50% of participants reported having hypertension, 33% hypercholesterolemia, and 18% diabetes. Smoking and hypercholesterolemia dropped significantly with age. Hypertension, physical inactivity, obesity, and hypercholesterolemia were more prevalent among women. Clustering of two or more factors was observed in 71.3% of the elderly, and diminished with age. Elderly subjects with IHD had a four-fold higher prevalence of clusters with four or more factors (PR=4.1; 95% CI: 2.6-6.4. CONCLUSION: The relationship between IHD and a larger clustering of risk factors probably represents a greater accumulated risk throughout life, but it also indicates the need to improve the risk profile of these elderly people.
Seyed Mohammad Mahdi Hazavehei
Full Text Available Introduction: Cardiovascular diseases are one of the 10 leading causes of death in the world and the first leading cause of death in Iran. Controlling the risk factors for these diseases can reduce more than 50% of disabilities resulted from these illnesses. In this regard, it is important to consider the behaviors associated with individuals’ lifestyles. The purpose of this study is to review the studies that have used educational interventions in order to reduce risk factors of cardiovascular diseases, based on methods, application of models, and theories of health education and health promotion and the effect of intervention on reducing risk factors. Methods: Electronic search of databases was performed using the key words in English and Persian. Databases reviewed were, Scientific Information Database (SID, Iran Medex, PubMed, Ebsco and Cochrane. The databases search was conducted from February 2012 to May 2012. Results: Interventions to reduce risk factors of cardiovascular diseases were divided into two types based on use of models and theories of health education and without use of models and theories of health education. In the 19 articles reviewed, 9 studies were conducted based on theories and models of health education,and 10 studies did not use theories and models of health education. Conclusion: The results indicate that training based on theories and models of health education and using the standardized programs have a greater impact on reducing risk factors of cardiovascular diseases. Time, place and length of intervention, the characteristics of the individuals and use of modern methods of training are important for some of the audience with regard to the effectiveness of the training in order to reduce risk factors.
Full Text Available The increasing burden of cardiovascular disease (CVD despite the progress in management entails the need of more effective preventive and curative strategies. As dietary-associated risk is the most important behavioral factor influencing global health, it appears the best target in the challenge against CVD. Although for many years, since the formulation of the cholesterol hypothesis, a nutrient-based approach was attempted for CVD prevention and treatment, in recent years a dietary-based approach resulted more effective in reducing cardiovascular risk worldwide. After the publication of randomized trials on the remarkable effects of the Mediterranean diet and the Dietary Approach to Stop Hypertension (DASH diet on CVD, new efforts were put on research about the effects of complex dietary interventions on CVD. The purpose of this paper is to review the evidence on dietary interventions in the prevention and disease modification of CVD, focusing on coronary artery disease and heart failure, the main disease responsible for the enormous toll taken by CVD worldwide.
Stephen D.Anton; Kacey Heekin; Carrah Simkins; Andres Acosta
According to the classic "diet-heart" hypothesis,high dietary intake of saturated fats and cholesterol combined with low intake of polyunsaturated fats can increase levels of serum cholesterol and lead to the development of atherogenic plaques and ultimately cardiovascular diseases.Recently,the beneficial health effects of omega-6 polyunsaturated fatty acids,particularly linoleic acid (LA),on cardiovascular health have been called into question with some scientists suggesting that consumption of LA should be reduced in Western countries.The focus of this critical review is on the controversy surrounding the effects of dietary intake of LA on cardiovascular health.Specifically,we critically examined the effects of both unadulterated and adulterated forms of LA on cardiovascular health outcomes based on findings from epidemiological studies and randomized controlled trials.Additionally,we address common concerns surrounding dietary intake of LA regarding its relationship with arachidonic acid,the ratio of omega-6 to omega-3 fatty acids,and its relationship with inflammation.Our critical review indicates that unadulterated forms of LA are cardioprotective and should be consumed as part of a healthy diet.In contrast,abundant evidence now indicates that adulterated forms of LA,predominantly hydrogenated vegetable oils,are atherogenic and should not be considered part of a healthy diet.The ability to adulterate the natural omega-6 fatty acid,LA,has contributed to mixed findings regarding the effects of this fatty acid on cardiovascular health.Thus,it is critical that the source of LA be taken into account when drawing conclusions about the physiological effects of this fatty acid.The findings of the present review are in line with current dietary recommendations of the American Heart Association.
Full Text Available Abstract Background Communicating risk is part of primary prevention of coronary heart disease and stroke, collectively referred to as cardiovascular disease (CVD. In Australia, health organisations have promoted an absolute risk approach, thereby raising the question of suitable standardised formats for risk communication. Methods Sixteen formats of risk representation were prepared including statements, icons, graphical formats, alone or in combination, and with variable use of colours. All presented the same risk, i.e., the absolute risk for a 55 year old woman, 16% risk of CVD in five years. Preferences for a five or ten-year timeframe were explored. Australian GPs and consumers were recruited for participation in focus groups, with the data analysed thematically and preferred formats tallied. Results Three focus groups with health consumers and three with GPs were held, involving 19 consumers and 18 GPs. Consumers and GPs had similar views on which formats were more easily comprehended and which conveyed 16% risk as a high risk. A simple summation of preferences resulted in three graphical formats (thermometers, vertical bar chart and one statement format as the top choices. The use of colour to distinguish risk (red, yellow, green and comparative information (age, sex, smoking status were important ingredients. Consumers found formats which combined information helpful, such as colour, effect of changing behaviour on risk, or comparison with a healthy older person. GPs preferred formats that helped them relate the information about risk of CVD to their patients, and could be used to motivate patients to change behaviour. Several formats were reported as confusing, such as a percentage risk with no contextual information, line graphs, and icons, particularly those with larger numbers. Whilst consumers and GPs shared preferences, the use of one format for all situations was not recommended. Overall, people across groups felt that risk
Barreto Sandhi Maria
Full Text Available OBJECTIVE - A population-based prospective study was analysed to: a determine the prevalence of hypertension; b investigate the clustering of other cardiovascular risk factors and c verify whether older differed from younger adults in the pattern of clustering. METHODS - The data comprised a representative sample of the population of Bambuí, Brazil. Multiple logistic regression was used to investigate the independent association between hypertension and selected factors. RESULTS - A total of 820 younger adults (82.5% and 1494 older adults (85.9% participated in this study. The overall prevalence of hypertension was 24.8% (SE=1.4 %, being higher in women (26.9±1.5% than in men (22.0± 1.7% (p=0.033. Hypertension was positively and significantly associated with physical inactivity, overweight, hypercholesterolemia hyperglycemia and hypertriglyceridemia. The coexistence of hypertension with 4 or more of these risk factors occurred 6 times more than expected by chance, after adjusting for age and sex (OR=6.3; 95%CI: 3.4-11.9. The pattern of risk factor clustering in hypertensive individuals differed with age. CONCLUSION - Our results reinforce the need to increase detection and treatment of hypertension and to approach patients' global risk profiles.
Padial, Luis Rodríguez
Ezetimibe is a drug that impairs intestinal cholesterol absorption and decreases blood cholesterol levels. It has been shown that added to statins it can achieve a further reduction of low-density lipoprotein-cholesterol of 18-20%, overcoming the increase in absorption that follow the reduction in cholesterol synthesis by statins. Four major outcome trials are underway to study the effect of ezetimibe plus simvastatin in different subsets of high-risk patients: familiar hypercholesterolemia, degenerative aortic stenosis, chronic kidney disease and acute coronary syndrome. Hopefully, in the next few years the information provided by these trials will allow us to further reduce the increasing burden of cardiovascular disease. PMID:18095904
textabstractIn the early 90’s epidemiological studies revealed an association between low birth weight and increased risk for cardiovascular disease (CVD) and type 2 diabetes. These observations led to the initiation of studies investigating Developmental Origins of Health and Disease (DOHaD). Some aspects in DOHaD, however, remained controversial, such as the role of preterm birth and postnatal growth patterns, which are highly related to low birth weight. In this doctoral thesis we investig...
Trekking includes downhill walking and enhances lower limb strength. Muscle fitness is a predictor of mortality and is associated with cardiovascular risk factors in adults. The purpose of this study was to investigate the effects of trekking on cardiovascular health and fitness in older obese women. The participants were randomly assigned to an exercise group (EG, n= 32) and a control group (CG, n= 48). The EG participated in the trekking program for 12 weeks, 3 times per week, and 90 min per session, at a moderate intensity. Cardiovascular health (BMI, percentage of body fat, blood pressure, glucose, triglycerides, and total cholesterol) and fitness (muscle strength, muscle endurance, balance, and flexibility) were measured before and after the 12-week program. A twoway repeated ANOVA was used to compare and analyze the group differences. Body weight, systolic blood pressure, and muscle strength were significantly different between the groups. These results indicate that trekking played a significant role in the reduction of weight and systolic blood pressure in obese women. The results of this study can be utilized to reduce cardiovascular risk factors associated with aging. PMID:25210697
Cho, Yoonsu; Shin, So-Youn; Won, Sungho; Relton, Caroline L; Davey Smith, George; Shin, Min-Jeong
Mendelian randomisation studies from Asia suggest detrimental influences of alcohol on cardiovascular risk factors, but such associations are observed mainly in men. The absence of associations of genetic variants (e.g. rs671 in ALDH2) with such risk factors in women - who drank little in these populations - provides evidence that the observations are not due to genetic pleiotropy. Here, we present a Mendelian randomisation study in a South Korean population (3,365 men and 3,787 women) that 1) provides robust evidence that alcohol consumption adversely affects several cardiovascular disease risk factors, including blood pressure, waist to hip ratio, fasting blood glucose and triglyceride levels. Alcohol also increases HDL cholesterol and lowers LDL cholesterol. Our study also 2) replicates sex differences in associations which suggests pleiotropy does not underlie the associations, 3) provides further evidence that association is not due to pleiotropy by showing null effects in male non-drinkers, and 4) illustrates a way to measure population-level association where alcohol intake is stratified by sex. In conclusion, population-level instrumental variable estimation (utilizing interaction of rs671 in ALDH2 and sex as an instrument) strengthens causal inference regarding the largely adverse influence of alcohol intake on cardiovascular health in an Asian population. PMID:26687910
Vivek Kumar Sharma; Madanmohan Trakroo,; Velkumary Subramaniam; Rajajeyakumar, M.; Bhavanani, Anand B; Ajit Sahai
Context: Perceived stress is higher for students in various healthcare courses. Previous studies have shown that pranayama practice is beneficial for combating stress and improve cardiovascular functions but both fast and slow pranayama practice produce different physiological responses. Aim: Present study was conducted to compare the effects of commonly practiced slow and fast pranayama on perceived stress and cardiovascular functions in young health-care students. Materials and Method...
Wermeling Paulien R
Full Text Available Abstract Background Type 2 diabetes patients have a decreased health-related quality of life compared to healthy persons, especially regarding physical functioning and well-being. Health-related quality of life is even lower in type 2 diabetes patients when other diseases co-exist. In contrast to earlier studies, we assessed the associations between the number and type of comorbidities and health status in well-controlled type 2 diabetes patients, in whom treatment goals for HbA1c, blood pressure and cholesterol had been reached. Approximately one in five type 2 diabetes patients belongs to this group. Methods Cross-sectional analysis was performed in 2086 well-controlled (HbA1c ≤58 mmol/mol, systolic blood pressure ≤145 mmHg, total cholesterol ≤5.2 mmol/l and not using insulin type 2 diabetes patients in general practice. Both number and type (cardiovascular and non-cardiovascular of comorbidities were determined for each patient. Health status was assessed with the questionnaires Short Form-36 (SF-36 and EuroQol (EQ. The SF-36 generates eight dimensions of health and a Physical and Mental Component Score (PCS and MCS, scale: 0–100. The EQ consists of two parts: EQ-5D and EQ Visual Analogue Scale. Multivariable linear regression analysis was used to assess if number and type of comorbidities were associated with health status. Results Well-controlled type 2 diabetes patients with comorbidities had a much lower health status, with a decrease ranging from -1.5 for the MCS to -26.3 for role limitations due to physical problems, compared to those without. Health status decreased when the number of comorbidities increased, except for mental health, role limitations due to emotional problems, MCS and both EQ measures. In patients with both cardiovascular and non-cardiovascular comorbidity, physical functioning, role limitations due to physical problems and PCS were significantly lower than in patients with only cardiovascular comorbidity
Sonia de Pascual-Teresa
Full Text Available Nowadays it is accepted that natural flavonoids present in fruits and plant-derived-foods are relevant, not only for technological reasons and organoleptic properties, but also because of their potential health-promoting effects, as suggested by the available experimental and epidemiological evidence. The beneficial biological effects of these food bioactives may be driven by two of their characteristic properties: their affinity for proteins and their antioxidant activity. Over the last 15 years, numerous publications have demonstrated that besides their in vitro antioxidant capacity, certain phenolic compounds, such as anthocyanins, catechins, proanthocyanidins, and other non coloured flavonoids, may regulate different signaling pathways involved in cell survival, growth and differentiation. In this review we will update the knowledge on the cardiovascular effects of anthocyanins, catechins and proanthocyanidins, as implied by the in vitro and clinical studies on these compounds. We also review the available information on the structure, distribution and bioavailability of flavanols (monomeric catechins and proanthocyanidins and anthocyanins, data necessary in order to understand their role in reducing risk factors and preventing cardiovascular health problems through different aspects of their bioefficacy on vascular parameters (platelet agregation, atherosclerosis, blood pressure, antioxidant status, inflammation-related markers, etc., myocardial conditions, and whole-body metabolism (serum biochemistry, lipid profile, highlighting the need for better-designed clinical studies to improve the current knowledge on the potential health benefits of these flavonoids to cardiovascular and metabolic health.
Ana Célia Caetano de Souza
Full Text Available Objective Investigating the educational technologies developed for promoting cardiovascular health in adults. Method Integrative review carried out in the databases of PubMed, SciELO and LILACS, with 15 articles selected. Results Over half (60% of the studies were randomized clinical trials. The developed educational technologies were programs involving three strategies, with duration of one year, use of playful technologies with storytelling, computer programs or software for smartphones, and electronic brochure. These technologies resulted in reduction of blood pressure, weight, waist circumference, decreased hospitalizations and increased years of life. Conclusion The studies with better impact on the cardiovascular health of adults were those who brought the technology in the form of program and duration of one year.
Background: Cardiovascular diseases (CVD) are increasingly common in Nigeria and sub Saharan Africa (SSA). Poverty is rampant and quality of primary care substandard. Moreover adherence capacity for prescribed anti-hypertensive treatment is limited and blood pressure (BP) control consequently poor.
Full Text Available Abstract Background Cardiovascular disease (CVD is the major cause of death after renal transplantation. Not only conventional CVD risk factors, but also transplant-specific risk factors can influence the development of CVD in kidney transplant recipients. The main objective of this study will be to determine the incidence of post-transplant CVD after renal transplantation and related factors. A secondary objective will be to examine the ability of standard cardiovascular risk scores (Framingham, Regicor, SCORE, and DORICA to predict post-transplantation cardiovascular events in renal transplant recipients, and to develop a new score for predicting the risk of CVD after kidney transplantation. Methods/Design Observational prospective cohort study of all kidney transplant recipients in the A Coruña Hospital (Spain in the period 1981-2008 (2059 transplants corresponding to 1794 patients. The variables included will be: donor and recipient characteristics, chronic kidney disease-related risk factors, pre-transplant and post-transplant cardiovascular risk factors, routine biochemistry, and immunosuppressive, antihypertensive and lipid-lowering treatment. The events studied in the follow-up will be: patient and graft survival, acute rejection episodes and cardiovascular events (myocardial infarction, invasive coronary artery therapy, cerebral vascular events, new-onset angina, congestive heart failure, rhythm disturbances and peripheral vascular disease. Four cardiovascular risk scores were calculated at the time of transplantation: the Framingham score, the European Systematic Coronary Risk Evaluation (SCORE equation, and the REGICOR (Registre Gironí del COR (Gerona Heart Registry, and DORICA (Dyslipidemia, Obesity, and Cardiovascular Risk functions. The cumulative incidence of cardiovascular events will be analyzed by competing risk survival methods. The clinical relevance of different variables will be calculated using the ARR (Absolute Risk
The Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked by the European Food Safety Authority (EFSA) t to draft guidance on scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health. This guidance has been drawn from scientific......, endorsed by the NDA Panel on 25 March 2011, was released for public consultation from 26 April 2011 to 31 August 2011....
van Rijn, B.B.
In this thesis, maternal constitutional factors related to long-term cardiovascular health and subsequent pregnancy outcome in women with early-onset preeclampsia is addressed. Aims of the thesis: To evaluate subsequent pregnancy outcome in women with a first pregnancy complicated by early-onset preeclampsia and to study risk factors for recurrence of preeclampsia and preterm delivery; To evaluate subsequent pregnancy outcome in women with a first pregnancy complicated by intrauterine growth ...
Golden, SH; Ferketich, A; Boyington, J; Dugan, S.; Garroutte, E; Kaufmann, PG; Krok, J; Kuo, A; Ortega, AN; Purnell, T; Srinivasan, S
The Centers for Population Health and Health Disparities program promotes multilevel and multifactorial health equity research and the building of research teams that are transdisciplinary. We summarized 5 areas of scientific training for empowering the next generation of health disparities investigators with research methods and skills that are needed to solve disparities and inequalities in cancer and cardiovascular disease. These areas include social epidemiology, multilevel modeling, heal...
Palazzo, Steven J.; Skager, Cherie; Kraiger, Anneliese
There is emerging evidence to suggest community-based interventions can change community-wide behaviors and attitudes toward cardiovascular health. This article describes a partnership between an academic institution and a community nonprofit organization to develop and implement a cardiovascular health promotion program targeting at risk high…
Jay, Kenneth; Frisch, Dennis; Hansen, Klaus;
The aim of this trial was to investigate the effectiveness of a worksite intervention using kettlebell training to improve musculoskeletal and cardiovascular health.......The aim of this trial was to investigate the effectiveness of a worksite intervention using kettlebell training to improve musculoskeletal and cardiovascular health....
F. J. Sánchez-Muniz
Full Text Available Cardiovascular disease (CVD is the leading cause of mortality and morbidity in developed countries. CVD is an inflammatory disease associated with risk factors that include hypercholesterolemia and hypertension. Furthermore, the evolution of this disease depends on the amount of modified lipoproteins (e.g. oxidized present in the arterial subendothelium. Diet is considered the cornerstone for CVD treatment, as it can lower not only atherogenic lipoprotein levels and degree of oxidation, but also blood pressure, thrombogenesis and concentrations of some relevant factors (e.g. homocystein.Among different diets, the Mediterranean diet stands out due to their benefits on several health benefits, in particular with regard to CVD. Rich in vegetable foods, this diet contributes both quantitatively and qualitatively to essential fibre compounds (cellulose, hemicellulose, gums, mucilages, pectins, oligosaccharides, lignins, etc.. The present paper analyzes the effects of fibre consumption on a cholesterol and lipoprotein levels; b systolic and diastolic blood pressures; and c antioxidant availability and profile. Some studies and meta-analysis are revised, as the possible mechanisms by which fibre may decrease plasma total cholesterol and LDL-cholesterol and blood pressure and to act as antioxidant, as well. In addition, author´s own publications regarding the effect of fibre matrix (e.g. seaweeds on arylesterase and the gene expression of some key antioxidant enzymes are reviewed. The paper also includes data concerning the possible interaction between fibre and some hypolipemic drugs, which may make it possible to attain similar hypolipemic effects with lower dosages, with the consequent decrease in possible side effects. The review concludes with a summary of nutritional objectives related to the consumption of carbohydrates and fibre supplements.La enfermedad cardiovascular (EC sigue siendo la causa más frecuente de morbi-mortalidad en los pa
Olsen, Gitte S; Holm, Ann-Sofie S; Jørgensen, Torben;
index <25 kg/m(2), blood pressure ≤120/80 mmHg and total cholesterol ≤5 mmol/l. Results are presented adjusted for age and stratified according to sex and educational level as length of vocational training. RESULTS: The proportion of women with ideal cardiovascular health increased from 2% in 1978 to 13......BACKGROUND: The focus on improvements in ideal cardiovascular health is a relatively new approach and to our knowledge nobody has published the trend in regard to educational difference. DESIGN: Time trend analysis from six cross-sectional studies in 1978-2006 from the south-western part of the......% in 2006. From 1991, an educational difference occurred, increasing to a 5-fold difference in 2006 between the highest and lowest educated women. For men, a less pronounced increase occurred from 1% in 1978 to 5% in 2006; a change which was only significant among the highest educated. An educational...
Hybholt, Lasse Gliemann; Schmidt, Jakob Friis; Olesen, Jesper;
signaling and through an improved antioxidant capacity. We tested the hypothesis that resveratrol supplementation enhances training-induced improvements in cardiovascular health parameters in aged men. Twenty-seven healthy physically inactive aged men (age: 65 ± 1 years; BMI: 25.4 ± 0.7 kg/m2; MAP: 95.8 ± 2.......02) and muscle TBX synthase was higher in the resveratrol group after training (P <0.05). Resveratrol administration also abolished the positive effects of exercise on LDL, TC/HDL ratio and triglycerides concentrations in blood (P <0.05). Resveratrol did not potentiate the effect of exercise training on......Aging is thought to be associated with decreased vascular function partly due to oxidative stress. Resveratrol is a polyphenol, which, in animal studies has been shown to decrease atherosclerosis, improve cardiovascular health and physical capacity, in part through its effects on Sirtuin 1...
Rosenwinkel, E T; Bloomfield, D M; Arwady, M A; Goldsmith, R L
Autonomic nervous system activity contributes to the regulation of cardiac output during rest, exercise, and cardiovascular disease. Measurement of HRV has been particularly useful in assessing parasympathetic activity, while its utility for assessing sympathetic function and overall sympathovagal balance remains controversial. Studies have revealed that parasympathetic tone dominates the resting state, while exercise is associated with prompt withdrawal of vagal tone and subsequent sympathetic activation. Conversely, recovery is characterized by parasympathetic activation followed by sympathetic withdrawal, although clarification of the normal trajectory and autonomic basis of heart rate decay following exercise is needed. Abnormalities in autonomic physiology--especially increased sympathetic activity, attenuated vagal tone, and delayed heart rate recovery--have been associated with increased mortality. Exercise training is associated with a relative enhancement of vagal tone, improved heart rate recovery after exercise, and reduced morbidity in patients with cardiovascular disease. However, whether exercise training leads to reduced mortality in this population because of its ability to specifically modulate autonomic function is unknown at the present time. Although the results of a recent randomized study in patients with CHF and a meta-analysis in the setting of a recent myocardial infarction determined that exercise training leads to improved outcomes in these populations, neither study measured autonomic function. Improved autonomic function due to exercise training is a promising rationale for explaining improvements in outcome, although more research is needed to confirm this hypothesis. PMID:11570111
Arsenic exposure at low-to-moderate levels and skin lesions, arsenic metabolism, neurological functions, and biomarkers for respiratory and cardiovascular diseases: Review of recent findings from the Health Effects of Arsenic Longitudinal Study (HEALS) in Bangladesh
The contamination of groundwater by arsenic in Bangladesh is a major public health concern affecting 35-75 million people. Although it is evident that high levels (> 300 μg/L) of arsenic exposure from drinking water are related to adverse health outcomes, health effects of arsenic exposure at low-to-moderate levels (10-300 μg/L) are not well understood. We established the Health Effects of Arsenic Longitudinal Study (HEALS) with more than 20,000 men and women in Araihazar, Bangladesh, to prospectively investigate the health effects of arsenic predominately at low-to-moderate levels (0.1 to 864 μg/L, mean 99 μg/L) of arsenic exposure. Findings to date suggest adverse effects of low-to-moderate levels of arsenic exposure on the risk of pre-malignant skin lesions, high blood pressure, neurological dysfunctions, and all-cause and chronic disease mortality. In addition, the data also indicate that the risk of skin lesion due to arsenic exposure is modifiable by nutritional factors, such as folate and selenium status, lifestyle factors, including cigarette smoking and body mass index, and genetic polymorphisms in genes related to arsenic metabolism. The analyses of biomarkers for respiratory and cardiovascular functions support that there may be adverse effects of arsenic on these outcomes and call for confirmation in large studies. A unique strength of the HEALS is the availability of outcome data collected prospectively and data on detailed individual-level arsenic exposure estimated using water, blood and repeated urine samples. Future prospective analyses of clinical endpoints and related host susceptibility will enhance our knowledge on the health effects of low-to-moderate levels of arsenic exposure, elucidate disease mechanisms, and give directions for prevention.
Thielke, Stephen M.; Diehr, Paula H.; Yee, Laura M.; Arnold, Alice M.; Quiñones, Ana R.; Whitson, Heather E.; Mini E. Jacob; Newman, Anne B.
Objective: Longevity fails to account for health and functional status during aging. We sought to quantify differences in years of total life, years of healthy life, and years of able life among groups defined by age, sex, and race. Design: Primary analysis of a cohort study. Setting: 18 years of annual evaluations in four U.S. communities. Participants: 5888 men and women aged 65 and older. Measurements: Years of life were calculated as the time from enrollment to death or 18 years. Years of...
Fuster, Valentin; Vahl, Torsten P
Cardiovascular disease (CVD) is the leading cause of death worldwide, and its prevalence is likely to increase in the near future. The morbidity and mortality associated with CVD causes an enormous economic burden, which has become a major problem for many societies across the globe. The current prevention strategies are aimed at identifying and reducing established risk factors for atherosclerosis including hypertension, hypercholesterolemia, diabetes, obesity, smoking, and sedentary lifestyle. However, some of our prevention goals, such as reducing LDL cholesterol, change dramatically once a subject has been diagnosed with coronary atherosclerosis. At the present time, atherosclerosis is frequently diagnosed relatively late in the course of the disease, when a patient develops symptoms or presents with acute events such as an acute coronary syndrome or a stroke. Several studies have demonstrated that novel noninvasive imaging techniques have the potential to identify subclinical atherosclerosis and high-risk plaques. Early detection of subclinical atherosclerosis may enable clinicians to improve the control of cardiovascular risk factors in affected patients earlier, thereby helping to prevent some of the manifestations of CVD. PMID:20574768
Aidan G O’Keeffe,1 Irwin Nazareth,2 Irene Petersen2 1Department of Statistical Science, 2Department of Primary Care and Population Health, University College London, London, UK Background: Statins are widely prescribed for the primary prevention of cardiovascular disease. Guidelines exist for statin prescriptions, but there is little recent analysis concerning prescription trends over time and how these vary with respect to demographic variables.Methods and results: Using The Health...
O’Keeffe AG; Nazareth I; Petersen I.
Aidan G O’Keeffe,1 Irwin Nazareth,2 Irene Petersen2 1Department of Statistical Science, 2Department of Primary Care and Population Health, University College London, London, UK Background: Statins are widely prescribed for the primary prevention of cardiovascular disease. Guidelines exist for statin prescriptions, but there is little recent analysis concerning prescription trends over time and how these vary with respect to demographic variables.Methods and results: Using The Health Imp...
Cardiovascular risk assessment in type 2 diabetes mellitus: comparison of the World Health Organization/International Society of Hypertension risk prediction charts versus UK Prospective Diabetes Study risk engine
Herath HMM; Weerarathna TP; Umesha D
Herath M Meththananda Herath, Thilak Priyantha Weerarathna, Dilini Umesha Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka Introduction: Patients with type 2 diabetes mellitus (T2DM) are at higher risk of developing cardiovascular diseases, and assessment of their cardiac risk is important for preventive strategies. Purpose: The Ministry of Health of Sri Lanka has recommended World Health Organization/International Society of Hypertension (WHO/ISH) charts f...
Full Text Available Limited data exit on the epidemiology of cardiovascular risk factors in Saudi Arabia particularly in relation to the differences between local citizens and expatriates. The aim of this analysis is to describe the current prevalence of cardiovascular risk factors among patients attending general practice clinics in Saudi Arabia. In a cross- sectional epidemiological study, the presence of cardiovascular risk factors (hypertension, diabetes, dyslipidaemia, obesity, smoking, and abdominal obesity was evaluated in stable adult outpatients attending primary care clinics in Saudi Arabia. Groups comparison were made between local Saudi patients and expatriates. A total of 550 participant were enrolled form different clinics in Saudi Arabia (71% were male, mean age was 43 ± 10 years. Nearly half of the study cohort had more than two cardiovascular risk factors (49.6%. Dyslipidemia had the highest prevalence (68.4%. Furthermore, prevalence of hypertension (47.5% vs. 31.4%, dyslipidaemia (75.2% vs. 55.1% and abdominal obesity (63.9% vs. 52.2% were higher among expatriates compare to Saudis (p-value < 0.001. This analysis clearly shows that there is a high prevalence of cardiovascular risk factors prevalence in Saudi population. In addition, a significant proportion of patients with risk factors have poor overall control. Programmed community based screening is needed for all cardiovascular risk factors in Saudi Arabia. Increased awareness and improved primary care services may decrease incidence of coronary artery disease and improve overall quality of life.
Tseng, Eva; Ho, Wen-Chao; Lin, Meng-Hung; Cheng, Tsun-Jen; Chen, Pau-Chung; Lin, Hsien-Ho
Background Evidence on the association between long-term exposure to air pollution and cardiovascular mortality is limited in Asian populations. Methods We conducted a cohort study on the association between fine particulate matter (PM2.5) and cardiovascular mortality using 43,227 individuals in a civil servants health service in Taiwan. Each participant was assigned an exposure level of particulate matter based on their district of residence using air pollution data collected by the Taiwan E...
Music may not only improve quality of life but may also effect changes in heart rate and heart rate variability. It has been shown that cerebral flow was significantly lower when listening to 'Va pensiero' from Verdi's 'Nabucco' (70.4±3.3 cm/s) compared with 'Libiam nei lieti calici' from Verdi's 'La Traviata' (70.2±3.1 cm/s) (pflow during rest (67.6±3.3 cm/s) or when listening to Beethoven's Ninth Symphony (69.4±3.1 cm/s). It was reported that relaxing music significantly decreases the level of anxiety of patients in a preoperative setting (State-Trait Anxiety Inventory (STAI)-X-1 score 34)-to a greater extent even than orally administered midazolam (STAI-X-1 score 36) (pmusic group (STAI-X-1 score 30) compared with the midazolam group (STAI-X-1 score 34) (pmusic a useful alternative to midazolam for premedication. In addition, there is sufficient practical evidence of stress reduction suggesting that a proposed regimen of listening to music while resting in bed after open-heart surgery is important in clinical use. After 30 min of bed rest, there was a significant difference in cortisol levels between the music (484.4 mmol/l) and the non-music group (618.8 mmol/l) (pmusic produce significantly better correlations between cardiovascular or respiratory signals compared with music with a more uniform emphasis (pmusic and meditation music, whereas heavy metal music or techno are not only ineffective but possibly dangerous and can lead to stress and/or life-threatening arrhythmias. The music of many composers most effectively improves quality of life, will increase health and probably prolong life, particularly music by Bach, Mozart or Italian composers. PMID:21062776
Full Text Available Abstract Background There is growing epidemiological evidence that short-term and long-term exposure to high levels of air pollution may increase cardiovascular morbidity and mortality. In addition, epidemiological studies have shown an association between air pollution exposure and respiratory health. To what extent the association between cardiovascular mortality and air pollution is driven by the impact of air pollution on respiratory health is unknown. The aim of this study was to investigate whether respiratory health at baseline contributes to the effects of long-term exposure to high levels of air pollution on cardiovascular mortality in a cohort of elderly women. Method We analyzed data from 4750 women, aged 55 at the baseline investigation in the years 1985–1994. 2593 of these women had their lung function tested by spirometry. Respiratory diseases and symptoms were asked by questionnaire. Ambient air pollution exposure was assessed by the concentrations of NO2 and total suspended particles at fixed monitoring sites and by the distance of residency to a major road. A mortality follow-up of these women was conducted between 2001 and 2003. For the statistical analysis, Cox' regression was used. Results Women with impaired lung function or pre-existing respiratory diseases had a higher risk of dying from cardiovascular causes. The impact of impaired lung function declined over time. The risk ratio (RR of women with forced expiratory volume in one second (FEV1 of less than 80% predicted to die from cardiovascular causes was RR = 3.79 (95%CI: 1.64–8.74 at 5 years survival time and RR = 1.35 (95%CI: 0.66–2.77 at 12 years. The association between air pollution levels and cardiovascular death rate was strong and statistically significant. However, this association did only change marginally when including indicators of respiratory health into the regression analysis. Furthermore, no interaction between air pollution and respiratory health
Full Text Available Abstract Background Although educational disparity has been linked to single risk behaviours, it has not previously been studied as a predictor of overall lifestyle. We examined if current education, parental education or educational mobility between generations was associated with healthy lifestyles in young Australian adults. Methods In 2004-06, participant and parental education (high [bachelor degree or higher], intermediate [vocational training], low [secondary school only] were assessed. Educational mobility was defined as: stable high (participant and parent in high group, stable intermediate (participant and parent in intermediate group, stable low (participant and parent in low group, downwardly (lower group than parent and upwardly (higher group than parent mobile. We derived a lifestyle score from 10 healthy behaviours (BMI, non-smoking, alcohol consumption, leisure time physical activity and six components of diet. Scores >4 indicated a high healthy lifestyle score. We estimated the likelihood of having a high healthy lifestyle score by education (participant and parent and educational mobility. Results Complete data were available for 1973 participants (53% female, age range 26 to 36 years. Those with lower education were less likely to have healthy lifestyles. Parental education was not associated with having a high healthy lifestyle score after adjustment for participant's education. Those who moved upward or downward were as likely to have a high healthy lifestyle score as those in the group they attained. Conclusions We found clear disparities in health behaviour by participant education and intergenerational educational mobility. People attaining a higher level of education than their parents appeared protected from developing an unhealthy lifestyle suggesting that population-wide improvements in education may be important for health.
Arun Gangadhar Ghorpade; Saurabh RamBihariLal Shrivastava; Sitanshu Sekhar Kar; Sonali Sarkar; Sumanth Mallikarjuna Majgi; Gautam Roy
Background World Health Organization/International Society of Hypertension (WHO/ISH) charts have been employed to predict the risk of cardiovascular outcome in heterogeneous settings. The aim of this research is to assess the prevalence of Cardiovascular Disease (CVD) risk factors and to estimate the cardiovascular risk among adults aged >40 years, utilizing the risk charts alone, and by the addition of other parameters. Methods A cross-sectional study was performed in two o...
The number of patients who use the internet in search for information that might improve their health conditions has increased. Among them, those looking for virtual environments to share experiences, doubts, opinions, and emotions, and to foster relationships aimed at giving and getting support stand out. Therefore, there is an increasing need to assess how those environments can affect the patients' health. This study was aimed at identifying scientific studies on the proliferation and impact of virtual communities, known as health social networks or online support groups, directed to cardiovascular diseases, which might be useful to patients with certain conditions, providing them with information and emotional support. A systematic review of the literature was conducted with articles published from 2007 to 2012, related to cardiovascular diseases and collected from the following databases: PubMed; Association for Computing Machinery(ACM); and Institute of Electrical and Electronics Engineers (IEEE). Four articles meeting the inclusion criteria were selected. The results were interesting and relevant from the health viewpoint, identifying therapeutic benefits, such as provision of emotional support, greater compliance to treatment, and information sharing on diseases and on life experiences
Medina, Edhelmira Lima, E-mail: email@example.com; Loques, Orlando Filho [Instituto de Computação - Universidade Federal Fluminense, Niterói, RJ (Brazil); Mesquita, Cláudio Tinoco [Hospital Universitário Antônio Pedro - Universidade Federal Fluminense, Niterói, RJ (Brazil)
The number of patients who use the internet in search for information that might improve their health conditions has increased. Among them, those looking for virtual environments to share experiences, doubts, opinions, and emotions, and to foster relationships aimed at giving and getting support stand out. Therefore, there is an increasing need to assess how those environments can affect the patients' health. This study was aimed at identifying scientific studies on the proliferation and impact of virtual communities, known as health social networks or online support groups, directed to cardiovascular diseases, which might be useful to patients with certain conditions, providing them with information and emotional support. A systematic review of the literature was conducted with articles published from 2007 to 2012, related to cardiovascular diseases and collected from the following databases: PubMed; Association for Computing Machinery(ACM); and Institute of Electrical and Electronics Engineers (IEEE). Four articles meeting the inclusion criteria were selected. The results were interesting and relevant from the health viewpoint, identifying therapeutic benefits, such as provision of emotional support, greater compliance to treatment, and information sharing on diseases and on life experiences.
Abildstrøm, Steen Z; Torp-Pedersen, Christian; Madsen, Mette
Introduction: The use of the unique personal identification number in the Nordic database systems enables the researchers to link the registers at the individual level. The registers can be used for both defining specific patient populations and to identify later events during follow-up. This rev...... the hospitalisation rate and treatment of cardiovascular disease. The risk of unmeasured factors affecting the results calls for cautious interpretation of the results.......-up. This review gives three examples within cardiovascular epidemiology to illustrate the use of the national administrative registers available to all researchers upon request. Research topics: The hospitalisation rate of acute myocardial infarction (AMI) was expected to be increased and case-fatality rate......-based treatment increased significantly over time and adherence to treatment was high. Finally, use of specific nonsteroidal antiinflammatory drugs by healthy subjects was associated with a dose-dependent increase in cardiovascular risk. CONCLUSION: The nationwide registers have proven very useful in monitoring...
Jack Homer, PhD
Full Text Available Numerous local interventions for cardiovascular disease are available, but resources to deliver them are limited. Identifying the most effective interventions is challenging because cardiovascular risks develop through causal pathways and gradual accumulations that defy simple calculation. We created a simulation model for evaluating multiple approaches to preventing and managing cardiovascular risks. The model incorporates data from many sources to represent all US adults who have never had a cardiovascular event. It simulates trajectories for the leading direct and indirect risk factors from 1990 to 2040 and evaluates 19 interventions. The main outcomes are first-time cardiovascular events and consequent deaths, as well as total consequence costs, which combine medical expenditures and productivity costs associated with cardiovascular events and risk factors. We used sensitivity analyses to examine the significance of uncertain parameters. A base case scenario shows that population turnover and aging strongly influence the future trajectories of several risk factors. At least 15 of 19 interventions are potentially cost saving and could reduce deaths from first cardiovascular events by approximately 20% and total consequence costs by 26%. Some interventions act quickly to reduce deaths, while others more gradually reduce costs related to risk factors. Although the model is still evolving, the simulated experiments reported here can inform policy and spending decisions.
Cardiovascular risk assessment in type 2 diabetes mellitus: comparison of the World Health Organization/International Society of Hypertension risk prediction charts versus UK Prospective Diabetes Study risk engine
Full Text Available Herath M Meththananda Herath, Thilak Priyantha Weerarathna, Dilini Umesha Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka Introduction: Patients with type 2 diabetes mellitus (T2DM are at higher risk of developing cardiovascular diseases, and assessment of their cardiac risk is important for preventive strategies. Purpose: The Ministry of Health of Sri Lanka has recommended World Health Organization/International Society of Hypertension (WHO/ISH charts for cardiac risk assessment in individuals with T2DM. However, the most suitable cardiac risk assessment tool for Sri Lankans with T2DM has not been studied. This study was designed to evaluate the performance of two cardiac risk assessments tools; WHO/ISH charts and UK Prospective Diabetes Study (UKPDS risk engine. Methods: Cardiac risk assessments were done in 2,432 patients with T2DM attending a diabetes clinic in Southern Sri Lanka using the two risk assessment tools. Validity of two assessment tools was further assessed by their ability to recognize individuals with raised low-density lipoprotein (LDL and raised diastolic blood pressure in a cohort of newly diagnosed T2DM patients (n=332. Results: WHO/ISH charts identified 78.4% of subjects as low cardiac risk whereas the UKPDS risk engine categorized 52.3% as low cardiac risk (P<0.001. In the risk categories of 10%–<20%, the UKPDS risk engine identified higher proportions of patients (28% compared to WHO/ISH charts (7%. Approximately 6% of subjects were classified as low cardiac risk (<10% by WHO/ISH when UKPDS recognized them as cardiac risk of >20%. Agreement between the two tools was poor (κ value =0.144, P<0.01. Approximately 82% of individuals categorized as low cardiac risk by WHO/ISH had higher LDL cholesterol than the therapeutic target of 100 mg/dL. Conclusion: There is a significant discrepancy between the two assessment tools with WHO/ISH risk chart recognizing higher proportions of patients
Full Text Available Abstract Background The purpose of the Finnish Cardiovascular Study (FINCAVAS is to construct a risk profile – using genetic, haemodynamic and electrocardiographic (ECG markers – of individuals at high risk of cardiovascular diseases, events and deaths. Methods and design All patients scheduled for an exercise stress test at Tampere University Hospital and willing to participate have been and will be recruited between October 2001 and December 2007. The final number of participants is estimated to reach 5,000. Technically successful data on exercise tests using a bicycle ergometer have been collected of 2,212 patients (1,400 men and 812 women by the end of 2004. In addition to repeated measurement of heart rate and blood pressure, digital high-resolution ECG at 500 Hz is recorded continuously during the entire exercise test, including the resting and recovery phases. About 20% of the patients are examined with coronary angiography. Genetic variations known or suspected to alter cardiovascular function or pathophysiology are analysed to elucidate the effects and interactions of these candidate genes, exercise and commonly used cardiovascular medications. Discussion FINCAVAS compiles an extensive set of data on patient history, genetic variation, cardiovascular parameters, ECG markers as well as follow-up data on clinical events, hospitalisations and deaths. The data enables the development of new diagnostic and prognostic tools as well as assessments of the importance of existing markers.
Deborah L. Feairheller
Full Text Available Studies report that football players have high blood pressure (BP and increased cardiovascular risk. There are over 70,000 NCAA football players and 450 Division III schools sponsor football programs, yet limited research exists on vascular health of athletes. This study aimed to compare vascular and cardiovascular health measures between football players and nonathlete controls. Twenty-three athletes and 19 nonathletes participated. Vascular health measures included flow-mediated dilation (FMD and carotid artery intima-media thickness (IMT. Cardiovascular measures included clinic and 24 hr BP levels, body composition, VO2 max, and fasting glucose/cholesterol levels. Compared to controls, football players had a worse vascular and cardiovascular profile. Football players had thicker carotid artery IMT (0.49 ± 0.06 mm versus 0.46 ± 0.07 mm and larger brachial artery diameter during FMD (4.3±0.5 mm versus 3.7±0.6 mm, but no difference in percent FMD. Systolic BP was significantly higher in football players at all measurements: resting (128.2±6.4 mmHg versus 122.4±6.8 mmHg, submaximal exercise (150.4±18.8 mmHg versus 137.3±9.5 mmHg, maximal exercise (211.3±25.9 mmHg versus 191.4±19.2 mmHg, and 24-hour BP (124.9±6.3 mmHg versus 109.8±3.7 mmHg. Football players also had higher fasting glucose (91.6±6.5 mg/dL versus 86.6±5.8 mg/dL, lower HDL (36.5±11.2 mg/dL versus 47.1±14.8 mg/dL, and higher body fat percentage (29.2±7.9% versus 23.2±7.0%. Division III collegiate football players remain an understudied population and may be at increased cardiovascular risk.
Hollman, P.C.H.; Cassidy, A.; Comte, B.; Heinonen, M.; Richelle, M.; Richling, E.; Serafini, M.; Scalbert, A.; Sies, H.; Vidry, S.
Human studies provide evidence for beneficial effects of polyphenol-rich foods on cardiovascular health. The antioxidant activity of polyphenols potentially explains these effects, but is the antioxidant activity a reliable predictor for these effects? An International Life Sciences Institute Europe
Full Text Available Background: In 2010, the American Heart Association developed a new definition of ideal cardiovascular health (CVH based on seven cardiovascular health metrics. This study aimed to investigate the relationship between modified ideal CVH metrics and the risk of stroke in the rural population of Northeast China. Methods: We included 11,417 adults from the rural population in Northeast China and collected all the information, including the baseline characteristics, history of stroke, and the seven ideal CVH metrics. Results: Our results showed that the presence of stroke was associated with high body mass index (BMI, poor diet score (salt intake, high total cholesterol (TC, high blood pressure (BP, and high fasting plasma glucose (FPG. The prevalence of stroke increased as the number of ideal CVH metrics decreased, and peaked to 13.1% among those with only one ideal CVH metric. Participants with only one ideal CVH had a 4.40-fold increased susceptibility of stroke than those with all seven ideal health metrics. Conclusion: This study revealed that people with a better CVH status had a lower prevalence of stroke and the susceptibility of stroke increased with the decreasing of the number of ideal CVH metrics.
Golden, Sherita Hill; Ferketich, Amy; Boyington, Josephine; Dugan, Sheila; Garroutte, Eva; Kaufmann, Peter G; Krok, Jessica; Kuo, Alice; Ortega, Alexander N; Purnell, Tanjala; Srinivasan, Shobha
The Centers for Population Health and Health Disparities program promotes multilevel and multifactorial health equity research and the building of research teams that are transdisciplinary. We summarized 5 areas of scientific training for empowering the next generation of health disparities investigators with research methods and skills that are needed to solve disparities and inequalities in cancer and cardiovascular disease. These areas include social epidemiology, multilevel modeling, health care systems or health care delivery, community-based participatory research, and implementation science. We reviewed the acquisition of the skill sets described in the training components; these skill sets will position trainees to become leaders capable of effecting significant change because they provide tools that can be used to address the complexities of issues that promote health disparities. PMID:25905828
Ruiz, John M; Brondolo, Elizabeth
Cardiovascular disease (CVD) is the leading cause of disability and death in the United States, accounting for 31.3% of all deaths in a given year (Mozaffarian et al., 2016). Importantly, risk factors for CVD, the incidence of CVD, and adverse outcomes associated with CVD are not experienced equally by all segments of society. This special issue is an opportunity to highlight contributions of health psychology to the understanding of disparities in cardiovascular health. The 12 papers published here include eight full manuscripts, two brief reports, and two invited commentaries. Sampling in these studies is largely restricted to healthy adults, with one paper focused on early life adversity and subsequent health in adolescents and a second examining social support in adolescence as a predictor of CVD risk in adulthood. These papers offer windows into cuttingedge themes, methodologies, challenges, and future directions in understanding psychosocial factors and sociocultural sequelae as they relate to cardiovascular health disparities. Examined together, the papers begin to elucidate the ways in which the social context drives biopsychological processes that contribute to cardiovascular health disparities. (PsycINFO Database Record PMID:27018721
Woo, Kam S; Kwok, Timothy C Y; Celermajer, David S
Vegetarian diets have been associated with atherosclerosis protection, with healthier atherosclerosis risk profiles, as well as lower prevalence of, and mortality from, ischemic heart disease and stroke. However, there are few data concerning the possible cardiovascular effects of a vegan diet (with no meat, dairy or egg products). Vitamin B-12 deficiency is highly prevalent in vegetarians; this can be partially alleviated by taking dairy/egg products in lact-ovo-vegetarians. However, metabolic vitamin B-12 deficiency is highly prevalent in vegetarians in Australia, Germany, Italy and Austria, and in vegans (80%) in Hong Kong and India, where vegans rarely take vitamin B-12 fortified food or vitamin B-12 supplements. Similar deficiencies exist in northern Chinese rural communities consuming inadequate meat, egg or dairy products due to poverty or dietary habits. Vascular studies have demonstrated impaired arterial endothelial function and increased carotid intima-media thickness as atherosclerosis surrogates in such metabolic vitamin B-12 deficient populations, but not in lactovegetarians in China. Vitamin B-12 supplementation has a favourable impact on these vascular surrogates in Hong Kong vegans and in underprivileged communities in northern rural China. Regular monitoring of vitamin B-12 status is thus potentially beneficial for early detection and treatment of metabolic vitamin B-12 deficiency in vegans, and possibly for prevention of atherosclerosis-related diseases. PMID:25195560
Kam S. Woo
Full Text Available Vegetarian diets have been associated with atherosclerosis protection, with healthier atherosclerosis risk profiles, as well as lower prevalence of, and mortality from, ischemic heart disease and stroke. However, there are few data concerning the possible cardiovascular effects of a vegan diet (with no meat, dairy or egg products. Vitamin B-12 deficiency is highly prevalent in vegetarians; this can be partially alleviated by taking dairy/egg products in lact-ovo-vegetarians. However, metabolic vitamin B-12 deficiency is highly prevalent in vegetarians in Australia, Germany, Italy and Austria, and in vegans (80% in Hong Kong and India, where vegans rarely take vitamin B-12 fortified food or vitamin B-12 supplements. Similar deficiencies exist in northern Chinese rural communities consuming inadequate meat, egg or dairy products due to poverty or dietary habits. Vascular studies have demonstrated impaired arterial endothelial function and increased carotid intima-media thickness as atherosclerosis surrogates in such metabolic vitamin B-12 deficient populations, but not in lactovegetarians in China. Vitamin B-12 supplementation has a favourable impact on these vascular surrogates in Hong Kong vegans and in underprivileged communities in northern rural China. Regular monitoring of vitamin B-12 status is thus potentially beneficial for early detection and treatment of metabolic vitamin B-12 deficiency in vegans, and possibly for prevention of atherosclerosis-related diseases.
Sofi, Francesco; Dinu, Monica; Pagliai, Giuditta; Cesari, Francesca; Marcucci, Rossella; Casini, Alessandro
Background Nutrition is able to alter the cardiovascular health of the general population. However, the optimal dietary strategy for cardiovascular disease prevention is still far from being defined. Mediterranean and vegetarian diets are those reporting the greatest grade of evidence in the literature, but no experimental studies comparing these two dietary patterns are available. Methods/design This is an open randomized crossover clinical trial including healthy subjects with a low-to-medi...
Cardiovascular risk assessment in type 2 diabetes mellitus: comparison of the World Health Organization/International Society of Hypertension risk prediction charts versus UK Prospective Diabetes Study risk engine
Herath, Herath M Meththananda; Weerarathna, Thilak Priyantha; Umesha, Dilini
Introduction Patients with type 2 diabetes mellitus (T2DM) are at higher risk of developing cardiovascular diseases, and assessment of their cardiac risk is important for preventive strategies. Purpose The Ministry of Health of Sri Lanka has recommended World Health Organization/International Society of Hypertension (WHO/ISH) charts for cardiac risk assessment in individuals with T2DM. However, the most suitable cardiac risk assessment tool for Sri Lankans with T2DM has not been studied. This study was designed to evaluate the performance of two cardiac risk assessments tools; WHO/ISH charts and UK Prospective Diabetes Study (UKPDS) risk engine. Methods Cardiac risk assessments were done in 2,432 patients with T2DM attending a diabetes clinic in Southern Sri Lanka using the two risk assessment tools. Validity of two assessment tools was further assessed by their ability to recognize individuals with raised low-density lipoprotein (LDL) and raised diastolic blood pressure in a cohort of newly diagnosed T2DM patients (n=332). Results WHO/ISH charts identified 78.4% of subjects as low cardiac risk whereas the UKPDS risk engine categorized 52.3% as low cardiac risk (P20%. Agreement between the two tools was poor (κ value =0.144, P<0.01). Approximately 82% of individuals categorized as low cardiac risk by WHO/ISH had higher LDL cholesterol than the therapeutic target of 100 mg/dL. Conclusion There is a significant discrepancy between the two assessment tools with WHO/ISH risk chart recognizing higher proportions of patients having low cardiac risk than the UKPDS risk engine. Risk assessment by both assessment tools demonstrated poor sensitivity in identifying those with treatable levels of LDL cholesterol and diastolic blood pressure. PMID:26622181
F. J. Sánchez-Muniz
Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in developed countries. CVD is an inflammatory disease associated with risk factors that include hypercholesterolemia and hypertension. Furthermore, the evolution of this disease depends on the amount of modified lipoproteins (e.g. oxidized) present in the arterial subendothelium. Diet is considered the cornerstone for CVD treatment, as it can lower not only atherogenic lipoprotein levels and degree of oxidation, but...
Wong, AY; Root, A.; Douglas, IJ; Chui, CS; Chan, EW; Ghebremichael-Weldeselassie, Y.; Siu, CW; Smeeth, L; Wong, IC
STUDY QUESTION: What is the association between clarithromycin use and cardiovascular outcomes? METHODS: In this population based study the authors compared cardiovascular outcomes in adults aged 18 or more receiving oral clarithromycin or amoxicillin during 2005-09 in Hong Kong. Based on age within five years, sex, and calendar year at use, each clarithromycin user was matched to one or two amoxicillin users. The cohort analysis included patients who received clarithromycin (n=108 988) or ...
Full Text Available Objective. To assess the blood pressure control and cardiovascular risk factors (CVRFs in a population of hypertensive patients with access to care under a government-financed program, the Cardiovascular Health Program (CHP. Design. A cross-sectional and multicenter study. Setting. 52 primary care centers, metropolitan area of Santiago, Chile. Participants. 1,194 patients were selected by a systematic random sampling from a universe of 316,654 hypertensive patients. Key Measurements. Demographic information, blood pressure (BP measurements, and CVRF were extracted from medical records of patients followed for a 12-month period. Results. 59.7% of patients reached target BP <140/90 mmHg. More women were captured in the sampling (2.1 : 1, achieving better BP control than men. Diabetic patients (26.4% had worse BP control than nondiabetics. Antihypertensive medications were used in 91.5%, with multidrug therapy more frequent in patients with higher BP and more difficult control. Conclusions. The success in improving the BP control to values <140/90 mmHg from 45.3% to 59.7% underscores the contribution of this program in the Chilean primary care cardiovascular preventive strategies. However, fewer hypertensive men than women were captured by this program, and it is of concern the underperforming of BP control observed in diabetics.
Sassen, Barbara; Kok, Gerjo; Mesters, Ilse; Crutzen, Rik; Cremers, Anita; Vanhees, Luc
Background Patients with cardiovascular risk factors can reduce their risk of cardiovascular disease by increasing their physical activity and their physical fitness. According to the guidelines for cardiovascular risk management, health professionals should encourage their patients to engage in physical activity. Objective In this paper, we provide insight regarding the systematic development of a Web-based intervention for both health professionals and patients with cardiovascular risk fact...
Personality is an important epidemiological factor for understanding health outcomes. This study investigated the associations of trait procrastination with hypertension and cardiovascular disease (HT/CVD) and maladaptive coping by testing an extension of the procrastination–health model among individuals with and without HT/CVD. Individuals with self-reported HT/CVD (N = 182) and healthy controls (N = 564), from a community sample, completed an online survey including measures of personality...
Mirajkar, Amrit M.; Shailaja Moodithaya; Harsha Halahalli; Nikhil Narayanaswamy
Cardiovascular diseases are important causes of morbidity and mortality in postmenopausal women. A major determinant of cardiovascular health is the status of autonomic nervous system and assessment of Heart Rate Variability (HRV). Heart Rate Variability is a noninvasive and sensitive technique to evaluate cardiovascular autonomic control. Reduced HRV is an independent risk factor for the development of heart disease. This study evaluated the risk factors for cardiovascular diseases using HRV...
U.S. Department of Health & Human Services — 2001 to 2014. The National Health Interview Survey (NHIS) has monitored the health of the nation since 1957. NHIS data on a broad range of health topics are...
Coppieters, Y; Béduwé, C; Collignon, J L; Hubens, V; Levêque, A
Cardiovascular diseases remain the first cause of mortality in Belgium and are a priority for the Five-year program of health promotion in the French speaking Community. It is declined in operational programs by priority thematics, including the heart health. With this framework, it appeared necessary to operationalize cardiovascular priorities. A process of systemic and participative planning was set up in order to seek operational strategies and actions, and to cover the whole population and actors concerned with these health problems. The various cardiovascular risk factors, which potentiate one another, are approached together and in a global way. Upstream to the risk factors, social health determinants play an important role in cardiovascular diseases and others diseases like cancers. Tracking cardiovascular risk factors among people 30 to 75 years is also proposed. It makes it possible to identify people at risk and to put forward individual and adapted measures. The plan integrates actions of health promotion (acting on the health determinants and factors which influence them) as well as actions aiming at improving tracking and the accompaniment of the patients in secondary and tertiary prevention. Actions on health determinants and the factors influencing them present moreover the advantage of being often common to many chronic diseases. PMID:20687443
[Purpose] The purpose of this study was to investigate health conditions and HRQoL (health-related quality of life) of community-dwelling populations with cancer, stroke, and CVD (cardiovascular disease) based on standardized data. [Subjects] The study subjects numbered 422 in total: 179 patients had cancer, 128 were stroke patients, and 115 were CVD patients. [Methods] This study used data collected during health interviews carried out as part of the sixth Korean National Health and Nutrition Examination Survey. Face-to-face health interviews were conducted by trained surveyors who visited households during 2013. The contents of the interviews included data on demographic factors, physical condition, psychological condition, and HRQoL. [Results] Stress perceptions related to health condition differed significantly across the populations of cancer, stroke, and CVD patients. The HRQoL items of mobility, self-care, usual activities, and anxiety/depression also differed significantly across these populations. [Conclusion] Healthcare teams will now be in a position to plan programs for improvement in these areas according to the features of each disease. PMID:26355816
Murphy, Marie; Nevill, Alan; Neville, Charlotte; Biddle, Stuart; Hardman, Adrianne
Compared the effects of different patterns of regular brisk walking on fitness, cardiovascular disease risk factors, and psychological well-being in previously sedentary adults. Data on adults who completed either short-bout or long-bout walking programs found that three short bouts of brisk walking accumulated throughout the day were as effective…
M. Gómez-Juaristi; L. González-Torres; L. Bravo; M. P. Vaquero; Bastida, S.; Sánchez-Muniz, F. J.
Desde la antigüedad se ha atribuido al chocolate propiedades saludables que lo han aproximado más hacia un uso terapéutico que alimentario. El presente trabajo revisa algunos estudios relevantes de los efectos del chocolate (y sus componentes activos) sobre diferentes factores de riesgo cardiovascular y señala la necesidad de futuros estudios. El consumo de cacao/chocolate (i) incrementa la actividad antioxidante, (ii) modula la función plaquetaria e inflamación y (iii) disminuye la presión a...
Full Text Available Abstract Background In Sub Saharan Africa, the incidence of hypertension and other modifiable cardiovascular risk factors is growing rapidly. Poor adherence to prescribed prevention and treatment regimens by patients can compromise treatment outcomes. Patient-centered cardiovascular health education is likely to improve shortcomings in adherence. This paper describes a study that aims to develop a cardiovascular health education program for patients participating in a subsidized insurance plan in Nigeria and to evaluate the applicability and effectiveness in patients at increased risk for cardiovascular disease. Methods/Design Design: The study has two parts. Part 1 will develop a cardiovascular health education program, using qualitative interviews with stakeholders. Part 2 will evaluate the effectiveness of the program in patients, using a prospective (pre-post observational design. Setting: A rural primary health center in Kwara State, Nigeria. Population: For part 1: 40 patients, 10 healthcare professionals, and 5 insurance managers. For part 2: 150 patients with uncontrolled hypertension or other cardiovascular risk factors after one year of treatment. Intervention: Part 2: patient-centered cardiovascular health education program. Measurements: Part 1: Semi-structured interviews to identify stakeholder perspectives. Part 2: Pre- and post-intervention assessments including patients' demographic and socioeconomic data, blood pressure, body mass index and self-reporting measures on medication adherence and perception of care. Feasibility of the intervention will be measured using process data. Outcomes: For program development (part 1: overview of healthcare professionals' perceptions on barriers and facilitators to care, protocol for patient education, and protocol implementation plan. For program evaluation (part 2: changes in patients' scores on adherence to medication and life style changes, blood pressure, and other physiological and self
Bernstein, Adam M; Titgemeier, Brigid; Kirkpatrick, Kristin; Golubic, Mladen; Roizen, Michael F
Numerous studies reveal the cardiovascular benefits of consuming dietary fiber and, especially, cereal fiber. Cereal fiber is associated with cardiovascular risk reduction through multiple mechanisms and consuming a variety of cereal fiber sources offers health benefits specific to the source. Certain cereal fibers have been studied more extensively than others and provide greater support for their incorporation into a healthful diet. β-glucan from oats or barley, or a combination of whole oats and barley, and soluble fiber from psyllium reduces the risk of coronary heart disease; inulin-type fructans added to foods and beverages may modestly decrease serum triacylglycerols; arabinoxylan and resistant starch may improve glycemic control. Individuals with low cereal fiber intake should increase their intake of whole grains in order to receive the benefits of whole grains in addition to fiber. For those adjusting to the texture and palatability of whole grains, turning to added-fiber products rich in β-glucan and psyllium may allow them to reach their fiber goals without increasing caloric intake. PMID:23628720
Michael F. Roizen
Full Text Available Numerous studies reveal the cardiovascular benefits of consuming dietary fiber and, especially, cereal fiber. Cereal fiber is associated with cardiovascular risk reduction through multiple mechanisms and consuming a variety of cereal fiber sources offers health benefits specific to the source. Certain cereal fibers have been studied more extensively than others and provide greater support for their incorporation into a healthful diet. β-glucan from oats or barley, or a combination of whole oats and barley, and soluble fiber from psyllium reduces the risk of coronary heart disease; inulin-type fructans added to foods and beverages may modestly decrease serum triacylglycerols; arabinoxylan and resistant starch may improve glycemic control. Individuals with low cereal fiber intake should increase their intake of whole grains in order to receive the benefits of whole grains in addition to fiber. For those adjusting to the texture and palatability of whole grains, turning to added-fiber products rich in β-glucan and psyllium may allow them to reach their fiber goals without increasing caloric intake.
Brenda W. Campbell Jenkins
Full Text Available The Jackson Heart Study (JHS is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC has initiated the Daniel Hale Williams Scholar (DHWS program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1 an enrichment curriculum; (2 a learning community; (3 quarterly seminars; and (4 a Summer Institute. Students attend enrichment activities comprising: (1 Applied Biostatistics; (2 Cardiovascular Disease Epidemiology; (3 Social Epidemiology; (4 Emerging Topics; and (5 Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs.
Campbell Jenkins, Brenda W; Addison, Clifton; Wilson, Gregory; Young, Lavon; Fields, Regina; Woodberry, Clevette; Payton, Marinelle
The Jackson Heart Study (JHS) is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC) has initiated the Daniel Hale Williams Scholar (DHWS) program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1) an enrichment curriculum; (2) a learning community; (3) quarterly seminars; and (4) a Summer Institute. Students attend enrichment activities comprising: (1) Applied Biostatistics; (2) Cardiovascular Disease Epidemiology; (3) Social Epidemiology; (4) Emerging Topics; and (5) Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs. PMID:26703701
Full Text Available Objective: The present study was designed to evaluate the physiological responses to noninvasive cardiovascular autonomic function tests in normal pregnancy and compare them with non- pregnant controls. Materials and Methods: The study population comprised of 90 apparently healthy, pregnant women divided equally into three groups based on their period of gestation and 30 otherwise healthy, non-pregnant women as controls. The standard autonomic function tests based on cardiovascular reflexes, including heart rate response tests and blood pressure response tests were performed. Result: It was observed that variability of mean between and within all the population groups and controls was significantly different. Multiple comparison analysis revealed a significantly lower Deep Breathing Difference in pregnant subjects, significant difference in Valsalva Ratio in third trimester group, a significantly lower Postural Tachycardia Index only during last trimester and a significantly higher fall in systolic blood pressure on standing only during 1st trimester. A significantly lower alteration in diastolic blood pressure during isometric handgrip in later trimesters and a significant increase in overall cardiovascular autonomic score between and within all groups were also observed. Conclusion: The observations serve to corroborate that the cardiovascular indices in pregnant women are significantly altered in comparison to non-pregnant women, thus highlighting the importance of cardiovascular monitoring during pregnancy. The study also helped to reaffirm the efficacy of simple cardiovascular reflex tests in research on pregnancy physiology.
Dieplinger, Benjamin; Egger, Margot; Haltmayer, Meinhard; Kleber, Marcus E.; Scharnagl, Hubert; Silbernagel, Guenther; de Boer, Rudolf A.; Maerz, Winfried; Mueller, Thomas
BACKGROUND: Soluble suppression of tumorigenicity 2 (sST2) has emerged as a strong prognostic biomarker in patients with heart failure and myocardial infarction. The aim of this study was to evaluate the longterm prognostic value of sST2 in patients with stable coronary artery disease (CAD). METHODS
Full Text Available Cardiovascular disease is the largest killer of women internationally and women often suffer inferior outcomes following an acute cardiac event as compared to men. A gendered approach to investigating cardiovascular disease in women incorporates the unique social, cultural, and economic circumstances that being a woman brings to the health encounter. The multiple roles enacted by many women may be important factors in this health discrepancy. In order to more fully understand the impact of the roles of women on health, a questionnaire was administered to participants of the Heart Awareness for Women group cardiac rehabilitation program which assessed women's role perceptions followed by discussions. We found that caregiving can be both positive and negative. It gives a sense of purpose, meaning, and community connection as well as burden and conflict. Emphasis must be placed on promoting strategies in women to achieve a balance between caregiving responsibilities and prioritisation of cardiovascular health.
6th grade) on health related outcomes in children. The objectives are: 1.To describe the Svendborg Project and the CHAMPS study-DK (paper I). 2.To evaluate the effect of four extra PE lessons per week in primary schools on body composition and weight status in children aged 8 to 13 (paper II). 3.To......Background In 2011 the World Health Organization (WHO) estimated that more than 40 million children under the age of five were overweight and ten per cent of the world’s school aged children are estimated to carry excess body fat. Childhood obesity is associated with a number of immediate...... Intervention had beneficial, but non significant effect on mean BMI or mean Total Body Fat percentage (TBF%), but a significant beneficial effect on overweight and obesity prevalence, as children at intervention schools had a significant reduced risk of becoming overweight or obese after 2 school years...
Cornell, C. E.; Littleton, M. A.; Greene, P. G.; Pulley, L.; Brownstein, J. N.; Sanderson, B. K.; Stalker, V. G.; Matson-Koffman, D.; Struempler, B.; Raczynski, J. M.
The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and…
Mohr, Magni; Nordsborg, Nikolai Baastrup; Lindenskov, Annika;
To test the hypothesis that high-intensity swim training improves cardiovascular health status in sedentary premenopausal women with mild hypertension, sixty-two women were randomized into high-intensity (n = 21; HIT), moderate-intensity (n = 21; MOD), and control groups (n = 20; CON). HIT...... health and physical performance...
Masters, Kevin S.; Hooker, Stephanie A.
Objective: Recently, behavioral scientists have developed greater interest in understanding the relations between religiousness and spirituality (R/S) and health. Our objectives were to (a) provide an overview of the R/S and health literature specific to cardiovascular disease (CVD) and cancer, (b) discuss the importance of religious culture…
Murphy, Megan N.; Mizuno, Masaki; Mitchell, Jere H.; Smith, Scott A
Heart rate and blood pressure are elevated at the onset and throughout the duration of dynamic or static exercise. These neurally mediated cardiovascular adjustments to physical activity are regulated, in part, by a peripheral reflex originating in contracting skeletal muscle termed the exercise pressor reflex. Mechanically sensitive and metabolically sensitive receptors activating the exercise pressor reflex are located on the unencapsulated nerve terminals of group III and group IV afferent...
Kam S. Woo; Timothy C.Y. Kwok; Celermajer, David S
Vegetarian diets have been associated with atherosclerosis protection, with healthier atherosclerosis risk profiles, as well as lower prevalence of, and mortality from, ischemic heart disease and stroke. However, there are few data concerning the possible cardiovascular effects of a vegan diet (with no meat, dairy or egg products). Vitamin B-12 deficiency is highly prevalent in vegetarians; this can be partially alleviated by taking dairy/egg products in lact-ovo-vegetarians. However, metabo...
Elevated cardiovascular risk among adults with obstructive and restrictive airway functioning in the United States: a cross-sectional study of the National Health and Nutrition Examination Survey from 2007–2010
Ford Earl S
Full Text Available Abstract Background Reasons for the excess risk for cardiovascular disease among people with chronic obstructive pulmonary disease remain unclear. Our objective was to examine the cardiovascular risk profile for adults with obstructive and restrictive impairments of lung functioning in a representative sample of adults from the United States. Methods We used data from adults aged 20–79 years who participated in the National Health and Nutrition Examination Survey from 2007 to 2010 and had a pulmonary function test. The severity of obstructive impairment was defined by adapting the Global Initiative for Chronic Obstructive Lung Disease criteria. Results Among 7249 participants, 80.9% had a normal pulmonary function test, 5.7% had a restrictive impairment, 7.9% had mild obstructive impairment, and 5.5% had moderate or severe/very severe obstructive impairment. Participants with obstructive impairment had high rates of smoking and increased serum concentrations of cotinine. Compared to participants with normal pulmonary functioning, participants with at least moderate obstructive impairment had elevated concentrations of C-reactive protein but lower concentrations of total cholesterol and non-high-density lipoprotein cholesterol. Among participants aged 50–74 years, participants with at least a moderate obstructive impairment or a restrictive impairment had an elevated predicted 10-year risk for cardiovascular disease. Conclusions The high rates of smoking among adults with impaired pulmonary functioning, particularly those with obstructive impairment, point to a need for aggressive efforts to promote smoking cessation in these adults. In addition, adults with restrictive impairment may require increased attention to and fine-tuning of their cardiovascular risk profile.
Purpose: To quantitatively measure cardiovascular diameters and function parameters by using electron beam computed tomography, EBCT. Methods: Men 50 health Chinese people accepted EBCT common transverse and short-axis enhanced movie scan (27 men, 23 women, average age 47.7 years.). The transverse scan was used to measure the diameters of the ascending aorta, descending aorta, pulmonary artery and left atrium. The movie study was used to measure the left ventricular myocardium thickness and analysis global, sectional and segmental function of the right and left ventricles. Results: The cardiovascular diameters and cardiac functional parameters were calculated. The diameters and most functional parameters (end syspoble volume, syspole volume, ejection fraction, cardiac-output, cardiac index) of normal Chinese men were greater than those of women (P>0.05). However, the EDV and MyM(myocardium mass) of both ventricles were significant (p<0.01). Conclusion: EBCT is a minimally invasive method for cardiovascular measurement and cardiac function evaluation
Baktash Bayani MD
Full Text Available Objective: Cardiac diseases are psycho-somatic disorders, and psychological aspects play an essential role in their initiation and exacerbation. The aim of this study was to gain appropriate knowledge in the epidemiology of co-morbid depression and anxiety disorder in cardiovascular outpatients.Method: This study is descriptive with a sample of patients attending a cardio-vascular clinic. 238 individuals were included in this study using a consecutive sampling method. The study instrument was Hospital Anxiety and Depression Scale (HADS questionnaire, which is a clinical scale for assessing anxiety and depression.Results: Of the 238 participants in this study, 93(38.7% were male and 146 (61.3% female. 28.5% of patients suffered from anxiety disorders , and 41.9% had depression. Regarding comorbid diseases such as diabetes mellitus, hyperlipidemia and hypertension, the severity of depression was just related to hypertension. There was a meaningful relationship between gender and symptoms of anxiety so that symptoms were more severe in women. Conclusion: Considering the high prevalence of depression and anxiety in patients suffering from cardio-vascular diseases, it is necessary to screen psychological disorders in patients with cardio-vascular diseases and improve their cardio-vascular health and quality of life as mush as possible.
Baker, Robert A
Studies of exercise and cardiovascular mortality were reviewed to determine whether leisure-time or work activity affects mortality. Twenty-one prospective cohort and 12 rehabilitation case-control studies were reviewed based on epidemiological criteria. Most studies suffered from design deficits.
Javaid, Abdul Qadir; Ashouri, Hazar; Tridandapani, Srini; Inan, Omer T
The ballistocardiogram (BCG), a signal describing the reaction forces of the body to cardiac ejection of blood, has recently gained interest in the research community as a potential tool for monitoring the mechanical aspects of cardiovascular health for patients at home and during normal activities of daily living. An important limitation in the field of BCG research is that while the BCG signal measures the forces of the body, the information desired (and understood) by clinicians and caregivers, regarding mechanical health of the cardiovascular system, is typically expressed as blood pressure or flow. This paper aims to explore, using system identification tools, the mathematical relationship between the BCG signal and the better-understood impedance cardiography (ICG) and arterial blood pressure (ABP) waveforms, with a series of human subject studies designed to asynchronously modulate cardiac output and blood pressure and with different magnitudes. With this approach, we demonstrate for 19 healthy subjects that the BCG waveform more closely maps to the ICG (flow) waveform as compared with the finger-cuff-based ABP (pressure) waveform, and that the BCG can provide a more accurate estimate of stroke volume ([Formula: see text], [Formula: see text]) as compared with pulse pressure changes ([Formula: see text]). We also examined, as a feasibility study, for one subject, the ability to calibrate the BCG measurement tool with an ICG measurement on the first day, and then track changes in stroke volume on subsequent days. Accordingly, we conclude that the BCG is a signal more closely related to blood flow than pressures, and that a key health parameter for titrating care-stroke volume-can potentially be accurately measured with BCG signals at home using unobtrusive and inexpensive hardware, such as a modified weighing scale, as compared with the state-of-the-art ICG and ABP devices, which are expensive and obtrusive for use at home. PMID:27620621
Although it is generally agreed upon that a physically active lifestyle and regular exercise are good for heart health, it is much less appreciated by the public that the prolonged hours of sedentary time resulting from sitting at work or screen time are also risk factors for cardiovascular outcomes and other cardiometabolic diseases. In this short narrative review, evidence is discussed and prudent recommendations are made in the context of the sedentary, affluent lifestyle that characterizes a large proportion of our population. It has become overwhelmingly clear that a sedentary lifestyle is a powerful risk factor for cardiovascular and other chronic diseases. In addition, vigorous physical activity and exercise is also associated with metabolic and cardiovascular adaptations that are compatible with cardiovascular health. In that regard, cardiorespiratory fitness, a reliable metric to assess the ability of the cardiovascular system to sustain prolonged physical work, has been shown to be the most powerful predictor of mortality and morbidity, way beyond classical cardiovascular disease (CVD) risk factors such as smoking, cholesterol, hypertension, and diabetes. On the basis of the evidence available, it is proposed that both dimensions of overall physical activity level (reducing sedentary time and performing regular physical activity or endurance type exercise) should be targeted to reduce CVD risk. Finally, because of the robust evidence that poor cardiorespiratory fitness is an independent risk factor for CVD and related mortality, it is proposed that this simple physiological metric should be incorporated as a vital sign in CVD risk factor evaluation and management. PMID:26907579
Public Health Agency
The PHA, supported by the Institute of Public Health in Ireland (IPH) and other agencies and individuals, has completed a health impact assessment (HIA) on the Cardiovascular Service Framework (CVSFW) for Northern Ireland.The CVSFW is the first in a series of service frameworks developed in Northern Ireland to guide HSC provision from prevention and health improvement over early intervention in communities and general practice into hospital and other institutional settings towards rehabilitat...
Liebert, MA; Snodgrass, JJ; Madimenos, FC; Cepon, TJ; Blackwell, AD; Sugiyama, LS
Background: Market integration (MI), the suite of social and cultural changes that occur with economic development, has been associated with negative health outcomes such as cardiovascular disease; however, key questions remain about how this transition manifests at the local level. Aim: The present paper investigates the effects of MI on health among Shuar, an indigenous lowland Ecuadorian population, with the goal of better understanding the mechanisms responsible for this health transition...
Objective To evaluate the feasibility of utilizing vascular cells combined with folded and framed culture model to develop completely autologous human tissue without using any scaffold material under the principles of Tissue Engineering. Methods Human vascular cells cultured from ascending aorta (group A) and saphenous vein (group B) were seeded into 15cm-dishes (each n =12 ) and cultured to form cell sheets over a period of four weeks with Dulbecco's modified Eagle's medium supplemented with lmmol/L L-ascorbic acid 2-phosphate. Thereafter, cell sheets (6 samples of each group) were four-layer folded and cultured in a newly developed frame device for additional four weeks. Controls remained under standard culture conditions. Tissue development was evaluated by light and electron microscopy, biochemical assays. Results The formation of multi-layered cell sheets and production of extracellular matrix were observed in each group after the initial four weeks. Analysis of the folded and framed neo-tissue revealed a solid structure with increased matrix formation and tissue organization compared to the control groups after additional four weeks. DNA assay indicated significantly lower cell proliferation in folded and framed cell sheets than in that of unframed counterparts. Yet hydroxyproline assay demonstrated significant increase of collagen content in the framed aortic and venous derived tissues, which contained 82 % and 42 % that of human pericardium. Conclusion It is feasible to obtain completely autologous human cardiovascular tissue with the alternative new approach. Numerous issues including improvement of mechanical strength of neo-tissue remain to be investingated.
Full Text Available Abstract Background Cardiovascular diseases (CVD are a leading contributor to the burden of disease in low- and middle-income countries. Guidelines for CVD prevention care in low resource settings have been developed but little information is available on strategies to implement this care. A community health insurance program might be used to improve patients' access to care. The operational research project "QUality Improvement Cardiovascular care Kwara - I (QUICK-I" aims to assess the feasibility of CVD prevention care in rural Nigeria, according to international guidelines, in the context of a community based health insurance scheme. Methods/Design Design: prospective observational hospital based cohort study. Setting: a primary health care centre in rural Nigeria. Study population: 300 patients at risk for development of CVD (patients with hypertension, diabetes, renal disease or established CVD who are enrolled in the Hygeia Community Health Plan. Measurements: demographic and socio- economic data, physical and laboratory examination, CVD risk profile including screening for target organ damage. Measurements will be done at 3 month intervals during 1 year. Direct and indirect costs of CVD prevention care will be estimated. Outcomes: 1 The adjusted cardiovascular quality of care indicator scores based on the "United Kingdom National Health Services Quality and Outcome Framework". 2 The average costs of CVD prevention and treatment per patient per year for patients, the clinic and the insurance company. 3 The estimated net health care costs of standard CVD prevention care per quality-adjusted life year gained. Analysis: The primary outcomes, the score on CVD quality indicators and cost data will be descriptive. The quality scores and cost data will be used to describe the feasibility of CVD prevention care according to international guidelines. A cost-effectiveness analysis will be done using a Markov model. Discussion Results of QUICK-I can
Full Text Available Abstract Background Cardiovascular disease is the cause of death in 32% of women in the Netherlands. Prediction of an individual's risk for cardiovascular disease is difficult, in particular in younger women due to low sensitive and specific tests for these women. 10% to 15% of all pregnancies are complicated by hypertensive disorders, the vast majority of which develop only after 36 weeks of gestation. Preeclampsia and cardiovascular disease in later life show both features of "the metabolic syndrome" and atherosclerosis. Hypertensive disorders in pregnancy and cardiovascular disease may develop by common pathophysiologic pathways initiated by similar vascular risk factors. Vascular damage occurring during preeclampsia or gestational hypertension may contribute to the development of future cardiovascular disease, or is already present before pregnancy. At present clinicians do not systematically aim at the possible cardiovascular consequences in later life after a hypertensive pregnancy disorder at term. However, screening for risk factors after preeclampsia or gestational hypertension at term may give insight into an individual's cardiovascular risk profile. Methods/Design Women with a history of preeclampsia or gestational hypertension will be invited to participate in a cohort study 2 1/2 years after delivery. Participants will be screened for established modifiable cardiovascular risk indicators. The primary outcome is the 10-year cardiovascular event risk. Secondary outcomes include differences in cardiovascular parameters, SNP's in glucose metabolism, and neonatal outcome. Discussion This study will provide evidence on the potential health gains of a modifiable cardiovascular risk factor screening program for women whose pregnancy was complicated by hypertension or preeclampsia. The calculation of individual 10-year cardiovascular event risks will allow identification of those women who will benefit from primary prevention by tailored
O'Keefe, James H; Bhatti, Salman K; Bajwa, Ata; DiNicolantonio, James J; Lavie, Carl J
Habitual light to moderate alcohol intake (up to 1 drink per day for women and 1 or 2 drinks per day for men) is associated with decreased risks for total mortality, coronary artery disease, diabetes mellitus, congestive heart failure, and stroke. However, higher levels of alcohol consumption are associated with increased cardiovascular risk. Indeed, behind only smoking and obesity, excessive alcohol consumption is the third leading cause of premature death in the United States. Heavy alcohol use (1) is one of the most common causes of reversible hypertension, (2) accounts for about one-third of all cases of nonischemic dilated cardiomyopathy, (3) is a frequent cause of atrial fibrillation, and (4) markedly increases risks of stroke-both ischemic and hemorrhagic. The risk-to-benefit ratio of drinking appears higher in younger individuals, who also have higher rates of excessive or binge drinking and more frequently have adverse consequences of acute intoxication (for example, accidents, violence, and social strife). In fact, among males aged 15 to 59 years, alcohol abuse is the leading risk factor for premature death. Of the various drinking patterns, daily low- to moderate-dose alcohol intake, ideally red wine before or during the evening meal, is associated with the strongest reduction in adverse cardiovascular outcomes. Health care professionals should not recommend alcohol to nondrinkers because of the paucity of randomized outcome data and the potential for problem drinking even among individuals at apparently low risk. The findings in this review were based on a literature search of PubMed for the 15-year period 1997 through 2012 using the search terms alcohol, ethanol, cardiovascular disease, coronary artery disease, heart failure, hypertension, stroke, and mortality. Studies were considered if they were deemed to be of high quality, objective, and methodologically sound. PMID:24582196
Jackson, Chandra L.; Redline, Susan; Emmons, Karen M.
Optimal sleep is integral to health but is commonly not obtained. Despite its wide ranging public health impact, sleep health is under-appreciated by the general public and is only rarely considered by policy makers, employers, schools, and others whose policies and structures can adversely affect sleep. Inadequate sleep duration and quality are prevalent in minority and low-income populations and may play a fundamental role in racial and socioeconomic status (SES) inequities for a wide range...
Mommersteeg, Paula M C; Denollet, Johan; Spertus, John A;
Patient-perceived health status is receiving increased recognition as a patient-centered outcome in chronic heart failure (CHF) and coronary artery disease (CAD), but poor health status is also associated with adverse prognosis. In this systematic review, we examined current evidence on the influ......Patient-perceived health status is receiving increased recognition as a patient-centered outcome in chronic heart failure (CHF) and coronary artery disease (CAD), but poor health status is also associated with adverse prognosis. In this systematic review, we examined current evidence...
Full Text Available "nBackground: Disability Weights (DWs are main components for computing summary measure of population health (SMPH and economic studies. They are specific for each community, but there are no previous studies in Iran. In this study, we investigated the feasibility of health state valuation (HSV in Iranian population."nMethods: Twelve cardiologists in 3 sessions of expert panels, defined 25 states, related to cardiovascular diseases (3 major and 22 specific diseases. From January to March 2008, 80 persons in 4 groups including: physicians, patients, patients' families and general publics (each group 20, were interviewed and valuated the states, using visual analogue scale (VAS method. SPSS® 15 for window® (SPSS Corporation, Chicago, Illinois was used for statistical analysis."nResults: Data showed that the defined health states had various severities. All the 4 groups ranked the "3 major-diseases" and "very-mild" and "very-severe" states, similarly. Non-physicians were not able to differentiate among "valvular-diseases" and "pacemakers" properly. The reliability of responses was acceptable."nConclusion: VAS is an appropriate and reliable method for HSV in Iranian population. Non-physicians' opinions can be consider in major cardiac diseases. Valuation of more specific situations must perform by physicians.
Clennin, Morgan N.; Payne, Jonathan P.W.; Rienzi, Edgardo G.; Lavie, Carl J.; Blair, Steven N.; Pate, Russell R.; Sui, Xuemei
To date, few studies have examined the relationship between cardiorespiratory fitness (CRF) and health-related quality of life (HRQoL) in populations at high risk for developing cardiovascular disease (CVD). Purpose To examine the association between objectively measured CRF and physical and mental components of HRQoL in a Uruguayan cohort at risk for developing CVD. Methods Patient data records from 2002–2012 at the Calidad de Vida Center were examined. To assess CRF, participants performed ...
Schmiegelow, Michelle D; Hedlin, Haley; Mackey, Rachel H;
BACKGROUND: It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups. METHODS AND RESULTS: We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting...... serum lipids and serum glucose and no history of cardiovascular disease or diabetes at baseline. We categorized women by body mass index (in kg/m(2)) as normal weight (body mass index 18.5 to <25), overweight (body mass index 25 to <30), or obese (body mass index ≥30) and by metabolic health, defined......, overweight women had similar risk to normal weight women (HR 0.92, interaction P=0.05). Obese black women without metabolic syndrome had higher adjusted risk (HR 1.95) than obese white women (HR 1.07; interaction P=0.02). Among women with only 2 metabolic abnormalities, cardiovascular risk was increased in...
Randers, Morten Bredsgaard; Petersen, Jesper; Andersen, Lars Juel;
This study examined the effect of 12 weeks of small-sided street soccer (2.2 ± 0.7 sessions/week) and fitness center training (0.5 ± 0.2 sessions/week) on physical fitness and cardiovascular health profile for homeless men. Exercise capacity, maximal oxygen uptake (VO(2max)), body composition (DXA...... daily-life activities. During a 60 min 4 versus 4 street soccer session 182 ± 62 intense running bouts were performed; mean HR was 82 ± 4% HR(max) and HR was >90% HR(max) for 21 ± 12% (±SD) of total time. On a day without training the participants performed 10,733 ± 4,341 steps and HR was >80% HR...
Mohr, Magni; Lindenskov, A; Holm, P M;
The present study examined the effects of short-term recreational football training on blood pressure (BP), fat mass, and fitness in sedentary, 35-50-year-old premenopausal women with mild hypertension. Forty-one untrained, hypertensive women were randomized into a football training group (n = 21......; FTG) and a control group (n = 20; CON). FTG performed 45 ± 1 1-h small-sided football training sessions during the 15-week intervention period. BP, body composition (dual-energy x-ray absorptiometry), blood lipid profile, and fitness level were determined pre- and post-intervention. After 15 weeks...... period. In conclusion, short-term football training resulted in a marked reduction in BP and induced multiple improvements in fitness and cardiovascular health profile of untrained, premenopausal women with mild hypertension....
Luiz Mário Baptista Martinelli
Full Text Available OBJECTIVE: To evaluate quality of life in a population that attended a specific community event on health care education, and to investigate the association of their quality of life with the presence of cardiovascular risk factors INTRODUCTION: Interest in health-related quality of life is growing worldwide as a consequence of increasing rates of chronic disease. However, little is known about the association between quality of life and cardiovascular risk factors. METHODS: This study included 332 individuals. Demographics, blood pressure, body mass index, and casual glycemia were evaluated. The brief version of the World Health Organization Quality of Life questionnaire on quality of life was given to them. The medians of the scores obtained for the physical, psychological, emotional, and environmental domains were used as cutoffs to define "higher" and "lower" scores. A multinomial logistic regression model was used to define the parameters associated with lower scores. RESULTS: Diabetes mellitus, dyslipidemia, and obesity were associated with lower scores in the physical domain. Dyslipidemia was also associeted with lower scores in the psychological domain. Male gender and regular physical activity had protective effects on quality of life. Aging was inversely associated with decreased quality of life in the environmental domain. CONCLUSION: The presence of cardiovascular risk factors is related to a decreased quality of life. Conversely, male gender and regular physical activity had protective effects on quality of life. These findings suggest that exercising should be further promoted by health-related public programs, with a special focus on women.
Holman, E Alison
Cardiovascular disorders (CVD) are associated with acute and posttraumatic stress responses, yet biological processes underlying this association are poorly understood. This study examined whether renin-angiotensin-aldosterone system activity, as indicated by a functional single nucleotide polymorphism (SNP) in the angiotensin converting enzyme (ACE) gene, is associated with both CVD and acute stress related to the September 11, 2001 (9/11) terrorist attacks. European-American respondents (N = 527) from a nationally representative longitudinal study of coping following 9/11 provided saliva for genotyping. Respondents had completed health surveys before 9/11 and annually for 3 years after, and acute stress assessments 9 to 23 days after 9/11. Respondents with rs4291 AA or TT genotypes reported high acute stress twice as often as those with the AT genotype. Individuals with the TT genotype were 43% more likely to report increased physician-diagnosed CVD over 3 years following 9/11, when the following variables were included in the model: (a) pre-9/11 CVD, mental health, and non-CVD ailments; (b) cardiac risk factors; (c) ongoing endocrine disorders; and (d) significant demographics. The ACE rs4291 TT genotype, which has been associated with HPA axis hyperactivity and higher levels of serum angiotensin converting enzyme (ACE), predicted acute stress response and reports of physician-diagnosed CVD in a national sample following collective stress. ACE gene function may be associated with both mental and physical health disorders following collective stress. PMID:23055331
Schneider, Sven; Diehl, Katharina; Bock, Christina; Herr, Raphael M; Mayer, Manfred; Görig, Tatiana
Cardiovascular diseases (CVD) are a major public health concern as they are the leading cause of death in developed countries. Primary care is considered to be the ideal setting for CVD prevention. Therefore, more than 4,000 German primary care physicians (PCPs) were asked about their attitudes towards and their activities regarding the prevention of CVD in the nationwide ÄSP-kardio Study. The focus of the study was on health behavior modification. Two thirds of the participating PCPs stated that they routinely provided brief inventions to assist patients in reducing both their tobacco (72%) and alcohol (61%) consumption, to encourage them to increase their levels of physical activity (72%), and to assist them in adjusting to a more healthy diet (66%), and in achieving a healthy body weight (69%). However, only between 23% (quitting smoking) and 49% (diet modification) of PCPs felt that they had been successful in helping patients modify their lifestyles. Insufficient reimbursement, cultural diversity and a lack of time were reported to be the most problematic barriers to successful intervention in the primary care setting. Despite these obstacles, the majority of German PCPs was engaged in prevention and health behavior intervention to reduce the incidence and progression of CVD. PMID:24739770
Full Text Available Cardiovascular diseases (CVD are a major public health concern as they are the leading cause of death in developed countries. Primary care is considered to be the ideal setting for CVD prevention. Therefore, more than 4,000 German primary care physicians (PCPs were asked about their attitudes towards and their activities regarding the prevention of CVD in the nationwide ÄSP-kardio Study. The focus of the study was on health behavior modification. Two thirds of the participating PCPs stated that they routinely provided brief inventions to assist patients in reducing both their tobacco (72% and alcohol (61% consumption, to encourage them to increase their levels of physical activity (72%, and to assist them in adjusting to a more healthy diet (66%, and in achieving a healthy body weight (69%. However, only between 23% (quitting smoking and 49% (diet modification of PCPs felt that they had been successful in helping patients modify their lifestyles. Insufficient reimbursement, cultural diversity and a lack of time were reported to be the most problematic barriers to successful intervention in the primary care setting. Despite these obstacles, the majority of German PCPs was engaged in prevention and health behavior intervention to reduce the incidence and progression of CVD.
Randers, Morten Bredsgaard; Andersen, Lars Juel; Ørntoft, Christina Øyangen;
Abstract This study examined the intermittent exercise performance and cardiovascular health profile in elite female football players in comparison to untrained young women, as well as a subgroup subjected to football training 2x1 h · week(-1) for 16 weeks. Twenty-seven Danish national team players...... weeks of football training with 26 and 46% increases in TAPSE and E/A ratio, respectively, reaching levels comparable to ET. In summary, elite female football players have a superior cardiovascular health profile and intermittent exercise performance compared to untrained controls, but short...... (elite trained, ET) and 28 untrained women (UT) underwent dual-energy X-ray absorptiometry-scanning (DXA), comprehensive transthoracic echocardiography, treadmill and Yo-Yo Intermittent Endurance level 2 (IE2) testing. Eight women in UT were also tested after the football training period. Maximal oxygen...
Serum Non-high-density lipoprotein cholesterol concentration and risk of death from cardiovascular diseases among U.S. adults with diagnosed diabetes: the Third National Health and Nutrition Examination Survey linked mortality study
Balluz Lina S
Full Text Available Abstract Background Non-high-density lipoprotein cholesterol (non-HDL-C measures all atherogenic apolipoprotein B-containing lipoproteins and predicts risk of cardiovascular diseases (CVD. The association of non-HDL-C with risk of death from CVD in diabetes is not well understood. This study assessed the hypothesis that, among adults with diabetes, non-HDL-C may be related to the risk of death from CVD. Methods We analyzed data from 1,122 adults aged 20 years and older with diagnosed diabetes who participated in the Third National Health and Nutrition Examination Survey linked mortality study (299 deaths from CVD according to underlying cause of death; median follow-up length, 12.4 years. Results Compared to participants with serum non-HDL-C concentrations of 35 to 129 mg/dL, those with higher serum levels had a higher risk of death from total CVD: the RRs were 1.34 (95% CI: 0.75-2.39 and 2.25 (95% CI: 1.30-3.91 for non-HDL-C concentrations of 130-189 mg/dL and 190-403 mg/dL, respectively (P = 0.003 for linear trend after adjustment for demographic characteristics and selected risk factors. In subgroup analyses, significant linear trends were identified for the risk of death from ischemic heart disease: the RRs were 1.59 (95% CI: 0.76-3.32 and 2.50 (95% CI: 1.28-4.89 (P = 0.006 for linear trend, and stroke: the RRs were 3.37 (95% CI: 0.95-11.90 and 5.81 (95% CI: 1.96-17.25 (P = 0.001 for linear trend. Conclusions In diabetics, higher serum non-HDL-C concentrations were significantly associated with increased risk of death from CVD. Our prospective data support the notion that reducing serum non-HDL-C concentrations may be beneficial in the prevention of excess death from CVD among affected adults.
Younus, Adnan; Aneni, Ehimen C; Spatz, Erica S; Osondu, Chukwuemeka U; Roberson, Lara; Ogunmoroti, Oluseye; Malik, Rehan; Ali, Shozab S; Aziz, Muhammad; Feldman, Theodore; Virani, Salim S; Maziak, Wasim; Agatston, Arthur S; Veledar, Emir; Nasir, Khurram
Several population-based studies have examined the prevalence and trends of the American Heart Association's ideal cardiovascular health (CVH) metrics as well as its association with cardiovascular disease (CVD)-related morbidity and mortality and with non-CVD outcomes. However, no efforts have been made to aggregate these studies. Accordingly, we conducted a systematic review to synthesize available data on the distribution and outcomes associated with ideal CVH metrics in both US and non-US populations. We conducted a systematic search of relevant studies in the MEDLINE and CINAHL databases, as well as the Cochrane Register of Controlled Trials (CENTRAL). Search terms used included "life's simple 7", "AHA 2020" and "ideal cardiovascular health". We included articles published in English Language from January 1, 2010, to July 31, 2015. Of the 14 US cohorts, the prevalence of 6 to 7 ideal CVH metrics ranged from as low as 0.5% in a population of African Americans to 12% in workers in a South Florida health care organization. Outside the United States, the lowest prevalence was found in an Iranian study (0.3%) and the highest was found in a large Chinese corporation (15%). All 6 mortality studies reported a graded inverse association between the increasing number of ideal CVH metrics and the all-cause and CVD-related mortality risk. A similar relationship between ideal CVH metrics and incident cardiovascular events was found in 12 of 13 studies. Finally, an increasing number of ideal CVH metrics was associated with a lower prevalence and incidence of non-CVD outcomes such as cancer, depression, and cognitive impairment. The distribution of ideal CVH metrics in US and non-US populations is similar, with low proportions of persons achieving 6 or more ideal CVH metrics. Considering the strong association of CVH metrics with both CVD and non-CVD outcomes, a coordinated global effort for improving CVH should be considered a priority. PMID:27040086