mHealth in Cardiovascular Health Care.

PubMed

Chow, Clara K; Ariyarathna, Nilshan; Islam, Sheikh Mohammed Shariful; Thiagalingam, Aravinda; Redfern, Julie

2016-08-01

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. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of

Socioeconomic status and health inequalities for cardiovascular prevention among elderly Spaniards.

PubMed

Mejía-Lancheros, Cília; Estruch, Ramón; Martínez-González, Miguel A; Salas-Salvadó, Jordi; Corella, Dolores; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Covas, Maria I; Arós, Fernando; Serra-Majem, Lluís; Pintó, Xavier; Basora, Josep; Sorlí, José V; Muñoz, Miguel A

2013-10-01

Although it is known that social factors may introduce inequalities in cardiovascular health, data on the role of socioeconomic differences in the prescription of preventive treatment are scarce. We aimed to assess the relationship between the socioeconomic status of an elderly population at high cardiovascular risk and inequalities in receiving primary cardiovascular treatment, within the context of a universal health care system. Cross-sectional study of 7447 individuals with high cardiovascular risk (57.5% women, mean age 67 years) who participated in the PREDIMED study, a clinical trial of nutritional interventions for cardiovascular prevention. Educational attainment was used as the indicator of socioeconomic status to evaluate differences in pharmacological treatment received for hypertension, diabetes, and dyslipidemia. Participants with the lowest socioeconomic status were more frequently women, older, overweight, sedentary, and less adherent to the Mediterranean dietary pattern. They were, however, less likely to smoke and drink alcohol. This socioeconomic subgroup had a higher proportion of coexisting cardiovascular risk factors. Multivariate analysis of the whole population found no differences between participants with middle and low levels of education in the drug treatment prescribed for 3 major cardiovascular risk factors (odds ratio [95% confidence interval]): hypertension (0.75 [0.56-1.00] vs 0.85 [0.65-1.10]); diabetic participants (0.86 [0.61-1.22] vs 0.90 [0.67-1.22]); and dyslipidemia (0.93 [0.75-1.15] vs 0.99 [0.82-1.19], respectively). In our analysis, socioeconomic differences did not affect the treatment prescribed for primary cardiovascular prevention in elderly patients in Spain. Free, universal health care based on a primary care model can be effective in reducing health inequalities related to socioeconomic status. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Ethnic disparities in cardiovascular health.

PubMed

Ofili, E

2001-01-01

Disparities in the cardiovascular outcomes of African-American patients is evident from national, regional, and local statistical data, as well as from the daily practice of medicine. This discussion highlights the complexity of ethnic disparities using a case-based approach with two typical cases from a cardiology practice. These cases underscore the complex interplay of the following factors in ethnic disparities. 1. Excess burden of cardiovascular risk factors in African Americans, with particular emphasis on high blood pressure, diabetes, obesity, physical inactivity, and psychosocial stress. 2. Inadequate knowledge of how personal risk factors are directly linked to atherosclerosis and heart disease. 3. Cultural factors in symptom recognition and health-care seeking behavior. 4. Economic factors influencing access to health care including prevention, diagnosis, and treatment. 5. A combination of psychosocial stress, racism, and frustration leading to sub-optimal interactions with the health care system. 6. Genetics of disease and predisposition to vascular disease and atherosclerosis. We must come to terms with these fundamental factors in the causation and, therefore, the resolution of ethnic disparities in cardiovascular health. Successful strategies must include: 1) partnerships for long-term, sustainable, population-wide strategies on risk factor modification; 2) models of culturally competent health care delivery; and 3) research on the gene-environment interactions, which cause the susceptibility of ethnic minorities to cardiovascular disease.

Elevated depressive affect is associated with adverse cardiovascular outcomes among African Americans with chronic kidney disease

PubMed Central

Fischer, Michael J.; Kimmel, Paul L.; Greene, Tom; Gassman, Jennifer J.; Wang, Xuelei; Brooks, Deborah H.; Charleston, Jeanne; Dowie, Donna; Thornley-Brown, Denyse; Cooper, Lisa A.; Bruce, Marino A.; Kusek, John W.; Norris, Keith C.; Lash, James P.

2011-01-01

This study was designed to examine the impact of elevated depressive affect on health outcomes among participants with hypertensive chronic kidney disease in the African-American Study of Kidney Disease and Hypertension (AASK) Cohort Study. Elevated depressive affect was defined by Beck Depression Inventory II (BDI-II) thresholds of 11 or more, above 14, and by 5-Unit increments in the score. Cox regression analyses were used to relate cardiovascular death/hospitalization, doubling of serum creatinine/end-stage renal disease, overall hospitalization, and all-cause death to depressive affect evaluated at baseline, the most recent annual visit (time-varying), or average from baseline to the most recent visit (cumulative). Among 628 participants at baseline, 42% had BDI-II scores of 11 or more and 26% had a score above 14. During a 5-year follow-up, the cumulative incidence of cardiovascular death/hospitalization was significantly greater for participants with baseline BDI-II scores of 11 or more compared with those with scores <11. The baseline, time-varying, and cumulative elevated depressive affect were each associated with a significant higher risk of cardiovascular death/hospitalization, especially with a time-varying BDI-II score over 14 (adjusted HR 1.63) but not with the other outcomes. Thus, elevated depressive affect is associated with unfavorable cardiovascular outcomes in African Americans with hypertensive chronic kidney disease. PMID:21633409

Plant-based diets and cardiovascular health.

PubMed

Satija, Ambika; Hu, Frank B

2018-02-13

Plant-based diets, defined in terms of low frequency of animal food consumption, have been increasingly recommended for their health benefits. Numerous studies have found plant-based diets, especially when rich in high quality plant foods such as whole grains, fruits, vegetables, and nuts, to be associated with lower risk of cardiovascular outcomes and intermediate risk factors. This review summarizes the current evidence base examining the associations of plant-based diets with cardiovascular endpoints, and discusses the potential biological mechanisms underlying their health effects, practical recommendations and applications of this research, and directions for future research. Healthful plant-based diets should be recommended as an environmentally sustainable dietary option for improved cardiovascular health. Copyright © 2018 Elsevier Inc. All rights reserved.

Cardiovascular Health Issues in Inner City Populations.

PubMed

Nayyar, Dhruv; Hwang, Stephen W

2015-09-01

Inner city populations in high-income countries carry a disproportionately high burden of cardiovascular disease. Although low individual socioeconomic status has long been associated with higher morbidity and mortality from cardiovascular disease, there is a growing body of evidence that area-level socioeconomic status may also have a major effect on cardiovascular outcomes. A lack of supermarkets, limited green space, and high rates of violent crime in inner city neighbourhoods result in poor dietary intake and low rates of physical activity among residents. The physical and social environments of inner city neighbourhoods may also contribute to high rates of comorbid mental illness in disadvantaged urban populations. Mental illness may lead to the clustering of cardiovascular risk factors through its impact on health behaviours, effects of psychiatric medications, and sequelae of substance abuse. Individuals residing in disadvantaged neighbourhoods experience reduced access to both primary preventive and acute in-hospital cardiovascular care. This may be driven by financial disincentives for caring for patients with low socioeconomic status, as well as system capacity issues in the inner city, and patient-level differences in health-seeking behaviours. Small-scale studies of interventions to improve individual-level health behaviours and access to care in the inner city have demonstrated some success in improving cardiovascular outcomes through the use of mobile clinics, health coaching, and case management approaches. There is a need for further research into community-wide interventions to improve the cardiovascular health of inner city populations. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Racial Differences in Ideal Cardiovascular Health Metrics Among Mississippi Adults, 2009 Mississippi Behavioral Risk Factor Surveillance System

PubMed Central

Gamble, Abigail; Mendy, Vincent

2013-01-01

Introduction Cardiovascular disease is a leading cause of death and health disparities in Mississippi. Identifying populations with poor cardiovascular health may help direct interventions toward those populations disproportionately affected, which may ultimately increase cardiovascular health and decrease prominent disparities. Our objective was to assess racial differences in the prevalence of cardiovascular health metrics among Mississippi adults. Methods We used data from the 2009 Mississippi Behavioral Risk Factor Surveillance System to determine age-standardized prevalence estimates and 95% confidence intervals of cardiovascular health metrics among 2,003 black and 5,125 white adults. Logistic regression models were used to evaluate the relationship between race and cardiovascular health metrics. The mean cardiovascular metrics score and percentage of the population with ideal and poor cardiovascular health were calculated by subgroup. Results Approximately 1.3% of blacks and 2.6% of whites exhibited ideal levels of all 7 cardiovascular health metrics. The prevalence of 4 of the 7 cardiovascular health metrics was significantly lower among the total population of blacks than among whites, including a normal body mass index (20.8% vs 32.3%, P < .001), no history of diabetes (85.1% vs 91.3%, P < .001), no history of hypertension (53.9% vs 67.9%, P < .001), and physical activity (52.8% vs 62.2%, P < .001). The logistic regression models revealed significant race-by-sex interactions; differences between blacks and whites for normal body mass index, no history of diabetes mellitus, and no current smoking were found among women but not among men. Conclusion Cardiovascular health is poor among Mississippi adults overall, and racial differences exist. PMID:24262026

Effects of perceived smoking-cancer relationship and cardiovascular health attitudes on childrens' views of smoking.

PubMed

Bektas, Ilknur; Bektas, Murat; Selekoğlu, Yasemin; Kudubes, Aslı Akdeniz; Altan, Sema Sal; Ayar, Dijle

2015-01-01

This study was conducted with the aim of determining how students' perceived smoking-cancer relationship and cardiovascular health attitudes affect childrens' views of smoking. The sample of this descriptive-cross sectional study comprised 574 subjects between the ages of 11-15. The data were collected using the Children's Cardiovascular Health Promotion Attitude Scale and the Children's Decisional Balance Measure for Assessing and Predicting Smoking Status. Correlation and logistic regression were used for analysis. It was determined that a statistically significant relationship exists between the attitudes of children towards smoking and their ideas about the relationship of smoking with cancer, which is negative and low (r=-0.223). There was also a statistically significant relationship between their attitudes towards cardiovascular health and their attitudes towards smoking, again at a low level (r=0.257). It was determined that children with ideas about smoking and cancer were 9.4 times less likely to have positive/negative attitudes towards smoking, while positive attitudes towards cardiovascular health made negative attitudes towards smoking 3.9 times less likely. It was determined that the attitudes of students towards cardiovascular health and their perceptions of smoking and cancer reduced the positive perceptions towards smoking.

Family-Based Approaches to Cardiovascular Health Promotion.

PubMed

Vedanthan, Rajesh; Bansilal, Sameer; Soto, Ana Victoria; Kovacic, Jason C; Latina, Jacqueline; Jaslow, Risa; Santana, Maribel; Gorga, Elio; Kasarskis, Andrew; Hajjar, Roger; Schadt, Eric E; Björkegren, Johan L; Fayad, Zahi A; Fuster, Valentin

2016-04-12

Cardiovascular disease is the leading cause of mortality in the world, and the increasing burden is largely a consequence of modifiable behavioral risk factors that interact with genomics and the environment. Continuous cardiovascular health promotion and disease prevention throughout the lifespan is critical, and the family is a central entity in this process. In this review, we describe the potential rationale and mechanisms that contribute to the importance of family for cardiovascular health promotion, focusing on: 1) mutual interdependence of the family system; 2) shared environment; 3) parenting style; 4) caregiver perceptions; and 5) genomics. We conclude that family-based approaches that target both caregivers and children, encourage communication among the family unit, and address the structural and environmental conditions in which families live and operate are likely to be the most effective approach to promote cardiovascular health. We describe lessons learned, future implications, and applications to ongoing and planned studies. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Cardiovascular Deconditioning

NASA Technical Reports Server (NTRS)

Charles, John B.; Fritsch-Yelle, Janice M.; Whitson, Peggy A.; Wood, Margie L.; Brown, Troy E.; Fortner, G. William

1999-01-01

Spaceflight causes adaptive changes in cardiovascular function that may deleteriously affect crew health and safety. Over the last three decades, symptoms of cardiovascular changes have ranged from postflight orthostatic tachycardia and decreased exercise capacity to serious cardiac rhythm disturbances during extravehicular activities (EVA). The most documented symptom of cardiovascular dysfunction, postflight orthostatic intolerance, has affected a significant percentage of U.S. Space Shuttle astronauts. Problems of cardiovascular dysfunction associated with spaceflight are a concern to NASA. This has been particularly true during Shuttle flights where the primary concern is the crew's physical health, including the pilot's ability to land the Orbiter, and the crew's ability to quickly egress and move to safety should a dangerous condition arise. The study of astronauts during Shuttle activities is inherently more difficult than most human research. Consequently, sample sizes have been small and results have lacked consistency. Before the Extended Duration Orbiter Medical Project (EDOMP), there was a lack of normative data on changes in cardiovascular parameters during and after spaceflight. The EDOMP for the first time allowed studies on a large enough number of subjects to overcome some of these problems. There were three primary goals of the Cardiovascular EDOMP studies. The first was to establish, through descriptive studies, a normative data base of cardiovascular changes attributable to spaceflight. The second goal was to determine mechanisms of cardiovascular changes resulting from spaceflight (particularly orthostatic hypotension and cardiac rhythm disturbances). The third was to evaluate possible countermeasures. The Cardiovascular EDOMP studies involved parallel descriptive, mechanistic, and countermeasure evaluations.

Cocoa antioxidants and cardiovascular health.

PubMed

Keen, Carl L; Holt, Roberta R; Oteiza, Patricia I; Fraga, César G; Schmitz, Harold H

2005-01-01

An increasing body of epidemiologic evidence supports the concept that diets rich in fruits and vegetables can promote health and attenuate, or delay, the onset of various diseases. Epidemiologic data support the idea that these health benefits are causally linked to the consumption of certain flavonoids present in fruit and vegetables. In the context of cardiovascular health, a particular group of flavonoids, namely, the flavan-3-ols (flavanols), has received attention. Flavanol-rich, plant-derived foods and beverages include wine, tea, and various fruits and berries, as well as cocoa and cocoa products. Numerous dietary intervention studies in humans and animals indicate that flavanol-rich foods and beverages might exert cardioprotective effects with respect to vascular function and platelet reactivity. This review discusses the bioactivity of flavanols in the context of cardiovascular health, with respect to their bioavailability, their antioxidant properties, and their vascular effects.

Racism and cardiovascular disease in African Americans.

PubMed

Wyatt, Sharon B; Williams, David R; Calvin, Rosie; Henderson, Frances C; Walker, Evelyn R; Winters, Karen

2003-06-01

This article provides an overview of the evidence on the ways racism can affect the disproportionate rates of cardiovascular disease (CVD) in African Americans. It describes the significant health disparities in CVD for blacks and whites and suggests that racial disparities should be understood within the context of persistent inequities in societal institutions and relations. Evidence and potential pathways for exploring effects of 3 levels of racism on cardiovascular health risk factors and outcomes are reviewed. First, institutional racism can lead to limited opportunities for socioeconomic mobility, differential access to goods and resources, and poor living conditions that can adversely affect cardiovascular health. Second, perceived/personally mediated racism acts as a stressor and can induce psychophysiological reactions that negatively affect cardiovascular health. Third, in race-conscious societies, such as the United States, the negative self-evaluations of accepting negative cultural stereotypes as true (internalized racism) can have deleterious effects on cardiovascular health. Few population-based studies have examined the relationship between racism and CVD. The findings, though suggestive of a positive association, are neither consistent nor clear. The research agenda of the Jackson Heart Study in addressing the role of racism in CVD is presented.

Cardiovascular Health and Arterial Stiffness: The Maine Syracuse Longitudinal Study

PubMed Central

Crichton, Georgina E; Elias, Merrill F; Robbins, Michael A

2014-01-01

Ideal cardiovascular health is a recently defined construct by the American Heart Association (AHA) to promote cardiovascular disease reduction. Arterial stiffness is a major risk factor for cardiovascular disease. The extent to which the presence of multiple prevalent cardiovascular risk factors and health behaviors is associated with arterial stiffness is unknown. The aim of this study was to examine the association between the AHA construct of cardiovascular health and arterial stiffness, as indexed by pulse wave velocity and pulse pressure. The AHA health metrics, comprising of four health behaviors (smoking, body mass index, physical activity, and diet) and three health factors (total cholesterol, blood pressure, and fasting plasma glucose) were evaluated among 505 participants in the Maine-Syracuse Longitudinal Study. Outcome measures were carotid-femoral pulse wave velocity (PWV) and pulse pressure measured at 4 to 5-year follow-up. Better cardiovascular health, comprising both health factors and behaviors, was associated with lower arterial stiffness, as indexed by pulse wave velocity and pulse pressure. Those with at least five health metrics at ideal levels had significantly lower PWV (9.8 m/s) than those with two or less ideal health metrics (11.7 m/s) (P<0.001). This finding remained with the addition of demographic and PWV-related variables (P=0.004). PMID:24384629

Cardiovascular health and arterial stiffness: the Maine-Syracuse Longitudinal Study.

PubMed

Crichton, G E; Elias, M F; Robbins, M A

2014-07-01

Ideal cardiovascular health is a recently defined construct by the American Heart Association (AHA) to promote cardiovascular disease reduction. Arterial stiffness is a major risk factor for cardiovascular disease. The extent to which the presence of multiple prevalent cardiovascular risk factors and health behaviors is associated with arterial stiffness is unknown. The aim of this study was to examine the association between the AHA construct of cardiovascular health and arterial stiffness, as indexed by pulse wave velocity (PWV) and pulse pressure. The AHA health metrics, comprising of four health behaviors (smoking, body mass index, physical activity and diet) and three health factors (total cholesterol, blood pressure and fasting plasma glucose), were evaluated among 505 participants in the Maine-Syracuse Longitudinal Study. Outcome measures were carotid-femoral PWV and pulse pressure measured at 4- to 5-year follow-up. Better cardiovascular health, comprising both health factors and behaviors, was associated with lower arterial stiffness, as indexed by PWV and pulse pressure. Those with at least five health metrics at ideal levels had significantly lower PWV (9.8 m s(-1)) than those with two or less ideal health metrics (11.7 m s(-1)) (P < 0.001). This finding remained with the addition of demographic and PWV-related variables (P = 0.004).

Health-risk appraisal with or without disease management for worksite cardiovascular risk reduction.

PubMed

Maron, David J; Forbes, Barbara L; Groves, Jay R; Dietrich, Mary S; Sells, Patrick; DiGenio, Andres G

2008-01-01

Worksite health promotion programs use health risk appraisal (HRA) surveys to identify employees at increased risk, then provide a range of interventions to encourage high-risk individuals to improve their health. Our objective was to determine how the intensity of intervention after HRA affected cardiovascular risk after 1 year, comparing individual follow-up counseling with environmental supports. 133 employees of Vanderbilt University with cardiovascular risk factors were randomly assigned to worksite HRA plus targeted disease management (DM group) or HRA plus information about worksite health promotion programs (HRA group). The DM group received longitudinal individualized counseling for risk reduction, whereas the HRA group members received one feedback session about their risk factors and information about free worksite health promotion programs. The main outcome measure was the difference between groups in the change in average Framingham risk score from baseline to 1 year. There was no significant baseline difference between groups in the Framingham risk score. Among DM participants, the mean (SD) Framingham risk score decreased by 22.6%; among HRA participants, the mean score rose by 4.3% (P = .017 for the difference between groups). In this study of employees with cardiovascular risk factors, HRA followed by individual counseling was more effective than providing information about free worksite health promotion programs.

Cumulative effect of psychosocial factors in youth on ideal cardiovascular health in adulthood: the Cardiovascular Risk in Young Finns Study.

PubMed

Pulkki-Råback, Laura; Elovainio, Marko; Hakulinen, Christian; Lipsanen, Jari; Hintsanen, Mirka; Jokela, Markus; Kubzansky, Laura D; Hintsa, Taina; Serlachius, Anna; Laitinen, Tomi T; Laitinen, Tomi; Pahkala, Katja; Mikkilä, Vera; Nevalainen, Jaakko; Hutri-Kähönen, Nina; Juonala, Markus; Viikari, Jorma; Raitakari, Olli T; Keltikangas-Järvinen, Liisa

2015-01-20

The American Heart Association has defined a new metric of ideal cardiovascular health as part of its 2020 Impact Goals. We examined whether psychosocial factors in youth predict ideal cardiovascular health in adulthood. Participants were 477 men and 612 women from the nationwide Cardiovascular Risk in Young Finns Study. Psychosocial factors were measured from cohorts 3 to 18 years of age at the baseline of the study, and ideal cardiovascular health was examined 27 years later in adulthood. The summary measure of psychosocial factors in youth comprised socioeconomic factors, emotional factors, parental health behaviors, stressful events, self-regulation of the child, and social adjustment of the child. There was a positive association between a higher number of favorable psychosocial factors in youth and greater ideal cardiovascular health index in adulthood (β=0.16; P<0.001) that persisted after adjustment for age, sex, medication use, and cardiovascular risk factors in childhood (β=0.15; P<0.001). The association was monotonic, suggesting that each increment in favorable psychosocial factors was associated with improvement in cardiovascular health. Of the specific psychosocial factors, a favorable socioeconomic environment (β=0.12; P<0.001) and participants' self-regulatory behavior (β=0.07; P=0.004) were the strongest predictors of ideal cardiovascular health in adulthood. The findings suggest a dose-response association between favorable psychosocial factors in youth and cardiovascular health in adulthood, as defined by the American Heart Association metrics. The effect seems to persist throughout the range of cardiovascular health, potentially shifting the population distribution of cardiovascular health rather than simply having effects in a high-risk population. © 2015 American Heart Association, Inc.

Climate Changes and Human Health: A Review of the Effect of Environmental Stressors on Cardiovascular Diseases Across Epidemiology and Biological Mechanisms.

PubMed

Giorgini, Paolo; Di Giosia, Paolo; Petrarca, Marco; Lattanzio, Francesco; Stamerra, Cosimo Andrea; Ferri, Claudio

2017-01-01

Climate change is rapidly affecting all the regions of our planet. The most relevant example is global warming, which impacts on the earth's ecosystems, threatening human health. Other effects include extreme variations in temperature and increases in air pollution. These events may negatively impact mortality and morbidity for cardiovascular diseases. In this review, we discuss the main effects of climate changes on cardiovascular diseases, reporting the epidemiological evidences and the biological mechanisms linking climate change consequences to hypertension, diabetes, ischemic heart diseases, heart failure and stroke. Up to now, findings suggest that humans acclimate under different weather conditions, even though extreme temperatures and higher levels of air pollution can influence health-related outcomes. In these cases, climate change adversely affects cardiovascular system and the high-risk subjects for cardiovascular diseases are those more exposed. Finally, we examine climate change implications on publich health and suggest adaptation strategies to monitor the high-risk population, and reduce the amount of hospital admissions associated to these events. Such interventions may minimize the costs of public health and reduce the mortality for cardiovascular diseases. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Ideal cardiovascular health influences cardiovascular disease risk associated with high lipoprotein(a) levels and genotype: The EPIC-Norfolk prospective population study.

PubMed

Perrot, Nicolas; Verbeek, Rutger; Sandhu, Manjinder; Boekholdt, S Matthijs; Hovingh, G Kees; Wareham, Nicholas J; Khaw, Kay-Tee; Arsenault, Benoit J

2017-01-01

Lipoprotein(a) (Lp[a]) is a strong genetic risk factor for cardiovascular disease (CVD). The American Heart Association has prioritised seven cardiovascular health metrics to reduce the burden of CVD: body mass index, healthy diet, physical activity, smoking status, blood pressure, diabetes and cholesterol levels (together also known as ideal cardiovascular health). Our objective was to determine if individuals with high Lp(a) levels could derive cardiovascular benefits if characterized by ideal cardiovascular health. A total of 14,051 participants of the EPIC-Norfolk study were stratified according to the cardiovascular health score (based on the number of health metrics with an ideal, intermediate or poor status). Of them, 1732 had a CVD event during a mean follow-up of 11.5 years. Cox proportional hazards models were used to describe the association between the cardiovascular health score and Lp(a) level or genotype (as estimated by the rs10455872 variant) with the risk of CVD. We observed little or no differences in serum Lp(a) levels across the seven cardiovascular health metric categories. Among participants with high serum Lp(a) levels ≥50 mg/dl), those in the highest (i.e. healthiest) cardiovascular health score category (10-14) had an adjusted hazard ratio for cardiovascular disease of 0.33 (95% CI = 0.17-0.63, p = 0.001) compared to participants in the lowest (i.e. unhealthiest) cardiovascular health score category(0-4). Similar results were obtained when we replaced Lp(a) with rs10455872. Although Lp(a) levels are only slightly influenced by cardiovascular health metrics, an ideal cardiovascular health could substantially reduce CVD risk associated with high Lp(a) levels or genotype. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Deaf Adolescents’ Learning of Cardiovascular Health Information: Sources and Access Challenges

PubMed Central

Smith, Scott R.; Kushalnagar, Poorna; Hauser, Peter C.

2015-01-01

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

Plastics and cardiovascular health: phthalates may disrupt heart rate variability and cardiovascular reactivity.

PubMed

Jaimes, Rafael; Swiercz, Adam; Sherman, Meredith; Muselimyan, Narine; Marvar, Paul J; Posnack, Nikki Gillum

2017-11-01

Plastics have revolutionized medical device technology, transformed hematological care, and facilitated modern cardiology procedures. Despite these advances, studies have shown that phthalate chemicals migrate out of plastic products and that these chemicals are bioactive. Recent epidemiological and research studies have suggested that phthalate exposure adversely affects cardiovascular function. Our objective was to assess the safety and biocompatibility of phthalate chemicals and resolve the impact on cardiovascular and autonomic physiology. Adult mice were implanted with radiofrequency transmitters to monitor heart rate variability, blood pressure, and autonomic regulation in response to di-2-ethylhexyl-phthalate (DEHP) exposure. DEHP-treated animals displayed a decrease in heart rate variability (-17% SD of normal beat-to-beat intervals and -36% high-frequency power) and an exaggerated mean arterial pressure response to ganglionic blockade (31.5% via chlorisondamine). In response to a conditioned stressor, DEHP-treated animals displayed enhanced cardiovascular reactivity (-56% SD major axis Poincarè plot) and prolonged blood pressure recovery. Alterations in cardiac gene expression of endothelin-1, angiotensin-converting enzyme, and nitric oxide synthase may partly explain these cardiovascular alterations. This is the first study to show an association between phthalate chemicals that are used in medical devices with alterations in autonomic regulation, heart rate variability, and cardiovascular reactivity. Because changes in autonomic balance often precede clinical manifestations of hypertension, atherosclerosis, and conduction abnormalities, future studies are warranted to assess the downstream impact of plastic chemical exposure on end-organ function in sensitive patient populations. This study also highlights the importance of adopting safer biomaterials, chemicals, and/or surface coatings for use in medical devices. NEW & NOTEWORTHY Phthalates are widely

Promethazine affects autonomic cardiovascular mechanisms minimally

NASA Technical Reports Server (NTRS)

Brown, T. E.; Eckberg, D. L.

1997-01-01

Promethazine hydrochloride, Phenergan, is a phenothiazine derivative with antihistaminic (H1), sedative, antiemetic, anticholinergic, and antimotion sickness properties. These properties have made promethazine a candidate for use in environments such as microgravity, which provoke emesis and motion sickness. Recently, we evaluated carotid baroreceptor-cardiac reflex responses during two Space Shuttle missions 18 to 20 hr after the 50 mg intramuscular administration of promethazine. Because the effects of promethazine on autonomic cardiovascular mechanisms in general and baroreflex function in particular were not known, we were unable to exclude a possible influence of promethazine on our results. Our purpose was to determine the ground-based effects of promethazine on autonomic cardiovascular control. Because of promethazine's antihistaminic and anticholinergic properties, we expected that a 50-mg intramuscular injection of promethazine would affect sympathetically and vagally mediated cardiovascular mechanisms. Eight healthy young subjects, five men and three women, were studied at rest in recumbency. All reported drowsiness as a result of the promethazine injection; most also reported nervous excitation, dry mouth, and fatigue. Three subjects had significant reactions: two reported excessive anxiety and one reported dizziness. Measurements were performed immediately prior to injection and 3.1 +/- 0.1 and 19.5 +/- 0.4 hr postinjection. We found no significant effect of promethazine on resting mean R-R interval, arterial pressure, R-R interval power spectra, carotid baroreflex function, and venous plasma catecholamine levels.

CATCH: Child and Adolescent Trial for Cardiovascular Health. [Multimedia.

ERIC Educational Resources Information Center

National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD.

The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health has launched an initiative called the Cardiovascular Health Promotion Project to teach heart-healthy habits to children. One of the programs developed by this initiative, CATCH, the Child and Adolescent Trial for Cardiovascular Health, is the largest…

Status of cardiovascular health among adults in a rural area of Northwest China

PubMed Central

Zhao, Yaling; Yan, Hong; Yang, Ruihai; Li, Qiang; Dang, Shaonong; Liu, Ruru; Pei, Leilei; Cao, Lei; Marshall, Roger J.; Wang, Duolao

2016-01-01

Abstract 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 < 0.001) and 65.7% (82.0% in men vs 49.1% in women, P < 0.001) of the participants had intermediate and poor cardiovascular health, respectively. The prevalence of poor cardiovascular health increased with increasing age (P < 0.001 for trend). Participants fulfilled, on average, 4.4 (95% confidence interval: 4.2–4.7) of the ideal cardiovascular 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

Deaf Adolescents' Learning of Cardiovascular Health Information: Sources and Access Challenges.

PubMed

Smith, Scott R; Kushalnagar, Poorna; Hauser, Peter C

2015-10-01

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. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Barriers to promote cardiovascular health in community pharmacies: a systematic review.

PubMed

Alonso-Perales, María Del Mar; Lasheras, Berta; Beitia, Guadalupe; Beltrán, Idoia; Marcos, Beatriz; Núñez-Córdoba, Jorge M

2017-06-01

Community pharmacists play an important role in the provision of health promotion services, and community pharmacies are considered as a potentially ideal site for cardiovascular health promotion. Information based on a systematic review of barriers to promoting cardiovascular health in community pharmacy is currently lacking. We have sought to identify the most important barriers to cardiovascular health promotion in the community pharmacy. We have systematically searched PubMed and International Pharmaceutical Abstracts for a period of 15 years from 1 April 1998 to 1 April 2013, contacted subject experts and hand-searched bibliographies. We have included peer-reviewed articles, with English abstracts in the analysis, if they reported community pharmacists' perceptions of the barriers to cardiovascular health promotion activities in a community pharmacy setting. Two reviewers have independently extracted study characteristics and data. We identified 24 studies that satisfy the eligibility criteria. The main barriers to cardiovascular health promotion in the community pharmacy included pharmacist-related factors; practice site factors; financial factors; legal factors; and patient-related factors. This review will help to provide reliable evidence for health promotion practitioners of the barriers to promoting cardiovascular health in the community pharmacy setting. This knowledge is valuable for the improvement of cardiovascular health promotion in this setting and guiding future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Reproductive health experiences of women with cardiovascular disease.

PubMed

Chor, Julie; Oswald, Lora; Briller, Joan; Cowett, Allison; Peacock, Nadine; Harwood, Bryna

2012-11-01

Limited research exists exploring contraceptive and pregnancy experiences of women with cardiovascular diseases. We conducted semistructured interviews with reproductive-age women with chronic hypertension or peripartum cardiomyopathy exploring thoughts and behaviors regarding future fertility. Transcribed interviews were coded and analyzed identifying salient themes. We interviewed 20 women with chronic hypertension and 10 women with peripartum cardiomyopathy. Women described a spectrum of perspectives regarding the relationship between disease and fertility: from complete disconnect to full integration of diagnosis and future fertility plans. Integration of reproductive and cardiovascular health was influenced by and reflected in circumstances of diagnosis, pregnancy-related experiences, contraception-related experiences and conceptualization of disease risk related to reproductive health. Providers must better understand how women perceive and consider their reproductive and cardiovascular health in order to optimize contraceptive care of women with cardiovascular disease and help them make safe, informed decisions about future fertility. Copyright © 2012 Elsevier Inc. All rights reserved.

ULTRAFINE CARBON PARTICLE (UFCP) INHALATION AFFECTS CARDIOVASCULAR PERFORMANCE IN HYPERTENSIVE RATS (SHR)

EPA Science Inventory

Inhaled UfCP affect cardiovascular performance in healthy rats (Harder et al. Inhal Toxicol 2005; 17:29-42) without apparent pulmonary damage. To assess whether geriatric cardiovascular compromised rats are more susceptible to UfCP effects, male adult (6months) and geriatric (13m...

Qingdao Port Cardiovascular Health Study: a prospective cohort study.

PubMed

Spatz, Erica S; Jiang, Xianyan; Lu, Jiapeng; Masoudi, Frederick A; Spertus, John A; Wang, Yongfei; Li, Xi; Downing, Nicholas S; Nasir, Khurram; Du, Xue; Li, Jing; Krumholz, Harlan M; Liu, Xiancheng; Jiang, Lixin

2015-12-09

In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. For this study, from 2000 through 2013, 32,404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221,923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4-39.4%; diabetes: 3.3-8.9%; hyperlipidaemia: 5.0-33.6%; body mass index >28 m/kg(2): 14.1-18.6%). We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge generated will be disseminated in the peer-reviewed literature, and will

Qingdao Port Cardiovascular Health Study: a prospective cohort study

PubMed Central

Spatz, Erica S; Jiang, Xianyan; Lu, Jiapeng; Masoudi, Frederick A; Spertus, John A; Wang, Yongfei; Li, Xi; Downing, Nicholas S; Nasir, Khurram; Du, Xue; Li, Jing; Krumholz, Harlan M; Liu, Xiancheng; Jiang, Lixin

2015-01-01

Purpose In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Participants For this study, from 2000 through 2013, 32 404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221 923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. Findings to date Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4–39.4%; diabetes: 3.3–8.9%; hyperlipidaemia: 5.0–33.6%; body mass index >28 m/kg2: 14.1–18.6%). Future Plans We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge

Cardiovascular Health of Construction Workers in Hong Kong: A Cross-Sectional Study.

PubMed

Chung, Joanne Wai-Yee; Wong, Bonny Yee-Man; Yan, Vincent Chun-Man; Chung, Louisa Ming-Yan; So, Henry Chi-Fuk; Chan, Albert

2018-06-12

Given a shortage of construction workers, it is important to develop strategies to avoid early retirement caused by cardiovascular diseases in Hong Kong. (1) to describe the cardiovascular health of construction workers in Hong Kong, (2) to examine the demographic differences in cardiovascular health, and (3) to examine the association between health behaviors and cardiovascular health factors. 626 registered construction workers were included in the analysis. Blood chemistry, blood pressure, weight, and height were measured. Face-to-face questionnaire interviews for health behaviors were conducted. Approximately two-thirds of the construction workers achieved only three out of the seven “ideal” cardiovascular health metrics. The younger, more educated, and female subjects had better cardiovascular health scores than the older, less educated, and male counterparts. Fish and seafood consumption was associated with (1) ideal weight status and (2) ideal cholesterol level, whereas less soft drink consumption was associated with ideal cholesterol level. The findings highlighted the importance of promoting cardiovascular health in the construction industry. This study provided some insights for future interventions, which should include increasing fish and seafood intake, decreasing soft drink consumption, and enhancing the health literacy amongst older, less educated, and male construction workers.

Cocoa and cardiovascular health.

PubMed

Corti, Roberto; Flammer, Andreas J; Hollenberg, Norman K; Lüscher, Thomas F

2009-03-17

Epidemiological data demonstrate that regular dietary intake of plant-derived foods and beverages reduces the risk of coronary heart disease and stroke. Among many ingredients, cocoa might be an important mediator. Indeed, recent research demonstrates a beneficial effect of cocoa on blood pressure, insulin resistance, and vascular and platelet function. Although still debated, a range of potential mechanisms through which cocoa might exert its benefits on cardiovascular health have been proposed, including activation of nitric oxide and antioxidant and antiinflammatory effects. This review summarizes the available data on the cardiovascular effects of cocoa, outlines potential mechanisms involved in the response to cocoa, and highlights the potential clinical implications associated with its consumption.

Converging evidence that subliminal evaluative conditioning does not affect self-esteem or cardiovascular activity.

PubMed

Versluis, Anke; Verkuil, Bart; Brosschot, Jos F

2018-04-01

Self-esteem moderates the relationship between stress and (cardiovascular) health, with low self-esteem potentially exacerbating the impact of stressors. Boosting self-esteem may therefore help to buffer against stress. Subliminal evaluative conditioning (SEC), which subliminally couples self-words with positive words, has previously been successfully used to boost self-esteem, but the existing studies are in need of replication. In this article, we aimed to replicate and extend previous SEC studies. The first 2 experiments simultaneously examined whether SEC increased self-esteem (Experiment 1, n = 84) and reduced cardiovascular reactivity to a stressor in high worriers (Experiment 2, n = 77). On the basis of these results, the 3rd experiment was set up to examine whether an adjusted personalized SEC task increased self-esteem and reduced cardiac activity in high worriers (n = 81). Across the 3 experiments, no effects were found of SEC on implicit or explicit self-esteem or affect or on cardiovascular (re)activity compared to a control condition in which the self was coupled with neutral words. The results do not support the use of the subliminal intervention in its current format. As stress is highly prevalent, future studies should focus on developing other cost-effective and evidence-based interventions. © 2017 The Authors. Stress and Health Published by John Wiley & Sons Ltd.

Ideal Cardiovascular Health and Incident Cardiovascular Events

PubMed Central

Ommerborn, Mark J.; Blackshear, Chad T.; Hickson, DeMarc A.; Griswold, Michael E.; Kwatra, Japneet; Djousse, Luc; Clark, Cheryl R.

2016-01-01

Introduction The epidemiology of American Heart Association ideal cardiovascular health (CVH) metrics has not been fully examined in African Americans. This study examines associations of CVH metrics with incident cardiovascular disease (CVD) in the Jackson Heart Study, a longitudinal cohort study of CVD in African Americans. Methods Jackson Heart Study participants without CVD (N=4,702) were followed prospectively between 2000 and 2011. Incidence rates and Cox proportional hazard ratios estimated risks for incident CVD (myocardial infarction, stroke, cardiac procedures, and CVD mortality) associated with seven CVH metrics by sex. Analyses were performed in 2015. Results Participants were followed for a median 8.3 years; none had ideal health on all seven CVH metrics. The prevalence of ideal health was low for nutrition, physical activity, BMI, and blood pressure metrics. The age-adjusted CVD incidence rate (IR) per 1,000 person years was highest for individuals with the least ideal health metrics: zero to one (IR=12.5, 95% CI=9.7, 16.1), two (IR=8.2, 95% CI=6.5, 10.4), three (IR=5.7, 95% CI=4.2, 7.6), and four or more (IR=3.4, 95% CI=2.0, 5.9). Adjusting for covariates, individuals with four or more ideal CVH metrics had lower risks of incident CVD compared with those with zero or one ideal CVH metric (hazard ratio, 0.29; 95% CI=0.17, 0.52; p<0.001). Conclusions African Americans with more ideal CVH metrics have lower risks of incident CVD. Comprehensive preventive behavioral and clinical supports should be intensified to improve CVD risk for African Americans with few ideal CVH metrics. PMID:27539974

Current Status of Chemical Public Health Risks and Testing Guidelines for Chemical Cardiovascular Safety Assessments

EPA Science Inventory

The cardiovascular system, at all its various developmental and life stages, represents a critical target organ system that can be adversely affected by a variety of chemicals and routes of exposure. A World Health Organization report estimated the impact of environmental chemica...

Cardiorespiratory fitness and ideal cardiovascular health in European adolescents.

PubMed

Ruiz, Jonatan R; Huybrechts, Inge; Cuenca-García, Magdalena; Artero, Enrique G; Labayen, Idoia; Meirhaeghe, Aline; Vicente-Rodriguez, German; Polito, Angela; Manios, Yannis; González-Gross, Marcela; Marcos, Ascensión; Widhalm, Kurt; Molnar, Denes; Kafatos, Anthony; Sjöström, Michael; Moreno, Luis A; Castillo, Manuel J; Ortega, Francisco B

2015-05-15

We studied in European adolescents (i) the association between cardiorespiratory fitness and ideal cardiovascular health as defined by the American Heart Association and (ii) whether there is a cardiorespiratory fitness threshold associated with a more favourable cardiovascular health profile. Participants included 510 (n=259 girls) adolescents from 9 European countries. The 20 m shuttle run test was used to estimate cardiorespiratory fitness. Ideal cardiovascular health was defined as meeting ideal levels of the following components: four behaviours (smoking, body mass index, physical activity and diet) and three factors (total cholesterol, blood pressure and glucose). Higher levels of cardiorespiratory fitness were associated with a higher number of ideal cardiovascular health components in both boys and girls (both p for trend ≤0.001). Levels of cardiorespiratory fitness were significantly higher in adolescents meeting at least four ideal components (13% higher in boys, p<0.001; 6% higher in girls, p=0.008). Receiver operating characteristic curve analyses showed a significant discriminating accuracy of cardiorespiratory fitness in identifying the presence of at least four ideal cardiovascular health components (43.8 mL/kg/min in boys and 34.6 mL/kg/min in girls, both p<0.001). The results suggest a hypothetical cardiorespiratory fitness level associated with a healthier cardiovascular profile in adolescents. The fitness standards could be used in schools as part of surveillance and/or screening systems to identify youth with poor health behaviours who might benefit from intervention programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Does knowledge of coronary artery calcium affect cardiovascular risk perception, likelihood of taking action, and health-promoting behavior change?

PubMed

Johnson, Jennie E; Gulanick, Meg; Penckofer, Sue; Kouba, Joanne

2015-01-01

Evidence indicates that a healthy lifestyle can reduce cardiovascular disease risk, yet many people engage in unhealthy behaviors. New technologies such as coronary artery calcium (CAC) screening detect atherosclerosis before clinical disease is manifested. Knowledge of an abnormal finding could provide the "teachable moment" to enhance motivation for change. The aim of this study was to examine how knowledge of CAC score affects risk perception, likelihood of taking action, and health-promoting behavior change in persons at high risk for cardiovascular disease. This study used a descriptive prospective design with 174 high-risk adults (≥3 major risk factors) recruited at a radiology center offering CAC scans. Baseline self-report surveys using the Perception of Risk of Heart Disease Scale, the Benefits and Barriers Scale, the Quality of Life Index, and the Health-Promoting Lifestyle Profile II were completed immediately after a screening CAC scan but before results were known. Follow-up occurred 3 months later using mailed packets. Participants' mean age was 58 years; 62% were men, 89% were white, and most were well educated. There was no significant change in risk perception scores over time or between groups, except for a positive interaction in the moderate-risk group (CAC scores of 101-400) (P = .004). Quality of life remained unchanged. Health-promoting behavior changes increased in all groups over time (P < .001). McNemar χ² analysis indicated that risk reduction medication use increased in all groups, with a significant increase in statin (P < .001) and aspirin (P < .001) intake. Predictors of behavior change were perceived barriers (β = -.41; P < .001) and quality of life (β = .44; P < .001). Knowledge of CAC score does impact risk perception for some at-risk groups. This knowledge does enhance motivation for behavior change. Knowledge of CAC score does not impact quality of life. It is hoped that through improved understanding of the effect of CAC

Cardiovascular and Affective Outcomes of Active Gaming: Using the Nintendo Wii as a Cardiovascular Training Tool

PubMed Central

Naugle, Keith E.; Naugle, Kelly M.; Wikstrom, Erik A.

2014-01-01

Naugle, KE, Naugle, KM, and Wikstrom, EA. Cardiovascular and affective outcomes of active gaming: Using the Nintendo Wii as a cardiovascular training tool. J Strength Cond Res 28(2): 443–451, 2014–Active-video gaming is purported to produce similar cardiovascular responses as aerobic fitness activities. This study compared the emotional and cardiovascular effects of Wii games with those of traditional exercise in college-aged adults with different exercise backgrounds. Specifically, the percentage of heart rate reserve, rate of perceived exertion (RPE), level of enjoyment, and Positive and Negative Affect Schedule scores were compared between subjects who reported exercising frequently at high intensities (high-intensity exerciser group: age = 20.18 years [0.87]; Height = 165.23 cm [9.97]; Mass = 62.37 kg [11.61]), N = 11 and those who exercise more often at lower intensities (low-intensity exercisers group: age = 20.72 years [1.19]; Height = 164.39 cm [8.05]; Mass = 68.04 kg [10.71]), N = 11. The subjects completed six 20-minute exercises sessions: treadmill walking, stationary cycling, and Wii's Tennis, Boxing, Cycling, and Step. The low-intensity exerciser group achieved a greater percentage of heart rate reserve (a) during traditional exercise compared with that during Wii boxing, (b) playing Wii boxing compared with that for Wii tennis, and (c) playing Wii boxing compared with that when the high-intensity exercisers group played any Wii games (p < 0.05). The RPE was greater for boxing and cycling compared with that for tennis and step (p < 0.05). Ratings of enjoyment and the increase in positive emotion were greater for boxing and for tennis compared with those for traditional exercises (p < 0.05). Results suggest that Wii boxing shows the greatest potential as a cardiovascular fitness tool among the Wii games, particularly for individuals who typically exercise at lower intensities. PMID:23660574

Cardiovascular health promotion for elementary school children. The Heart Smart Program.

PubMed

Berenson, G S; Arbeit, M L; Hunter, S M; Johnson, C C; Nicklas, T A

1991-01-01

Models of health promotion directed to cardiovascular disease prevention are becoming increasingly important, based on the wealth of behavioral and physiologic data that examine the determinants, distributions, and interrelationships and trends over time of cardiovascular risk factors in children. The epidemiologic studies of children of cardiovascular risk factors and of life-styles provide the foundation to address intervention strategies beginning at the school age. Cardiovascular health promotion programs in elementary schools have tremendous potential for the prevention of adult cardiovascular diseases in our nation.

Association of sedentary behavior time with ideal cardiovascular health: the ORISCAV-LUX study.

PubMed

Crichton, Georgina E; Alkerwi, Ala'a

2014-01-01

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.

Association of Sedentary Behavior Time with Ideal Cardiovascular Health: The ORISCAV-LUX Study

PubMed Central

Crichton, Georgina E.; Alkerwi, Ala'a

2014-01-01

Background 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. Methods 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. Results 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). Conclusion Higher time spent sitting, viewing television, and using a computer during a day off may be unfavorably associated with ideal cardiovascular health. PMID:24925084

Salud de Corazon: Cultural Resources for Cardiovascular Health among Older Hispanic Women.

PubMed

Perez, Adriana; Fleury, Julie; Shearer, Nelma

2012-06-01

The prevalence of cardiovascular disease risk factors in Hispanic women has been substantiated across studies. While many studies have focused on the impact of these risk factors, few qualitative studies have addressed cultural and contextual meanings of cardiovascular health promotion in this population. This research explored cultural resources for cardiovascular health promotion among older Hispanic women. A qualitative descriptive methodological design using focus groups with 7 Hispanic women was used. Culture provided an overarching perspective, guiding identification and choice of resources and supports in order to promote cardiovascular health. Themes included Living Tradition, Caring for Family, Connecting with Friends, Having Faith, and Moving as Life. Data provide an initial step toward generating a more complete understanding of perceived cultural resources for cardiovascular health in older Hispanic women. Researchers and clinicians are increasingly recognizing that individuals, families and communities uniquely define cultural and contextual meaning of cardiovascular health promotion.

Cocoa, blood pressure, and cardiovascular health.

PubMed

Ferri, Claudio; Desideri, Giovambattista; Ferri, Livia; Proietti, Ilenia; Di Agostino, Stefania; Martella, Letizia; Mai, Francesca; Di Giosia, Paolo; Grassi, Davide

2015-11-18

High blood pressure is an important risk factor for cardiovascular disease and cardiovascular events worldwide. Clinical and epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. According to this, cocoa has a high content in polyphenols, especially flavanols. Flavanols have been described to exert favorable effects on endothelium-derived vasodilation via the stimulation of nitric oxide-synthase, the increased availability of l-arginine, and the decreased degradation of NO. Cocoa may also have a beneficial effect by protecting against oxidative stress alterations and via decreased platelet aggregation, decreased lipid oxidation, and insulin resistance. These effects are associated with a decrease of blood pressure and a favorable trend toward a reduction in cardiovascular events and strokes. Previous meta-analyses have shown that cocoa-rich foods may reduce blood pressure. Long-term trials investigating the effect of cocoa products are needed to determine whether or not blood pressure is reduced on a chronic basis by daily ingestion of cocoa. Furthermore, long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events. A 3 mmHg systolic blood pressure reduction has been estimated to decrease the risk of cardiovascular and all-cause mortality. This paper summarizes new findings concerning cocoa effects on blood pressure and cardiovascular health, focusing on putative mechanisms of action and "nutraceutical " viewpoints.

Obesity and the cardiovascular health effects of fine particulate air pollution.

PubMed

Weichenthal, Scott; Hoppin, Jane A; Reeves, Francois

2014-07-01

This review examines evidence related to the potential impact of obesity on the cardiovascular health effects of fine particulate air pollution (PM₂.₅). A PubMed search was conducted in December, 2013 and studies were included if they examined the relationship between PM₂.₅ and cardiovascular health as well as effect modification by obesity. One hundred twenty-one citations were reviewed; three large prospective cohort studies and 14 panel studies with short-term follow-up met the above criteria. All three cohort studies reported stronger associations between PM₂.₅ and cardiovascular mortality among obese subjects and one reported a significant trend of increased risk with increased body mass index. Similarly, 11 of 14 panel studies reported stronger associations between PM₂.₅ and acute changes in physiological measures of cardiovascular health among obese subjects including outcomes such as blood pressure and arrhythmia. Although interactions were not always statistically significant, the consistent pattern of stronger associations among obese subjects suggests that obesity may modify the impact of PM2.5 on cardiovascular health. Epidemiological evidence suggests that obesity may increase susceptibility to the cardiovascular health effects of PM₂.₅. This an important area of research as the public health impacts of air pollution could increase with increasing prevalence of obesity. Copyright © 2014 The Obesity Society.

Elements of patient-health-care provider communication related to cardiovascular rehabilitation referral.

PubMed

Pourhabib, Sanam; Chessex, Caroline; Murray, Judy; Grace, Sherry L

2016-04-01

Cardiovascular rehabilitation has been designed to decrease the burden of cardiovascular disease. This study described (1) patient-health-care provider interactions regarding cardiovascular rehabilitation and (2) which discussion elements were related to patient referral. This was a prospective study of cardiovascular patients and their health-care providers. Discussion utterances were coded using the Roter Interaction Analysis System. Discussion between 26 health-care providers and 50 patients were recorded. Cardiovascular rehabilitation referral was related to greater health-care provider interactivity (odds ratio = 2.82, 95% confidence interval = 1.01-7.86) and less patient concern and worry (odds ratio = 0.64, 95% confidence interval = 0.45-0.89). Taking time for reciprocal discussion and allaying patient anxiety may promote greater referral. © The Author(s) 2014.

A Cardiovascular Health Intervention for Spanish Speakers: The Health Literacy and ESL Curriculum.

PubMed

Soto Mas, Francisco; Schmitt, Cheryl L; Jacobson, Holly E; Myers, Orrin B

2018-02-10

Spanish speakers in the United States are in need of effective interventions that address both cardiovascular disease (CVD) and health literacy. However, the literature lacks interventions that have used and evaluated a strategies that focus on both, particularly at the community level. The aim of this study was to explore the effect of a health literacy curriculum on cardiovascular health behavior among Spanish speaking adults. It used a randomized controlled pre-posttest design. Participants included Hispanic adults with a low-to-intermediate level of English proficiency. The intervention group received the health literacy and English as a second language (ESL) Curriculum with CVD specific content, while the control group received a conventional ESL curriculum. Tools included the Spanish Cardiovascular Health Questionnaire (CSC), the test of functional health literacy in adults (TOFHLA), and the Combined English Language Skills Assessment. Analysis of change scores included independent sample t test and multiple linear regression. A total of 155 participants completed the study. There was a significant greater improvement for the intervention group in change of CSC score from pretest to posttest (P = 0.049) compared to controls. The study also found significantly improved TOFHLA (P = 0.011), however it did not find a relationship between changes in CVD behavior and health literacy or English proficiency. The Health Literacy and ESL Curriculum constitutes a valuable resource for addressing the cardiovascular health, literacy, and language needs of Spanish-speaking adults. Interventions that take a multilevel education and health approach may be more effective in addressing the needs of immigrants. Research should further explore the interactions between CVD behavior, health literacy, and English proficiency.

[Cardiovascular health in women: the role of anger and its expression].

PubMed

Pérez-García, Ana M; Sanjuán, Pilar; Rueda, Beatriz; Ruiz, M Anleles

2011-11-01

The relationships between anger expression (in, out, and control) and cardiovascular health (emotional distress, cardiovascular symptoms reported, and preventive health behaviors) were analyzed in 327 women (range 17-60 years). The same criteria (N= 218), as well as blood pressure (BP) registered in medical checkups (N= 90) were recorded one year later. Four groups according to anger-in and anger-control scores, going from the most hostile (high anger-in and low anger-control) to the least hostile (low anger-in and high anger-control) were considered. The results indicated that the most hostile group, with the least adaptive anger expression, presented worst cardiovascular health than the other three groups, at both temporal moments. Furthermore, the presence of women with pathological BP levels was higher in the groups of high anger-in. These data ratify the role of anger expression, especially its repression (anger-in) and the lack of adequate canalization or control in women's cardiovascular health from a prospective design. Appropriate management of anger feelings and the practice of preventive health behaviors can protect women from cardiovascular problems.

[Dark or white chocolate? Cocoa and cardiovascular health].

PubMed

Corti, Roberto; Perdrix, Jean; Flammer, Andreas J; Noll, Georg

2010-03-10

Epidemiological data show that a regular dietary intake of plant-derived foods reduces the risk of cardiovascular disease. Recent research indeed demonstrates interesting data about cocoa consumption, with high concentrations of polyphenols, and beneficial effects on blood pressure, insulin resistance and platelet function. Although still debated, a range of potential mechanisms through which cocoa might exert their benefits on cardiovascular health have been suggested: activation of nitric oxide, antioxidant, anti-inflammatory, anti-platelet effects, which might in turn improve endothelial function, lipid levels, blood pressure and insulin resistance. This article reviews available data about the effects of the consumption of cocoa and different types of chocolate on cardiovascular health, and outlines potential mechanisms involved on the basis of recent studies.

The Supply and Demand of the Cardiovascular Workforce

PubMed Central

Narang, Akhil; Sinha, Shashank S.; Rajagopalan, Bharath; Ijioma, Nkechinyere N.; Jayaram, Natalie; Kithcart, Aaron P.; Tanguturi, Varsha K.; Cullen, Michael W.

2017-01-01

As the burden of cardiovascular disease in the United States continues to increase, uncertainty remains on how well-equipped the cardiovascular workforce is to meet the challenges that lie ahead. In a time when health care is rapidly shifting, numerous factors affect the supply and demand of the cardiovascular workforce. This Council Commentary critically examines several factors that influence the cardiovascular workforce. These include current workforce demographics and projections, evolving health care and practice environments, and the increasing burden of cardiovascular disease. Finally, we propose 3 strategies to optimize the workforce. These focus on cardiovascular disease prevention, the effective utilization of the cardiovascular care team, and alterations to the training pathway for cardiologists. PMID:27712782

HOW MAY PROTON PUMP INHIBITORS IMPAIR CARDIOVASCULAR HEALTH?

PubMed Central

Sukhovershin, Roman A.; Cooke, John P.

2016-01-01

Proton pump inhibitors (PPIs) are among the most widely used drugs worldwide. They are used to treat a number of gastro-esophageal disorders and usually prescribed as a long-term medication or even taken without a prescription. There are a number of clinical studies that associate PPI use with an increased cardiovascular risk. In this article we review the clinical evidence for adverse cardiovascular effects of PPIs, and we discuss possible biological mechanisms by which PPIs can impair cardiovascular health. PMID:26817947

Polyphenols: Benefits to the Cardiovascular System in Health and in Aging

PubMed Central

Khurana, Sandhya; Venkataraman, Krishnan; Hollingsworth, Amanda; Piche, Matthew; Tai, T. C.

2013-01-01

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. PMID:24077237

Is Sex Good for Your Health? A National Study on Partnered Sexuality and Cardiovascular Risk among Older Men and Women.

PubMed

Liu, Hui; Waite, Linda J; Shen, Shannon; Wang, Donna H

2016-09-01

Working from a social relationship and life course perspective, we provide generalizable population-based evidence on partnered sexuality linked to cardiovascular risk in later life using national longitudinal data from the National Social Life, Health and Aging Project (NSHAP) (N = 2,204). We consider characteristics of partnered sexuality of older men and women, particularly sexual activity and sexual quality, as they affect cardiovascular risk. Cardiovascular risk is defined as hypertension, rapid heart rate, elevated C-reactive protein (CRP), and general cardiovascular events. We find that older men are more likely to report being sexually active, having sex more often, and more enjoyably than are older women. Results from cross-lagged models suggest that high frequency of sex is positively related to later risk of cardiovascular events for men but not women, whereas good sexual quality seems to protect women but not men from cardiovascular risk in later life. We find no evidence that poor cardiovascular health interferes with later sexuality for either gender. © American Sociological Association 2016.

Perceptions of cardiovascular health in underserved communities.

PubMed

Bryant, Lucinda L; Chin, Nancy P; Cottrell, Lesley A; Duckles, Joyce M; Fernandez, I Diana; Garces, D Marcela; Keyserling, Thomas C; McMilin, Colleen R; Peters, Karen E; Samuel-Hodge, Carmen D; Tu, Shin-Ping; Vu, Maihan B; Fitzpatrick, Annette L

2010-03-01

Cardiovascular disease is the leading cause of deaths and illnesses in US adults, and the prevalence is disproportionately high in underserved populations. In this study, we assessed respondents' understanding of context-specific differences in knowledge and perceptions of disease, risk, and prevention in 6 underserved communities, with the longer-term goal of developing appropriate interventions. Thirty-nine small-group sessions and 14 interviews yielded data from 318 adults. Each site's researchers coded, analyzed, and extracted key themes from local data. Investigators from all sites synthesized results and identified common themes and differences. Themes clustered in 3 areas (barriers to cardiovascular health, constraints related to multiple roles, and suggestions for effective communications and programs). Barriers spanned individual, social and cultural, and environmental levels; women in particular cited multiple roles (eg, competing demands, lack of self-care). Programmatic suggestions included the following: personal, interactive, social context; information in language that people use; activities built around cultural values and interests; and community orientation. In addition, respondents preferred health-related information from trusted groups (eg, AARP), health care providers (but with noticeable differences of opinion), family and friends, and printed materials. Interventions to decrease barriers to cardiovascular health are needed; these strategies should include family and community context, small groups, interactive methods, culturally sensitive materials, and trusted information sources. New-immigrant communities need culturally and linguistically tailored education before receiving more substantive interventions.

Effects of Social Exclusion on Cardiovascular and Affective Reactivity to a Socially Evaluative Stressor.

PubMed

Williamson, Timothy J; Thomas, KaMala S; Eisenberger, Naomi I; Stanton, Annette L

2018-04-03

Socially disconnected individuals have worse health than those who feel socially connected. The mechanisms through which social disconnection influences physiological and psychological outcomes warrant study. The current study tested whether experimental manipulations of social exclusion, relative to inclusion, influenced subsequent cardiovascular (CV) and affective reactivity to socially evaluative stress. Young adults (N = 81) were assigned through block randomization to experience either social exclusion or inclusion, using a standardized computer-based task (Cyberball). Immediately after exposure to Cyberball, participants either underwent a socially evaluative stressor or an active control task, based on block randomization. Physiological activity (systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR)) and state anxiety were assessed throughout the experiment. Excluded participants evidenced a significant increase in cardiovascular and affective responses to a socially evaluative stressor. Included participants who underwent the stressor evidenced similar increases in anxiety, but systolic blood pressure, diastolic blood pressure, and heart rate did not change significantly in response to the stressor. Results contribute to the understanding of physiological consequences of social exclusion. Further investigation is needed to test whether social inclusion can buffer CV stress reactivity, which would carry implications for how positive social factors may protect against the harmful effects of stress.

Knowledge and Behavioral Effects in Cardiovascular Health: Community Health Worker Health Disparities Initiative, 2007–2010

PubMed Central

Hurtado, Margarita; Yang, Manshu; Evensen, Christian; Windham, Amy; Ortiz, Gloria; Tracy, Rachel; Ivy, Edward Donnell

2014-01-01

Introduction Cardiovascular disease is the leading cause of death in the United States, and disparities in cardiovascular health exist among African Americans, American Indians, Hispanics, and Filipinos. The Community Health Worker Health Disparities Initiative of the National Heart, Lung, and Blood Institute (NHLBI) includes culturally tailored curricula taught by community health workers (CHWs) to improve knowledge and heart-healthy behaviors in these racial/ethnic groups. Methods We used data from 1,004 community participants in a 10-session curriculum taught by CHWs at 15 sites to evaluate the NHLBI’s health disparities initiative by using a 1-group pretest–posttest design. The curriculum addressed identification and management of cardiovascular disease risk factors. We used linear mixed effects and generalized linear mixed effects models to examine results. Results Average participant age was 48; 75% were female, 50% were Hispanic, 35% were African American, 8% were Filipino, and 7% were American Indian. Twenty-three percent reported a history of diabetes, and 37% reported a family history of heart disease. Correct pretest to posttest knowledge scores increased from 48% to 74% for heart healthy knowledge. The percentage of participants at the action or maintenance stage of behavior change increased from 41% to 85%. Conclusion Using the CHW model to implement community education with culturally tailored curricula may improve heart health knowledge and behaviors among minorities. Further studies should examine the influence of such programs on clinical risk factors for cardiovascular disease. PMID:24524426

Effect of gender on awareness of cardiovascular risk factors, preventive action taken, and barriers to cardiovascular health in a group of Austrian subjects.

PubMed

Haidinger, Teresa; Zweimüller, Martin; Stütz, Lena; Demir, Dondue; Kaider, Alexandra; Strametz-Juranek, Jeanette

2012-04-01

The incidence of cardiovascular disease (CVD) is increasing in industrialized countries. Preventive action is an important factor in minimizing CVD-associated morbidity and mortality. However, it is not known whether gender differences affect CVD or risk factor awareness influencing self-assessment of personal risk and preventive action. This study was performed to assess individual CVD and risk factor awareness, preventive action taken, and barriers to cardiovascular health. The study included 573 women and 336 men, randomly chosen to complete an anonymous questionnaire to assess individual CVD and risk factor awareness, preventive action taken, and barriers to cardiovascular health. The data were analyzed using SAS software. Cardiovascular disease was identified in 75% of patients, in both sexes, as the leading cause of death; however, both groups showed significant lack of knowledge about CVD risk factors. Type 2 diabetes was identified correctly in only 27.5%. Preventive action was linked more often to family members in 66.5% of women and 62.8% of men. The primary barrier to cardiovascular health in adults was incorrect assessment of personal CVD risk. More than half of female respondents (56.4%) and male respondents (52.7%) underestimated their risk of CVD. Knowledge about risk factors for CVD needs to be improved in members of both sexes. Because women, in particular, have difficulty in correctly assessing their personal CVD risk, future education programs are warranted to inform both women and men about CVD and its risk factors, thereby helping them to correctly assess their individual risk. However, greater effort is needed to inform men, compared with women, about the various ways in which to prevent CVD and to motivate them to take preventive action. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

Converging evidence that subliminal evaluative conditioning does not affect self‐esteem or cardiovascular activity

PubMed Central

Verkuil, Bart; Brosschot, Jos F.

2017-01-01

Abstract Self‐esteem moderates the relationship between stress and (cardiovascular) health, with low self‐esteem potentially exacerbating the impact of stressors. Boosting self‐esteem may therefore help to buffer against stress. Subliminal evaluative conditioning (SEC), which subliminally couples self‐words with positive words, has previously been successfully used to boost self‐esteem, but the existing studies are in need of replication. In this article, we aimed to replicate and extend previous SEC studies. The first 2 experiments simultaneously examined whether SEC increased self‐esteem (Experiment 1, n = 84) and reduced cardiovascular reactivity to a stressor in high worriers (Experiment 2, n = 77). On the basis of these results, the 3rd experiment was set up to examine whether an adjusted personalized SEC task increased self‐esteem and reduced cardiac activity in high worriers (n = 81). Across the 3 experiments, no effects were found of SEC on implicit or explicit self‐esteem or affect or on cardiovascular (re)activity compared to a control condition in which the self was coupled with neutral words. The results do not support the use of the subliminal intervention in its current format. As stress is highly prevalent, future studies should focus on developing other cost‐effective and evidence‐based interventions. PMID:28795525

Sex differences in cardiovascular health: does sexism influence women's health?

PubMed

Molix, Lisa

2014-08-01

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 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 cardiovascular disease, but smaller studies have yielded fairly consistent results. It is suggested that future research should aim to examine the influence of 2 types of sexism (ie, hostile and benevolent) and that daily or within-day designs be used to assess cognitive, behavioral and physiological responses to everyday sexist experiences.

Health Social Networks as Online Life Support Groups for Patients With Cardiovascular Diseases

PubMed Central

Medina, Edhelmira Lima; Loques, Orlando; Mesquita, Cláudio Tinoco

2013-01-01

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. PMID:24030085

Ideal cardiovascular health in young adult populations from the United States, Finland, and Australia and its association with cIMT: The International Childhood Cardiovascular Cohort Consortium

USDA-ARS?s Scientific Manuscript database

The goals for cardiovascular disease prevention were set by the American Heart Association in 2010 for the concept of cardiovascular health. Ideal cardiovascular health is defined by senen cardiovascular health metrics: blood pressure, glucose, cholesterol, body mass index, and physical activity on ...

Health promotion and cardiovascular disease prevention in sub-Saharan Africa.

PubMed

Sampson, Uchechukwu K A; Amuyunzu-Nyamongo, Mary; Mensah, George A

2013-01-01

Recent population studies demonstrate an increasing burden of cardiovascular disease (CVD) and related risk factors in sub-Saharan Africa (SSA). The mitigation or reversal of this trend calls for effective health promotion and preventive interventions. In this article, we review the core principles, challenges, and progress in promoting cardiovascular health with special emphasis on interventions to address physical inactivity, poor diet, tobacco use, and adverse cardiometabolic risk factor trends in SSA. We focus on the five essential strategies of the Ottawa Charter for Health Promotion. Successes highlighted include community-based interventions in Ghana, Nigeria, South Africa, and Mauritius and school-based programs in Kenya, Namibia, and Swaziland. We address the major challenge of developing integrated interventions, and showcase partnerships opportunities. We conclude by calling for intersectoral partnerships for effective and sustainable intervention strategies to advance cardiovascular health promotion and close the implementation gap in accordance with the 2009 Nairobi Call to Action on Health Promotion. © 2013.

Gut microbiota derived metabolites in cardiovascular health and disease.

PubMed

Wang, Zeneng; Zhao, Yongzhong

2018-05-03

Trillions of microbes inhabit the human gut, not only providing nutrients and energy to the host from the ingested food, but also producing metabolic bioactive signaling molecules to maintain health and elicit disease, such as cardiovascular disease (CVD). CVD is the leading cause of mortality worldwide. In this review, we presented gut microbiota derived metabolites involved in cardiovascular health and disease, including trimethylamine-N-oxide (TMAO), uremic toxins, short chain fatty acids (SCFAs), phytoestrogens, anthocyanins, bile acids and lipopolysaccharide. These gut microbiota derived metabolites play critical roles in maintaining a healthy cardiovascular function, and if dysregulated, potentially causally linked to CVD. A better understanding of the function and dynamics of gut microbiota derived metabolites holds great promise toward mechanistic predicative CVD biomarker discoveries and precise interventions.

Tetrahydrobiopterin in Cardiovascular Health and Disease

PubMed Central

Bendall, Jennifer K.; Douglas, Gillian; McNeill, Eileen; Channon, Keith M.

2014-01-01

Abstract Tetrahydrobiopterin (BH4) functions as a cofactor for several important enzyme systems, and considerable evidence implicates BH4 as a key regulator of endothelial nitric oxide synthase (eNOS) in the setting of cardiovascular health and disease. BH4 bioavailability is determined by a balance of enzymatic de novo synthesis and recycling, versus degradation in the setting of oxidative stress. Augmenting vascular BH4 levels by pharmacological supplementation has been shown in experimental studies to enhance NO bioavailability. However, it has become more apparent that the role of BH4 in other enzymatic pathways, including other NOS isoforms and the aromatic amino acid hydroxylases, may have a bearing on important aspects of vascular homeostasis, inflammation, and cardiac function. This article reviews the role of BH4 in cardiovascular development and homeostasis, as well as in pathophysiological processes such as endothelial and vascular dysfunction, atherosclerosis, inflammation, and cardiac hypertrophy. We discuss the therapeutic potential of BH4 in cardiovascular disease states and attempt to address how this modulator of intracellular NO-redox balance may ultimately provide a powerful new treatment for many cardiovascular diseases. Antioxid. Redox Signal. 20, 3040–3077. PMID:24294830

Occupational Health Promotion Programs to Reduce Cardiovascular Risk.

ERIC Educational Resources Information Center

Glasgow, Russell E.; Terborg, James R.

1988-01-01

Surveys literature on worksite health promotion programs targeting cardiovascular risk factors. Reviews findings on health-risk appraisal, hypertension control, smoking cessation, weight reduction, exercise, and programs addressing multiple risk factors. Discusses current knowledge, highlights exemplary studies, and identifies problems and…

Do environmental effects on human emotions cause cardiovascular disorders?

PubMed

Rosenman, R H

1997-01-01

Environmental influences on human health include the effects of toxic materials and adverse ecological factors. Natural milieu stressors also affect emotions that may adversely affect cardiovascular function and precipitate or otherwise contribute to complications of cardiovascular diseases. However, although variously hypothesized, there is inadequate evidence that they directly contribute to the pathogenesis of sustained hypertension or coronary atherosclerosis.

Community Based Cardiovascular Health Interventions in Vulnerable Populations: A Systematic Review

PubMed Central

Walton-Moss, Benita; Samuel, Laura; Nguyen, Tam H; Commodore-Mensah, Yvonne; Hayat, Matthew J.; Szanton, Sarah L.

2013-01-01

Background Although cardiovascular health has been improving for many Americans, this is not true of those in “vulnerable populations.” To address this growing disparity communities and researchers have worked for decades, and as a result of their work a growing body of literature supports the use of community engagement as a component of successful interventions. However, little literature synthesizes community-based interventions that address this disparity among a wide range of vulnerable populations. Objective This paper provides a critical review of community-based cardiovascular disease (CVD) interventions to improve cardiovascular health behaviors and factors among vulnerable populations based on the American Heart Association’s 7 metrics of ideal cardiovascular health. Methods In February 2011, four databases (PubMed, PsychInfo, CINAHL, and Scopus) were searched using the following keywords: vulnerable populations OR healthcare disparities AND cardiovascular disease AND clinical trials OR public health practice AND English. Results This search strategy resulted in the retrieval of 7,120 abstracts. Each abstract was reviewed by at least two authors and eligibility for the systematic review was confirmed after reading the full article. Thirty two studies met eligibility criteria. Education was the most common intervention (41%), followed by counseling or support (38%), and exercise classes (28%). Half of the interventions were multi-component. Health care providers were the most frequent interventionists. Interventions aimed at decreasing blood pressure were the most promising while behavior change interventions were the most challenging. Almost all of the interventions were at the individual level, and were proof of concept or efficacy trials. Conclusions This analysis provides a step towards understanding the current literature on cardiovascular interventions for vulnerable population. The next step should be integrating the identified successful

Ideal cardiovascular health predicts lower risk of abnormal liver enzymes levels in the Chilean National Health Survey (2009-2010).

PubMed

García-Hermoso, Antonio; Hackney, Anthony C; Ramírez-Vélez, Robinson

2017-01-01

High levels of gamma glutamyltransferase (gamma-GT) and alanine aminotransferase (ALT), as well as fatty liver index (FLI) has been associated with higher cardiovascular disease risk factors in adults. The aim of this study was to examine the relationship between gamma-GT, ALT, and fatty liver index FLI levels across a gradient number of ideal cardiovascular health metrics in a representative sample of adults from the Chilean National Health Survey 2009-2010. Data from 1,023 men and 1,449 women (≥ 15 years) from the Chilean Health Survey 2009-2010 were analyzed. Ideal cardiovascular health was defined as meeting ideal levels of the following components: four behaviours (smoking, body mass index, physical activity and diet adherence) and three factors (total cholesterol, blood pressure and fasting glucose). Adults were grouped into three categories according to their number of ideal cardiovascular health metrics: ideal (5-7 metrics), intermediate (3-4 metrics), and poor (0-2 metrics). Blood levels of gamma-GT and ALT were measured and the FLI was calculated. A higher number of ideal cardiovascular health index metric was associated with lower gamma-GT, ALT and FLI (p from trend analysis <0.001). Also, adults meeting at least 3-4 metrics were predicted less likely to have prevalence of abnormal levels of gamma-GT and FLI (p<0.001) compared to adults who met only 0-2 metrics. These findings reinforce the usefulness of the ideal cardiovascular health metrics proposed by the American Heart Association as a tool to identify target subjects and promote cardiovascular health in South-American adults.

Community-based cardiovascular health interventions in vulnerable populations: a systematic review.

PubMed

Walton-Moss, Benita; Samuel, Laura; Nguyen, Tam H; Commodore-Mensah, Yvonne; Hayat, Matthew J; Szanton, Sarah L

2014-07-01

Although cardiovascular health has been improving for many Americans, this is not true of those in "vulnerable populations." To address this growing disparity, communities and researchers have worked for decades, and as a result of their work, a growing body of literature supports the use of community engagement as a component of successful interventions. However, little literature synthesizes community-based interventions that address this disparity among a wide range of vulnerable populations. This article provides a critical review of community-based cardiovascular disease interventions to improve cardiovascular health behaviors and factors among vulnerable populations based on the American Heart Association's 7 metrics of ideal cardiovascular health. In February 2011, 4 databases (PubMed, PsychInfo, CINAHL, and Scopus) were searched using the following keywords: vulnerable populations OR healthcare disparities AND cardiovascular disease AND clinical trials OR public health practice AND English. This search strategy resulted in the retrieval of 7120 abstracts. Each abstract was reviewed by at least 2 authors, and eligibility for the systematic review was confirmed after reading the full article. Thirty-two studies met eligibility criteria. Education was the most common intervention (41%), followed by counseling or support (38%) and exercise classes (28%). Half of the interventions were multicomponent. Healthcare providers were the most frequent interventionists. Interventions aimed at decreasing blood pressure were the most promising, whereas behavior change interventions were the most challenging. Almost all of the interventions were at the individual level and were proof-of-concept or efficacy trials. This analysis provides a step toward understanding the current literature on cardiovascular interventions for vulnerable population. The next step should be integrating the identified successful interventions into larger health systems and/or social policies.

Sleep, health behaviors, and behavioral interventions: Reducing the risk of cardiovascular disease in adults

PubMed Central

Kaar, Jill L; Luberto, Christina M; Campbell, Kirsti A; Huffman, Jeff C

2017-01-01

Numerous health behaviors, including physical activity, diet, smoking, and sleep, play a major role in preventing the development and progression of cardiovascular disease (CVD). Among these behaviors, sleep may play a pivotal role, yet it has been studied somewhat less than other behaviors and there have been few well-designed sleep intervention studies targeting CVD. Furthermore, despite the fact that these behaviors are often interrelated, interventions tend to focus on changing one health behavior rather than concurrently intervening on multiple behaviors. Psychological constructs from depression to positive affect may also have a major effect on these health behaviors and ultimately on CVD. In this review, we summarize the existing literature on the impact of sleep and other cardiac health behaviors on CVD onset and prognosis. We also describe interventions that may promote these behaviors, from established interventions such as motivational interviewing and cognitive behavioral therapy, to more novel approaches focused on mindfulness and other positive psychological constructs. Finally, we outline population-health-level care management approaches for patients with psychiatric conditions (e.g., depression) that may impact cardiac health, and discuss their potential utility in improving mental health, promoting health behaviors, and reducing CVD-related risk. Much work is still needed to better understand how sleep and other health behaviors may uniquely contribute to CVD risk, and additional high-quality studies of interventions designed to modify cardiac health behaviors are required to improve cardiovascular health in individuals and the population at large. PMID:28603586

Systematic Review of Yoga Interventions to Promote Cardiovascular Health in Older Adults.

PubMed

Barrows, Jennifer L; Fleury, Julie

2016-06-01

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. © The Author(s) 2015.

Evaluation of HeartSmarts, a Faith-Based Cardiovascular Health Education Program.

PubMed

Tettey, Naa-Solo; Duran, Pedro A; Andersen, Holly S; Boutin-Foster, Carla

2017-02-01

In order to effectively address cardiovascular disease among African Americans, evidence-based health information must be disseminated within a context aligned with the values and beliefs of the population. Faith-based organizations play a critical role in meeting the religious and spiritual needs of many African Americans. Additionally, faith-based organizations can be effective in health promotion. A manual was created by incorporating biblical scriptures relating to health messages drawn from existing health manuals oriented toward African Americans. Lay health educators active in their churches participated in a 12-week training to learn the basics of cardiovascular disease and methods for delivering the program to their congregations' members. After the completion of the training, these lay health educators recruited participants from their respective churches and administered their own 12-week HeartSmarts program. Measurements of participants' systolic and diastolic blood pressure (mmHg), height (in.), weight (lbs.), and waist circumference (in.) were taken, and cardiovascular disease knowledge assessments (based on 20 open-ended questions) were administered at the start and end of the 12-week programs. Fourteen predominantly African American churches in NYC participated. Of the 221 participants, 199 completed the program. There were significant reductions in pretest and posttest total participant averages for systolic BP (4.48 mmHg, p < 0.001), diastolic BP (3.38 mmHg, p < 0.001), weight (3lbs., p = 0.001), and BMI (0.46, p = 0.001). Cardiovascular disease health assessment scores had an average increase of 12.74 correct responses (p < 0.001). The HeartSmarts program may be an effective ecumenical and cultural model for disseminating health messages and reducing cardiovascular risk among African Americans.

Improving access and equity in reducing cardiovascular risk: the Queensland Health model.

PubMed

Ski, Chantal F; Vale, Margarite J; Bennett, Gary R; Chalmers, Victoria L; McFarlane, Kim; Jelinek, V Michael; Scott, Ian A; Thompson, David R

2015-02-16

To measure changes in cardiovascular risk factors among patients with coronary heart disease (CHD) and/or type 2 diabetes enrolled in a centralised statewide coaching program delivered by telephone and mail-out in the public health sector in Queensland. A population-based audit of cardiovascular risk factor data collected prospectively as part of The COACH (Coaching Patients On Achieving Cardiovascular Health) Program (TCP) delivered through Queensland Health's Health Contact Centre. 1962 patients with CHD and 707 patients with type 2 diabetes who completed TCP from 20 February 2009 to 20 June 2013, of whom 145 were Indigenous Australians. Changes in fasting lipids, fasting glucose, glycosylated haemoglobin levels, blood pressure, body weight, body mass index, smoking, alcohol consumption and physical activity, as measured at entry to and completion of the program. Statistically significant improvements in cardiovascular risk factor status, from entry to completion of the program, were found across all biomedical and lifestyle factors in patients with CHD and/or type 2 diabetes. For both diseases, improvements in serum lipids, blood glucose, smoking habit and alcohol consumption combined with increases in physical activity were the most notable findings. Similar differences were found in mean change scores in cardiovascular risk factors between Indigenous and non-Indigenous Queenslanders. A centralised statewide coaching program delivered by telephone and mail-out overcomes obstacles of distance and limited access to health services and facilitates a guideline-concordant decrease in cardiovascular risk.

Nutrition, environment and cardiovascular health (NESCAV): protocol of an inter-regional cross-sectional study.

PubMed

Alkerwi, Ala'a; Guillaume, Michèle; Zannad, Faiez; Laufs, Ulrich; Lair, Marie-Lise

2010-11-15

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. 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. 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.

Cardiovascular Health Awareness Program (CHAP): a community cluster-randomised trial among elderly Canadians.

PubMed

Kaczorowski, Janusz; Chambers, Larry W; Karwalajtys, Tina; Dolovich, Lisa; Farrell, Barbara; McDonough, Beatrice; Sebaldt, Rolf; Levitt, Cheryl; Hogg, William; Thabane, Lehana; Tu, Karen; Goeree, Ron; Paterson, J Michael; Shubair, Mamdouh; Gierman, Tracy; Sullivan, Shannon; Carter, Megan

2008-06-01

High blood pressure is an important and modifiable cardiovascular disease risk factor that remains under-detected and under-treated. Community-level interventions that address high blood pressure and other modifiable risk factors are a promising strategy to improve cardiovascular health in populations. The present study is a community cluster-randomised trial testing the effectiveness of CHAP (Cardiovascular Health Awareness Program) on the cardiovascular health of older adults. Thirty-nine mid-sized communities in Ontario, Canada were stratified by geographic location and size of the population aged >or=65 years and randomly allocated to receive CHAP or no intervention. In CHAP communities, residents aged >or=65 years were invited to attend cardiovascular risk assessment sessions held in pharmacies over 10 weeks in Fall, 2006. Sessions included blood pressure measurement and feedback to family physicians. Trained volunteers delivered the program with support from pharmacists, community nurses and local organisations. The primary outcome measure is the relative change in the mean annual rate of hospital admission for acute myocardial infarction, congestive heart failure and stroke (composite end-point) among residents aged >or=65 years in intervention and control communities, using routinely collected, population-based administrative health data. This paper highlights considerations in design, implementation and evaluation of a large-scale, community-wide cardiovascular health promotion initiative.

[Cardiovascular disease prevention and health promotion in the French speaking community of Belgium].

PubMed

Coppieters, Y; Béduwé, C; Collignon, J L; Hubens, V; Levêque, A

2010-01-01

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.

[Beneficial effects of chocolate on cardiovascular health].

PubMed

Gómez-Juaristi, M; González-Torres, L; Bravo, L; Vaquero, M P; Bastida, S; Sánchez-Muniz, F J

2011-01-01

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 interaction of chocolate and its components with candidate genes will also supply necessary information regarding the individuals best suited to benefit from a potential cardiovascular disease treatment with chocolate.

Ideal cardiovascular health status and its association with socioeconomic factors in Chinese adults in Shandong, China.

PubMed

Ren, J; Guo, X L; Lu, Z L; Zhang, J Y; Tang, J L; Chen, X; Gao, C C; Xu, C X; Xu, A Q

2016-09-07

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the world. In 2010, a goal released by the American Heart Association (AHA) Committee focused on the primary reduction in cardiovascular risk. Data collected from 7683 men and 7667 women aged 18-69 years were analyzed. The distribution of ideal cardiovascular health metrics based on 7 cardiovascular disease risk factors or health behaviors in according to the definition of AHA was evaluated among the subjects. The association of the socioeconomic factors on the prevalence of meeting 5 or more ideal cardiovascular health metrics was estimated by logistic regression analysis, and a chi-square test for categorical variables and the general linear model (GLM) procedure for continuous variables were used to compare differences in prevalence and in means among genders. Seven of 15350 participants (0.05 %) met all 7 cardiovascular health metrics. The women had a higher proportion of meeting 5 or more ideal health metrics compared with men (32.67 VS.14.27 %). The subjects with a higher education and income level had a higher proportion of meeting 5 or more ideal health metrics than the subjects with a lower education and income level. A comparison between subjects with meeting 5 or more ideal cardiovascular health metrics with subjects meeting 4 or fewer ideal cardiovascular health metrics reveals that adjusted odds ratio [OR, 95 % confidence intervals (95 % CI)] was 1.42 (0.95, 2.21) in men and 2.59 (1.74, 3.87) in women for higher education and income, respectively. The prevalence of meeting all 7 cardiovascular health metrics was low in the adult population. Women, young subjects, and those with higher levels of education or income tend to have a greater number of the ideal cardiovascular health metrics. Higher socioeconomic status was associated with an increasing prevalence of meeting 5 or more cardiovascular health metrics in women but not in men. It's urgent to develop comprehensive

Is Sex Good for Your Health? A National Study on Partnered Sexuality and Cardiovascular Risk Among Older Men and Women

PubMed Central

Liu, Hui; Waite, Linda; Shen, Shannon; Wang, Donna

2016-01-01

Working from a social relationship and life course perspective, we provide generalizable population-based evidence on partnered sexuality linked to cardiovascular risk in later life using national longitudinal data from the NSHAP (N=2204). We consider characteristics of partnered sexuality of older men and women, particularly sexual activity and sexual quality, as they affect cardiovascular risk. Cardiovascular risk is defined as hypertension, rapid heart rate, elevated CRP, and general cardiovascular events. We find that older men are more likely to report being sexually active, report having sex more often and more enjoyably than are older women. Results from cross-lagged models suggest that high frequency of sex is positively related to later risk of cardiovascular events for men but not women, whereas good sexual quality seems to protect women but not men from cardiovascular risk in later life. We find no evidence that poor cardiovascular health interferes with later sexuality for either gender. PMID:27601406

Socioeconomic status and parenting during adolescence in relation to ideal cardiovascular health in Black and White men.

PubMed

Matthews, Karen A; Boylan, Jennifer M; Jakubowski, Karen P; Cundiff, Jenny M; Lee, Laisze; Pardini, Dustin A; Jennings, J Richard

2017-07-01

American Heart Association (AHA) developed a new metric to evaluate ideal cardiovascular health based on optimal levels of 7 cardiovascular risk factors and health behaviors. We evaluated the relationships of parenting characteristics and academic achievement in adolescence in relation to ideal cardiovascular health in midlife men. We measured cardiovascular risk factors in 171 Black and 136 White men and their ideal cardiovascular health score was constructed based on AHA guidelines. When the participants were 13-16 years old, annual measures of parent-child communication, positive relationship, parental monitoring, family cohesion, boys' involvement in family activities, and academic achievement were recorded and averaged. Confirmatory factor analysis of adolescent parenting measures revealed a single Parenting Composite. Multiple linear regressions showed a significant Race by Parenting Composite interaction term, β = -.19, p = .03; better parenting was significantly related to more ideal cardiovascular health in Blacks only, β = -.23, p = .004, which remained after adjustments for adolescent and adult socioeconomic status (SES). Academic achievement was related to ideal cardiovascular health, β = -.13, but was no longer significant after controls for adult SES. Adult SES was a strong correlate of ideal cardiovascular health in Black and White men. Black men exposed to positive parenting during adolescence had more ideal cardiovascular health based on AHA guidelines. Improving academic achievement in adolescence may indirectly benefit adult cardiovascular health through improving adult SES. This is the first study of adolescent family predictors of the extent of ideal cardiovascular health. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Cardiovascular Health in Ambulatory Care Research Team performance indicators for the primary prevention of cardiovascular disease: a modified Delphi panel study.

PubMed

Tu, Jack V; Maclagan, Laura C; Ko, Dennis T; Atzema, Clare L; Booth, Gillian L; Johnston, Sharon; Tu, Karen; Lee, Douglas S; Bierman, Arlene; Hall, Ruth; Bhatia, R Sacha; Gershon, Andrea S; Tobe, Sheldon W; Sanmartin, Claudia; Liu, Peter; Chu, Anna

2017-04-25

High-quality ambulatory care can reduce cardiovascular disease risk, but important gaps exist in the provision of cardiovascular preventive care. We sought to develop a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. As part of the Cardiovascular Health in Ambulatory Care Research Team initiative, we established a 14-member multidisciplinary expert panel to develop a set of indicators for measuring primary prevention performance in ambulatory cardiovascular care. We used a 2-stage modified Delphi panel process to rate potential indicators, which were identified from the literature and national cardiovascular organizations. The top-rated indicators were pilot tested to determine their measurement feasibility with the use of data routinely collected in the Canadian health care system. A set of 28 indicators of primary prevention performance were identified, which were grouped into 5 domains: risk factor prevalence, screening, management, intermediate outcomes and long-term outcomes. The indicators reflect the major cardiovascular risk factors including smoking, obesity, hypertension, diabetes, dyslipidemia and atrial fibrillation. All indicators were determined to be amenable to measurement with the use of population-based administrative (physician claims, hospital admission, laboratory, medication), survey or electronic medical record databases. The Cardiovascular Health in Ambulatory Care Research Team indicators of primary prevention performance provide a framework for the measurement of cardiovascular primary prevention efforts in Canada. The indicators may be used by clinicians, researchers and policy-makers interested in measuring and improving the prevention of cardiovascular disease in ambulatory care settings. Copyright 2017, Joule Inc. or its licensors.

The Importance of Inclusion for Cardiovascular Health Promotion Programs in Delaware.

PubMed

Papas, Mia A; Stolz, Nicole; Orsega-Smith, Elizabeth; Sparling, Eileen; Freedman, Brian

2018-03-01

Individuals with disabilities experience greater rates of cardiovascular disease than individuals without disabilities. This increase can be attributed to decreased levels of physical activity, poor eating habits, and increased levels of diabetes, smoking, and obesity. Individuals with disabilities are often excluded from surveillance, treatment, and prevention efforts. Consequently, there is little known about their participation rates in health promotion and disease prevention programs. The aims of this investigation are (1) to examine time trends in cardiovascular disease and risk factors over a 10-year period by disability status and (2) to assess the inclusiveness of health promotion programs in Delaware. The percentage of individuals with disabilities increased from 18% in 2001 to 28% in 2011. Individuals with disabilities had higher rates of cardiovascular disease (t = 80.45; degrees of freedom [df] = 198; p < .0001) and obesity (body mass index > 30 kg/m2) than individuals without disabilities (t = 33.0; df = 198; p < .0001). They also reported less physical activity (t = 44.21; df = 198; p < .0001) and worse diet quality (t = 4.70; df = 198; p < .0001). There was a consistent lack of information about inclusion and participation of individuals with disabilities in health promotion programs. Making adaptations within cardiovascular disease prevention programs in Delaware is imperative to improving the health of individuals with disabilities. Ensuring cardiovascular disease programs are accessible and provide disability-specific trained staff will reduce barriers to participation so that all individuals can benefit.

Emotion suppression affects cardiovascular responses to initial and subsequent laboratory stressors.

PubMed

Quartana, Phillip J; Burns, John W

2010-09-01

The study of anger suppression and risk for cardiovascular disease has relied predominately on inspection of correlations between trait anger-in and cardiovascular risk factors and disease. This approach tells us little about whether inhibitory processes have anything to do with outcomes, and cannot speak to whether suppression of anger per se affects cardiovascular parameters. Drawing on the broader emotion regulation literature, we examined the effects of experimentally induced anger and general negative emotion in the context of expressive and experiential suppression on cardiovascular responses to initial and subsequent laboratory stressors. Of all participants, 201 healthy participants were randomly assigned to one of six conditions formed by crossing emotion (anxiety, anger) and suppression (experiential, expressive, control) conditions. Participants completed a mental arithmetic task with anxiety or anger induction under their respective suppression manipulation instructions, and subsequently were exposed to a cold pressor task. Systolic blood pressure (SBP), diastolic blood pressure, and heart rate values were obtained for each experimental epoch. More robust SBP responses to the initial stressor were evidenced for those in the expressive versus the control condition. In response to the subsequent stressor, those in the experiential suppression condition showed the most pronounced SBP responses, suggesting pronounced delayed effects of this type of suppression. Effects of suppression on SBP reactivity were indistinguishable across anxiety and anger conditions. Effortful suppression of negative emotion has immediate and delayed consequences for stress-induced cardiovascular reactivity. Theoretical and clinical significance of these findings are discussed.

Prevalence of ideal cardiovascular health in European adolescents: The HELENA study.

PubMed

Henriksson, Pontus; Henriksson, Hanna; Gracia-Marco, Luis; Labayen, Idoia; Ortega, Francisco B; Huybrechts, Inge; España-Romero, Vanesa; Manios, Yannis; Widhalm, Kurt; Dallongeville, Jean; González-Gross, Marcela; Marcos, Ascensión; Moreno, Luis A; Castillo, Manuel J; Ruiz, Jonatan R

2017-08-01

The ideal cardiovascular health (iCVH) construct consists of 4 health behaviours and 3 health factors and is strongly related to later cardiovascular disease. However, the prevalence of iCVH in European adolescents is currently unknown. The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional, multicentre study conducted in 9 European countries during 2006-2007 and included 3528 adolescents (1683 boys and 1845 girls) between 12.5 and 17.5years of age. Status (ideal vs. non-ideal) for the health behaviours (smoking status, body mass index, physical activity and diet) and health factors (total cholesterol, blood pressure and fasting glucose) were determined. Overall, the prevalence of ideal health behaviours was low; non-smoking (60.9% ideal), body mass index (76.8%), physical activity (62.1%), and diet (1.7%). The prevalence of ideal health factors was; total cholesterol (65.8%), blood pressure (62.0%) and plasma glucose (88.8%). The low prevalence of iCVH behaviours, especially diet and physical activity, identified in European adolescents is likely to influence later cardiovascular health which strongly motivates efforts to increase ideal health behaviours in this population. Copyright © 2017 Elsevier B.V. All rights reserved.

Cocoa and chocolate flavonoids: implications for cardiovascular health.

PubMed

Steinberg, Francene M; Bearden, Monica M; Keen, Carl L

2003-02-01

This paper offers a review of current scientific research regarding the potential cardiovascular health benefits of flavonoids found in cocoa and chocolate. Recent reports indicate that the main flavonoids found in cocoa, flavan-3-ols and their oligomeric derivatives, procyanidins, have a variety of beneficial actions, including antioxidant protection and modulation of vascular homeostasis. These findings are supported by similar research on other flavonoid-rich foods. Other constituents in cocoa and chocolate that may also influence cardiovascular health are briefly reviewed. The lipid content of chocolate is relatively high; however, one third of the lipid in cocoa butter is composed of the fat stearic acid, which exerts a neutral cholesterolemic response in humans. Cocoa and chocolate contribute to trace mineral intake, which is necessary for optimum functioning of all biologic systems and for vascular tone. Thus, multiple components in chocolate, particularly flavonoids, can contribute to the complex interplay of nutrition and health. Applications of this knowledge include recommendations by health professionals to encourage individuals to consume a wide range of phytochemical-rich foods, which can include dark chocolate in moderate amounts.

Pre-eclampsia and offspring cardiovascular health: mechanistic insights from experimental studies.

PubMed

Davis, Esther F; Newton, Laura; Lewandowski, Adam J; Lazdam, Merzaka; Kelly, Brenda A; Kyriakou, Theodosios; Leeson, Paul

2012-07-01

Pre-eclampsia is increasingly recognized as more than an isolated disease of pregnancy. Women who have had a pregnancy complicated by pre-eclampsia have a 4-fold increased risk of later cardiovascular disease. Intriguingly, the offspring of affected pregnancies also have an increased risk of higher blood pressure and almost double the risk of stroke in later life. Experimental approaches to identify the key features of pre-eclampsia responsible for this programming of offspring cardiovascular health, or the key biological pathways modified in the offspring, have the potential to highlight novel targets for early primary prevention strategies. As pre-eclampsia occurs in 2-5% of all pregnancies, the findings are relevant to the current healthcare of up to 3 million people in the U.K. and 15 million people in the U.S.A. In the present paper, we review the current literature that concerns potential mechanisms for adverse cardiovascular programming in offspring exposed to pre-eclampsia, considering two major areas of investigation: first, experimental models that mimic features of the in utero environment characteristic of pre-eclampsia, and secondly, how, in humans, offspring cardiovascular phenotype is altered after exposure to pre-eclampsia. We compare and contrast the findings from these two bodies of work to develop insights into the likely key pathways of relevance. The present review and analysis highlights the pivotal role of long-term changes in vascular function and identifies areas of growing interest, specifically, response to hypoxia, immune modification, epigenetics and the anti-angiogenic in utero milieu.

Pre-eclampsia and offspring cardiovascular health: mechanistic insights from experimental studies

PubMed Central

Davis, Esther F.; Newton, Laura; Lewandowski, Adam J.; Lazdam, Merzaka; Kelly, Brenda A.; Kyriakou, Theodosios; Leeson, Paul

2012-01-01

Pre-eclampsia is increasingly recognized as more than an isolated disease of pregnancy. Women who have had a pregnancy complicated by pre-eclampsia have a 4-fold increased risk of later cardiovascular disease. Intriguingly, the offspring of affected pregnancies also have an increased risk of higher blood pressure and almost double the risk of stroke in later life. Experimental approaches to identify the key features of pre-eclampsia responsible for this programming of offspring cardiovascular health, or the key biological pathways modified in the offspring, have the potential to highlight novel targets for early primary prevention strategies. As pre-eclampsia occurs in 2–5% of all pregnancies, the findings are relevant to the current healthcare of up to 3 million people in the U.K. and 15 million people in the U.S.A. In the present paper, we review the current literature that concerns potential mechanisms for adverse cardiovascular programming in offspring exposed to pre-eclampsia, considering two major areas of investigation: first, experimental models that mimic features of the in utero environment characteristic of pre-eclampsia, and secondly, how, in humans, offspring cardiovascular phenotype is altered after exposure to pre-eclampsia. We compare and contrast the findings from these two bodies of work to develop insights into the likely key pathways of relevance. The present review and analysis highlights the pivotal role of long-term changes in vascular function and identifies areas of growing interest, specifically, response to hypoxia, immune modification, epigenetics and the anti-angiogenic in utero milieu. PMID:22455350

Ideal cardiovascular health predicts lower risk of abnormal liver enzymes levels in the Chilean National Health Survey (2009–2010)

PubMed Central

Hackney, Anthony C.

2017-01-01

High levels of gamma glutamyltransferase (gamma-GT) and alanine aminotransferase (ALT), as well as fatty liver index (FLI) has been associated with higher cardiovascular disease risk factors in adults. The aim of this study was to examine the relationship between gamma-GT, ALT, and fatty liver index FLI levels across a gradient number of ideal cardiovascular health metrics in a representative sample of adults from the Chilean National Health Survey 2009–2010. Data from 1,023 men and 1,449 women (≥ 15 years) from the Chilean Health Survey 2009–2010 were analyzed. Ideal cardiovascular health was defined as meeting ideal levels of the following components: four behaviours (smoking, body mass index, physical activity and diet adherence) and three factors (total cholesterol, blood pressure and fasting glucose). Adults were grouped into three categories according to their number of ideal cardiovascular health metrics: ideal (5–7 metrics), intermediate (3–4 metrics), and poor (0–2 metrics). Blood levels of gamma-GT and ALT were measured and the FLI was calculated. A higher number of ideal cardiovascular health index metric was associated with lower gamma-GT, ALT and FLI (p from trend analysis <0.001). Also, adults meeting at least 3–4 metrics were predicted less likely to have prevalence of abnormal levels of gamma-GT and FLI (p<0.001) compared to adults who met only 0–2 metrics. These findings reinforce the usefulness of the ideal cardiovascular health metrics proposed by the American Heart Association as a tool to identify target subjects and promote cardiovascular health in South-American adults. PMID:29049384

Vitamin D and Cardiovascular Disease: Potential Role in Health Disparities

PubMed Central

Artaza, Jorge N.; Contreras, Sandra; Garcia, Leah A.; Mehrotra, Rajnish; Gibbons, Gary; Shohet, Ralph; Martins, David; Norris, Keith C.

2012-01-01

Cardiovascular disease (CVD), which includes coronary artery disease and stroke, is the leading cause of mortality in the nation. Excess CVD morbidity and premature mortality in the African American community is one of the most striking examples of racial/ethnic disparities in health outcomes. African Americans also suffer from increased rates of hypovitaminosis D, which has emerged as an independent risk factor for all-cause and cardiovascular mortality. This overview examines the potential role of hypovitaminosis D as a contributor to racial and ethnic disparities in cardiovascular disease (CVD). We review the epidemiology of vitamin D and CVD in African Americans and the emerging biological roles of vitamin D in key CVD signaling pathways that may contribute to the epidemiological findings and provide the foundation for future therapeutic strategies for reducing health disparities. PMID:22102304

Anxiety and depression mediate the health-related quality of life differently in patients with cardiovascular disease and stroke-preliminary report of the Yilan study: a population-based community health survey.

PubMed

Hsu, Nai-Wei; Tsao, Hsuan-Ming; Chen, Hsi-Chung; Chou, Pesus

2014-01-01

Cardiovascular disease and stroke have emerged as substantial and growing health challenges to populations around the world. Besides for the survival and medical prognosis, how to improve the health-related quality of life (HRQoL) might also become one of the goals of treatment programs. There are multiple factors that influence HRQol, including comorbidity, mental function and lifestyle. However, substantial research and investigation have still not clarified these underlying pathways, which merit further attention. The purpose of this study was to determine how psychological factors affect the link between cardiovascular disease and stroke with HRQoL. A total of 1,285 elder subjects at least 65 years of age (47.2% male) were enrolled. The mental function and HRQol of each patient was then measured using the Hospital Anxiety and Depression Scale and Short Form-12. After multiple regression analysis, anxiety, depression, cardiovascular disease, stroke, education level and age were shown to be associated with both mental component score (MCS) and physical component score (PCS). In the mediation analysis using the SPSS macro provided by Preacher and Hayes, cardiovascular disease and stroke affected HRQoL via anxiety and depression, respectively. These results suggest that cardiovascular disease and stroke have negative impacts on patient MCS and PCS through different underlying pathways. Cardiovascular disease influences the HRQoL both directly and indirectly with the mediation of anxiety, and stroke influences the HRQoL by way of depression. These findings support the proposition that different combinations of both physical and psychological support are necessary to best manage these diseases.

Public Health Options for Improving Cardiovascular Health Among Older Americans

PubMed Central

Keenan, Nora L.; Clayton, Paula F.; Pandey, Dilip K.; Hong, Yuling

2012-01-01

Life expectancy at birth has increased from 74 years in 1980 to 78 years in 2006. Older adults (aged 65 years and older) are living longer with cardiovascular conditions, which are leading causes of death and disability and thus an important public health concern. We describe several major issues, including the impact of comorbidities, the role of cognitive health, prevention and intervention approaches, and opportunities for collaboration to strengthen the public health system. Prevention can be effective at any age, including for older adults. Public health models focusing on policy, systems, and environmental change approaches have the goal of providing social and physical environments and promoting healthy choices. PMID:22698028

Impact of beverage intake on metabolic and cardiovascular health.

PubMed

Helm, Laura; Macdonald, Ian A

2015-09-01

This review is based on a presentation that was made at a meeting concerning hydration. It summarizes the epidemiological evidence for selected beverages in relation to cardiovascular and/or metabolic health. The review focuses on tea, cocoa, milk, orange juice, alcohol, and beverages sweetened with sugars. These beverage types were chosen because of their widespread consumption, with tea, cocoa, orange juice, and milk being of potential benefit while alcohol and sugars may be detrimental. There is reasonably consistent evidence of reduced risk of cardiovascular disease (CVD) in association with high consumption of tea, with the tea flavonoids appearing to be responsible for these benefits. There is also a growing evidence base for cocoa flavanols to have beneficial cardiovascular effects. The bulk of the evidence supporting these conclusions is epidemiological and needs to be confirmed with randomized controlled trials. Milk is associated with reduced risk of CVD, particularly in relation to blood pressure, with certain milk tripeptides being implicated in having effects to reduce angiotensin action. Further work is needed to confirm these potentially beneficial effects. There is some evidence of potentially beneficial effects of orange juice on aspects of cardiovascular function, but this is by no means convincing, and further evidence is needed from randomized controlled trials, together with the elucidation of whether any benefits are linked to the citrus flavanones or simply to the vitamin C content. While there is some evidence that red wine may convey some health benefits, there is also clear evidence that alcoholic beverages can have undesirable effects on blood pressure and increase the risk of CVD. It is possible that low to moderate intakes of alcoholic beverages may be beneficial. There is some evidence that beverages sweetened with sugars may contribute to increased energy intake and weight gain, and there is also an indication from longitudinal cohort

Cardiovascular health knowledge, attitude and practice/behaviour in an urbanising community of Nepal: a population-based cross-sectional study from Jhaukhel-Duwakot Health Demographic Surveillance Site

PubMed Central

Vaidya, Abhinav; Aryal, Umesh Raj; Krettek, Alexandra

2013-01-01

Objectives This study determined the knowledge, attitude and practice/behaviour of cardiovascular health in residents of a semiurban community of Nepal. Design To increase the understanding of knowledge, attitude and practice/behaviour towards cardiovascular health, we conducted in-home interviews using a questionnaire based on the WHO STEPwise approach to surveillance and other resources, scoring all responses. We also recorded blood pressure and took anthropometric measurements. Setting Our study was conducted as part of the Heart-Health-Associated Research and Dissemination in the Community project in the Jhaukhel-Duwakot Health Demographic Surveillance Site in two urbanising villages near Kathmandu. Participants The study population included 777 respondents from six randomly selected clusters in both villages. Results Seventy per cent of all participants were women and 26.9% lacked formal education. The burden of cardiovascular risk factors was high; 20.1% were current smokers, 43.3% exhibited low physical activity and 21.6% were hypertensive. Participants showed only poor knowledge of heart disease causes; 29.7% identified hypertension and 11% identified overweight and physical activity as causes, whereas only 2.2% identified high blood sugar as causative. Around 60% of respondents did not know any heart attack symptoms compared with 20% who knew 2–4 symptoms. Median percentage scores for knowledge, attitude and practice/behaviour were 79.3, 74.3 and 48, respectively. Nearly 44% of respondents had insufficient knowledge and less than 20% had highly satisfactory knowledge. Among those with highly satisfactory knowledge, only 14.7% had a highly satisfactory attitude and 19.5% and 13.9% had satisfactory and highly satisfactory practices, respectively. Conclusions Our study demonstrates a gap between cardiovascular health knowledge, attitude and practice/behaviour in a semiurban community in a low-income nation, even among those already affected by

Perceived health, life satisfaction, and cardiovascular risk factors among elderly Korean immigrants and elderly Koreans.

PubMed

Sin, Mo-Kyung; Chae, Young-Ran; Choe, Myoung-Ae; Murphy, Patrick; Kim, Jeungim; Jeon, Mi-Yang

2011-03-01

Acknowledging that changes in sociocultural environment influence health status, the purpose of this study was to compare perceived health, life satisfaction, and cardiovascular health in elderly Korean immigrants and elderly Koreans. In this cross-sectional study, a convenience sample of 88 elderly Korean immigrants and 295 elderly Koreans 65 and older were recruited from Korean communities in the United States and Korea. Respondents' perceived health was measured by self-assessment; life satisfaction was self-assessed using a dichotomous scale of general satisfaction with life; and cardiovascular health status was surveyed by self-report of major diagnosed cardiovascular risk factors (i.e., hypertension, hyperlipidemia, diabetes mellitus) and body mass index measurement for obesity. Despite having better perceived health and life satisfaction, elderly Korean immigrants also had higher prevalence of cardiovascular risk factors. The findings provide health care providers with useful information for effective health assessment of minority immigrants. Copyright 2011, SLACK Incorporated.

Poorer cardiovascular health is associated with psychiatric comorbidity: results from the ELSA-Brasil Study.

PubMed

Szlejf, Claudia; Suemoto, Claudia K; Santos, Itamar S; Brunoni, Andre R; Nunes, Maria Angélica; Viana, Maria Carmen; Barreto, Sandhi Maria; Lotufo, Paulo A; Benseñor, Isabela M

2018-06-12

Common psychiatric symptoms may hinder achieving ideal cardiovascular health (ICH). We aimed to investigate the association between the ICH score and psychiatric disorders in Brazilian adults. In this cross-sectional analysis, 13,743 participants free of cardiovascular disease from the ELSA-Brasil study were assessed using the American Heart Association ICH score. Cardiovascular health was classified as poor (0-2 ideal metrics), intermediate (3-4 ideal metrics), and optimal (5-7 ideal metrics). We used the Clinical Interview Scheduled Revised (CIS-R) to assess psychiatric disorders and investigate their association with the ICH score and each non-ICH metric. The frequency of poor, intermediate, and optimal cardiovascular health were 54.1%, 38.1%, and 7.8%, respectively. Depressive and anxiety disorders were associated with poor cardiovascular health (depressive disorder: OR = 2.49, 95% CI = 1.62-3.80, p < 0.001; anxiety disorder: OR = 1.47, 95% CI = 1.22-1.78, p < 0.001), and intermediate cardiovascular health (depressive disorder: OR = 1.94, 95% CI = 1.26-2.98, p = 0.002; anxiety disorder: OR = 1.22, 95% CI = 1.01-1.47, p = 0.043). In the analysis stratified by sex, these associations were significant only among women. The disorders were also associated with the following non-ICH metrics: body mass index, physical activity, healthy diet score, and smoking. Participants with depressive disorder and anxiety disorder had expected lower global and lifestyle ICH score than participants without these conditions, with significant results among women in the stratified analysis. Psychiatric comorbidity was associated with poorer cardiovascular health. These conditions may compromise the adoption of healthy cardiovascular risk reduction behaviors. Copyright © 2017. Published by Elsevier B.V.

Dissatisfaction with cardiovascular health and primary health care services: Southern Mani, isolated area in Europe. A case study.

PubMed

Mariolis, Anargiros; Mihas, Constantinos; Alevizos, Alevizos; Mariolis-Sapsakos, Theodoros; Sergentanis, Theodoros N; Kalogerakos, Nikolaos; Virvilis, Christos; Fourkas, Constantinos; Skandalakis, Panayiotis; Stefanadis, Christodoulos

2008-01-01

Access to local providers of primary health care (PHC) services and their utilisation is a challenge faced by the authorities of developed as well as developing countries. The aim of our study was to assess and evaluate the level of satisfaction with the currently provided cardiovascular and PHC services in the southernmost region of continental Greece (and of the European Union), Southern Mani. The sample (422 individuals, 375 of whom finally participated: 187 men and 188 women, response ratio: 88.86%), was selected between January-December 2006, using stratified randomisation by sex and age. Participants were asked to fill in a validated questionnaire containing socio-demographic data and items about the health needs/level of satisfaction with cardiovascular health and PHC services, as well as two indices for cardiovascular health: i) frequency of international normalised ratio (INR) measurement in case of atrial fibrillation, and ii) history of timely thrombolysis in case of acute myocardial infarction. The majority of the responders stated that their level of satisfaction with PHC services was "low" or "very low" (total: 52.80%), while the percentage of dissatisfaction with cardiovascular health services was 56.0%. In addition, most of the participants expressed a strong wish for improvement of PHC services (71.33%). The level of satisfaction with PHC services was higher than with cardiovascular health services (2.49 +/- 1.26 vs. 2.38 +/- 1.24; p < 0.001). Satisfaction scores for both cardiovascular health and PHC services were negatively associated with the distance from the nearest PHC Unit. Only 11.1% of patients (95% CI: 0.3%-48.2%) reported annual testing of prothrombin time more than once, while among those with a history of acute myocardial infarction, none reported timely thrombolysis (0%, one-sided 97.5% CI: 0%-41.0%). It is evident that a large portion of the Southern Mani population perceives the provided cardiovascular health and PHC services as

Cardiovascular health in the Americas: facts, priorities and the UN high-level meeting on non-communicable diseases.

PubMed

Ordúñez, Pedro

2011-10-01

Population aging, smoking, unhealthy diet and physical inactivity, in the context of globalization and unregulated urbanization, explain the high prevalences of hypertension, hypercholesterolemia and diabetes in the Americas, making cardiovascular diseases the main cause of death. Moreover, cardiovascular diseases and their risk factors disproportionately affect the poorest people, obstructing antipoverty efforts and further deepening health and other inequities. The global crisis of chronic non-communicable diseases has reached such proportions that the UN General Assembly called a high-level meeting in September 2011 to address the issue as one of human development, aiming to stimulate political commitment to a concerted global effort to stem the pandemic. In reference to the Americas, this article reviews the burden of cardiovascular diseases and describes priorities for strategies and action in the region and their relation to the results of the UN meeting.

Caffeine and cardiovascular health.

PubMed

Turnbull, Duncan; Rodricks, Joseph V; Mariano, Gregory F; Chowdhury, Farah

2017-10-01

This report evaluates the scientific literature on caffeine with respect to potential cardiovascular outcomes, specifically relative risks of total cardiovascular disease (CVD), coronary heart disease (CHD) and acute myocardial infarction (AMI), effects on arrhythmia, heart failure, sudden cardiac arrest, stroke, blood pressure, hypertension, and other biomarkers of effect, including heart rate, cerebral blood flow, cardiac output, plasma homocysteine levels, serum cholesterol levels, electrocardiogram (EKG) parameters, heart rate variability, endothelial/platelet function and plasma/urine catecholamine levels. Caffeine intake has been associated with a range of reversible and transient physiological effects broadly and cardiovascular effects specifically. This report attempts to understand where the delineations exist in caffeine intake and corresponding cardiovascular effects among various subpopulations. The available literature suggests that cardiovascular effects experienced by caffeine consumers at levels up to 600 mg/day are in most cases mild, transient, and reversible, with no lasting adverse effect. The point at which caffeine intake may cause harm to the cardiovascular system is not readily identifiable in part because data on the effects of daily intakes greater than 600 mg is limited. However, the evidence considered within this review suggests that typical moderate caffeine intake is not associated with increased risks of total cardiovascular disease; arrhythmia; heart failure; blood pressure changes among regular coffee drinkers; or hypertension in baseline populations. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Study of Cardiovascular Health Outcomes in the Era of Claims Data: The Cardiovascular Health Study.

PubMed

Psaty, Bruce M; Delaney, Joseph A; Arnold, Alice M; Curtis, Lesley H; Fitzpatrick, Annette L; Heckbert, Susan R; McKnight, Barbara; Ives, Diane; Gottdiener, John S; Kuller, Lewis H; Longstreth, W T

2016-01-12

Increasingly, the diagnostic codes from administrative claims data are being used as clinical outcomes. Data from the Cardiovascular Health Study (CHS) were used to compare event rates and risk factor associations between adjudicated hospitalized cardiovascular events and claims-based methods of defining events. The outcomes of myocardial infarction (MI), stroke, and heart failure were defined in 3 ways: the CHS adjudicated event (CHS[adj]), selected International Classification of Diseases, Ninth Edition diagnostic codes only in the primary position for Medicare claims data from the Center for Medicare & Medicaid Services (CMS[1st]), and the same selected diagnostic codes in any position (CMS[any]). Conventional claims-based methods of defining events had high positive predictive values but low sensitivities. For instance, the positive predictive value of International Classification of Diseases, Ninth Edition code 410.x1 for a new acute MI in the first position was 90.6%, but this code identified only 53.8% of incident MIs. The observed event rates for CMS[1st] were low. For MI, the incidence was 14.9 events per 1000 person-years for CHS[adj] MI, 8.6 for CMS[1st] MI, and 12.2 for CMS[any] MI. In general, cardiovascular disease risk factor associations were similar across the 3 methods of defining events. Indeed, traditional cardiovascular disease risk factors were also associated with all first hospitalizations not resulting from an MI. The use of diagnostic codes from claims data as clinical events, especially when restricted to primary diagnoses, leads to an underestimation of event rates. Additionally, claims-based events data represent a composite end point that includes the outcome of interest and selected (misclassified) nonevent hospitalizations. © 2015 American Heart Association, Inc.

Deaf Adolescents' Learning of Cardiovascular Health Information: Sources and Access Challenges

ERIC Educational Resources Information Center

Smith, Scott R.; Kushalnagar, Poorna; Hauser, Peter C.

2015-01-01

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…

A structural model of health behavior modification among patients with cardiovascular disease.

PubMed

Goong, Hwasoo; Ryu, Seungmi; Xu, Lijuan

2016-02-01

The purpose of the study was to test a structural equation model in which social support, health beliefs, and stage of change predict the health behaviors of patients with cardiovascular disease. A cross-sectional correlational design was used. Using convenience sampling, a survey about social support, health belief, stage of change, and health behavior was completed by 314 adults with cardiovascular disease from outpatient clinics in 2 university hospitals in Korea. Data were analyzed using a structural equation model with the Analysis of Moment program. The participants were aged 53.44±13.19 years (mean±SD), and about 64% of them were male. The proposed model fit the data from the study well, explaining 19% and 60% of the variances in the stage of change and health behavior, respectively. The findings indicate that the performance of health behavior modification among the patients with cardiovascular disease can be explained by social support, health belief, and stage of change based on a health-belief and stage-of-change model. Further studies are warranted to confirm the efficacy of health-promoting strategies in initiating and maintaining the performance of health behaviors by providing social support from family and medical staff and enhancing health belief. Copyright © 2015 Elsevier Inc. All rights reserved.

Cardiovascular Health Promotion in Children: Challenges and Opportunities for 2020 and Beyond: A Scientific Statement From the American Heart Association.

PubMed

Steinberger, Julia; Daniels, Stephen R; Hagberg, Nancy; Isasi, Carmen R; Kelly, Aaron S; Lloyd-Jones, Donald; Pate, Russell R; Pratt, Charlotte; Shay, Christina M; Towbin, Jeffrey A; Urbina, Elaine; Van Horn, Linda V; Zachariah, Justin P

2016-09-20

This document provides a pediatric-focused companion to "Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction: The American Heart Association's Strategic Impact Goal Through 2020 and Beyond," focused on cardiovascular health promotion and disease reduction in adults and children. The principles detailed in the document reflect the American Heart Association's new dynamic and proactive goal to promote cardiovascular health throughout the life course. The primary focus is on adult cardiovascular health and disease prevention, but critical to achievement of this goal is maintenance of ideal cardiovascular health from birth through childhood to young adulthood and beyond. Emphasis is placed on the fundamental principles and metrics that define cardiovascular health in children for the clinical or research setting, and a balanced and critical appraisal of the strengths and weaknesses of the cardiovascular health construct in children and adolescents is provided. Specifically, this document discusses 2 important factors: the promotion of ideal cardiovascular health in all children and the improvement of cardiovascular health metric scores in children currently classified as having poor or intermediate cardiovascular health. Other topics include the current status of cardiovascular health in US children, opportunities for the refinement of health metrics, improvement of health metric scores, and possibilities for promoting ideal cardiovascular health. Importantly, concerns about the suitability of using single thresholds to identify elevated cardiovascular risk throughout the childhood years and the limits of our current knowledge are noted, and suggestions for future directions and research are provided. © 2016 American Heart Association, Inc.

The importance of non-exercise physical activity for cardiovascular health and longevity.

PubMed

Ekblom-Bak, Elin; Ekblom, Björn; Vikström, Max; de Faire, Ulf; Hellénius, Mai-Lis

2014-02-01

Sedentary time is increasing in all societies and results in limited non-exercise physical activity (NEPA) of daily life. The importance of low NEPA for cardiovascular health and longevity is limited, especially in elderly. To examine the association between NEPA and cardiovascular health at baseline as well as the risk of a first cardiovascular disease (CVD) event and total mortality after 12.5 years. Cohort study. Every third 60-year-old man and woman in Stockholm County was invited to a health screening study; 4232 individuals participated (78% response rate). At baseline, NEPA and exercise habits were assessed from a self-administrated questionnaire and cardiovascular health was established through physical examinations and laboratory tests. The participants were followed for an average of 12.5 years for the assessment of CVD events and mortality. At baseline, high NEPA was, regardless of regular exercise and compared with low NEPA, associated with more preferable waist circumference, high-density lipoprotein cholesterol and triglycerides in both sexes and with lower insulin, glucose and fibrinogen levels in men. Moreover, the occurrence of the metabolic syndrome was significantly lower in those with higher NEPA levels in non-exercising and regularly exercising individuals. Furthermore, reporting a high NEPA level, compared with low, was associated with a lower risk of a first CVD event (HR=0.73; 95% CI 0.57 to 0.94) and lower all-cause mortality (0.70; 0.53 to 0.98). A generally active daily life was, regardless of exercising regularly or not, associated with cardiovascular health and longevity in older adults.

[Cardiovascular risk factors in a group of health care workers].

PubMed

Kramer, Verónica; Adasme, Marcela; Bustamante, M José; Jalil, Jorge; Navarrete, Carlos; Acevedo, Mónica

2012-05-01

Health promotion can be carried out at work places. To assess cardiovascular risk factors among workers of a University hospital. Cross sectional study of 888 participants (aged 41 ± 11 years, 76% women), who answered a survey about cardiovascular risk factors. Body mass index, waist, blood pressure and total cholesterol (TC) by capillary method were determined. Self reported prevalence of risk factors were as follows: 19% of participants had high blood pressure, 30% hypercholesterolemia, 6% diabetes, 41% smoked, 88% were sedentary and 26% had a family history of cardiovascular diseases. Five percent of participants did not have any risk factor, 20% had one risk factor, 32% had two and 43% had three or more. The highest frequency of lack of awareness was about blood glucose values. A high blood cholesterol level was found in 27% of those reporting normal cholesterol levels. Likewise, a high body mass index was found in 18% of those reporting a normal weight. The prevalence of cardiovascular risk factors in this group of participants is similar to that found in the last national health survey in Chile. Noteworthy is the lack of awareness about these risk factors.

Nutrition and Cardiovascular Disease: Finding the Perfect Recipe for Cardiovascular Health.

PubMed

Ravera, Alice; Carubelli, Valentina; Sciatti, Edoardo; Bonadei, Ivano; Gorga, Elio; Cani, Dario; Vizzardi, Enrico; Metra, Marco; Lombardi, Carlo

2016-06-14

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.

Nutrition and Cardiovascular Disease: Finding the Perfect Recipe for Cardiovascular Health

PubMed Central

Ravera, Alice; Carubelli, Valentina; Sciatti, Edoardo; Bonadei, Ivano; Gorga, Elio; Cani, Dario; Vizzardi, Enrico; Metra, Marco; Lombardi, Carlo

2016-01-01

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. PMID:27314382

Neighborhood context and youth cardiovascular health behaviors.

PubMed

Lee, Rebecca E; Cubbin, Catherine

2002-03-01

This study sought to determine the relationships between race/ethnicity, socioeconomic status (SES), and cardiovascular health behaviors among youths and whether neighborhood characteristics are associated with such behaviors independently of individual characteristics. Linear models determined the effects of individual and neighborhood characteristics (SES, social disorganization, racial/ethnic minority concentration, urbanization) on dietary habits, physical activity, and smoking among 8165 youths aged 12 to 21 years. Low SES was associated with poorer dietary habits, less physical activity, and higher odds of smoking. After adjustment for SES, Black race was associated with poorer dietary habits and lower odds of smoking. Hispanic ethnicity was associated with healthier dietary habits, lower levels of physical activity, and lower odds of smoking than non-Hispanic ethnicity. Low neighborhood SES and high neighborhood social disorganization were independently associated with poorer dietary habits, while high neighborhood Hispanic concentration and urbanicity were associated with healthier dietary habits. Neighborhood characteristics were not associated with physical activity or smoking. Changes in neighborhood social structures and policies that reduce social inequalities may enhance cardiovascular health behaviors.

Associations Between Discrimination and Cardiovascular Health Among Asian Indians in the United States

PubMed Central

Dulin-Keita, A.; Salas, C.; Kanaya, A. M.; Kandula, Namratha R.

2016-01-01

Asian Indians (AI) have a high risk of atherosclerotic cardiovascular disease. The study investigated associations between discrimination and (1) cardiovascular risk and (2) self-rated health among AI. Higher discrimination scores were hypothesized to relate to a higher cardiovascular risk score (CRS) and poorer self-rated health. Asian Indians (n = 757) recruited between 2010 and 2013 answered discrimination and self-reported health questions. The CRS (0–8 points) included body-mass index, systolic blood pressure, total cholesterol, and fasting blood glucose levels of AI. Multiple linear regression analyses were conducted to evaluate relationships between discrimination and the CRS and discrimination and self-rated health, adjusting for psychosocial and clinical factors. There were no significant relationships between discrimination and the CRS (p ≥ .05). Discrimination was related to poorer self-reported health, B = −.41 (SE = .17), p = .02. Findings suggest perhaps there are important levels at which discrimination may harm health. PMID:27039100

Associations Between Discrimination and Cardiovascular Health Among Asian Indians in the United States.

PubMed

Nadimpalli, S B; Dulin-Keita, A; Salas, C; Kanaya, A M; Kandula, Namratha R

2016-12-01

Asian Indians (AI) have a high risk of atherosclerotic cardiovascular disease. The study investigated associations between discrimination and (1) cardiovascular risk and (2) self-rated health among AI. Higher discrimination scores were hypothesized to relate to a higher cardiovascular risk score (CRS) and poorer self-rated health. Asian Indians (n = 757) recruited between 2010 and 2013 answered discrimination and self-reported health questions. The CRS (0-8 points) included body-mass index, systolic blood pressure, total cholesterol, and fasting blood glucose levels of AI. Multiple linear regression analyses were conducted to evaluate relationships between discrimination and the CRS and discrimination and self-rated health, adjusting for psychosocial and clinical factors. There were no significant relationships between discrimination and the CRS (p ≥ .05). Discrimination was related to poorer self-reported health, B = -.41 (SE = .17), p = .02. Findings suggest perhaps there are important levels at which discrimination may harm health.

Heart health in Lebanon and considerations for addressing the burden of cardiovascular disease.

PubMed

Deek, Hiba; Newton, Phillip; Inglis, Sally; Kabbani, Samer; Noureddine, Samar; Macdonald, Peter S; Davidson, Patricia M

2015-01-01

Lebanon is a small country located at the western boundary of the Middle East. Approximately 40% of health care in Lebanon is financed by the public sector. Cardiovascular diseases in Lebanon are scarcely addressed in the literature raising the need for baseline data on these health condition to be better treated. To (1) aggregate and define the burden of cardiovascular disease in Lebanon and (2) describe implications for policy, practice and research to improve health outcomes in Lebanon. An integrative review was conducted of both peer-reviewed papers and unpublished reports. CINAHL, Medline, Google Scholar and Academic Search Complete were searched along with the websites of The World Health Organization, Ministry of Public Health Lebanon and Central Intelligence Agency of Lebanon. No year limit was applied to our search. The search yielded 28 peer-reviewed articles and 15 reports. Cardiovascular diseases are the leading cause of morbidity and mortality in Lebanon and is also the primary cause of hospital admission. A range of social, political, economic and cultural factors explain the burden of cardiovascular diseases, some of these risks are culture specific such as the arghile smoking and the high rates of familial hypercholesterolemia. Workforce shortage produced by high rates of migrating nurses also has an implication on the patients' outcomes. Conclusion: Much of the presented data are sourced from the gray literature; more research, using systematic and prospective data collection methods, are needed to inform health services planning, delivery and evaluation. Primary care needs to be enhanced to produce better outcomes for a population with high profile of cardiovascular risk factors.

The concept of Maslow's pyramid for cardiovascular health and its impact on "change cycle".

PubMed

Behjati, Mohaddeseh

2014-01-01

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 understanding it as a "true human derive" and its consecutive "behaviors". Most people are unaware of their real needs, and even if they know all of their cardiovascular needs, this knowledge is not projected in their behaviors. In the present paper, I try to outline the Herzberg two-factor hypothesis and Maslow's hierarchy of needs.

Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management

PubMed Central

Piette, John D.; List, Justin; Rana, Gurpreet K.; Townsend, Whitney; Striplin, Dana; Heisler, Michele

2015-01-01

We examined evidence on whether mobile health (mHealth) tools, including Interactive Voice Response (IVR) calls, short message service (SMS) 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 grey 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 (LMICs). IVR and SMS interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. IVR and SMS-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multi-modal 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 more than 30 LMICs, 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. PMID:25690685

Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management

PubMed Central

Piette, John D.; List, Justin; Rana, Gurpreet K.; Townsend, Whitney; Striplin, Dana; Heisler, Michele

2016-01-01

We examined evidence on whether mobile health (mHealth) tools, including Interactive Voice Response (IVR) calls, short message service (SMS) 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 grey 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 (LMICs). IVR and SMS interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. IVR and SMS-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multi-modal 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 more than 30 LMICs, 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. PMID:26596977

Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management.

PubMed

Piette, John D; List, Justin; Rana, Gurpreet K; Townsend, Whitney; Striplin, Dana; Heisler, Michele

2015-11-24

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

Measuring myokines with cardiovascular functions: pre-analytical variables affecting the analytical output.

PubMed

Lombardi, Giovanni; Sansoni, Veronica; Banfi, Giuseppe

2017-08-01

In the last few years, a growing number of molecules have been associated to an endocrine function of the skeletal muscle. Circulating myokine levels, in turn, have been associated with several pathophysiological conditions including the cardiovascular ones. However, data from different studies are often not completely comparable or even discordant. This would be due, at least in part, to the whole set of situations related to the preparation of the patient prior to blood sampling, blood sampling procedure, processing and/or store. This entire process constitutes the pre-analytical phase. The importance of the pre-analytical phase is often not considered. However, in routine diagnostics, the 70% of the errors are in this phase. Moreover, errors during the pre-analytical phase are carried over in the analytical phase and affects the final output. In research, for example, when samples are collected over a long time and by different laboratories, a standardized procedure for sample collecting and the correct procedure for sample storage are acknowledged. In this review, we discuss the pre-analytical variables potentially affecting the measurement of myokines with cardiovascular functions.

Strategies and methods to study female-specific cardiovascular health and disease: a guide for clinical scientists.

PubMed

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

2016-01-01

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. There are also physiologic and psychosocial factors unique to women that may affect CVD risk, such as issues related to reproduction. The Society for Women's Health Research (SWHR) CV Network compiled an inventory of sex-specific strategies and methods for the study of women and CV health and disease across the lifespan. References for methods and strategy details are provided to gather and evaluate this information. Some items comprise robust measures; others are in development. To address female-specific CV health and disease in population, physiology, and clinical trial research, data should be collected on reproductive history, psychosocial variables, and other factors that disproportionately affect CVD in women. Variables related to reproductive health include the following: age of menarche, menstrual cycle regularity, hormone levels, oral contraceptive use, pregnancy history/complications, polycystic ovary syndrome (PCOS) components, menopause age, and use and type of menopausal hormone therapy. Other factors that differentially affect women's CV risk include diabetes mellitus, autoimmune inflammatory disease, and autonomic vasomotor control. Sex differences in aging as well as psychosocial variables such as depression and stress should also be considered. Women are frequently not included/enrolled in mixed-sex CVD studies; when they are included, information on these variables is generally not collected. These omissions limit the ability to determine the role of sex

CARDIOVASCULAR AND OTHER HEALTH EFFECTS ASSOCIATED WITH ARSENIC EXPOSURE IN INNER MONGOLIA

EPA Science Inventory

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...

Lifelong Exercise Patterns and Cardiovascular Health.

PubMed

Maessen, Martijn F H; Verbeek, André L M; Bakker, Esmée A; Thompson, Paul D; Hopman, Maria T E; Eijsvogels, Thijs M H

2016-06-01

To determine the relationship between lifelong exercise dose and the prevalence of cardiovascular morbidity. From June 1, 2011, through December 31, 2014, 21,266 individuals completed an online questionnaire regarding their lifelong exercise patterns and cardiovascular health status. Cardiovascular disease (CVD) was defined as a diagnosis of myocardial infarction, stroke, or heart failure, and cardiovascular risk factors (CVRFs) were defined as hypertension, hypercholesterolemia, or type 2 diabetes. Lifelong exercise patterns were measured over a median of 32 years for 405 patients with CVD, 1379 patients with CVRFs, and 10,656 controls. Participants were categorized into nonexercisers and quintiles (Q1-Q5) of exercise dose (metabolic equivalent task [MET] minutes per week). The CVD/CVRF prevalence was lower for each exercise quintile compared with nonexercisers (CVD: nonexercisers, 9.6% vs Q1: 4.4%, Q2: 2.8%, Q3: 2.4%, Q4: 3.6%, Q5: 3.9%; P<.001; CVRF: nonexercisers, 24.6% vs Q1: 13.8%, Q2: 10.2%, Q3: 9.0%, Q4: 9.4%, Q5: 12.0%; P<.001). The lowest exercise dose (Q1) significantly reduced CVD and CVRF prevalence, but the largest reductions were found at 764 to 1091 MET-min/wk for CVD (adjusted odds ratio=0.31; 95% CI, 0.20-0.48) and CVRFs (adjusted odds ratio=0.36; 95% CI, 0.28-0.47). The CVD/CVRF prevalence did not further decrease in higher exercise dose groups. Exercise intensity did not influence the relationship between exercise patterns and CVD or CVRFs. These findings demonstrate a curvilinear relationship between lifelong exercise patterns and cardiovascular morbidity. Low exercise doses can effectively reduce CVD/CVRF prevalence, but engagement in exercise for 764 to 1091 MET-min/wk is associated with the lowest CVD/CVRF prevalence. Higher exercise doses do not yield additional benefits. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review.

PubMed

van Ballegooijen, Adriana J; Pilz, Stefan; Tomaschitz, Andreas; Grübler, Martin R; Verheyen, Nicolas

2017-01-01

Vitamins D and K are both fat-soluble vitamins and play a central role in calcium metabolism. Vitamin D promotes the production of vitamin K-dependent proteins, which require vitamin K for carboxylation in order to function properly. The purpose of this review is to summarize available evidence of the synergistic interplay between vitamins D and K on bone and cardiovascular health. Animal and human studies suggest that optimal concentrations of both vitamin D and vitamin K are beneficial for bone and cardiovascular health as supported by genetic, molecular, cellular, and human studies. Most clinical trials studied vitamin D and K supplementation with bone health in postmenopausal women. Few intervention trials studied vitamin D and K supplementation with cardiovascular-related outcomes. These limited studies indicate that joint supplementation might be beneficial for cardiovascular health. Current evidence supports the notion that joint supplementation of vitamins D and K might be more effective than the consumption of either alone for bone and cardiovascular health. As more is discovered about the powerful combination of vitamins D and K, it gives a renewed reason to eat a healthy diet including a variety of foods such as vegetables and fermented dairy for bone and cardiovascular health.

The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review

PubMed Central

Pilz, Stefan; Tomaschitz, Andreas; Grübler, Martin R.; Verheyen, Nicolas

2017-01-01

Vitamins D and K are both fat-soluble vitamins and play a central role in calcium metabolism. Vitamin D promotes the production of vitamin K-dependent proteins, which require vitamin K for carboxylation in order to function properly. The purpose of this review is to summarize available evidence of the synergistic interplay between vitamins D and K on bone and cardiovascular health. Animal and human studies suggest that optimal concentrations of both vitamin D and vitamin K are beneficial for bone and cardiovascular health as supported by genetic, molecular, cellular, and human studies. Most clinical trials studied vitamin D and K supplementation with bone health in postmenopausal women. Few intervention trials studied vitamin D and K supplementation with cardiovascular-related outcomes. These limited studies indicate that joint supplementation might be beneficial for cardiovascular health. Current evidence supports the notion that joint supplementation of vitamins D and K might be more effective than the consumption of either alone for bone and cardiovascular health. As more is discovered about the powerful combination of vitamins D and K, it gives a renewed reason to eat a healthy diet including a variety of foods such as vegetables and fermented dairy for bone and cardiovascular health. PMID:29138634

Cardiovascular health status between standard and nonstandard workers in Korea.

PubMed

Seon, Jong Ju; Lim, Yu Jin; Lee, Hae Won; Yoon, Jae Moon; Kim, Sang June; Choi, Seulggie; Kawachi, Ichiro; Park, Sang Min

2017-01-01

The effect of employment insecurity on employee health is an important public health issue due to the recent effects of neoliberalism and the global financial crisis (2007-2008) on labor markets. This study aims to evaluate the differences in cardiovascular health status and the use of preventive screening services between standard and nonstandard workers. Waged employees (N = 5,338) between the ages of 20 and 64 were grouped into standard (full-time, permanent) and nonstandard (part-time, temporary, or daily) employees. Data from the Fourth Korea National Health and Nutrition Examination Survey, 2007-2009, a nationwide representative survey, were examined, including cardiovascular health risk behaviors (tobacco, alcohol, physical inactivity), measured morbidities (blood pressure, blood glucose level, lipid profiles, body mass index), and the use of screening services for hypertension and diabetes mellitus. Female nonstandard employees tended to have higher blood pressure than did female standard employees (adjusted odds ratio, aOR 1.42, 95% confidence interval, CI 1.02 to 1.98). However, nonstandard employees (both men and women) were less likely to use preventive screening services for hypertension (aOR 0.72, 95% CI 0.54 to 0.94 in men; aOR 0.56, 95% CI 0.43 to 0.73 in women) and diabetes (aOR 0.58, 95% CI 0.43 to 0.79 in men; aOR 0.55, 95% CI 0.43 to 0.71 in women). Nonstandard work is associated with the underuse of screening services and poorer cardiovascular health in a specific population. Policies to reduce employment insecurity and encourage nonstandard employees to receive health screening services should be prioritized.

Cardiovascular health status between standard and nonstandard workers in Korea

PubMed Central

Seon, Jong Ju; Lim, Yu Jin; Lee, Hae Won; Yoon, Jae Moon; Kim, Sang June; Choi, Seulggie; Kawachi, Ichiro

2017-01-01

Objectives The effect of employment insecurity on employee health is an important public health issue due to the recent effects of neoliberalism and the global financial crisis (2007–2008) on labor markets. This study aims to evaluate the differences in cardiovascular health status and the use of preventive screening services between standard and nonstandard workers. Methods Waged employees (N = 5,338) between the ages of 20 and 64 were grouped into standard (full-time, permanent) and nonstandard (part-time, temporary, or daily) employees. Data from the Fourth Korea National Health and Nutrition Examination Survey, 2007–2009, a nationwide representative survey, were examined, including cardiovascular health risk behaviors (tobacco, alcohol, physical inactivity), measured morbidities (blood pressure, blood glucose level, lipid profiles, body mass index), and the use of screening services for hypertension and diabetes mellitus. Results Female nonstandard employees tended to have higher blood pressure than did female standard employees (adjusted odds ratio, aOR 1.42, 95% confidence interval, CI 1.02 to 1.98). However, nonstandard employees (both men and women) were less likely to use preventive screening services for hypertension (aOR 0.72, 95% CI 0.54 to 0.94 in men; aOR 0.56, 95% CI 0.43 to 0.73 in women) and diabetes (aOR 0.58, 95% CI 0.43 to 0.79 in men; aOR 0.55, 95% CI 0.43 to 0.71 in women). Conclusion Nonstandard work is associated with the underuse of screening services and poorer cardiovascular health in a specific population. Policies to reduce employment insecurity and encourage nonstandard employees to receive health screening services should be prioritized. PMID:28570650

Childhood cardiovascular health and subfertility: the Bogalusa Heart Study.

PubMed

Wang, Yiping; Xiong, Xu; Bazzano, Lydia; Harville, Emily W

2018-06-13

Although childhood cardiovascular risk can contribute to adult cardiovascular disease, and fertility and adult cardiovascular health are linked, the association between early-life cardiovascular risk and female infertility has not been studied. A total of 1799 women participated in the Babies substudy of the Bogalusa Heart Study. Systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, glucose, and insulin were age-standardized and examined as predictors of self-reported fertility difficulties using multivariable logistic regression with adjustment for confounders. Polycystic ovarian syndrome (PCOS) was assessed via a report of diagnosis and symptoms, using a validated questionnaire. Women with a history of PCOS were more likely to report fertility difficulties. Childhood and adolescent cardiovascular risk factors were generally not associated with fertility indicators, although childhood LDL (aOR 1.38 per one-SD increase, 0.97-1.96) and total cholesterol (aOR 1.49, 1.06-2.11) were raised in those who never became pregnant. Pre-pregnancy risk SBP (overall fertility, aOR 1.49, 1.00-2.23) and glucose levels (ever tried but unable, aOR 2.65, 1.39-5.06) were associated with an increased risk of some infertility indicators. These results were largely unaffected by exclusion of women with PCOS. Some childhood and pre-pregnancy cardiovascular risk factors are associated with adult subfertility.

Promoting Cardiovascular Health in Patients Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome.

PubMed

Harris, Robin

2018-03-01

Patients living with human immunodeficiency virus/acquired immunodeficiency syndrome (PLWHA) are at increased risk of cardiovascular disease because of advances in human immunodeficiency virus/acquired immunodeficiency syndrome treatment and increased life expectancy. Cardiovascular health promotion in PLWHA includes strategies for risk factor reduction, disease prevention, early detection, and treatment of cardiovascular disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Health-related variables and predictors of Health-promoting Lifestyle in cardiovascular disease patients.

PubMed

Mohsenipouya, Hossein; Majlessi, Fereshteh; Shojaeizadeh, Davood; Foroushani, Abbas Rahimi; Ghafari, Rahman; Habibi, Vali; Makrani, Azam Seyfi

2016-04-01

The principal cause for death in the world is cardiovascular disease. Poor lifestyle is a contributing element in this regard. The objective of this study was to estimate the effects of health-related variables and lifestyle variables on the results of exercise stress tests in patients with cardiovascular disease in Iran. The study population in this case-control study was 220 patients who were candidates for exercise stress tests in Mazandaran Province (Iran) in 2015. The patients were divided randomly into two groups based on the results of their exercise stress tests, i.e., positive (110 patients) and negative (110 patients). The data collection tool was a standard questionnaire entitled "Health promotion lifestyle profile-II." The data were analyzed using mean, standard deviation, the chi-squared test, and logistic regression by SPSS version 22 software. The risk of a positive exercise stress test increases with age. The age group above 65 was 1.049 times more at risk of a positive exercise stress test than the age group of less than 45. The people with dyslipidemia had 1.635 times greater risk of positive exercise stress tests than the group without dyslipidemia. In addition, patients with hypertension had 1.579 times greater risk of positive exercise stress tests than the group without hypertension. The lack of individual health responsibility (Odds ratio (OR): 1.622), stress management (OR: 1.592), and physical activity (OR: 1.245) contributed more to positive exercise tests than the other risk factors. Educational interventions can improve the responsibility for health, physical activity, and stress management among people with the risk of cardiovascular disease.

Racial/Ethnic Differences in Knowledge of Personal and Target Levels of Cardiovascular Health Indicators.

PubMed

Ma, Mindy; Ma, Alyson

2015-10-01

This study aimed to examine ethnic differences in knowledge of personal and target levels of cardiovascular health indicators between non-Hispanic whites and African Americans. A secondary objective was to evaluate the associations between knowledge of cardiovascular health indicators and health promotion behaviors. Participants (66.7% female) consisted of 265 whites and 428 African Americans, ages 18 and older recruited from primary care clinics and churches. Respondents completed a brief survey on blood pressure (BP), total cholesterol, blood glucose, body mass index (BMI), diet, and physical activity. Whites were more likely than African Americans to report knowing their personal and target levels of cardiovascular health indicators. Knowledge of personal BP and/or BMI was positively associated with actual physical activity, and awareness of personal blood glucose was positively associated with healthy dietary practices for participants in both groups. Among whites, awareness of personal BP and knowledge of target levels for BP, total cholesterol, and BMI were also associated with healthy diet. Results suggest there are racial/ethnic disparities in knowledge of personal and ideal levels of cardiovascular health indicators, and that this knowledge is related to health promotion behaviors. Targeted educational efforts are warranted to enhance knowledge of personal risk indicators among African Americans.

Cardiovascular Health Status in Baby Boomers with Diabetes Mellitus

PubMed Central

King, Dana E.; Xiang, Jun; Kulshreshtha, Ambar

2016-01-01

Objectives The objective of this study was to assess the cardiovascular health status of baby boomers with diabetes mellitus (DM) in comparison to the same-age population with DM 10 years previously. Methods The study was conducted in baby boomers with DM using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2012 compared with NHANES 1999–2002. Cardiovascular health metrics were derived from the American Heart Association’s Life’s Simple 7. The primary outcome was the comparison of the proportion of individuals with each characteristic, including healthy diet, healthy weight, not smoking, exercising regularly, and maintaining an optimal level of glycated hemoglobin (HbA1c), cholesterol, and blood pressure. Results Current baby boomers with DM (NHANES 2009–2012) had more obesity (70.9% vs 58.8%; P = 0.009) and a lower proportion of ideal physical activity (20.9% vs 31.7%; P = 0.01) than people of the same age 10 years ago; fewer than 1% adhere to an ideal healthy diet. Current baby boomers more often had ideal cholesterol (59.4% vs 47.2; P = 0.01) and reached an ideal HbA1c (51.0% vs 43.4%; P = 0.047). Blood pressure control, adherence to ideal diet, and smoking rates were not significantly different from 10 years ago. In logistic regression analyses controlling for likely confounders, baby boomers persisted in having more obesity and exercising less often, and reaching an ideal cholesterol level more often (P < 0.01). Conclusions Although improving in cholesterol and HbA1c, baby boomers demonstrated worsening in several key cardiovascular health indicators, particularly obesity and physical activity. PMID:27255090

Does respiratory health contribute to the effects of long-term air pollution exposure on cardiovascular mortality?

PubMed

Schikowski, Tamara; Sugiri, Dorothea; Ranft, Ulrich; Gehring, Ulrike; Heinrich, Joachim; Wichmann, H-Erich; Krämer, Ursula

2007-03-07

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. 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. 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 on cardiovascular mortality indicating a higher risk of

The concept of Maslow's pyramid for cardiovascular health and its impact on “change cycle”

PubMed Central

Behjati, Mohaddeseh

2014-01-01

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 understanding it as a "true human derive" and its consecutive "behaviors". Most people are unaware of their real needs, and even if they know all of their cardiovascular needs, this knowledge is not projected in their behaviors. In the present paper, I try to outline the Herzberg two-factor hypothesis and Maslow's hierarchy of needs. PMID:24963317

Describing an Academic and Nonprofit Organization Partnership to Educate At-Risk Adolescents about Cardiovascular Health

ERIC Educational Resources Information Center

Palazzo, Steven J.; Skager, Cherie; Kraiger, Anneliese

2014-01-01

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…

Air Quality and Heart Health: Managing an Emerging Cardiovascular Risk Factor

EPA Science Inventory

Dr. Cascio will share with a broad range of federal agencies current understanding of the links between air quality and cardiovascular health. The key facts include that air pollution contributes a high attributable health burden. That certain well-defined vulnerable subpopulat...

Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association.

PubMed

Carnethon, Mercedes R; Pu, Jia; Howard, George; Albert, Michelle A; Anderson, Cheryl A M; Bertoni, Alain G; Mujahid, Mahasin S; Palaniappan, Latha; Taylor, Herman A; Willis, Monte; Yancy, Clyde W

2017-11-21

Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management. The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention. The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment. The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines. © 2017 American Heart Association, Inc.

Women's cardiovascular health in India.

PubMed

Chow, Clara K; Patel, Anushka A

2012-03-01

Cardiovascular diseases (CVDs) are the leading cause of death among adult women in many parts of India and a major cause of morbidity. In some parts of the world, gender inequities have been observed in cardiovascular healthcare and cardiovascular outcomes. The authors discuss the data for potential disparities in cardiovascular healthcare for women in India. Data on cardiovascular healthcare provision and CVD outcomes among women in India are generally lacking. The little available data suggest that women in rural areas, younger women and girl children with CVD are less likely to receive appropriate management than men, with this disparity most apparent in those of lower socioeconomic status and education. However, there is a particular lack of information about the prevention and management of atherosclerotic heart disease in women from a range of communities that comprise the extremely diverse population of India.

Food insecurity and cardiovascular health: Findings from a statewide population health survey in Wisconsin.

PubMed

Saiz, Augustine M; Aul, Allison M; Malecki, Kristen M; Bersch, Andrew J; Bergmans, Rachel S; LeCaire, Tamara J; Nieto, F Javier

2016-12-01

The social and economic environment has become a major area of interest regarding the determinants of cardiovascular health. Among markers of economic distress, food insecurity has been found associated with metabolic disorders, dyslipidemia, and obesity, but no previous studies have examined its association with overall cardiovascular health. We conducted a cross-sectional analysis among 2935 participants in the Survey of the Health of Wisconsin (SHOW), a statewide population-based representative sample. The presence of food insecurity was determined by an affirmative answer to the question "In the last 12months, have you been concerned about having enough food for you or your family?" Cardiovascular health (CVH) was defined based on the American Heart Association Life's Simple 7 criteria and classified as "poor," "intermediate," or "ideal" using previously published criteria. "Good" CVH was defined as having no poor in any of the seven criteria (any amount of intermediate or ideal). Crude and adjusted odds ratios (OR) of good CVH according to presence of food insecurity were calculated using logistic regression models. Overall, food insecurity was associated with a decreased likelihood of good CVH (OR 0.53; 95% Confidence Interval 0.31 to 0.92; p=0.02). This association persisted in models controlling for age, gender, race, and urbanization. Participants who were food insecure were significantly less likely to have good CVH compared to participants who were food secure. Even though this study cannot confirm causality, these results suggest that food insecurity might be one of several socio-economic barriers contributing to poor CVH. Copyright © 2016 Elsevier Inc. All rights reserved.

Factors of health in the protection against death and cardiovascular disease among adults with subclinical atherosclerosis

USDA-ARS?s Scientific Manuscript database

While cardiovascular disease (CVD) prevention traditionally emphasizes risk-factor control, recent evidence also supports the promotion of "health-factors" associated with cardiovascular wellness. However, whether such health-factors exist among adults with advanced subclinical atherosclerosis is un...

Cardiovascular risks in firefighters: implications for occupational health nurse practice.

PubMed

Byczek, Lance; Walton, Surrey M; Conrad, Karen M; Reichelt, Paul A; Samo, Daniel G

2004-02-01

Limited cardiovascular risk data are available for firefighters. This cross sectional study of data collected during annual physical examinations described the prevalence of cardiovascular risk factors among firefighters (N = 200) and examined relationships between body mass index (BMI) and other cardiovascular risk factors. Evidence based guidelines were used to determine prevalence of cardiovascular risk factors and Framingham risk scoring was used to estimate probability of coronary heart disease (CHD). Firefighters ranged in age from 22 to 64 with a mean of 41. The prevalence of obesity, elevated total cholesterol, and elevated blood pressure in firefighters exceeded Healthy People 2010 targets. In addition, their prevalence of obesity, low high density lipoprotein (HDL), high low density lipoprotein (LDL), and high total cholesterol levels was higher relative to the general population. Elevated body mass index (BMI) values had positive significant (p < or = .01) associations with elevated blood pressures, triglycerides, and glucose levels, and a negative significant (p < .05) association with lower HDL cholesterol levels. Fire department worksite health and fitness policies and programs should proactively target firefighters' cardiovascular risks. Future firefighter related intervention research will benefit from considering not only the individual determinants of cardiovascular disease, but also the ecological framework that includes the influences of workplace and external environmental factors.

Implications of market integration for cardiovascular and metabolic health among an indigenous Amazonian Ecuadorian population.

PubMed

Liebert, Melissa A; Snodgrass, J Josh; Madimenos, Felicia C; Cepon, Tara J; Blackwell, Aaron D; Sugiyama, Lawrence S

2013-05-01

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. 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. This study examines associations between measures of MI and several dimensions of cardiovascular and metabolic health (fasting glucose, lipids [LDL, HDL and total cholesterol; triglycerides] and blood pressure) among 348 adults. Overall, Shuar males and females have relatively favourable cardiovascular and metabolic health. Shuar who live closer to town have higher total (p < 0.001) and HDL cholesterol (p < 0.001), while Shuar in more remote regions have higher diastolic blood pressure (p = 0.007). HDL cholesterol is positively associated with consumption of market foods (r = 0.140; p = 0.045) and ownership of consumer products (r = 0.184; p = 0.029). This study provides evidence that MI among Shuar is not a uniformly negative process but instead produces complex cardiovascular and metabolic health outcomes.

Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR. Part II.

PubMed

Vanhees, L; Geladas, N; Hansen, D; Kouidi, E; Niebauer, J; Reiner, Z; Cornelissen, V; Adamopoulos, S; Prescott, E; Börjesson, M; Bjarnason-Wehrens, B; Björnstad, H H; Cohen-Solal, A; Conraads, V; Corrado, D; De Sutter, J; Doherty, P; Doyle, F; Dugmore, D; Ellingsen, Ø; Fagard, R; Giada, F; Gielen, S; Hager, A; Halle, M; Heidbüchel, H; Jegier, A; Mazic, S; McGee, H; Mellwig, K P; Mendes, M; Mezzani, A; Pattyn, N; Pelliccia, A; Piepoli, M; Rauch, B; Schmidt-Trucksäss, A; Takken, T; van Buuren, F; Vanuzzo, D

2012-10-01

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 exercise, or both) or characteristic of exercise (frequency, intensity, time or duration, and volume) would yield more benefit for each separate risk factor. The present paper, therefore, will review and make recommendations for PA and exercise training in the management of cardiovascular health in individuals with cardiovascular risk factors. The guidance offered in this series of papers is aimed at medical doctors, health practitioners, kinesiologists, physiotherapists and exercise physiologists, politicians, public health policy makers, and individual members of the public. Based on previous and the current literature overviews, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding type, volume, and intensity of PA and regarding appropriate risk evaluation during exercise in individuals with cardiovascular risk factors.

The Lucent-Takes-Heart cardiovascular health management program. Successful workplace screening.

PubMed

Guico-Pabia, Christine J; Cioffi, Laura; Shoner, Lawrence G

2002-08-01

This prospective, pre- and post-evaluation of a worksite cardiovascular health management program consisted of employee education, measurement of cardiovascular risk factors, and onsite individual counseling for all employees, along with follow up screening for high risk participants. Of 1,099 employees (16.4% of those eligible) who participated in the initial screening, 596 (54.2%) were classified as high risk. A total of 167 (28.0%) high risk participants completed the 6 month follow up screening. Most high risk participants in the 6 month follow up screening reported they had increased their exercise (64.7%), improved their diet (71.3%), and visited a physician (61.7%). A minority of the participants (16.8%) began new cardiovascular medications, and 2.4% were diagnosed with diabetes. In addition, there were statistically significant decreases in the percentages of participants with elevated systolic blood pressure, diastolic blood pressure, low density lipoprotein cholesterol, and total cholesterol to high density lipoprotein ratio. Almost all (99.7%) of the 909 participants (82.7% of all participants) who completed the satisfaction survey were satisfied or very satisfied with the overall program. Screening in the workplace can identify individuals at high risk for cardiovascular disease. In this study, more than half of the participants were classified as high risk. Most high risk individuals who attended the 6 month follow up screening had improved their cardiovascular health, but attrition remains a challenge for worksite programs.

Recognizing global burden of cardiovascular disease and related chronic diseases.

PubMed

Kelly, Bridget B; Narula, Jagat; Fuster, Valentín

2012-01-01

Cardiovascular disease is the leading cause of death worldwide, affecting not only high-income but also low- and middle-income countries. Nearly 80 percent of all estimated cardiovascular disease-related deaths worldwide now occur in low- and middle-income countries, where nearly 30 percent of all deaths are attributable to cardiovascular disease. The health burden of cardiovascular disease and other chronic diseases is also accompanied by a significant deleterious economic impact at the level of both national economies and households. The global trends in the health and economic burden of cardiovascular disease provide a compelling argument in support of prioritizing urgent yet carefully planned efforts to prevent and control cardiovascular disease worldwide-and especially in low- and middle-income countries. After decades of escalating efforts to draw attention to the high burden of cardiovascular disease and other chronic diseases, this critically important issue is now emerging as a more central part of the global health and development agenda. The breadth of behavioral, biological, social, environmental, and systems-level factors that contribute to cardiovascular disease necessitates multisectoral approaches across the lifecourse that promote healthful lifestyles, reduce risk, and reduce cardiovascular-disease morbidity and mortality through the delivery of quality health care services. Given that the complex interactions among the determinants of cardiovascular disease vary in different contexts, real progress in control efforts will come through approaches that are driven by a country's disease burden and risk profile, capacities, resources, and priorities-approaches that are led by a country's key decision-makers and stakeholders, including governments, civil society, the private sector, and communities. Many countries are already establishing efforts to address chronic diseases. In addition to these locally driven efforts, success will require active

Sleep as a Potential Fundamental Contributor to Cardiovascular Health Disparities

PubMed Central

Jackson, Chandra L.; Redline, Susan; Emmons, Karen M.

2016-01-01

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 of health conditions including cardiovascular disease (CVD).The goal of this review is to examine the relationship between sleep and CVD health disparities. To this end, we describe the overall public health importance of sleep and the role of sleep duration as well as the two most common disorders (sleep apnea and insomnia) as risk factors for a number of chronic diseases. We then focus on the potential link between sleep and CVD disparities. A multilevel model developed for the analysis of population health and health disparities as a part of the National Cancer Institute’s Centers on Population Health and Health Disparities served as our conceptual framework. It is based on the notion that individual behaviors, like sleep, are influenced by complex and dynamic interrelations among the individual and his or her physical and social environments across the lifespan. Using this model, we describe modifiable factors that contribute to insufficient sleep and circadian misalignment, propose potential interventions in various sectors (e.g. neighborhoods, schools, workplaces) that address social structures that contribute to disparities, and conclude by recommending critical areas for future sleep research. We ultimately suggest that integrating sleep into public health research will identify novel approaches for closing the gap in health disparities, such as CVD. PMID:25785893

The Implicit Positive and Negative Affect Test: Validity and Relationship with Cardiovascular Stress-Responses

PubMed Central

van der Ploeg, Melanie M.; Brosschot, Jos F.; Thayer, Julian F.; Verkuil, Bart

2016-01-01

Self-report, i.e., explicit, measures of affect cannot fully explain the cardiovascular (CV) responses to stressors. Measuring affect beyond self-report, i.e., using implicit measures, could add to our understanding of stress-related CV activity. The Implicit Positive and Negative Affect Test (IPANAT) was administered in two studies to test its ecological validity and relation with CV responses and self-report measures of affect. In Study 1 students (N = 34) viewed four film clips inducing anger, happiness, fear, or no emotion, and completed the IPANAT and the Positive And Negative Affect Scale at baseline and after each clip. Implicit negative affect (INA) was higher and implicit positive affect (IPA) was lower after the anger inducing clip and vice versa after the happiness inducing clip. In Study 2 students performed a stressful math task with (n = 14) or without anger harassment (n = 15) and completed the IPANAT and a Visual Analog Scale as an explicit measure afterwards. Systolic (SBP), diastolic (DBP) blood pressure, heart rate (HR), heart rate variability (HRV), and total peripheral resistance (TPR) were recorded throughout. SBP and DBP were higher and TPR was lower in the harassment condition during the task with a prolonged effect on SBP and DBP during recovery. As expected, explicit negative affect (ENA) was higher and explicit positive affect (EPA) lower after harassment, but ENA and EPA were not related to CV activity. Although neither INA nor IPA differed between the tasks, during both tasks higher INA was related to higher SBP, lower HRV and lower TPR and to slower recovery of DBP after both tasks. Low IPA was related to slower recovery of SBP and DBP after the tasks. Implicit affect was not related to recovery of HR, HRV, and TPR. In conclusion, the IPANAT seems to respond to film clip-induced negative and positive affect and was related to CV activity during and after stressful tasks. These findings support the theory that implicitly measured affect

The Implicit Positive and Negative Affect Test: Validity and Relationship with Cardiovascular Stress-Responses.

PubMed

van der Ploeg, Melanie M; Brosschot, Jos F; Thayer, Julian F; Verkuil, Bart

2016-01-01

Self-report, i.e., explicit, measures of affect cannot fully explain the cardiovascular (CV) responses to stressors. Measuring affect beyond self-report, i.e., using implicit measures, could add to our understanding of stress-related CV activity. The Implicit Positive and Negative Affect Test (IPANAT) was administered in two studies to test its ecological validity and relation with CV responses and self-report measures of affect. In Study 1 students (N = 34) viewed four film clips inducing anger, happiness, fear, or no emotion, and completed the IPANAT and the Positive And Negative Affect Scale at baseline and after each clip. Implicit negative affect (INA) was higher and implicit positive affect (IPA) was lower after the anger inducing clip and vice versa after the happiness inducing clip. In Study 2 students performed a stressful math task with (n = 14) or without anger harassment (n = 15) and completed the IPANAT and a Visual Analog Scale as an explicit measure afterwards. Systolic (SBP), diastolic (DBP) blood pressure, heart rate (HR), heart rate variability (HRV), and total peripheral resistance (TPR) were recorded throughout. SBP and DBP were higher and TPR was lower in the harassment condition during the task with a prolonged effect on SBP and DBP during recovery. As expected, explicit negative affect (ENA) was higher and explicit positive affect (EPA) lower after harassment, but ENA and EPA were not related to CV activity. Although neither INA nor IPA differed between the tasks, during both tasks higher INA was related to higher SBP, lower HRV and lower TPR and to slower recovery of DBP after both tasks. Low IPA was related to slower recovery of SBP and DBP after the tasks. Implicit affect was not related to recovery of HR, HRV, and TPR. In conclusion, the IPANAT seems to respond to film clip-induced negative and positive affect and was related to CV activity during and after stressful tasks. These findings support the theory that implicitly measured affect

Cardiovascular Effects of Air Pollution Clinical and Public Health Implications: Knowledge Gaps and Opportunities

EPA Science Inventory

“Healthy Heart: Air Pollution and Cardiovascular Health” is a webinar presentation designed to introduce the fundamental epidemiological associations between ambient air pollution and cardiovascular health. Despite the phenomenal improvement in air quality across th...

Hypertensive disorders of pregnancy and subsequent maternal cardiovascular health.

PubMed

Bergen, Nienke E; Schalekamp-Timmermans, Sarah; Roos-Hesselink, Jolien; Roeters van Lennep, Jeanine E; Jaddoe, Vincent V W; Steegers, Eric A P

2018-05-19

To examine associations between hypertensive pregnancy disorders and maternal cardiovascular disease (CVD) in later life. We examined the associations between blood pressure (BP) in pregnancy, gestational hypertension (GH) and preeclampsia (PE) with cardiovascular measurements 6 years after index pregnancy among 4912 women participating in the Generation R Study, the Netherlands. BP, left ventricular mass (LV mass), aortic root diameter (AOD), left atrial diameter, fractional shortening, and carotid-femoral pulse wave velocity (PWV). Early pregnancy systolic and diastolic BP were associated with more adverse maternal cardiovascular measurements and a higher incidence of chronic hypertension 6 years after pregnancy. GH was associated with a higher BP, a higher PWV, a larger AOD and an increased LV mass 6 years after index pregnancy. Compared to previous normotensive pregnancies these women had a sixfold increased risk to develop chronic hypertension after pregnancy (OR 6.6, 95% CI 4.6-9.5). Compared to women with a normotensive pregnancy, women with PE had a higher BP and a higher risk of chronic hypertension (OR 4.5, 95% CI 2.6-7.8) at follow-up. After adjustment for BMI at follow-up in all the analyses on GH, PE and cardiovascular measurements, effect estimates attenuated up to 65%, but remained significant. Both GH and PE are associated with markers of adverse maternal cardiovascular health after pregnancy with an increased risk of chronic hypertension. Women with GH and PE may be offered long-term cardiovascular follow-up incorporated in CVD risk management guidelines.

Analysis of Online Information Searching for Cardiovascular Diseases on a Consumer Health Information Portal

PubMed Central

Jadhav, Ashutosh; Sheth, Amit; Pathak, Jyotishman

2014-01-01

Since the early 2000’s, Internet usage for health information searching has increased significantly. Studying search queries can help us to understand users “information need” and how do they formulate search queries (“expression of information need”). Although cardiovascular diseases (CVD) affect a large percentage of the population, few studies have investigated how and what users search for CVD. We address this knowledge gap in the community by analyzing a large corpus of 10 million CVD related search queries from MayoClinic.com. Using UMLS MetaMap and UMLS semantic types/concepts, we developed a rule-based approach to categorize the queries into 14 health categories. We analyzed structural properties, types (keyword-based/Wh-questions/Yes-No questions) and linguistic structure of the queries. Our results show that the most searched health categories are ‘Diseases/Conditions’, ‘Vital-Sings’, ‘Symptoms’ and ‘Living-with’. CVD queries are longer and are predominantly keyword-based. This study extends our knowledge about online health information searching and provides useful insights for Web search engines and health websites. PMID:25954380

Preventing Heart Attacks and Strokes: Increasing Awareness of the Adverse Cardiovascular Health Impacts of Air Pollution

EPA Science Inventory

Summary: Chronic cardiovascular disease imposes a significant health and economic burden on individuals and communities. Despite decades of improvement in cardiovascular mortality, cardiovascular disease and stroke remain the leading cause of death in the U.S. and disparities i...

Which interventions are used by health care professionals to enhance medication adherence in cardiovascular patients? A survey of current clinical practice.

PubMed

Berben, Lut; Bogert, Laura; Leventhal, Marcia E; Fridlund, Bengt; Jaarsma, Tiny; Norekvål, Tone M; Smith, Karen; Strömberg, Anna; Thompson, David R; De Geest, Sabina

2011-03-01

Complex medication regimens are often required to manage cardiovascular diseases. As non-adherence, which can have severe negative outcomes, is common among cardiovascular patients, various interventions to improve adherence should be implemented in daily practice. To assess which strategies cardiovascular nurses and allied health professionals utilize to (1) assess patients' adherence to medication regimen, and (2) enhance medication adherence via educational/cognitive, counseling/behavioral, and psychological/affective interventions. A 45-item questionnaire to assess adherence assessment and interventional strategies utilized by health care professionals in daily clinical practice was distributed to a convenience sample of attendants of the 10th Annual Spring Meeting of the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions conference in Geneva (Switzerland) in March 2010. Respondents not in direct clinical practice were excluded. Descriptive statistics were used to describe practice patterns regarding adherence management. Of 276 distributed questionnaires, 171 (62%) were returned, of which 34 (20%) were excluded as respondents performed no direct patient care. Questioning patients about non-adherence during follow-up was the most frequently reported assessment strategy (56%). Educational/cognitive adherence enhancing interventions were used most frequently, followed by counseling/behavioral interventions. Psychological/affective interventions were less frequently used. The most frequent intervention used was providing reading materials (66%) followed by training patients regarding medication taking during inpatient recovery (48%). Slightly over two-thirds (69%) reported using a combination of interventions to improve patient's adherence. Educational interventions are used most in clinical practice, although evidence shows they are less effective than behavioral interventions at enhancing medication adherence. Copyright �

A web-based intervention for health professionals and patients to decrease cardiovascular risk attributable to physical inactivity: development process.

PubMed

Sassen, Barbara; Kok, Gerjo; Mesters, Ilse; Crutzen, Rik; Cremers, Anita; Vanhees, Luc

2012-12-14

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. In this paper, we provide insight regarding the systematic development of a Web-based intervention for both health professionals and patients with cardiovascular risk factors using the development method Intervention Mapping. The different steps of Intervention Mapping are described to open up the "black box" of Web-based intervention development and to support future Web-based intervention development. The development of the Professional and Patient Intention and Behavior Intervention (PIB2 intervention) was initiated with a needs assessment for both health professionals (ie, physiotherapy and nursing) and their patients. We formulated performance and change objectives and, subsequently, theory- and evidence-based intervention methods and strategies were selected that were thought to affect the intention and behavior of health professionals and patients. The rationale of the intervention was based on different behavioral change methods that allowed us to describe the scope and sequence of the intervention and produced the Web-based intervention components. The Web-based intervention consisted of 5 modules, including individualized messages and self-completion forms, and charts and tables. The systematic and planned development of the PIB2 intervention resulted in an Internet-delivered behavior change intervention. The intervention was not developed as a substitute for face-to-face contact between professionals and patients, but as an application to complement and optimize health services. The focus of the Web-based intervention was to extend professional behavior of health care professionals, as well as to improve the risk-reduction behavior of patients with

A Web-Based Intervention for Health Professionals and Patients to Decrease Cardiovascular Risk Attributable to Physical Inactivity: Development Process

PubMed Central

2012-01-01

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 factors using the development method Intervention Mapping. The different steps of Intervention Mapping are described to open up the “black box” of Web-based intervention development and to support future Web-based intervention development. Methods The development of the Professional and Patient Intention and Behavior Intervention (PIB2 intervention) was initiated with a needs assessment for both health professionals (ie, physiotherapy and nursing) and their patients. We formulated performance and change objectives and, subsequently, theory- and evidence-based intervention methods and strategies were selected that were thought to affect the intention and behavior of health professionals and patients. The rationale of the intervention was based on different behavioral change methods that allowed us to describe the scope and sequence of the intervention and produced the Web-based intervention components. The Web-based intervention consisted of 5 modules, including individualized messages and self-completion forms, and charts and tables. Results The systematic and planned development of the PIB2 intervention resulted in an Internet-delivered behavior change intervention. The intervention was not developed as a substitute for face-to-face contact between professionals and patients, but as an application to complement and optimize health services. The focus of the Web-based intervention was to extend professional behavior of health care professionals, as well as to improve the risk

Reporting diet-related health issues through newspapers: portrayal of cardiovascular disease and Type 2 diabetes.

PubMed

Hellyer, Nicole Elizabeth; Haddock-Fraser, Janet

2011-02-01

This study identifies (i) the extent to which newsprint media communicate to their readers the lifestyle factors associated with the development of cardiovascular disease and Type 2 diabetes and (ii) newspaper portrayal of social determinants affecting onset of disease. A content analysis of five leading UK national newspapers and their Sunday equivalents was conducted over a 3-month period between January and March 2008. This study shows that cardiovascular disease had much higher press interest than Type 2 diabetes. 'Middle-market' and 'Quality' papers had higher levels of reporting than the 'Popular' press, but the patterns were more complex when the comprehensiveness of reporting was measured within each article. Social determinants affecting disease onset were poorly reported by newspapers, supporting similar research conducted in other countries. This research identifies that there is potential for newspapers to improve their reporting of lifestyle diseases, by including individual and social determinants of disease onset. Lower social classes who read the popular press receive the lowest frequency of reporting and could benefit most from this information. While the research identifies that newspapers are missing the potential to actively communicate and reinforce government health policy, it recognises that the commercial context of the print media may counter such behaviour.

Wine and Cardiovascular Health: A Comprehensive Review.

PubMed

Haseeb, Sohaib; Alexander, Bryce; Baranchuk, Adrian

2017-10-10

Alcoholic beverages have been consumed for thousands of years, attracting great human interest for social, personal, and religious occasions. In addition, they have long been debated to confer cardioprotective benefits. The French Paradox is an observation of a low prevalence of ischemic heart disease, with high intakes of saturated fat, a phenomenon accredited to the consumption of red wine. Although many epidemiological investigations have supported this view, others have attributed it to beer or spirits, with many suggesting that the drink type is not important. Although excessive consumption of alcoholic beverages is commonly regarded to be detrimental to cardiovascular health, there is a debate as to whether light-to-moderate intake is cardioprotective. Although there is extensive epidemiological support for this drinking pattern, a consensus has not been reached. On the basis of published work, we describe the composition of wine and the effects of constituent polyphenols on chronic cardiovascular diseases. © 2017 American Heart Association, Inc.

Nutrition and cardiovascular health.

PubMed

Berciano, Silvia; Ordovás, José M

2014-09-01

A multitude of studies have been published on the relationship between cardiovascular disease risk and a variety of nutrients, foods, and dietary patterns. Despite the well-accepted notion that diet has a significant influence on the development and prevention of cardiovascular disease, the foods considered healthy and harmful have varied over the years. This review aims to summarize the current scientific evidence on the cardioprotective effect of those foods and nutrients that have been considered healthy as well as those that have been deemed unhealthy at any given time in history. For this purpose, we reviewed the most recent literature using as keywords foods and nutrients (ie, meat, omega-3) and cardiovascular disease-related terms (ie, cardiovascular diseases, stroke). Emphasis has been placed on meta-analyses and Cochrane reviews. In general, there is a paucity of intervention studies with a high level of evidence supporting the benefits of healthy foods (ie, fruits and vegetables), whereas the evidence supporting the case against those foods considered less healthy (ie, saturated fat) seems to be weakened by most recent evidence. In summary, most of the evidence supporting the benefits and harms of specific foods and nutrients is based on observational epidemiological studies. The outcome of randomized clinical trials reveals a more confusing picture with most studies providing very small effects in one direction or another; the strongest evidence comes from dietary patterns. The current status of the relationship between diet and cardiovascular disease risk calls for more tailored recommendations based on genomic technologies. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association.

PubMed

Magnani, Jared W; Mujahid, Mahasin S; Aronow, Herbert D; Cené, Crystal W; Dickson, Victoria Vaughan; Havranek, Edward; Morgenstern, Lewis B; Paasche-Orlow, Michael K; Pollak, Amy; Willey, Joshua Z

2018-06-04

Health literacy is the degree to which individuals are able to access and process basic health information and services and thereby participate in health-related decisions. Limited health literacy is highly prevalent in the United States and is strongly associated with patient morbidity, mortality, healthcare use, and costs. The objectives of this American Heart Association scientific statement are (1) to summarize the relevance of health literacy to cardiovascular health; (2) to present the adverse associations of health literacy with cardiovascular risk factors, conditions, and treatments; (3) to suggest strategies that address barriers imposed by limited health literacy on the management and prevention of cardiovascular disease; (4) to demonstrate the contributions of health literacy to health disparities, given its association with social determinants of health; and (5) to propose future directions for how health literacy can be integrated into the American Heart Association's mandate to advance cardiovascular treatment and research, thereby improving patient care and public health. Inadequate health literacy is a barrier to the American Heart Association meeting its 2020 Impact Goals, and this statement articulates the rationale to anticipate and address the adverse cardiovascular effects associated with health literacy. © 2018 American Heart Association, Inc.

[Low level of physical fitness in Spanish adolescents. Relevance for future cardiovascular health (AVENA study)].

PubMed

Ortega, Francisco B; Ruiz, Jonatan R; Castillo, Manuel J; Moreno, Luis A; González-Gross, Marcela; Wärnberg, Julia; Gutiérrez, Angel

2005-08-01

Several studies have demonstrated that physical fitness in childhood and adolescence is related to cardiovascular risk in adulthood. Current data on the physical fitness of Spanish adolescents are not available. Therefore, the aims of this study were: a) to assess the physical fitness of Spanish adolescents and establish reference values for use in health and educational settings as indicators of cardiovascular health, and b) to determine the percentage of Spanish adolescents below the minimum level of aerobic fitness needed to guarantee future cardiovascular health. The modified EUROFIT battery of tests was used to assess physical fitness in a representative sample of Spanish adolescents (n=2859; 1357 boys and 1502 girls) taking part in the AVENA (Alimentación y Valoración del Estado Nutricional de los Adolescentes) study. Standard parameters for the physical condition of Spanish adolescents are reported in this study. The 5th percentile for maximum aerobic capacity (Course Navette test) ranged from 2.0-3.3 palier in boys and from 1.4-1.9 palier in girls. The findings indicate that, on the basis of aerobic fitness, approximately 20% of Spanish adolescents have an increased risk of future cardiovascular disease. This subgroup also performed poorly in all other tests of physical fitness used. The results reported in this study enable the level of physical fitness in adolescents to be interpreted as an indicator of future cardiovascular health. They also indicate that the physical fitness of Spanish adolescents must be improved to help protect against cardiovascular disease in adulthood.

Loneliness, Social Isolation, and Cardiovascular Health.

PubMed

Xia, Ning; Li, Huige

2018-03-20

Social and demographic changes have led to an increased prevalence of loneliness and social isolation in modern society. Recent Advances: Population-based studies have demonstrated that both objective social isolation and the perception of social isolation (loneliness) are correlated with a higher risk of mortality and that both are clearly risk factors for cardiovascular disease (CVD). Lonely individuals have increased peripheral vascular resistance and elevated blood pressure. Socially isolated animals develop more atherosclerosis than those housed in groups. Molecular mechanisms responsible for the increased cardiovascular risk are poorly understood. In recent reports, loneliness and social stress were associated with activation of the hypothalamic-pituitary-adrenocortical axis and the sympathetic nervous system. Repeated and chronic social stress leads to glucocorticoid resistance, enhanced myelopoiesis, upregulated proinflammatory gene expression, and oxidative stress. However, the causal role of these mechanisms in the development of loneliness-associated CVD remains unclear. Elucidation of the molecular mechanisms of how CVD is induced by loneliness and social isolation requires additional studies. Understanding of the pathomechanisms is essential for the development of therapeutic strategies to prevent the detrimental effects of social stress on health. Antioxid. Redox Signal. 28, 837-851.

Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related?

PubMed

Wang, Qing; Shen, Jay J

2016-06-06

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.

Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related?

PubMed Central

Wang, Qing; Shen, Jay J.

2016-01-01

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

Impact of Physical Activity in Cardiovascular and Musculoskeletal Health: Can Motion Be Medicine?

PubMed Central

Curtis, Gannon L.; Chughtai, Morad; Khlopas, Anton; Newman, Jared M.; Khan, Rafay; Shaffiy, Shervin; Nadhim, Ali; Bhave, Anil; Mont, Michael A.

2017-01-01

Physical activity is a well-known therapeutic tool for various types of medical conditions, including vasculopathic diseases such as coronary artery disease, stroke, type 2 diabetes, and obesity. Additionally, increased physical activity has been proposed as a therapy to improve musculoskeletal health; however, there are conflicting reports about physical activity potentially leading to degenerative musculoskeletal disease, especially osteoarthritis (OA). Additionally, although physical activity is known to have its benefits, it is unclear as to what amount of physical activity is the most advantageous. Too much, as well as not enough exercise can have negative consequences. This could impact how physicians advise their patients about exercise intensity. Multiple studies have evaluated the effect of physical activity on various aspects of health. However, there is a paucity of systematic studies which review cardiovascular and musculoskeletal health as outcomes. Therefore, the purpose of this review was to assess how physical activity impacts these aspects of health. Specifically, we evaluated the effect of various levels of physical activity on: 1) cardiovascular and 2) musculoskeletal health. The review revealed that physical activity may decrease cardiovascular disease and improve OA symptoms, and therefore, motion can be considered a “medicine”. However, because heavy activity can potentially lead to increased OA risk, physicians should advise their patients that excessive activity can also potentially impact their health negatively, and should be done in moderation, until further study. PMID:28392856

Resveratrol blunts the positive effects of exercise training on cardiovascular health in aged men

PubMed Central

Gliemann, Lasse; Schmidt, Jakob Friis; Olesen, Jesper; Biensø, Rasmus Sjørup; Peronard, Sebastian Louis; Grandjean, Simon Udsen; Mortensen, Stefan Peter; Nyberg, Michael; Bangsbo, Jens; Pilegaard, Henriette; Hellsten, Ylva

2013-01-01

Ageing 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, and improve cardiovascular health and physical capacity, in part through its effects on Sirtuin 1 signalling 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; body mass index: 25.4 ± 0.7 kg m−2; mean arterial pressure (MAP): 95.8 ± 2.2 mmHg; maximal oxygen uptake: 2488 ± 72 ml O2 min−1) were randomized into 8 weeks of either daily intake of either 250 mg trans-resveratrol (n= 14) or of placebo (n= 13) concomitant with high-intensity exercise training. Exercise training led to a 45% greater (P < 0.05) increase in maximal oxygen uptake in the placebo group than in the resveratrol group and to a decrease in MAP in the placebo group only (−4.8 ± 1.7 mmHg; P < 0.05). The interstitial level of vasodilator prostacyclin was lower in the resveratrol than in the placebo group after training (980 ± 90 vs. 1174 ± 121 pg ml−1; P < 0.02) and muscle thromboxane synthase was higher in the resveratrol group after training (P < 0.05). Resveratrol administration also abolished the positive effects of exercise on low-density lipoprotein, total cholesterol/high-density lipoprotein ratio and triglyceride concentrations in blood (P < 0.05). Resveratrol did not alter the effect of exercise training on the atherosclerosis marker vascular cell adhesion molecule 1 (VCAM-1). Sirtuin 1 protein levels were not affected by resveratrol supplementation. These findings indicate that, whereas exercise training effectively improves several cardiovascular health parameters in aged men, concomitant resveratrol supplementation can blunt these effects. PMID:23878368

Correlates of ideal cardiovascular health in European adolescents: The HELENA study.

PubMed

Henriksson, P; Henriksson, H; Labayen, I; Huybrechts, I; Gracia-Marco, L; Ortega, F B; España-Romero, V; Manios, Y; González-Gross, M; Marcos, A; Moreno, L A; Gutiérrez, Á; Ruiz, J R

2018-02-01

The ideal cardiovascular health (iCVH) construct consists of 4 health behaviors (smoking status, body mass index, physical activity and diet) and 3 health factors (total cholesterol, blood pressure and fasting glucose). A greater number of iCVH components in adolescence are related to better cardiovascular health, but little is known about the correlates of iCVH in adolescents. Thus, the aim of the study was to examine correlates of iCVH in European adolescents. The study comprised 637 European adolescents with complete iCVH data. Participants were part of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional, multicenter study conducted in 9 different European countries. Correlates investigated were sex and age, family affluence scale, maternal education, geographic location, sleep time, television viewing, duration of pregnancy, birth weight and breastfeeding. Younger adolescents, those whose mothers had medium/high education or those who watched television less than 2 h per day had a greater number of iCVH components compared to those who were older, had a mother with low education or watched television 2 h or more daily (P ≤ 0.01). Since in our study older adolescents had worse iCVH than younger adolescents, early promotion of cardiovascular health may be important. Future studies may also investigate the usefulness of limiting television viewing to promote iCVH. Finally, since adolescents of mothers with low education had poorer iCVH, it may be of special interest to tailor public health promotion to adolescents from families with low socioeconomic status. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Affective health bias in older adults: Considering positive and negative affect in a general health context.

PubMed

Whitehead, Brenda R; Bergeman, C S

2016-09-01

Because subjective health reports are a primary source of health information in a number of medical and research-based contexts, much research has been devoted to establishing the extent to which these self-reports of health correspond to health information from more objective sources. One of the key factors considered in this area is trait affect, with most studies emphasizing the impact of negative affect (negative emotions) over positive affect (positive emotions), and focusing on high-arousal affect (e.g., anger, excitement) over moderate- or low-arousal affect (e.g., relaxed, depressed). The present study examines the impact of both Positive and Negative Affect (PA/NA)-measured by items of both high and low arousal-on the correspondence between objective health information and subjective health reports. Another limitation of existing literature in the area is the focus on samples suffering from a particular diagnosis or on specific symptom reports; here, these effects are investigated in a sample of community-dwelling older adults representing a broader spectrum of health. 153 older adults (Mage = 71.2) took surveys assessing Perceived Health and Affect and underwent an objective physical health assessment. Structural equation modeling was used to investigate the extent to which the relationship between Objective Health and Perceived Health was moderated by PA or NA, which would indicate the presence of affective health bias. Results reveal a significant moderation effect for NA, but not for PA; PA appeared to serve a more mediational function, indicating that NA and PA operate on health perceptions in distinct ways. These findings provide evidence that in our high-functioning, community-dwelling sample of older adults, a) affective health bias is present within a general health context, and not only within specific symptom or diagnostic categories; and b) that both PA and NA play important roles in the process. Copyright © 2016 Elsevier Ltd. All rights

Cardiovascular complications of obesity in adolescents.

PubMed

Orio, F; Palomba, S; Cascella, T; Savastano, S; Lombardi, G; Colao, A

2007-01-01

Obesity is an increasingly important worldwide health problem, representing the major risk factor for coronary heart disease. The increase in the prevalence of obesity, particularly among younger age groups, is likely to have long-term implications for cardiovascular disease (CVD) in the years to come, especially at a young age. Obesity plays a central role in the insulin resistance (IR) syndrome and increases the risk of atherosclerotic CVD. The present review will examine the relationships among cardiovascular risk (CVR) factors during the childhood-adolescence-adulthood transition. In fact, the relation between obesity, in particular visceral obesity and CVD, appears to develop at a relatively young age. The foremost physical consequence of obesity is atherosclerotic CVD, and an intriguing example of obesity-related cardiovascular complications affecting young women is the polycystic ovary syndrome (PCOS).

Spices: Therapeutic Potential in Cardiovascular Health.

PubMed

Rastogi, Subha; Pandey, Madan Mohan; Rawat, Ajay Kumar Singh

2017-01-01

Dietary factors play a key role in the development as well as prevention of certain human diseases, including cardiovascular diseases. Currently there has been an increase in global interest to identify medicinal plants that are pharmacologically effective and have low or no side effects for use in preventive medicine. Culinary herbs and spices are an important part of human nutrition in all the cultures of the world. There is a growing amount of literature concerning the potential benefits of these herbs and spices from a health perspective especially in conferring protection against cardiovascular diseases. The objective of this review is to provide information on the recent scientific findings on some common spices that have a distinct place in folk medicine in several of the Asian countries as well as on their traditional uses for the role they can play in the management of heart diseases and which may be useful in defining cost effective and inexpensive interventions for the prevention and control of CVDs. Systematic literature searches were carried out and the available information on various medicinal plants traditionally used for cardiovascular disorders was collected via electronic search (using Pubmed, SciFinder, Scirus, GoogleScholar, JCCC@INSTIRC and Web of Science) and a library search for articles published in peerreviewed journals. No restrictions regarding the language of publication were imposed. This article highlights the recent scientific findings on four common spices viz. Greater cardamom (Amomum subulatum Roxb.), Coriander (Coriandrum sativum L.), Turmeric (Curcuma longa L.) and Ginger (Zingiber officinale Roscoe), for the role they can play in the management of heart diseases. Although they have been used by many cultures since ancient times and have been known to exhibit several medicinal properties, current research shows that they can also be effectively used for the prevention and control of CVDs. Although scientific evidences supporting

Using Photovoice to Understand Barriers to and Facilitators of Cardiovascular Health Among African American Adults and Adolescents, North Carolina, 2011-2012.

PubMed

Kowitt, Sarah; Woods-Jaeger, Briana; Lomas, Jesse; Taggart, Tamara; Thayer, Linden; Sutton, Sussie; Lightfoot, Alexandra F

2015-10-01

Cardiovascular disease is the leading cause of death in the United States, and mortality rates are higher among African Americans than among people of other races/ethnicities. We aimed to understand how African American adults and adolescents conceptualize cardiovascular health and perceive related barriers and facilitators. This qualitative study was conducted as formative research for a larger study, Heart Healthy Lenoir, which aimed to reduce cardiovascular disease disparities among African Americans in eastern North Carolina, part of the widely-known "stroke belt" that runs through the southeastern United States. Using photovoice, a community-based participatory research method, we conducted eight 90-minute photovoice sessions with 6 adults and 9 adolescents in Lenoir County, North Carolina. Topics for each discussion were selected by participants and reflected themes related to cardiovascular health promotion. All sessions were transcribed and coded using a data-driven, inductive approach. Participants conceptualized cardiovascular health to have mental, spiritual, and social health dimensions. Given these broad domains, participants acknowledged many ecological barriers to cardiovascular health; however, they also emphasized the importance of personal responsibility. Facilitators for cardiovascular health included using social health (eg, family/community relationships) and spiritual health dimensions (eg, understanding one's body and purpose) to improve health behaviors. The perspectives of African American adults and adolescents elicited through this formative research provided a strong foundation for Heart Healthy Lenoir's ongoing engagement of community members in Lenoir County and development and implementation of its intervention to prevent cardiovascular disease.

Changes in Cardiovascular Health Status and the Risk of New-Onset Hypertension in Kailuan Cohort Study

PubMed Central

Wang, Xizhu; Chen, Shouhua; Shi, Jihong; Zhang, Ying; Wu, Shouling; Cai, Jun

2016-01-01

American Heart Association cardiovascular health metrics are intimately related to cardiovascular diseases. Acting as a key independent risk factor for high morbidity and mortality of cardiovascular diseases, hypertension and its relationship between health status get urgent attention. While the influence of individual health status changes and the future risk of new-onset hypertension is rarely understood, the present study applied this construct to assess the changes of cardiovascular health status and the morbidity of hypertension in Kailuan cohort study in north China. The Cardiovascular Health Score (CHS) was evaluated by the follow-ups of 2006–2007, 2008–2009, 2010–2011 and 2012–2013. The study population (n = 19381) was divided into 5 groups based on the changes in their CHS score between the first two follow-ups (△CHS) of 2006–2007 and 2008–2009 (≤-2, -1, 0, 1, ≥2). The morbidity of hypertension was collected during 2010–2011 and 2012–2013 follow-ups. Data analysis showed that during a median follow-up of 3.79±0.96 years, morbidity of hypertension had a graded relationship with △CHS. As △CHS scored from low to high, the standardized morbidity of hypertension for all participants were 81.40, 75.47, 68.37, 71.43 and 83.13 per 1000 person-year, respectively. An increased △CHS score of 1 was associated with a 10% decrease in the future risk of new-onset hypertension(HR: 0.90, 95% CI: 0.88–0.92). In conclusion, there was a strong inverse relationship between the incidence of new-onset hypertension and elevation of cardiovascular health metrics. Population-wide prevention, especially the promotion of lifestyle improvements, is critical to reducing the morbidity of new-onset hypertension. PMID:27434049

Laser therapy in cardiovascular disease

NASA Astrophysics Data System (ADS)

Rindge, David

2009-02-01

Cardiovascular disease is the number one cause of death worldwide. It is broadly defined to include anything which adversely affects the heart or blood vessels. One-third of Americans have one or more forms of it. By one estimate, average human life expectancy would increase by seven years if it were eliminated. The mainstream medical model seeks mostly to "manage" cardiovascular disease with pharmaceuticals or to surgically bypass or reopen blocked vessels via angioplasty. These methods have proven highly useful and saved countless lives. Yet drug therapy may be costly and ongoing, and it carries the risk of side effects while often doing little or nothing to improve underlying health concerns. Similarly, angioplasty or surgery are invasive methods which entail risk. Laser therapy1 regenerates tissue, stimulates biological function, reduces inflammation and alleviates pain. Its efficacy and safety have been increasingly well documented in cardiovascular disease of many kinds. In this article we will explore the effects of laser therapy in angina, atherosclerosis, coronary artery disease, hypertension, hyperlipidemia, myocardial infarction, stroke and other conditions. The clinical application of various methods of laser therapy, including laserpuncture and transcutaneous, supravascular and intravenous irradiation of blood will be discussed. Implementing laser therapy in the treatment of cardiovascular disease offers the possibility of increasing the health and wellbeing of patients while reducing the costs and enhancing safety of medical care.

Impact of Physical Activity and Body Mass Index in Cardiovascular and Musculoskeletal Health: A Review.

PubMed

Chughtai, Morad; Gwam, Chukwuweike U; Mohamed, Nequesha; Khlopas, Anton; Sodhi, Nipun; Sultan, Assem A; Bhave, Anil; Mont, Michael A

2017-12-22

Due to an increasing elderly population coupled with a growing obesity epidemic, there has been an increased prevalence in cardiovascular and musculoskeletal diseases. This has led to an increased burden in healthcare expenditures, now estimated to be over 17.8% of gross domestic product. As a result, physical activity has been increasingly encouraged due to its potential prophylactic effects on health. Recent reports have demonstrated a relationship between physical activity and body mass index (BMI) on cardiovascular and musculoskeletal health. However, the effect of the combination of the two have not been reported. Therefore, the purpose of this review was to assess the effect of various levels of physical activity on: 1) cardiovascular disease risk; and 2) the development of musculoskeletal disease (osteoarthritis [OA]) when accounting for various levels of BMIs. A total of 143 abstracts were identified for cardiovascular health and 55 abstracts for musculoskeletal health. Upon review, 11 reports were included for final evaluation. Despite patient BMI, physical activity was associated with a decreased risk of cardiovascular events. Additionally, moderate levels of physical activity were demonstrated to be protective against the development of OA; however, the levels of physical activity necessary to be beneficial were not fully elucidated. This suggests that the prophylactic effects of physical activity were maintained despite patient BMI. Future studies are needed to explore the appropriate levels of physical activity for optimal effectiveness when stratifying by patient BMI.

A randomised controlled trial of a consumer-focused e-health strategy for cardiovascular risk management in primary care: the Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) study protocol.

PubMed

Redfern, Julie; Usherwood, T; Harris, M F; Rodgers, A; Hayman, N; Panaretto, K; Chow, C; Lau, A Y S; Neubeck, L; Coorey, G; Hersch, F; Heeley, E; Patel, A; Jan, S; Zwar, N; Peiris, D

2014-01-31

Fewer than half of all people at highest risk of a cardiovascular event are receiving and adhering to best practice recommendations to lower their risk. In this project, we examine the role of an e-health-assisted consumer-focused strategy as a means of overcoming these gaps between evidence and practice. Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) aims to test whether a consumer-focused e-health strategy provided to Aboriginal and Torres Strait Islander and non-indigenous adults, recruited through primary care, at moderate-to-high risk of a cardiovascular disease event will improve risk factor control when compared with usual care. Randomised controlled trial of 2000 participants with an average of 18 months of follow-up to evaluate the effectiveness of an integrated consumer-directed e-health portal on cardiovascular risk compared with usual care in patients with cardiovascular disease or who are at moderate-to-high cardiovascular disease risk. The trial will be augmented by formal economic and process evaluations to assess acceptability, equity and cost-effectiveness of the intervention. The intervention group will participate in a consumer-directed e-health strategy for cardiovascular risk management. The programme is electronically integrated with the primary care provider's software and will include interactive smart phone and Internet platforms. The primary outcome is a composite endpoint of the proportion of people meeting the Australian guideline-recommended blood pressure (BP) and cholesterol targets. Secondary outcomes include change in mean BP and fasting cholesterol levels, proportion meeting BP and cholesterol targets separately, self-efficacy, health literacy, self-reported point prevalence abstinence in smoking, body mass index and waist circumference, self-reported physical activity and self-reported medication adherence. Primary ethics approval was received from the University of Sydney Human Research Ethics Committee and the

THE FUTURE OF MOBILE HEALTH APPLICATIONS AND DEVICES IN CARDIOVASCULAR HEALTH.

PubMed

Kelli, Heval Mohamed; Witbrodt, Bradley; Shah, Amit

2017-01-01

Mobile health (mHealth) is the utilisation of mobile technologies in healthcare and has particular relevance in improving lifestyle behaviours which may ultimately reduce cardiovascular disease risk. Various intervention studies for example integrate self-monitoring of diet and physical activity with text messaging systems to improve intermediate outcomes. Currently the future progress of mHealth technologies in formal diagnostic and therapeutic roles is pending and includes the need to validate and standardise accelerometer and heart rate data from various devices. Data also needs to be integrated from such devices into the medical record system to facilitate communication between providers and patients. Although short-term behaviour changes have been found with technologies such as Fitbit® (Fitbit, Inc., San Francisco, California, USA), whether such technologies/interventions lead to sustained behaviour change and reduced risk of myocardial infarction and death remains to be seen.

Cardiovascular Risk and Its Associated Factors in Health Care Workers in Colombia: A Study Protocol.

PubMed

Gamboa Delgado, Edna M; Rojas Sánchez, Lyda Z; Bermon Angarita, Anderson; Rangel Díaz, Yully Andrea; Jaraba Suárez, Silvia J; Serrano Díaz, Norma C; Vega Fernández, Evaristo

2015-07-30

Cardiovascular diseases are the leading cause of mortality worldwide, for this reason, they are a public health problem. In Colombia, cardiovascular diseases are the main cause of mortality, having a death rate of 152 deaths per 100,000 population. There are 80% of these cardiovascular events that are considered avoidable. The objective of the study is to determine the prevalence of the cardiovascular risk and its associated factors among the institution's workers in order to design and implement interventions in the work environment which may achieve a decrease in such risk. An analytical cross-sectional study was designed to determine the cardiovascular risk and its associated factors among workers of a high complexity health care institution. A self-applied survey will be conducted considering sociodemographic aspects, physical activity, diet, alcohol consumption, smoking, level of perceived stress, and personal and family history. In a second appointment, a physical examination will be made, as well as anthropometric measurements and blood pressure determination. Also, blood samples for evaluating total and high density lipoprotein cholesterol, triglycerides, and fasting blood sugar will be taken. A ten-year global risk for cardiovascular disease will be determined using the Framingham score. A descriptive analysis of the population's characteristics and a stratified analysis by sex, age, and occupation will be made. Bivariate and multivariate analysis will be made using logistic regression models to evaluate the association between cardiovascular risk and the independent variables. The research protocol was approved by the Scientific and Technical Committee and the Ethics Committee on Research of the Fundación Cardiovascular de Colombia. The protocol has already received funding and the enrollment phase will begin in the coming months. The results of this study will give the foundation for the design, implementation, and evaluation of a program based on

Cardiovascular Health and Incident Hypertension in Blacks: JHS (The Jackson Heart Study).

PubMed

Booth, John N; Abdalla, Marwah; Tanner, Rikki M; Diaz, Keith M; Bromfield, Samantha G; Tajeu, Gabriel S; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P; Spruill, Tanya M; Shimbo, Daichi; Muntner, Paul

2017-08-01

Several modifiable health behaviors and health factors that comprise the Life's Simple 7-a cardiovascular health metric-have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in JHS (the Jackson Heart Study)-a cohort of blacks. We analyzed participants without hypertension or cardiovascular disease at baseline (2000-2004) who attended ≥1 follow-up visit in 2005 to 2008 or 2009 to 2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure (BP), total cholesterol, and fasting glucose were assessed at baseline and categorized as ideal, intermediate, or poor using the American Heart Association's Life's Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, or self-reported taking antihypertensive medication. The percentage of participants with ≤1, 2, 3, 4, 5, and 6 ideal Life's Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0%, and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median, 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5, and 6 versus ≤1 ideal component were 0.80 (0.61-1.03), 0.58 (0.45-0.74), 0.30 (0.23-0.40), 0.26 (0.18-0.37), and 0.10 (0.03-0.31), respectively ( P trend <0.001). This association was present among participants with baseline systolic BP <120 mm Hg and diastolic BP <80 mm Hg and separately systolic BP 120 to 139 mm Hg or diastolic BP 80 to 89 mm Hg. Blacks with better cardiovascular health have lower hypertension risk. © 2017 American Heart Association, Inc.

Loneliness, Social Isolation, and Cardiovascular Health

PubMed Central

Xia, Ning

2018-01-01

Abstract Significance: Social and demographic changes have led to an increased prevalence of loneliness and social isolation in modern society. Recent Advances: Population-based studies have demonstrated that both objective social isolation and the perception of social isolation (loneliness) are correlated with a higher risk of mortality and that both are clearly risk factors for cardiovascular disease (CVD). Lonely individuals have increased peripheral vascular resistance and elevated blood pressure. Socially isolated animals develop more atherosclerosis than those housed in groups. Critical Issues: Molecular mechanisms responsible for the increased cardiovascular risk are poorly understood. In recent reports, loneliness and social stress were associated with activation of the hypothalamic–pituitary–adrenocortical axis and the sympathetic nervous system. Repeated and chronic social stress leads to glucocorticoid resistance, enhanced myelopoiesis, upregulated proinflammatory gene expression, and oxidative stress. However, the causal role of these mechanisms in the development of loneliness-associated CVD remains unclear. Future Directions: Elucidation of the molecular mechanisms of how CVD is induced by loneliness and social isolation requires additional studies. Understanding of the pathomechanisms is essential for the development of therapeutic strategies to prevent the detrimental effects of social stress on health. Antioxid. Redox Signal. 28, 837–851. PMID:28903579

Primary prevention of stroke and cardiovascular disease in the community (PREVENTS): Methodology of a health wellness coaching intervention to reduce stroke and cardiovascular disease risk, a randomized clinical trial.

PubMed

Mahon, Susan; Krishnamurthi, Rita; Vandal, Alain; Witt, Emma; Barker-Collo, Suzanne; Parmar, Priya; Theadom, Alice; Barber, Alan; Arroll, Bruce; Rush, Elaine; Elder, Hinemoa; Dyer, Jesse; Feigin, Valery

2018-02-01

Rationale Stroke is a major cause of death and disability worldwide, yet 80% of strokes can be prevented through modifications of risk factors and lifestyle and by medication. While management strategies for primary stroke prevention in high cardiovascular disease risk individuals are well established, they are underutilized and existing practice of primary stroke prevention are inadequate. Behavioral interventions are emerging as highly promising strategies to improve cardiovascular disease risk factor management. Health Wellness Coaching is an innovative, patient-focused and cost-effective, multidimensional psychological intervention designed to motivate participants to adhere to recommended medication and lifestyle changes and has been shown to improve health and enhance well-being. Aims and/or hypothesis To determine the effectiveness of Health Wellness Coaching for primary stroke prevention in an ethnically diverse sample including Māori, Pacific Island, New Zealand European and Asian participants. Design A parallel, prospective, randomized, open-treatment, single-blinded end-point trial. Participants include 320 adults with absolute five-year cardiovascular disease risk ≥ 10%, calculated using the PREDICT web-based clinical tool. Randomization will be to Health Wellness Coaching or usual care groups. Participants randomized to Health Wellness Coaching will receive 15 coaching sessions over nine months. Study outcomes A substantial relative risk reduction of five-year cardiovascular disease risk at nine months post-randomization, which is defined as 10% relative risk reduction among those at moderate five-year cardiovascular disease risk (10-15%) and 25% among those at high risk (>15%). Discussion This clinical trial will determine whether Health Wellness Coaching is an effective intervention for reducing modifiable risk factors, and hence decrease the risk of stroke and cardiovascular disease.

Cumulative effect of reproductive factors on ideal cardiovascular health in postmenopausal women: a cross-sectional study in central south China.

PubMed

Cao, Xia; Zhou, Jiansong; Yuan, Hong; Chen, Zhiheng

2015-12-21

The American Heart Association developed the Life's Simple 7 metric for defining cardiovascular health. Little is known, however, whether co-occurring reproductive factors, which affects endogenous oestrogen levels during a woman's life, also influences ideal cardiovascular health in postmenopausal women. Using data on a cross-sectional study with a convenience sample of 1,625 postmenopausal women (median age, 60.0 years) in a medical health checkup program at a general hospital in central south China 2013-2014, we examined the association between cumulative reproductive risk and ideal cardiovascular health in postmenopausal women. A cumulative risk score (range 0 to 4) was created by summing four reproductive risk factors (age at menarche, age at menopause, number of children, and pregnancy losses) present in each individual from binary variables in which 0 stands for favorable and 1 for less-than-favorable level. Ideal levels for each component in Life's Simple 7 (blood pressure, cholesterol, glucose, BMI, smoking, physical activity, and diet) were used to create an ideal Life's Simple 7 score [0-1 (low), 2, 3, 4, 5 and 6-7 (high)]. Participants with earlier age at menarche (odds ratio [OR] =0.42 [95 % CI 0.26-0.48]), earlier age at menopause [0.46 (0.32-0.58)], who have more than three children (0.42 [0.38-0.56]) and have history of pregnancy losses [0.76 (0.66-0.92)] were more likely to attain low (0-1) ideal Life's Simple 7 after adjustment for age. Participants were more likely to attain low (0-1) ideal Life's Simple 7 as exposure to the number of reproductive risk factors increased [OR (95 % CI) of 0.52 (0.42-0.66), 0.22 (0.16-0.26), and 0.16 (0.12-0.22) for cumulative reproductive risk scores of 1, 2, and 3 or 4, respectively, each versus 0]. The postmenopausal Chinese women with an increasing number of reproductive risk factors were progressively less likely to attain ideal levels of cardiovascular health factors.

Demographics, Affect, and Adolescents' Health Behaviors.

ERIC Educational Resources Information Center

Terre, Lisa; And Others

1992-01-01

Examined relationship between affect, demographics, and health-related lifestyle among 139 public high school students. Data analyses revealed distinctive demographic and affective correlates of different health behaviors. No one variable uniformly predicted adolescents' health behaviors. Demographics and affect showed differential relationships…

Cannabis Smoking and Cardiovascular Health: It's Complicated.

PubMed

Piano, M R

2017-08-01

Many states have legalized cannabis use for treatment of certain medical conditions or have legalized cannabis for recreational use. Consequently, cannabis use prevalence has escalated, giving rise to concerns about potential health effects. Cannabis smoking remains the most prevalent route of administration and is associated with inhalation of chemical toxicants. The aim of this article is to summarize the effects of cannabis smoking on the vasculature and occurrence of cardiovascular (CV) events such as myocardial infarction (MI) and stroke. © 2017 American Society for Clinical Pharmacology and Therapeutics.

Exercise Training and Cardiovascular Health in Cancer Patients.

PubMed

Squires, Ray W; Shultz, Adam M; Herrmann, Joerg

2018-03-10

Cancer patients nearly universally experience a decline in quality of life, with fatigue and reduced exercise tolerance as cardinal reflections. A routine exercise program can improve these signs and symptoms as well as overall outcomes. The review provides an updated overview of the field and its translation to clinical practice. A wealth of clinical studies have documented the safety and benefits of exercise after and during cancer therapy, and pilot and larger-scale studies are currently ongoing to integrate exercise into the treatment program for cancer patients undergoing active therapy (EXACT pilot, OptiTrain, and TITAN study). More recently, efforts have emerged to commence exercise programs before the start of cancer therapy, so-called pre-habilitation. The concept of increasing the cardiovascular reserve beforehand is intuitively attractive. In agreement, preclinical studies support exercise as an effective preventive means before and during cardiotoxic drug exposure. Assuming that a pronounced drop in exercise tolerance will occur during cancer therapy, pre-habilitation can potentially curtail or raise the nadir level of exercise tolerance. Furthermore, such efforts might serve as pre-conditioning efforts in reducing not only the nadir, but even the magnitude of drop in cardiovascular reserve. Initiated beforehand, cancer patients are also more likely to continue these efforts during cancer therapy. Finally, an active exercise routine (≥ 150 min/week moderate intensity or ≥ 75 min/week vigorous intensity or combination) in conjunction with the other six American Heart Association's cardiovascular health metrics (BMI < 25 kg/m 2 , blood pressure < 120/80 mmHg, fasting plasma glucose < 100 mg/dL, total cholesterol < 200 mg/dL, 4-5 component healthy diet, no smoking) reduces not only the cardiovascular but also the cancer disease risk. Exercise can reduce the risks of developing cancer, the detrimental effects of its treatment on the

Business cycles, hypertension and cardiovascular disease: evidence from the Icelandic economic collapse.

PubMed

Asgeirsdottir, Tinna Laufey; Olafsdottir, Thorhildur; Ragnarsdottir, Dagny Osk

2014-08-01

Business cycles affect people's lives. A growing literature examines their effect on health outcomes. The available studies on the relationship between ambient economic conditions and cardiovascular health show mixed results. They are furthermore limited in their outcome measures, focusing mostly on mortality. We examined the relationship between economic conditions and cardiovascular disease and hypertension, using the Icelandic economic collapse of 2008. Logit regression analyses are used to examine the relationship between economic conditions and the probability of reporting a cardiovascular disease or hypertension. We furthermore investigated potential mediators of this relationship. The data used come from a health and lifestyle survey carried out by the Public Health Institute of Iceland in 2007 and 2009. The crisis was positively related to hypertension in males but no statistically significant relationship was found for females. The mediation analyses indicated partial mediation through changes in working hours and stress level, but negligible mediation through changes in income. The male hypertension was, however, suppressed by concurrent changes in smoking and body weight. Only examining mortality effects of society-wide economic conditions may understate the overall effect on cardiovascular health.

Sex Differences in Cardiovascular Health: Does Sexism Influence Women’s Health?

PubMed Central

Molix, Lisa

2014-01-01

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 smaller studies have yielded fairly consistent results. It is suggested that future research should aim to examine the influence of two types of sexism (i.e., hostile and benevolent) and that daily or within-day designs be employed to assess cognitive, behavioral, and physiological responses to everyday sexist experiences. PMID:25054736

Long-term effect of population screening for diabetes on cardiovascular morbidity, self-rated health, and health behavior.

PubMed

Echouffo-Tcheugui, Justin B; Simmons, Rebecca K; Prevost, A Toby; Williams, Kate M; Kinmonth, Ann-Louise; Wareham, Nicholas J; Griffin, Simon J

2015-03-01

There is limited trial evidence concerning the long-term effects of screening for type 2 diabetes on population morbidity. We examined the effect of a population-based diabetes screening program on cardiovascular morbidity, self-rated health, and health-related behaviors. We conducted a pragmatic, parallel-group, cluster-randomized controlled trial of diabetes screening (the ADDITION-Cambridge study) including 18,875 individuals aged 40 to 69 years at high risk of diabetes in 32 general practices in eastern England (27 practices randomly allocated to screening, 5 to no-screening for control). Of those eligible for screening, 466 (2.9%) were diagnosed with diabetes. Seven years after randomization, a random sample of patients was sent a postal questionnaire: 15% from the screening group (including diabetes screening visit attenders and non-attenders) and 40% from the no-screening control group. Self-reported cardiovascular morbidity, self-rated health (using the SF-8 Health Survey and EQ-5D instrument), and health behaviors were compared between trial groups using an intention-to-screen analysis. Of the 3,286 questionnaires mailed out, 1,995 (61%) were returned, with 1,945 included in the analysis (screening: 1,373; control: 572). At 7 years, there were no significant differences between the screening and control groups in the proportion of participants reporting heart attack or stroke (OR = 0.90, 95% CI, 0.71-1.15); SF-8 physical health summary score as an indicator of self-rated health status (β -0.33, 95% CI, -1.80 to 1.14); EQ-5D visual analogue score (β: 0.80, 95% CI, -1.28 to 2.87); total physical activity (β 0.50, 95% CI, -4.08 to 5.07); current smoking (OR 0.97, 95% CI, 0.72 to 1.32); and alcohol consumption (β 0.14, 95% CI, -1.07 to 1.35). Invitation to screening for type 2 diabetes appears to have limited impact on population levels of cardiovascular morbidity, self-rated health status, and health behavior after 7 years. © 2015 Annals of Family

Associations of mental health with cardiovascular risk phenotypes and adiposity in adolescence: A cross-sectional community-based study.

PubMed

Lycett, Kate; McNamara, Clare; Mensah, Fiona K; Burgner, David; Kerr, Jessica A; Muller, Josh; Wake, Melissa

2018-06-01

Cardiovascular disease and mental illness commonly co-occur in later life, but it is unknown how early these associations arise. We aimed to determine the extent to which: (i) childhood mental health is associated with functional and structural cardiovascular risk phenotypes and adiposity in late childhood/adolescence, and (ii) associations between mental health and cardiovascular phenotypes may be explained by differential body mass index. This cross-sectional study drew on three longitudinal community-based cohort studies (two enriched for overweight/obesity) in metropolitan Melbourne, Australia, with harmonized follow-up in 2014. Mental health exposures included emotional and behavioural problems (Strength and Difficulties Questionnaire) and psychosocial health and general well-being (Pediatric Quality of Life Inventory (PedsQL)), which were assessed by self- and parent-proxy report. Cardiovascular risk phenotypes and adiposity measures included mean arterial pressure, pulse wave velocity, carotid artery intima-media thickness, retinal arterioleto-venule ratio, waist circumference, % body fat, and BMI z-score. We used multivariable linear regression models, adjusting for age, sex and neighbourhood disadvantage, to examine associations. Of the 364 participants (mean age 14.7, standard deviation 2.0, years), 30% were overweight and 16% obese. All adiposity indicators were positively associated with higher behavioural/emotional problems and poorer psychosocial health and negatively associated with better ratings of positive general well-being, as reported by parents and children (all P ≤ 0.03). However, there was little evidence that cardiovascular functional or structural phenotypes varied by mental health. By late childhood/adolescence, mental health is strongly associated with adiposity but not with cardiovascular structure or function. This suggests that the known relationship between these constructs may not develop until early or mid-adulthood. © 2018

The relationship between physician supply, cardiovascular health service use and cardiac disease burden in Ontario: Supply-need mismatch

PubMed Central

Alter, David A; Stukel, Therese A; Newman, Alice

2008-01-01

BACKGROUND: While health service use appears to be positively correlated with resource availability, no study has explored the interactions among health service supply, cardiovascular disease burden and health service use. The objective of the present study was to examine the relationship among cardiovascular evaluation and management intensity, physician supply and cardiovascular disease burden in the Canadian population. METHODS: The present cross-sectional, population-based study consisted of adult residents in Ontario in 2001. Cardiac evaluation and management intensity, the main outcome measure, was measured at the individual level, and consisted of receiving one or more of the following services: noninvasive cardiac testing, coronary angiography and statin use (the latter among individuals 65 years of age and older). Mortality was the secondary outcome measure. Cardiovascular disease burden, and cardiologist and primary care physician supply were measured at the regional (ie, county) level. Analyses were adjusted for age and sex using Poisson regression, accounting for regional clustering. RESULTS: Regional per capita cardiologist supply varied more than twofold across regions, but was inversely related to the regional cardiovascular disease burden (r=−0.34, P=0.01). Primary care physician supply was relatively evenly distributed across regions. Residents in areas with more cardiologists were more likely to receive some form of cardiac intervention (RR=1.074, 95% CI 1.066 to 1.082 per additional cardiologist per 100,000). Those in areas with more primary care physicians were also more likely to receive noninvasive cardiac testing (RR=1.056, 95% CI 1.051 to 1.061 per six additional primary care physicians per 100,000). However, the intensity of provision of cardiac health services was unrelated to regional cardiovascular disease burden and was not associated with improved survival. CONCLUSIONS: The mismatch between physician supply and cardiac disease burden

A Contemporary Review of the Relationship between Red Meat Consumption and Cardiovascular Risk

PubMed Central

Bronzato, Sofia; Durante, Alessandro

2017-01-01

Cardiovascular diseases burden is increasing due to aging populations and represents one of the major health issues worldwide. Dietary habits have been extensively studied in the cardiovascular field despite the difficulty in the quantification of the assumption of each single food and the observation that several foods affect cardiovascular risk with opposite effects. Moreover, some older findings have been reverted by more recent studies. Red meat has been widely studied in this context, and it has been suggested to increase cardiovascular risk primarily by causing dyslipidemia. Our aim is to review the relationship between red meat assumption and cardiovascular risk and to present novel findings regarding their link. PMID:28656096

Heme Oxygenases in Cardiovascular Health and Disease

PubMed Central

Ayer, Anita; Zarjou, Abolfazl; Agarwal, Anupam; Stocker, Roland

2016-01-01

Heme oxygenases are composed of two isozymes, Hmox1 and Hmox2, that catalyze the degradation of heme to carbon monoxide (CO), ferrous iron, and biliverdin, the latter of which is subsequently converted to bilirubin. While initially considered to be waste products, CO and biliverdin/bilirubin have been shown over the last 20 years to modulate key cellular processes, such as inflammation, cell proliferation, and apoptosis, as well as antioxidant defense. This shift in paradigm has led to the importance of heme oxygenases and their products in cell physiology now being well accepted. The identification of the two human cases thus far of heme oxygenase deficiency and the generation of mice deficient in Hmox1 or Hmox2 have reiterated a role for these enzymes in both normal cell function and disease pathogenesis, especially in the context of cardiovascular disease. This review covers the current knowledge on the function of both Hmox1 and Hmox2 at both a cellular and tissue level in the cardiovascular system. Initially, the roles of heme oxygenases in vascular health and the regulation of processes central to vascular diseases are outlined, followed by an evaluation of the role(s) of Hmox1 and Hmox2 in various diseases such as atherosclerosis, intimal hyperplasia, myocardial infarction, and angiogenesis. Finally, the therapeutic potential of heme oxygenases and their products are examined in a cardiovascular disease context, with a focus on how the knowledge we have gained on these enzymes may be capitalized in future clinical studies. PMID:27604527

Is tree loss associated with cardiovascular-disease risk in the Women's Health Initiative? A natural experiment

Treesearch

Geoffrey H. Donovan; Yvonne L. Michael; Demetrios Gatziolis; Jeffrey P. Prestemon; Eric A. Whitsel

2015-01-01

Data from the Women's Health Initiative were used to quantify the relationship between the loss of trees to an invasive forest pest—the emerald ash borer—and cardiovascular disease. We estimated semi- parametric Cox proportional hazards model of time to cardiovascular disease, adjusting for confounders. We defined the incidence of cardiovascular disease as acute...

Race and ethnicity, obesity, metabolic health, and risk of cardiovascular disease in postmenopausal women.

PubMed

Schmiegelow, Michelle D; Hedlin, Haley; Mackey, Rachel H; Martin, Lisa W; Vitolins, Mara Z; Stefanick, Marcia L; Perez, Marco V; Allison, Matthew; Hlatky, Mark A

2015-05-20

It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups. 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 first as the metabolic syndrome (metabolically unhealthy: ≥3 metabolic abnormalities) and second as the number of metabolic abnormalities. We used Cox proportional hazards regression to assess associations between baseline characteristics and cardiovascular risk. Over 13 years of follow-up, 1101 women had a first cardiovascular disease event (coronary heart disease or ischemic stroke). Among black women without metabolic syndrome, overweight women had higher adjusted cardiovascular risk than normal weight women (hazard ratio [HR] 1.49), whereas among white women without metabolic syndrome, 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 black women who were overweight (HR 1.77) or obese (HR 2.17) but not in white women who were overweight (HR 0.98) or obese (HR 1.06). Overweight and obese women with ≤1 metabolic abnormality did not have increased cardiovascular risk, regardless of race or ethnicity. Metabolic abnormalities appeared to convey more cardiovascular risk among black women. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Race and Ethnicity, Obesity, Metabolic Health, and Risk of Cardiovascular Disease in Postmenopausal Women

PubMed Central

Schmiegelow, Michelle D; Hedlin, Haley; Mackey, Rachel H; Martin, Lisa W; Vitolins, Mara Z; Stefanick, Marcia L; Perez, Marco V; Allison, Matthew; Hlatky, Mark A

2015-01-01

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/m2) 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 first as the metabolic syndrome (metabolically unhealthy: ≥3 metabolic abnormalities) and second as the number of metabolic abnormalities. We used Cox proportional hazards regression to assess associations between baseline characteristics and cardiovascular risk. Over 13 years of follow-up, 1101 women had a first cardiovascular disease event (coronary heart disease or ischemic stroke). Among black women without metabolic syndrome, overweight women had higher adjusted cardiovascular risk than normal weight women (hazard ratio [HR] 1.49), whereas among white women without metabolic syndrome, 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 black women who were overweight (HR 1.77) or obese (HR 2.17) but not in white women who were overweight (HR 0.98) or obese (HR 1.06). Overweight and obese women with ≤1 metabolic abnormality did not have increased cardiovascular risk, regardless of race or ethnicity. Conclusions Metabolic abnormalities appeared to convey more cardiovascular risk among black women. PMID:25994446

Role of fruits and vegetables in adolescent cardiovascular health: a systematic review.

PubMed

Collese, Tatiana Sadalla; Nascimento-Ferreira, Marcus Vinicius; de Moraes, Augusto César Ferreira; Rendo-Urteaga, Tara; Bel-Serrat, Silvia; Moreno, Luis A; Carvalho, Heráclito Barbosa

2017-05-01

Levels of fruit and vegetable consumption are low among adolescents, and the possible effect of this on cardiovascular health in this age group is undefined. The aim of this systematic review was to investigate the potential role of fruit and vegetable consumption in adolescent cardiovascular health. Six electronic databases (BioMed Central, MEDLINE, Web of Science, CINAHL, Scopus, PsycINFO) were searched from database inception to December 2015. The search strategy used the following sets of descriptors: adolescents; fruits and vegetables; cardiovascular risk indicators; cross-sectional and cohort studies. Potentially eligible articles were selected independently by 2 reviewers. Eleven articles meeting the inclusion criteria were included (10 cross-sectional, 1 cohort). The main reasons for study exclusion (n = 71) were misclassification of individuals as adolescents, an unspecified outcome that was incongruent with the definitions provided, and assessment of fruits and vegetables as part of a food pattern. Articles evaluated fruit and vegetable intake (separately, together, only vegetables, or with fruit juice) in diverse units, using food frequency questionnaires, 24-hour dietary recalls, and food records. One-third of the studies showed significant inverse associations of fruit and vegetable intake with systolic blood pressure, abdominal obesity, triglycerides, high-density lipoprotein cholesterol, and metabolic syndrome. The associations between fruit and vegetable consumption and indicators of cardiovascular risk in adolescents are inconsistent, likely because of heterogeneity in the methods used to assess and classify consumption and to define cardiovascular risk in adolescents. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

A novel approach for measuring residential socioeconomic factors associated with cardiovascular and metabolic health

EPA Science Inventory

Individual-level characteristics, including socioeconomic status, have been associated with poor metabolic and cardiovascular health; however, residential area-level characteristics may also independently contribute to health status. In the current study, we used hierarchical clu...

A novel approach to measuring residential socioeconomic factors associated with cardiovascular and metabolic health

EPA Science Inventory

Individual-level characteristics, including socioeconomic status, have been associated with poor metabolic and cardiovascular health; however, residential area-level characteristics may also independently contribute to health status. In the current study, we used a novel applica...

[Healthy heart: Results of a community education program on cardiovascular health].

PubMed

Madridejos Mora, Rosa; Majem Fabres, Lourdes; Puig Acebal, Helena; Sanz Latorre, Inma; Llobet Traveset, Eva; Arce Casas, Mar; Ruiz Morilla, Dolors; Mercadal Dalmau, Angel; Pañart Sánchez, Dani

2014-11-01

To improve the knowledge of the population about heart-healthy habits through a training program supplemented by a web site and community activities. A controlled clinical trial with intervention done through participation in the Cardiovascular Health Training Classroom (CHTC) LOCATION: A town of 80,000 inhabitants. both sexes, aged 55 to 70 years, with at least one cardiovascular risk factor (CVRF). The intervention group (IG) consisted of patients who participated in the CHTC. Intervention was carried out through a 20-hour presential group course in which a support web site was offered and complementary activities were organized. Classes were taught by three Primary Care nurses. The primary endpoint was knowledge of CVRF. The secondary variables were age, sex, CVRF, lifestyle, visits to health centers, pharmaceutical use adherence, and satisfaction with the program. Data from patients in the first 10 courses (n=150) were evaluated. A statistically significant improvement was observed in overall knowledge of CVRF in the IG (87.3% to 100%) compared with control group (GC) (84.5% to 92.7%), p<.001, as well as an improvement in physical activity is (IG: 71.2% to 83.1% versus CG: 72.6% to 78.2%), p=.05. The total number of Primary Care visits (medical and nursing) decreased in the IG more than in the CG. The satisfaction rate of the course was very high. This experience is effective in improving cardiovascular health knowledge and promoting some healthy habits. Copyright © 2012 Elsevier España, S.L.U. All rights reserved.

The role of epigenetics in cardiovascular health and ageing: A focus on physical activity and nutrition.

PubMed

Wallace, Robert G; Twomey, Laura C; Custaud, Marc-Antoine; Turner, Jonathan D; Moyna, Niall; Cummins, Philip M; Murphy, Ronan P

2017-11-16

The cardiovascular system is responsible for transport of blood and nutrients to tissues, and is pivotal to the physiological health and longevity. Epigenetic modification is a natural, age-associated process resulting in highly contextualised gene expression with clear implications for cell differentiation and disease onset. Biological/epigenetic age is independent of chronological age, constituting a highly reflective snapshot of an individual's overall health. Accelerated vascular ageing is of major concern, effectively lowering disease threshold. Age-related chronic illness involves a complex interplay between many biological processes and is modulated by non-modifiable and modifiable risk factors. These alter the static genome by a number of epigenetic mechanisms, which change gene expression in an age and lifestyle dependent manner. This 'epigenetic drift' impacts health and contributes to the etiology of chronic illness. Lifestyle factors may cause acceleration of this epigenetic "clock", pre-disposing individuals to cardiovascular disease. Nutrition and physical activity are modifiable lifestyle choices, synergistically contributing to cardiovascular health. They represent a powerful potential epigenetic intervention point for effective cardiovascular protective and management strategies. Thus, together with traditional risk factors, monitoring the epigenetic signature of ageing may prove beneficial for tailoring lifestyle to fit biology - supporting the increasingly popular concept of "ageing well". Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence of cardiovascular diseases among older adults. The Cardiovascular Health Study.

PubMed

Mittelmark, M B; Psaty, B M; Rautaharju, P M; Fried, L P; Borhani, N O; Tracy, R P; Gardin, J M; O'Leary, D H

1993-02-01

The Cardiovascular Health Study is a population-based longitudinal study of 5,201 adults aged 65 years and older. Prevalences of myocardial infarction, angina pectoris, congestive heart failure, peripheral artery disease, stroke, and transient ischemic attack were ascertained between June 1989 and May 1990 in participants recruited from Forsyth County, North Carolina; Washington County, Maryland; Sacramento County, California; and Pittsburgh, Pennsylvania. A medical history was taken to obtain self-reports of prevalent disease. For all participants, use of nitrates was ascertained to document angina, electrocardiograms were used to document prevalent myocardial infarction, and ankle-arm blood pressure studies were used to document peripheral artery disease. Self-reports of disease that were not confirmed by examination findings were further investigated by examination of medical records. Reported disease that was confirmed by examination findings or by medical records was classified as "definite." Disease that was documented by examination, but not reported by the participant, was classified as "unreported." The prevalence rates of definite myocardial infarction and angina were 11% and 15%, respectively, among men aged 65-69 years, 18% and 17% among men aged 80-84 years, 4% and 8% among women aged 65-69 years, and 3% and 13% among women aged 80-84 years. Twenty-three percent of men and 38% of women with electrocardiographic evidence of myocardial infarction did not report it. These results suggest that prevalent disease estimates based only on self-report may underestimate the prevalence of cardiovascular diseases in older Americans.

The link between erectile and cardiovascular health: the canary in the coal mine.

PubMed

Meldrum, David R; Gambone, Joseph C; Morris, Marge A; Meldrum, Donald A N; Esposito, Katherine; Ignarro, Louis J

2011-08-15

Lifestyle and nutrition have been increasingly recognized as central factors influencing vascular nitric oxide (NO) production and erectile function. This review underscores the importance of NO as the principal mediator influencing cardiovascular health and erectile function. Erectile dysfunction (ED) is associated with smoking, excessive alcohol intake, physical inactivity, abdominal obesity, diabetes, hypertension, and decreased antioxidant defenses, all of which reduce NO production. Better lifestyle choices; physical exercise; improved nutrition and weight control; adequate intake of or supplementation with omega-3 fatty acids, antioxidants, calcium, and folic acid; and replacement of any testosterone deficiency will all improve vascular and erectile function and the response to phosphodiesterase-5 inhibitors, which also increase vascular NO production. More frequent penile-specific exercise improves local endothelial NO production. Excessive intake of vitamin E, calcium, l-arginine, or l-citrulline may impart significant cardiovascular risks. Interventions discussed also lower blood pressure or prevent hypertension. Certain angiotensin II receptor blockers improve erectile function and reduce oxidative stress. In men aged <60 years and in men with diabetes or hypertension, erectile dysfunction can be a critical warning sign for existing or impending cardiovascular disease and risk for death. The antiarrhythmic effect of omega-3 fatty acids may be particularly crucial for these men at greatest risk for sudden death. In conclusion, by better understanding the complex factors influencing erectile and overall vascular health, physicians can help their patients prevent vascular disease and improve erectile function, which provides more immediate motivation for men to improve their lifestyle habits and cardiovascular health. Copyright © 2011 Elsevier Inc. All rights reserved.

Nutritional Aspects of Crewmembers' Cardiovascular Health Indicated by Dietary Lipids

NASA Technical Reports Server (NTRS)

Thurston, Marcelle A.

1999-01-01

This summer's project examined the relationships between dietary and physiological factors on serum lipoproteins using data from past United States astronauts. Nutritional assessment was required to determine whether a relationship existed between dietary intake and risk of cardiovascular disease (CVD) in crewmembers. Risk for CVD was assessed by the measurement of preflight, inflight, and postflight serum lipoproteins. The purpose of this project was to evaluate the dietary practices of past crewmembers before and during flight, and to examine their relationship with blood indicators of lipid status. Because of mortality and morbidity associated with CVD, such assessments are critical for the maintenance of astronaut health before, during, and after space flight. It was anticipated that the results from this project would assess the effects space flight and diet have on cardiovascular health, thus, defining the adequacy of the current dietary recommendations during space travel. It was hypothesized that the mean preflight serum lipoproteins compared to mean postflight serum lipoproteins would not be statistically different and that the current inflight diet is adequate in nutrient content, having little or no effect on lipoprotein levels.

Merging Electronic Health Record Data and Genomics for Cardiovascular Research

PubMed Central

Hall, Jennifer L.; Ryan, John J.; Bray, Bruce E.; Brown, Candice; Lanfear, David; Newby, L. Kristin; Relling, Mary V.; Risch, Neil J.; Roden, Dan M.; Shaw, Stanley Y.; Tcheng, James E.; Tenenbaum, Jessica; Wang, Thomas N.; Weintraub, William S.

2017-01-01

The process of scientific discovery is rapidly evolving. The funding climate has influenced a favorable shift in scientific discovery toward the use of existing resources such as the electronic health record. The electronic health record enables long-term outlooks on human health and disease, in conjunction with multidimensional phenotypes that include laboratory data, images, vital signs, and other clinical information. Initial work has confirmed the utility of the electronic health record for understanding mechanisms and patterns of variability in disease susceptibility, disease evolution, and drug responses. The addition of biobanks and genomic data to the information contained in the electronic health record has been demonstrated. The purpose of this statement is to discuss the current challenges in and the potential for merging electronic health record data and genomics for cardiovascular research. PMID:26976545

Cardiovascular benefits of probiotics: a review of experimental and clinical studies.

PubMed

Thushara, Ram Mohan; Gangadaran, Surendiran; Solati, Zahra; Moghadasian, Mohammed H

2016-02-01

The microbiota inhabiting the human gastro-intestinal tract is reported to have a significant impact on the health of an individual. Recent findings suggest that the microbial imbalance of the gut may play a role in pathogenesis of cardiovascular diseases (CVD). Therefore, several studies have delved into the aspect of altering gut microbiota with probiotics as an approach to prevent and/or treat CVD. The World Health Organization defines probiotics as live microorganisms that, when consumed in adequate amounts, have a positive influence on the individual's health. The present review focuses on strategies of human dietary intervention with probiotic strains and their impact on cardiovascular risk factors like hypercholesterolemia, hypertension, obesity and type-2 diabetes. Accumulating evidence shows probiotics to lower low density lipoproteins (LDL)-cholesterol and improve the LDL/high density lipoproteins (HDL) ratio, as well as lower blood pressure, inflammatory mediators, blood glucose levels and body mass index. Thus, probiotics have the scope to be developed as dietary supplements with potential cardiovascular health benefits. However, there is not only ambiguity regarding the exact strains and dosages of the probiotics that will bring about positive health effects, but also factors like immunity and genetics of the individual that might influence the efficacy of probiotics. Therefore, further studies are required not only to understand the mechanisms by which probiotics may beneficially affect the cardiovascular system, but also to rule out any of their probable negative effects on health. The present review aims to critically appraise the complexity of the available data with regard to the cardiovascular benefits of probiotics.

The role of mHealth for improving medication adherence in patients with cardiovascular disease: a systematic review.

PubMed

Gandapur, Yousuf; Kianoush, Sina; Kelli, Heval M; Misra, Satish; Urrea, Bruno; Blaha, Michael J; Graham, Garth; Marvel, Francoise A; Martin, Seth S

2016-10-01

Cardiovascular disease is a leading cause of morbidity and mortality worldwide, and a key barrier to improved outcomes is medication non-adherence. The aim of this study is to review the role of mobile health (mHealth) tools for improving medication adherence in patients with cardiovascular disease. We performed a systematic search for randomized controlled trials that primarily investigated mHealth tools for improving adherence to cardiovascular disease medications in patients with hypertension, coronary artery disease, heart failure, peripheral arterial disease, and stroke. We extracted and reviewed data on the types of mHealth tools used, preferences of patients and healthcare providers, the effect of the mHealth interventions on medication adherence, and the limitations of trials. We identified 10 completed trials matching our selection criteria, mostly with <100 participants, and ranging in duration from 1 to 18 months. mHealth tools included text messages, Bluetooth-enabled electronic pill boxes, online messaging platforms, and interactive voice calls. Patients and healthcare providers generally preferred mHealth to other interventions. All 10 studies reported that mHealth interventions improved medication adherence, though the magnitude of benefit was not consistently large and in one study was not greater than a telehealth comparator. Limitations of trials included small sample sizes, short duration of follow-up, self-reported outcomes, and insufficient assessment of unintended harms and financial implications. Current evidence suggests that mHealth tools can improve medication adherence in patients with cardiovascular diseases. However, high-quality clinical trials of sufficient size and duration are needed to move the field forward and justify use in routine care.

Gut Microbiota in Cardiovascular Health and Disease.

PubMed

Tang, W H Wilson; Kitai, Takeshi; Hazen, Stanley L

2017-03-31

Significant interest in recent years has focused on gut microbiota-host interaction because accumulating evidence has revealed that intestinal microbiota play an important role in human health and disease, including cardiovascular diseases. Changes in the composition of gut microbiota associated with disease, referred to as dysbiosis, have been linked to pathologies such as atherosclerosis, hypertension, heart failure, chronic kidney disease, obesity, and type 2 diabetes mellitus. In addition to alterations in gut microbiota composition, the metabolic potential of gut microbiota has been identified as a contributing factor in the development of diseases. Recent studies revealed that gut microbiota can elicit a variety of effects on the host. Indeed, the gut microbiome functions like an endocrine organ, generating bioactive metabolites, that can impact host physiology. Microbiota interact with the host through many pathways, including the trimethylamine/trimethylamine N -oxide pathway, short-chain fatty acids pathway, and primary and secondary bile acids pathways. In addition to these metabolism-dependent pathways, metabolism-independent processes are suggested to also potentially contribute to cardiovascular disease pathogenesis. For example, heart failure-associated splanchnic circulation congestion, bowel wall edema, and impaired intestinal barrier function are thought to result in bacterial translocation, the presence of bacterial products in the systemic circulation and heightened inflammatory state. These are thought to also contribute to further progression of heart failure and atherosclerosis. The purpose of the current review is to highlight the complex interplay between microbiota, their metabolites, and the development and progression of cardiovascular diseases. We will also discuss the roles of gut microbiota in normal physiology and the potential of modulating intestinal microbial inhabitants as novel therapeutic targets. © 2017 American Heart

Religiousness/Spirituality, Cardiovascular Disease, and Cancer: Cultural Integration for Health Research and Intervention

ERIC Educational Resources Information Center

Masters, Kevin S.; Hooker, Stephanie A.

2013-01-01

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…

Cardiovascular fitness in late adolescent males and later risk of serious non-affective mental disorders: a prospective, population-based study.

PubMed

Nyberg, J; Henriksson, M; Åberg, M A I; Rosengren, A; Söderberg, M; Åberg, N D; Kuhn, H G; Waern, M

2018-02-01

Cardiovascular fitness in late adolescence is associated with future risk of depression. Relationships with other mental disorders need elucidation. This study investigated whether fitness in late adolescence is associated with future risk of serious non-affective mental disorders. Further, we examined how having an affected brother might impact the relationship. Prospective, population-based cohort study of 1 109 786 Swedish male conscripts with no history of mental illness, who underwent conscription examinations at age 18 between 1968 and 2005. Cardiovascular fitness was objectively measured at conscription using a bicycle ergometer test. During the follow-up (3-42 years), incident cases of serious non-affective mental disorders (schizophrenia and schizophrenia-like disorders, other psychotic disorders and neurotic, stress-related and somatoform disorders) were identified through the Swedish National Hospital Discharge Register. Cox proportional hazards models were used to assess the influence of cardiovascular fitness at conscription and risk of serious non-affective mental disorders later in life. Low fitness was associated with increased risk for schizophrenia and schizophrenia-like disorders [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.29-1.61], other psychotic disorders (HR 1.41, 95% CI 1.27-1.56), and neurotic or stress-related and somatoform disorders (HR 1.45, 95% CI 1.37-1.54). Relationships persisted in models that included illness in brothers. Lower fitness in late adolescent males is associated with increased risk of serious non-affective mental disorders in adulthood.

Lifestyle Management Program: Promoting Cardiovascular Health: in Community College Campuses.

ERIC Educational Resources Information Center

Castro, Felipe G.; Jichaku, Patrick

The Lifestyle Management Project is a health promotion project and research study conducted in the spring of 1984 at five Los Angeles junior college campuses. Its goal was to increase knowledge of cardiovascular disease (CHD) risk factors among 400 to 2000 junior college students in each campus. This was done via five risk factor activities: blood…

Cardiovascular health in adolescents with type 1 diabetes: the SEARCH CVD study.

PubMed

Alman, Amy C; Talton, Jennifer W; Wadwa, R Paul; Urbina, Elaine M; Dolan, Lawrence M; Daniels, Stephen R; Hamman, Richard F; D'Agostino, Ralph B; Marcovina, Santica M; Mayer-Davis, Elizabeth J; Dabelea, Dana M

2014-11-01

In their Strategic Impact Goal Statement, the American Heart Association focused on primordial prevention of cardiovascular risk factors by defining metrics for ideal cardiovascular health (ICH). The prevalence of ICH among youth with type 1 diabetes is unknown. Youth with type 1 diabetes face an increased risk of cardiovascular disease (CVD) as they age. The purpose of this report was to examine the prevalence of ICH in a population of youth with type 1 diabetes and to examine the association of ICH with measures of cardiovascular structure and function. This report is based on SEARCH CVD an ancillary study to the SEARCH for Diabetes in Youth. A total of 190 adolescents with type 1 diabetes had complete data on all of the ICH metrics at baseline and had measures of arterial stiffness [pulse wave velocity (PWV), brachial distensibility (BrachD), and augmentation index (AIx)] and carotid intima-media thickness completed at a follow-up visit [on average 5 yr after baseline (interquartile range 4-5)]. No subjects met the ICH criteria for all 7 metrics. Meeting an increasing number of ICH metrics was significantly associated with lower arterial stiffness [lower PWV of the trunk (β = -0.02 ±0.01; p = 0.004) and AIx (β = -2.2 ±0.66; p = 0.001), and increased BrachD (β = 0.14 ±0.07; p = 0.04)]. Increasing number of ICH metrics was significantly associated with decreased arterial stiffness, but prevalence of ICH in this population was low. Youth with type 1 diabetes could benefit from improvements in their cardiovascular health. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Randomised controlled trial of a 12 week yoga intervention on negative affective states, cardiovascular and cognitive function in post-cardiac rehabilitation patients.

PubMed

Yeung, Alan; Kiat, Hosen; Denniss, A Robert; Cheema, Birinder S; Bensoussan, Alan; Machliss, Bianca; Colagiuri, Ben; Chang, Dennis

2014-10-24

Negative affective states such as anxiety, depression and stress are significant risk factors for cardiovascular disease, particularly in cardiac and post-cardiac rehabilitation populations.Yoga is a balanced practice of physical exercise, breathing control and meditation that can reduce psychosocial symptoms as well as improve cardiovascular and cognitive function. It has the potential to positively affect multiple disease pathways and may prove to be a practical adjunct to cardiac rehabilitation in further reducing cardiac risk factors as well as improving self-efficacy and post-cardiac rehabilitation adherence to healthy lifestyle behaviours. This is a parallel arm, multi-centre, randomised controlled trial that will assess the outcomes of post- phase 2 cardiac rehabilitation patients assigned to a yoga intervention in comparison to a no-treatment wait-list control group. Participants randomised to the yoga group will engage in a 12 week yoga program comprising of two group based sessions and one self-administered home session each week. Group based sessions will be led by an experienced yoga instructor. This will involve teaching beginner students a hatha yoga sequence that incorporates asana (poses and postures), pranayama (breathing control) and meditation. The primary outcomes of this study are negative affective states of anxiety, depression and stress assessed using the Depression Anxiety Stress Scale. Secondary outcomes include measures of quality of life, and cardiovascular and cognitive function. The cardiovascular outcomes will include blood pressure, heart rate, heart rate variability, pulse wave velocity, carotid intima media thickness measurements, lipid/glucose profiles and C-reactive protein assays. Assessments will be conducted prior to (week 0), mid-way through (week 6) and following the intervention period (week 12) as well as at a four week follow-up (week 16). This study will determine the effect of yoga practice on negative affective states

Long-Term Effect of Population Screening for Diabetes on Cardiovascular Morbidity, Self-Rated Health, and Health Behavior

PubMed Central

Echouffo-Tcheugui, Justin B.; Simmons, Rebecca K.; Prevost, A. Toby; Williams, Kate M.; Kinmonth, Ann-Louise; Wareham, Nicholas J.; Griffin, Simon J.

2015-01-01

PURPOSE There is limited trial evidence concerning the long-term effects of screening for type 2 diabetes on population morbidity. We examined the effect of a population-based diabetes screening program on cardiovascular morbidity, self-rated health, and health-related behaviors. METHODS We conducted a pragmatic, parallel-group, cluster-randomized controlled trial of diabetes screening (the ADDITION-Cambridge study) including 18,875 individuals aged 40 to 69 years at high risk of diabetes in 32 general practices in eastern England (27 practices randomly allocated to screening, 5 to no-screening for control). Of those eligible for screening, 466 (2.9%) were diagnosed with diabetes. Seven years after randomization, a random sample of patients was sent a postal questionnaire: 15% from the screening group (including diabetes screening visit attenders and non-attenders) and 40% from the no-screening control group. Self-reported cardiovascular morbidity, self-rated health (using the SF-8 Health Survey and EQ-5D instrument), and health behaviors were compared between trial groups using an intention-to-screen analysis. RESULTS Of the 3,286 questionnaires mailed out, 1,995 (61%) were returned, with 1,945 included in the analysis (screening: 1,373; control: 572). At 7 years, there were no significant differences between the screening and control groups in the proportion of participants reporting heart attack or stroke (OR = 0.90, 95% CI, 0.71–1.15); SF-8 physical health summary score as an indicator of self-rated health status (β −0.33, 95% CI, −1.80 to 1.14); EQ-5D visual analogue score (β: 0.80, 95% CI, −1.28 to 2.87); total physical activity (β 0.50, 95% CI, −4.08 to 5.07); current smoking (OR 0.97, 95% CI, 0.72 to 1.32); and alcohol consumption (β 0.14, 95% CI, −1.07 to 1.35). CONCLUSIONS Invitation to screening for type 2 diabetes appears to have limited impact on population levels of cardiovascular morbidity, self-rated health status, and health

Cardiovascular disease in menopause: does the obstetric history have any bearing?

PubMed

Mahendru, Amita A; Morris, Edward

2013-09-01

Cardiovascular disease remains a leading cause of morbidity and mortality in menopausal women in spite of the overall reduction in age-adjusted mortality from the disease in the last few years. It is now clear that mechanisms of cardiovascular disease in menopausal women are similar to men and rather than midlife acceleration of cardiovascular disease in women, the final impact of cardiovascular disease in later life may be a reflection of cardiovascular changes during reproductive years as a result of woman's obstetric history. A decade after the Women's Health Initiative trial, there is upcoming evidence to suggest that hormone replacement therapy in young recently menopausal women has a cardioprotective effect. Cardiovascular changes during normal pregnancy or pregnancy complications such as preeclampsia may affect a woman's long-term cardiovascular health. Therefore, it is plausible that the cardioprotective benefit of hormone replacement therapy depends on occult pre-existing cardiovascular risks in women in relation to their previous obstetric history. In this review, we describe the cardiovascular changes during and after pregnancy in obstetric complications such as recurrent miscarriage, preeclampsia, intrauterine growth restriction, preterm labour and gestational diabetes; existing evidence regarding their association with cardiovascular disease later in life, and hypothesize possible mechanisms. Our aim is to improve the understanding and highlight the importance of including obstetric history in risk assessment in menopausal women and individualizing their risks before prescribing hormone replacement therapy. Future research in risk benefit assessment of hormone replacement therapy should also account for a woman's background cardiovascular risk in the light of her obstetric history.

Positive affect and psychobiological processes

PubMed Central

Dockray, Samantha; Steptoe, Andrew

2010-01-01

Positive affect has been associated with favourable health outcomes, and it is likely that several biological processes mediate the effects of positive mood on physical health. There is converging evidence that positive affect activates the neuroendocrine, autonomic and immune systems in distinct and functionally meaningful ways. Cortisol, both total output and the awakening response, has consistently been shown to be lower among individuals with higher levels of positive affect. The beneficial effects of positive mood on cardiovascular function, including heart rate and blood pressure, and the immune system have also been described. The influence of positive affect on these psychobiological processes are independent of negative affect, suggesting that positive affect may have characteristic biological correlates. The duration and conceptualisation of positive affect may be important considerations in understanding how different biological systems are activated in association with positive affect. The association of positive affect and psychobiological processes has been established, and these biological correlates may be partly responsible for the protective effects of positive affect on health outcomes. PMID:20097225

eHealth Literacy: Predictors in a Population With Moderate-to-High Cardiovascular Risk

PubMed Central

Richtering, Sarah S; Hyun, Karice; Neubeck, Lis; Coorey, Genevieve; Chalmers, John; Usherwood, Tim; Peiris, David; Chow, Clara K

2017-01-01

Background Electronic health (eHealth) literacy is a growing area of research parallel to the ongoing development of eHealth interventions. There is, however, little and conflicting information regarding the factors that influence eHealth literacy, notably in chronic disease. We are similarly ill-informed about the relationship between eHealth and health literacy, 2 related yet distinct health-related literacies. Objective The aim of our study was to investigate the demographic, socioeconomic, technology use, and health literacy predictors of eHealth literacy in a population with moderate-to-high cardiovascular risk. Methods Demographic and socioeconomic data were collected from 453 participants of the CONNECT (Consumer Navigation of Electronic Cardiovascular Tools) study, which included age, gender, education, income, cardiovascular-related polypharmacy, private health care, main electronic device use, and time spent on the Internet. Participants also completed an eHealth Literacy Scale (eHEALS) and a Health Literacy Questionnaire (HLQ). Univariate analyses were performed to compare patient demographic and socioeconomic characteristics between the low (eHEALS<26) and high (eHEALS≥26) eHealth literacy groups. To then determine the predictors of low eHealth literacy, multiple-adjusted generalized estimating equation logistic regression model was used. This technique was also used to examine the correlation between eHealth literacy and health literacy for 4 predefined literacy themes: navigating resources, skills to use resources, usefulness for oneself, and critical evaluation. Results The univariate analysis showed that patients with lower eHealth literacy were older (68 years vs 66 years, P=.01), had lower level of education (P=.007), and spent less time on the Internet (P<.001). However, multiple-adjusted generalized estimating equation logistic regression model demonstrated that only the time spent on the Internet (P=.01) was associated with the level of eHealth

Vascular Health in American Football Players: Cardiovascular Risk Increased in Division III Players

PubMed Central

Feairheller, Deborah L.; Aichele, Kristin R.; Oakman, Joyann E.; Neal, Michael P.; Cromwell, Christina M.; Lenzo, Jessica M.; Perez, Avery N.; Bye, Naomi L.; Santaniello, Erica L.; Hill, Jessica A.; Evans, Rachel C.; Thiele, Karla A.; Chavis, Lauren N.; Getty, Allyson K.; Wisdo, Tia R.; McClelland, JoAnna M.; Sturgeon, Kathleen; Chlad, Pam

2016-01-01

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. PMID:26904291

Flaxseed and cardiovascular health.

PubMed

Prasad, Kailash

2009-11-01

Flaxseed and its components may improve cardiovascular health because of their numerous attributes. Flaxseed contains 35% of its mass as oil, of which 55% is alpha-linolenic acid (ALA). Flax meal, which is devoid of oil, contains the lignan secoisolariciresinol diglucoside (SDG). Flaxseed, flaxseed with very low ALA, flaxseed oil, flax lignan complex (FLC), and SDG reduce the development of hypercholesterolemic atherosclerosis by 46%, 69%, 0%, 73%, and 34%, respectively, in the rabbit model. FLC and SDG slow the progression of atherosclerosis but have no effect in regression of atherosclerosis. Suppression of atherosclerosis by flaxseed is the result of its lignan content and not the result of ALA content. Suppression of atherosclerosis is associated with lowering of serum lipids and antioxidant activity. Effects of flaxseed on serum lipids in experimental animals are variable from no change to slight reduction. Flaxseed oil does not affect serum lipids, except for a slight reduction in serum triglycerides. Lignan in general reduces serum total cholesterol and low-density lipoprotein cholesterol and raises serum high-density lipoprotein cholesterol. SDG and its metabolites have antioxidant activity. Flaxseed and flaxseed oil do not have antioxidant activity except they suppress oxygen radical production by white blood cells. Flaxseed oil/ALA has variable effects on inflammatory mediators/markers (interleukin [IL]-1beta, IL-2, IL-4, IL-6, IL-10, tumor necrosis factor-alpha, interferon-gamma, C-reactive protein, and serum amyloid A). Doses of ALA less than 14 g/d do not affect inflammatory mediators/markers, but 14 g/d or greater reduce inflammatory mediators/markers. Flaxseed oil decreases soluble vascular cell adhesion molecule-1 but has no effect on soluble intracellular adhesion molecule-1, soluble E-selectin, and monocyte colony-stimulating factor. Flaxseed has variable effects on IL-6, high-sensitivity C-reactive protein, and soluble vascular cell adhesion

Validation of the cardiac health behavior scale for Korean adults with cardiovascular risks or diseases.

PubMed

Song, Rhayun; Oh, Hyunkyoung; Ahn, Sukhee; Moorhead, Sue

2018-02-01

The purpose of this study was to validate the Cardiac Health Behavior Scale for Korean adults (CHB-K) to determine its validity and reliability. Cardiovascular diseases (CVDs) are one of the most important chronic diseases due to their high prevalence and mortality rates. Patients with cardiovascular risks or diseases need to perform appropriate cardiac health behaviors that help to prevent the progression of the disease and improve their health status. This secondary analysis obtained data from two clinical trials of cardiac rehabilitation. Data from 298 patients with cardiovascular risks or diseases were analyzed for validation. Data analyses included correlation coefficients, t-tests, and exploratory and confirmatory factor analyses using SPSS (version WIN 22.0) and AMOS (version 20.0). The Self-Efficacy Scale was used to assess convergent validity, while reliability was assessed using Cronbach's alpha coefficients. Five main factors were verified: health responsibility, physical activity, diet habit (eating habit and food choice), stress management, and smoking cessation. A set of 21 items from the 25-item scale was verified after performing item analysis, factor analyses, and critical evaluation of the statistical results. The 21-item CHB-K (CHB-K21) exhibited acceptable validity, and the model of the CHB-K21 provided a good fit to the data. Most of the factors were found to be moderately correlated with SES scores (r=0.45-0.52, p<0.001). The CHB-K21 also demonstrated acceptable reliability (Cronbach's alpha=0.83). The CHB-K21 demonstrates strong validity and reliability. It can be used to assess cardiac health behaviors in Korean adults with cardiovascular risks or diseases. Copyright © 2017 Elsevier Inc. All rights reserved.

Screening for cardiovascular risk in asymptomatic users of the primary health care network in Lebanon, 2012-2013.

PubMed

Yamout, Rouham; Adib, Salim M; Hamadeh, Randa; Freidi, Alia; Ammar, Walid

2014-07-17

In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascular screening in the publicly subsidized Primary Health Care (PHC) Network. We present an epidemiological analysis of data produced during this pilot to justify the inclusion of this service in the package of essential services offered through PHC and to present a preliminary cardiovascular risk profile in an asymptomatic population. A total of 4,205 participants (two-thirds of which were women) aged at least 40 years and reportedly free from diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD) were screened. The screening protocol used a questionnaire and direct measurements to assess 5 modifiable cardiovascular risk factors; total cardiovascular risk score was calculated according to a paper-based algorithm developed by the World Health Organization and the International Society of Hypertension. Approximately 25% of the sample displayed metabolic impairments (11% for impaired blood glucose metabolism and 17% for impaired systolic blood pressure), and 6.6% were classified at total cardiovascular risk of 10% or more. Just over one-quarter of the sample was obese, almost half had a substantially elevated waist circumference, and 41% were smokers. Men were significantly more likely to screen positive for metabolic impairment than women, and women were more likely to be obese. The implementation of a multifactorial screening for CVD among asymptomatic subjects detected a substantial proportion of previously undiagnosed cases of high metabolic risk, people who could now be referred to optimal medical follow-up.

Health inequalities in Germany: do regional-level variables explain differentials in cardiovascular risk?

PubMed Central

Breckenkamp, Juergen; Mielck, Andreas; Razum, Oliver

2007-01-01

Background Socioeconomic status is a predictor not only of mortality, but also of cardiovascular risk and morbidity. An ongoing debate in the field of social inequalities and health focuses on two questions: 1) Is individual health status associated with individual income as well as with income inequality at the aggregate (e. g. regional) level? 2) If there is such an association, does it operate via a psychosocial pathway (e.g. stress) or via a "neo-materialistic" pathway (e.g. systematic under-investment in societal infrastructures)? For the first time in Germany, we here investigate the association between cardiovascular health status and income inequality at the area level, controlling for individual socio-economic status. Methods Individual-level explanatory variables (age, socio-economic status) and outcome data (body mass index, blood pressure, cholesterol level) as well as the regional-level variable (proportion of relative poverty) were taken from the baseline survey of the German Cardiovascular Prevention Study, a cross-sectional, community-based, multi-center intervention study, comprising six socio-economically diverse intervention regions, each with about 1800 participants aged 25–69 years. Multilevel modeling was used to examine the effects of individual and regional level variables. Results Regional effects are small compared to individual effects for all risk factors analyzed. Most of the total variance is explained at the individual level. Only for diastolic blood pressure in men and for cholesterol in both men and women is a statistically significant effect visible at the regional level. Conclusion Our analysis does not support the assumption that in Germany cardiovascular risk factors were to a large extent associated with income inequality at regional level. PMID:17603918

The role of mHealth for improving medication adherence in patients with cardiovascular disease: a systematic review

PubMed Central

Gandapur, Yousuf; Kianoush, Sina; Kelli, Heval M.; Misra, Satish; Urrea, Bruno; Blaha, Michael J.; Graham, Garth; Marvel, Francoise A.; Martin, Seth S.

2016-01-01

Abstract Cardiovascular disease is a leading cause of morbidity and mortality worldwide, and a key barrier to improved outcomes is medication non-adherence. The aim of this study is to review the role of mobile health (mHealth) tools for improving medication adherence in patients with cardiovascular disease. We performed a systematic search for randomized controlled trials that primarily investigated mHealth tools for improving adherence to cardiovascular disease medications in patients with hypertension, coronary artery disease, heart failure, peripheral arterial disease, and stroke. We extracted and reviewed data on the types of mHealth tools used, preferences of patients and healthcare providers, the effect of the mHealth interventions on medication adherence, and the limitations of trials. We identified 10 completed trials matching our selection criteria, mostly with <100 participants, and ranging in duration from 1 to 18 months. mHealth tools included text messages, Bluetooth-enabled electronic pill boxes, online messaging platforms, and interactive voice calls. Patients and healthcare providers generally preferred mHealth to other interventions. All 10 studies reported that mHealth interventions improved medication adherence, though the magnitude of benefit was not consistently large and in one study was not greater than a telehealth comparator. Limitations of trials included small sample sizes, short duration of follow-up, self-reported outcomes, and insufficient assessment of unintended harms and financial implications. Current evidence suggests that mHealth tools can improve medication adherence in patients with cardiovascular diseases. However, high-quality clinical trials of sufficient size and duration are needed to move the field forward and justify use in routine care. PMID:29474713

Physical Inactivity and the Economic and Health Burdens Due to Cardiovascular Disease: Exercise as Medicine.

PubMed

Hamer, Mark; O'Donovan, Gary; Murphy, Marie

2017-01-01

Leisure time physical activity, or exercise, has been described as today's best buy in public health. Physical inactivity is responsible for around 10% of all deaths and physical inactivity costs global healthcare systems billions of dollars each year. Here, we describe the human and economic costs of cardiovascular disease. Then, we explain that physical inactivity is a major modifiable risk factor for cardiovascular disease. The evidence of the role of physical activity in the primary prevention of cardiovascular disease is reviewed and we make the case that exercise is medicine.

Neighborhood Environmental Health and Premature Death From Cardiovascular Disease.

PubMed

Gaglioti, Anne H; Xu, Junjun; Rollins, Latrice; Baltrus, Peter; O'Connell, Laura Kathryn; Cooper, Dexter L; Hopkins, Jammie; Botchwey, Nisha D; Akintobi, Tabia Henry

2018-02-01

Cardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD. We examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city. We found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality. This study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes.

[Cardiovascular Prevention: Acceptance of Enhanced Occupational Health Care].

PubMed

Bleckwenn, M; Theisel, N; Mücke, M; Steudel, H

2016-06-17

Background: To date, prevention efforts of company medical officers and general practitioners are largely independent of each other. In a comprehensive model of healthcare management including both sets of doctors, the company doctor should determine the risk of cardiovascular disease in the employees of the company. In case increased risk is detected, there should be exchange of information between the 2 professional groups so that common preventive interventions can be decided upon. Aim: The aim of this pilot study was to determine how well cardiovascular risk assessment is accepted by employees of a midsize company and where prevention is needed. Materials and Methods: In a company with 660 employees, risk analysis was conducted among staff in the context of regular preventive measures. In addition to risk factors, primary care, agreement with an interdisciplinary exchange of information and motivation for health promotion activities were investigated. Results: 204 employees (4 females only) were examined. The average age of the participants was 42.9±10.3 years. In 27% (n=55), an increased overall risk was present. Employees with risk requiring medical intervention were under the care of primary care physician and most of them (70%) agreed to the transfer of information to these physicians. In the survey itself, employees showed sufficient motivation (VAS 6.4±2.8) for workplace health promotion. Conclusion: The examined company agreed to implementing further health promoting activities. Due to demographic changes, new concepts for effective prevention are needed. The high acceptance of the proposed prevention framework should motivate implementation of this concept. As a next step, studies must be conducted to examine the effectiveness of screening for risk carried out by company medical officers. © Georg Thieme Verlag KG Stuttgart · New York.

Effects of a worksite program to improve the cardiovascular health of female health care workers.

PubMed

Low, Vivian; Gebhart, Bonnie; Reich, Christine

2015-01-01

Reducing cardiovascular risk for female health care workers supports self-care and facilitates a culture of health promotion. We examined the effect of individualized motivational communications on risk and measured program participation at a busy hospital, utilizing cardiac rehabilitation resources. Women (40-65 years old) who self-identified as having increased cardiovascular risk and ready for change were randomly assigned to weekly motivational counseling or control. All participants were offered classes (weight/diet, stress, exercise, and smoking cessation) and gym access. Physical and perceptual measures were recorded before and after the 6-month program to measure change. Followup 1 year later measured current weight, stress, and physical activity. Participants (n = 57) ranked weight as their greatest concern (42%). Compared with control, the intervention group resulted in greater: weight loss (7.2 vs 3.8 pounds); stress reduction (6.5 vs 4.7; Cohen stress scale); and exercise days per week (1.4 vs 1.2). Differences were not statistically significant in this small sample, but all changes consistently favored the intervention. Program participation was low, as was participation in the 1-year followup, although those responding indicated maintenance or further improvement. These consistent and positive findings are promising but only suggestive because of the small sample size. Future studies should focus on how to get more buy-in from employees, to help insure persistence toward health goals. Study results assisted development of a comprehensive Web-based employee wellness motivational program to address the issues of on-site participation. Attention to health risks in health care workers remains an important area of study.

Trans fatty acid intake is related to emotional affect in the Adventist Health Study-2.

PubMed

Ford, Patricia A; Jaceldo-Siegl, Karen; Lee, Jerry W; Tonstad, Serena

2016-06-01

Trans fatty acids in Western diets increase health risks, and have been associated with the risk of depression. We hypothesized that intakes of trans fatty acids (primarily from margarines and baked goods) were inversely associated with positive affect and positively associated with negative affect in a longitudinal study. Church attendees residing in North America completed a food frequency questionnaire in 2002-6 as part of the Adventist Health Study-2. A subset in which we excluded participants with established cardiovascular disease (n=8,771) completed the Positive and Negative Affect Schedule (PANAS) in 2006-7. The associations between dietary intakes of fatty acids to positive and negative affect were tested with linear regression analysis controlling for age, gender, ethnicity, education, body mass index, exercise, sleep, sleep squared, Mediterranean diet, total energy intake and alcohol. Intakes of trans fatty acids were inversely associated with positive affect (β=-0.06, B=-0.27 [95% CI -0.37, -0.17], p<.001) and positively associated with negative affect (β=0.05, B=0.21 [95% CI 0.11, 0.31], p<.001). In comparison, we found no association between n-3 polyunsatured fatty acids (PUFA) intakes with affect. The n-6:n-3 PUFA ratio was inversely associated with positive affect (β=-0.03, B=-0.34 [95% CI -0.58, -0.10], p=0.006). The findings suggest that a lower dietary trans fatty acid intake has beneficial effects on emotional affect while the n-6: n-3 ratio is detrimental to positive affect. Copyright © 2016 Elsevier Inc. All rights reserved.

Physical Activity, Sedentary Behaviours, and Cardiovascular Health: When Will Cardiorespiratory Fitness Become a Vital Sign?

PubMed

Després, Jean-Pierre

2016-04-01

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. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Cardiovascular Benefits of Dietary Melatonin: A Myth or a Reality?

PubMed

Jiki, Zukiswa; Lecour, Sandrine; Nduhirabandi, Frederic

2018-01-01

The role of the diet as well as the impact of the dietary habits on human health and disease is well established. Apart from its sleep regulatory effect, the indoleamine melatonin is a well-established antioxidant molecule with multiple health benefits. Convincing evidence supports the presence of melatonin in plants and foods with the intake of such foods affecting circulating melatonin levels in humans. While numerous actions of both endogenous melatonin and melatonin supplementation are well described, little is known about the influence of the dietary melatonin intake on human health. In the present review, evidence for the cardiovascular health benefits of melatonin supplementation and dietary melatonin is discussed. Current knowledge on the biological significance as well as the underlying physiological mechanism of action of the dietary melatonin is also summarized. Whether dietary melatonin constitutes an alternative preventive treatment for cardiovascular disease is addressed.

The cardiovascular macrophage: a missing link between gut microbiota and cardiovascular diseases?

PubMed

Chen, X; Zheng, L; Zheng, Y-Q; Yang, Q-G; Lin, Y; Ni, F-H; Li, Z-H

2018-03-01

The prevalence of cardiovascular diseases is on the rise. Interventions that would aid prevention or treatment of these diseases are essential. The microbes residing in the gut, collectively called "gut microbiota", produce a plethora of compounds that enter the bloodstream and affect the cardiovascular system. Signals ascending from gut microbiome are believed to modulate differentiation and functional activity of macrophages residing in perivascular tissue, atherosclerotic plaques, and perivascular areas of the brain. Cardiovascular macrophages may be the key players that transform the signals ascending from gut microbiome into increased predisposition to cardiovascular diseases. The present review summarizes the knowledge to date on potential relationships between gut microbiota, cardiovascular macrophages, and cardiovascular diseases.

The effectiveness of mobile-health behaviour change interventions for cardiovascular disease self-management: A systematic review.

PubMed

Pfaeffli Dale, Leila; Dobson, Rosie; Whittaker, Robyn; Maddison, Ralph

2016-05-01

Mobile wireless devices (mHealth) have been used to deliver cardiovascular disease self-management interventions to educate and support patients in making healthy lifestyle changes. This systematic review aimed to determine the effectiveness of mHealth interventions on behavioural lifestyle changes and medication adherence for cardiovascular disease self-management. A comprehensive literature search was conducted from inception through to 3 March 2015 using MEDLINE, PubMed, PsycINFO, EMBASE and The Cochrane Library. Eligible studies used an experimental trial design to determine the effectiveness of an mHealth intervention to change lifestyle behaviours in any cardiovascular disease population. Data extracted included intervention and comparison group characteristics with a specific focus on the use of behaviour change techniques. Seven studies met our inclusion criteria and were included in the qualitative synthesis. All interventions were delivered in part by mobile phone text messaging. Three studies were effective at improving adherence to medication and two studies increased physical activity behaviour. No effects were observed on dietary behaviour or smoking cessation, measured in one study each. Simple text messaging interventions appeared to be most effective; however, no clear relationships were found between study findings and intervention dose, duration or behaviour change techniques targeted. Our review found mHealth has the potential to change lifestyle behaviour. Results are still limited to a small number of trials, inconsistent outcome measures and ineffective reporting of intervention characteristics. Large scale, longitudinal studies are now warranted to gain a clear understanding of the effects of mHealth on behaviour change in the cardiovascular disease population. © The European Society of Cardiology 2015.

Cardiovascular Risk in Women With PCOS

PubMed Central

Scicchitano, Pietro; Dentamaro, Ilaria; Carbonara, Rosa; Bulzis, Gabriella; Dachille, Annamaria; Caputo, Paola; Riccardi, Roberta; Locorotondo, Manuela; Mandurino, Cosimo; Matteo Ciccone, Marco

2012-01-01

Polycystic ovary syndrome (PCOS), or Stein-Leventhal syndrome, is a common endocrine disorder defined by two of the three following features: i) oligoovulation or anovulation, ii) clinical and/or biochemical signs of hyperandrogenism, or iii) polycystic ovaries, once the related endocrinological and gynaecological disorders have been excluded. PCOS does not exclusively involve the reproductive apparatus , it has a complex number of systemic relevancy symptoms. It leads to Metabolic Syndrome, with severe consequences on the cardiovascular apparatus. Many clinical studies have underlined the connection between PCOS and the cardiovascular risk profile of such female patients, due to a lipid/glucose altered metabolism, hypertension, systemic inflammatory condition (assessable by markers such as VES, TNF-alfa, citokines and C-reactive protein (hsPCR) levels), and vascular injuries. Considering the early onset of the disease, PCOS could be considered as a real cardiovascular risk factor which affects the quality of life seriously. The current review aimed to point out the main connections between PCOS and cardiovascular risk factors according to the latest findings coming from literature data analysis, and try to depict the great influences that such a common disease can have on the patients’ health integrity. PMID:23843832

Chocolate and cardiovascular health: is it too good to be true?

PubMed

Ariefdjohan, Merlin W; Savaiano, Dennis A

2005-12-01

Recent findings indicate that cocoa and chocolate, when processed appropriately, may contain relatively large amounts of flavonoids, particularly catechin and epicatechin. We review the benefits of these flavonoids, specifically with regard to cardiovascular health, and raise several unresolved issues that suggest the need for additional research and product development in this area.

Knowledge Translation for Cardiovascular Disease Research and Management in Japan

PubMed Central

Shommu, Nusrat S

2017-01-01

Knowledge translation is an essential and emerging arena in healthcare research. It is the process of aiding the application of research knowledge into clinical practice or policymaking. Individuals at all levels of the health care system, including patients, healthcare professionals, and policymakers, are affected by the gaps that exist between research evidence and practice; the process of knowledge translation plays a role in bridging these gaps and incorporating high-quality clinical research into decision-making. Cardiovascular disease (CVD) management is a crucial area of healthcare where information gaps are known to exist. Although Japan has one of the lowest risks and mortality rates from CVDs, an increasing trend of cardiovascular incidence and changes in the risk factor conditions have been observed in recent years. This article provides an overview of knowledge translation and its importance in the cardiovascular health of the Japanese population, and describes the key steps of a typical knowledge translation strategy. PMID:28757537

Knowledge Translation for Cardiovascular Disease Research and Management in Japan.

PubMed

Shommu, Nusrat S; Turin, Tanvir C

2017-09-01

Knowledge translation is an essential and emerging arena in healthcare research. It is the process of aiding the application of research knowledge into clinical practice or policymaking. Individuals at all levels of the health care system, including patients, healthcare professionals, and policymakers, are affected by the gaps that exist between research evidence and practice; the process of knowledge translation plays a role in bridging these gaps and incorporating high-quality clinical research into decision-making. Cardiovascular disease (CVD) management is a crucial area of healthcare where information gaps are known to exist. Although Japan has one of the lowest risks and mortality rates from CVDs, an increasing trend of cardiovascular incidence and changes in the risk factor conditions have been observed in recent years. This article provides an overview of knowledge translation and its importance in the cardiovascular health of the Japanese population, and describes the key steps of a typical knowledge translation strategy.

Forging a future of better cardiovascular health: addressing childhood obesity.

PubMed

Pratt, Charlotte A; Arteaga, Sonia; Loria, Catherine

2014-02-04

This paper describes ongoing National, Heart, Lung, and Blood Institute (NHLBI)-initiated childhood obesity research. It calls on clinicians, researchers, and cardiologists to work with other healthcare providers, community agencies, schools and caregivers to foster better cardiovascular health in children by intervening on multiple levels of influence on childhood obesity. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Does personality affect health-related quality of life? A systematic review

PubMed Central

Huang, I-Chan; Lee, Joy L.; Ketheeswaran, Pavinarmatha; Jones, Conor M.; Revicki, Dennis A.; Wu, Albert W.

2017-01-01

Background Health-related quality of life (HRQOL) is increasingly measured as an outcome for clinical and health services research. However, relatively little is known about how non-health factors affect HRQOL. Personality is a potentially important factor, yet evidence regarding the effects of personality on HRQOL measures is unclear. Methods This systematic review examined the relationships among aspects of personality and HRQOL. Eligible studies were identified from Medline and PsycINFO. The review included 76 English-language studies with HRQOL as a primary outcome and that assessed personality from the psychological perspective. Individuals with various health states, including ill (e.g., cancer, cardiovascular disorders), aging, and healthy, were included in this review study. Results Some personality characteristics were consistently related to psychosocial aspects more often than physical aspects of HRQOL. Personality characteristics, especially neuroticism, mastery, optimism, and sense of coherence were most likely to be associated with psychosocial HRQOL. Personality explained varying proportions of variance in different domains of HRQOL. The range of variance explained in psychosocial HRQOL was 0 to 45% and the range of explained variance in physical HRQOL was 0 to 39%. Conclusions Personality characteristics are related to HRQOL. Systematic collection and analysis of personality data alongside HRQOL measures may be helpful in medical research, clinical practice, and health policy evaluation. PMID:28355244

The influence of the work environment on cardiovascular health: a historical, conceptual, and methodological perspective.

PubMed

Kasl, S V

1996-01-01

The framework of psychosocial epidemiology is used to examine research developments that characterize the accumulation of knowledge regarding the role of the work environment in cardiovascular health and disease. The discussion of current programs of research focuses on the work of T. Theorell and R. Karasek (1996) and J. Siegrist (1996) as exemplars of European and American studies that have contributed the most to the understanding of occupational cardiovascular health. It is argued that researchers need to maintain and nurture relatively broad conceptual models of etiology because cardiovascular disease involves multiple biomedical risk factors and because specific aspects of the work environment are embedded in a large, complex matrix of other psychosocial influences. At the same time, investigators need to push ahead with focused research strategies to clarify the precise nature of the work environmental risk factors that emerge in the broad, somewhat imprecise epidemiologic study designs.

Association between cumulative social risk and ideal cardiovascular health in US adults: NHANES 1999-2006.

PubMed

Caleyachetty, Rishi; Echouffo-Tcheugui, Justin B; Muennig, Peter; Zhu, Wenyi; Muntner, Paul; Shimbo, Daichi

2015-07-15

The American Heart Association developed the Life's Simple 7 metric for defining cardiovascular health. Little is known about the association of co-occurring social risk factors on ideal cardiovascular health. Using data on 11,467 adults aged ≥25 years from the National Health and Nutrition Examination Survey 1999-2006, we examined the association between cumulative social risk and ideal cardiovascular health in US adults. A cumulative risk score (range 0 to 3 or 4) was created by summing four social risk factors (low family income, low education level, minority race, and single-living status). Ideal levels for each component in Life's Simple 7 (blood pressure, cholesterol, glucose, BMI, smoking, physical activity, and diet) were used to create an ideal Life's Simple 7 score [0-1 (low), 2, 3, 4, and 5-7 (high)]. Adults with low income (odds ratio [OR]=0.30 [95% CI 0.23-0.39]), low education [0.22 (0.16-0.28)], who are non-white (0.44 [0.36-0.54]) and single-living [0.79 (0.67-0.95)] were less likely to have 5-7 versus 0 ideal Life's Simple 7 scores after adjustment for age and sex. Adults were less likely to attain 5-7 versus 0 ideal Life's Simple 7 scores as exposure to the number of social risk factors increased [OR (95% CI) of 0.58 (0.49-0.68); 0.27 (0.21-0.35); and 0.19 (0.14-0.27) for cumulative social risk scores of 1, 2, and 3 or 4, respectively, each versus 0]. US adults with an increasing number of socially risk factors, were progressively less likely to attain ideal levels of cardiovascular health factors. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

High-Intensity Interval Training After Stroke: An Opportunity to Promote Functional Recovery, Cardiovascular Health, and Neuroplasticity.

PubMed

Crozier, Jennifer; Roig, Marc; Eng, Janice J; MacKay-Lyons, Marilyn; Fung, Joyce; Ploughman, Michelle; Bailey, Damian M; Sweet, Shane N; Giacomantonio, Nicholas; Thiel, Alexander; Trivino, Michael; Tang, Ada

2018-04-01

Stroke is the leading cause of adult disability. Individuals poststroke possess less than half of the cardiorespiratory fitness (CRF) as their nonstroke counterparts, leading to inactivity, deconditioning, and an increased risk of cardiovascular events. Preserving cardiovascular health is critical to lower stroke risk; however, stroke rehabilitation typically provides limited opportunity for cardiovascular exercise. Optimal cardiovascular training parameters to maximize recovery in stroke survivors also remains unknown. While stroke rehabilitation recommendations suggest the use of moderate-intensity continuous exercise (MICE) to improve CRF, neither is it routinely implemented in clinical practice, nor is the intensity always sufficient to elicit a training effect. High-intensity interval training (HIIT) has emerged as a potentially effective alternative that encompasses brief high-intensity bursts of exercise interspersed with bouts of recovery, aiming to maximize cardiovascular exercise intensity in a time-efficient manner. HIIT may provide an alternative exercise intervention and invoke more pronounced benefits poststroke. To provide an updated review of HIIT poststroke through ( a) synthesizing current evidence; ( b) proposing preliminary considerations of HIIT parameters to optimize benefit; ( c) discussing potential mechanisms underlying changes in function, cardiovascular health, and neuroplasticity following HIIT; and ( d) discussing clinical implications and directions for future research. Preliminary evidence from 10 studies report HIIT-associated improvements in functional, cardiovascular, and neuroplastic outcomes poststroke; however, optimal HIIT parameters remain unknown. Larger randomized controlled trials are necessary to establish ( a) effectiveness, safety, and optimal training parameters within more heterogeneous poststroke populations; (b) potential mechanisms of HIIT-associated improvements; and ( c) adherence and psychosocial outcomes.

Apples and cardiovascular health--is the gut microbiota a core consideration?

PubMed

Koutsos, Athanasios; Tuohy, Kieran M; Lovegrove, Julie A

2015-05-26

There is now considerable scientific evidence that a diet rich in fruits and vegetables can improve human health and protect against chronic diseases. However, it is not clear whether different fruits and vegetables have distinct beneficial effects. Apples are among the most frequently consumed fruits and a rich source of polyphenols and fiber. A major proportion of the bioactive components in apples, including the high molecular weight polyphenols, escape absorption in the upper gastrointestinal tract and reach the large intestine relatively intact. There, they can be converted by the colonic microbiota to bioavailable and biologically active compounds with systemic effects, in addition to modulating microbial composition. Epidemiological studies have identified associations between frequent apple consumption and reduced risk of chronic diseases such as cardiovascular disease. Human and animal intervention studies demonstrate beneficial effects on lipid metabolism, vascular function and inflammation but only a few studies have attempted to link these mechanistically with the gut microbiota. This review will focus on the reciprocal interaction between apple components and the gut microbiota, the potential link to cardiovascular health and the possible mechanisms of action.

Major Cereal Grain Fibers and Psyllium in Relation to Cardiovascular Health

PubMed Central

Bernstein, Adam M.; Titgemeier, Brigid; Kirkpatrick, Kristin; Golubic, Mladen; Roizen, Michael F.

2013-01-01

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

eHealth Literacy: Predictors in a Population With Moderate-to-High Cardiovascular Risk.

PubMed

Richtering, Sarah S; Hyun, Karice; Neubeck, Lis; Coorey, Genevieve; Chalmers, John; Usherwood, Tim; Peiris, David; Chow, Clara K; Redfern, Julie

2017-01-27

Electronic health (eHealth) literacy is a growing area of research parallel to the ongoing development of eHealth interventions. There is, however, little and conflicting information regarding the factors that influence eHealth literacy, notably in chronic disease. We are similarly ill-informed about the relationship between eHealth and health literacy, 2 related yet distinct health-related literacies. The aim of our study was to investigate the demographic, socioeconomic, technology use, and health literacy predictors of eHealth literacy in a population with moderate-to-high cardiovascular risk. Demographic and socioeconomic data were collected from 453 participants of the CONNECT (Consumer Navigation of Electronic Cardiovascular Tools) study, which included age, gender, education, income, cardiovascular-related polypharmacy, private health care, main electronic device use, and time spent on the Internet. Participants also completed an eHealth Literacy Scale (eHEALS) and a Health Literacy Questionnaire (HLQ). Univariate analyses were performed to compare patient demographic and socioeconomic characteristics between the low (eHEALS<26) and high (eHEALS≥26) eHealth literacy groups. To then determine the predictors of low eHealth literacy, multiple-adjusted generalized estimating equation logistic regression model was used. This technique was also used to examine the correlation between eHealth literacy and health literacy for 4 predefined literacy themes: navigating resources, skills to use resources, usefulness for oneself, and critical evaluation. The univariate analysis showed that patients with lower eHealth literacy were older (68 years vs 66 years, P=.01), had lower level of education (P=.007), and spent less time on the Internet (P<.001). However, multiple-adjusted generalized estimating equation logistic regression model demonstrated that only the time spent on the Internet (P=.01) was associated with the level of eHealth literacy. Regarding the comparison

Exploring cardiovascular health: the Healthy Life in Suriname (HELISUR) study. A protocol of a cross-sectional study

PubMed Central

Diemer, Frederieke S; Aartman, Jet Q; Karamat, Fares A; Baldew, Sergio M; Jarbandhan, Ameerani V; van Montfrans, Gert A; Oehlers, Glenn P; Brewster, Lizzy M

2014-01-01

Introduction Obesity, hypertension and diabetes are on a dramatic rise in low-income and middle-income countries, and this foretells an overwhelming increase in chronic disease burden from cardiovascular disease. Therefore, rapid action should be taken through preventive population-based programmes. However, in these regions, data on the population distribution of cardiovascular risk factors, and of intermediate and final end points for cardiovascular disease are scarce. The Healthy Life in Suriname (HELISUR) study is a cardiovascular population study in Suriname, which is part of the Caribbean Community. The HELISUR study is dedicated to provide data on risk factors and prevalent cardiovascular disease in the multiethnic population, which is mainly of African and Asian descent. Methods and analysis In a cross-sectional, observational population-based setting, a random representative sample of 1800 citizens aged between 18 and 70 years will be selected using a cluster household sampling method. Self-reported demographic, socioeconomic and (cardiovascular) health-related data will be collected. Physical examination will include the assessment of cardiovascular risk factors and prevalent cardiovascular disease. In addition, we will study cardiovascular haemodynamics non-invasively, as a novel intermediate outcome. Finally, fasting blood and overnight urine samples will be collected to monitor cardiometabolic risk factors. The main outcome will be descriptive in reporting the prevalence of risk factors and measures of (sub) clinical end organ damage, stratified for ethnicity and sex-age groups. Ethics and dissemination Ethical approval has been obtained from the State Secretary of Health. Data analysis and manuscript submission are scheduled for 2016. Findings will be disseminated in peer-reviewed journals, and at national, regional and international scientific meetings. Importantly, data will be presented to Surinamese policymakers and healthcare workers, to

Cardiovascular disease risk and secondary prevention of cardiovascular disease among patients with low health literacy.

PubMed

van Schaik, T M; Jørstad, H T; Twickler, T B; Peters, R J G; Tijssen, J P G; Essink-Bot, M L; Fransen, M P

2017-07-01

To explore the association between health literacy and the risk of cardiovascular disease (CVD), and to assess the differential effects by health literacy level of a nurse-coordinated secondary prevention program (NCPP) in patients with coronary artery disease (CAD). Data were collected in two medical centres participating in the RESPONSE trial (Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists). CVD risk profiles were assessed at baseline and 12-month follow-up using the Systematic Coronary Risk Evaluation (SCORE). Health literacy was assessed by the short Rapid Estimate of Adult Literacy in Medicine (REALM-D) and the Newest Vital Sign (NVS-D); self-reported health literacy was evaluated by the Set of Brief Screening Questions (SBSQ-D). Among 201 CAD patients, 18% exhibited reading difficulties, 52% had difficulty understanding and applying written information, and 5% scored low on self-reported health literacy. Patients with low NVS-D scores had a higher CVD risk [mean SCORE 5.2 (SD 4.8) versus 3.3 (SD 4.1), p < 0.01]. Nurse-coordinated care seemed to reduce CVD risk irrespective of health literacy levels without significant differences. Inadequate health literacy is prevalent in CAD patients in the Netherlands, and is associated with less favourable CVD risk profiles. Where many other forms of CVD prevention fail, nurse-coordinated care seems to be effective among patients with inadequate health literacy.

Cell Systems to Investigate the Impact of Polyphenols on Cardiovascular Health

PubMed Central

Grootaert, Charlotte; Kamiloglu, Senem; Capanoglu, Esra; Van Camp, John

2015-01-01

Polyphenols are a diverse group of micronutrients from plant origin that may serve as antioxidants and that contribute to human health in general. More specifically, many research groups have investigated their protective effect against cardiovascular diseases in several animal studies and human trials. Yet, because of the excessive processing of the polyphenol structure by human cells and the residing intestinal microbial community, which results in a large variability between the test subjects, the exact mechanisms of their protective effects are still under investigation. To this end, simplified cell culture systems have been used to decrease the inter-individual variability in mechanistic studies. In this review, we will discuss the different cell culture models that have been used so far for polyphenol research in the context of cardiovascular diseases. We will also review the current trends in cell culture research, including co-culture methodologies. Finally, we will discuss the potential of these advanced models to screen for cardiovascular effects of the large pool of bioactive polyphenols present in foods and their metabolites. PMID:26569293

Cardiovascular Disease Screening By Community Health Workers Can Be Cost-Effective In Low-Resource Countries

PubMed Central

Gaziano, Thomas; Abrahams-Gessel, Shafika; Surka, Sam; Sy, Stephen; Pandya, Ankur; Denman, Catalina A.; Mendoza, Carlos; Puoane, Thandi; Levitt, Naomi S.

2016-01-01

In low-resource settings, a physician is not always available. We recently demonstrated that community health workers—instead of physicians or nurses—can efficiently screen adults for cardiovascular disease in South Africa, Mexico, and Guatemala. In this analysis we sought to determine the health and economic impacts of shifting this screening to community health workers equipped with either a paper-based or a mobile phone–based screening tool. We found that screening by community health workers was very cost-effective or even cost-saving in all three countries, compared to the usual clinic-based screening. The mobile application emerged as the most cost-effective strategy because it could save more lives than the paper tool at minimal extra cost. Our modeling indicated that screening by community health workers, combined with improved treatment rates, would increase the number of deaths averted from 15,000 to 110,000, compared to standard care. Policy makers should promote greater acceptance of community health workers by both national populations and health professionals and should increase their commitment to treating cardiovascular disease and making medications available. PMID:26355056

Reducing indoor air pollution by air conditioning is associated with improvements in cardiovascular health among the general population.

PubMed

Lin, Lian-Yu; Chuang, Hsiao-Chi; Liu, I-Jung; Chen, Hua-Wei; Chuang, Kai-Jen

2013-10-01

Indoor air pollution is associated with cardiovascular effects, however, little is known about the effects of improving indoor air quality on cardiovascular health. The aim of this study was to explore whether improving indoor air quality through air conditioning can improve cardiovascular health in human subjects. We recruited a panel of 300 healthy subjects from Taipei, aged 20 and over, to participate in six home visits each, to measure a variety of cardiovascular endpoints, including high sensitivity-C-reactive protein (hs-CRP), 8-hydroxy-2'-deoxyguanosine (8-OHdG), fibrinogen in plasma and heart rate variability (HRV). Indoor particles and total volatile organic compounds (VOCs) were measured simultaneously at the participant's home during each visit. Three exposure conditions were investigated in this study: participants were requested to keep their windows open during the first two visits, close their windows during the next two visits, and close the windows and turn on their air conditioners during the last two visits. We used linear mixed-effects models to associate the cardiovascular endpoints with individual indoor air pollutants. The results showed that increases in hs-CRP, 8-OHdG and fibrinogen, and decreases in HRV indices were associated with increased levels of indoor particles and total VOCs in single-pollutant and two-pollutant models. The effects of indoor particles and total VOCs on cardiovascular endpoints were greatest during visits with the windows open. During visits with the air conditioners turned on, no significant changes in cardiovascular endpoints were observed. In conclusion, indoor air pollution is associated with inflammation, oxidative stress, blood coagulation and autonomic dysfunction. Reductions in indoor air pollution and subsequent improvements in cardiovascular health can be achieved by closing windows and turning on air conditioners at home. Copyright © 2013 Elsevier B.V. All rights reserved.

The Study of Cardiovascular Health Outcomes in the Era of Claims Data: The Cardiovascular Health Study

PubMed Central

Psaty, Bruce M; Delaney, Joseph A; Arnold, Alice M; Curtis, Lesley H; Fitzpatrick, Annette L; Heckbert, Susan R; McKnight, Barbara; Ives, Diane; Gottdiener, John S; Kuller, Lewis H; Longstreth, W T

2015-01-01

Background Increasingly, the diagnostic codes from administrative claims data are being used as clinical outcomes. Methods and Results Data from the Cardiovascular Health Study (CHS) were used to compare event rates and risk-factor associations between adjudicated hospitalized cardiovascular events and claims-based methods of defining events. The outcomes of myocardial infarction (MI), stroke, and heart failure (HF) were defined in three ways: 1) the CHS adjudicated event (CHS[adj]); 2) selected ICD9 diagnostic codes only in the primary position for Medicare claims data from the Center for Medicare and Medicaid Services (CMS[1st]); and 3) the same selected diagnostic codes in any position (CMS[any]). Conventional claims-based methods of defining events had high positive predictive values (PPVs) but low sensitivities. For instance, the PPV of an ICD9 code of 410.×1 for a new acute MI in the first position was 90.6%, but this code identified only 53.8% of incident MIs. The observed event rates were low. For MI, the incidence was 14.9 events per 1000 person years for CHS[adj] MI, 8.6 for CMS[1st] and 12.2 for CMS[any]. In general, CVD risk factor associations were similar across the three methods of defining events. Indeed, traditional CVD risk factors were also associated with all first hospitalizations not due to an MI. Conclusions The use of diagnostic codes from claims data as clinical events, especially when restricted to primary diagnoses, leads to an underestimation of event rates. Additionally, claims-based events data represent a composite endpoint that includes the outcome of interest and selected (misclassified) non-event hospitalizations. PMID:26538580

Characterizing Cardiovascular Health and Evaluating a Low-Intensity Intervention to Promote Smoking Cessation in a Food-Assistance Population

PubMed Central

Perkett, Mackenzie; Robson, Shannon M.; Kripalu, Varsha; Wysota, Christina; McGarry, Charlotte; Weddle, David; Papas, Mia A.

2017-01-01

Food assistance recipients are at higher risk for poor cardiovascular health given their propensity to poor dietary intake and tobacco use. This study sought to evaluate the cardiovascular health status, and determine the impact of a low-intensity smoking cessation education intervention that connected mobile food pantry participants to state quit-smoking resources. A pre-post design with a 6-week follow-up was used to evaluate the impact of a 10–12 min smoking cessation education session implemented in five food pantries in Delaware. Baseline cardiovascular health, smoking behaviors and food security status were assessed. Smoking cessation knowledge, intention to quit and use of the state quit line were also assessed at follow-up. Of the 144 participants 72.3% reported having hypertension, 34.3% had diabetes, 13.9% had had a stroke. 50.0% were current smokers. The low-intensity intervention significantly increased smoking cessation knowledge but not intention to quit at follow-up. Seven percent of current smokers reported calling the quit line. Current tobacco use was five times more likely in food insecure versus food secure adults (OR 4.98; p=0.006), even after adjustment for demographic factors. Systems based approaches to address tobacco use and cardiovascular health in low-income populations are needed. The extent to which smoking cessation could reduce food insecurity and risk for cardiovascular disease in this population warrants investigation. PMID:27837357

Relationship Between Ideal Cardiovascular Health and Disability in Older Adults: The Chilean National Health Survey (2009-10).

PubMed

García-Hermoso, Antonio; Ramírez-Vélez, Robinson; Ramirez-Campillo, Rodrigo; Izquierdo, Mikel

2017-12-01

This study aimed to examine the relationship between disability and the American Heart Association metric of ideal cardiovascular health (CVH) in older adults from the 2009-10 Chilean National Health Survey. Data from 460 older adults were analyzed. All subjects were interviewed using the standardized World Health Survey, which includes 16 health-related questions and assesses the domains of mobility, self-care, pain and discomfort, cognition, interpersonal activities, vision, sleep and energy, and affect. A person who responds with a difficulty rating of severe, extreme, or unable to do in at least one of these eight functioning domains is considered to have a disability. Ideal CVH was defined as meeting the ideal levels of four behaviors (smoking, body mass index, physical activity, diet adherence) and three factors (total cholesterol, fasting glucose, blood pressure). Logistic regression analysis suggested that ideal physical activity reduces the odds of disability (odds ratio (OR) = 0.55, 95% confidence interval (CI) = 0.36-0.85). Moreover, participants with intermediate (3-4 metrics) (OR = 0.63, 95% CI = 0.41-0.97) and ideal (5-7 metrics) (OR = 0.51, 95% CI = 0.24-0.97) CVH profiles had lower odds of disability independent of history of vascular events and arthritis disease than those with a poor profile (0-2 metrics). In conclusion, despite the cross-sectional design, this study suggests the importance of promoting ideal CVH because of their relationship with disability. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

National Institutes of Health Career Development Awards for Cardiovascular Physician-Scientists: Recent Trends and Strategies for Success

PubMed Central

Carlson, Drew E.; Balke, C. William; Jackson, Elizabeth A.; Madhur, Meena S.; Barac, Ana; Abdalla, Marwah; Brittain, Evan L.; Desai, Nihar; Kates, Andrew M.; Freeman, Andrew M.; Mann, Douglas L.

2015-01-01

Nurturing the development of cardiovascular physician-scientist investigators is critical for sustained progress in cardiovascular science and improving human health. The transition from an inexperienced trainee to an independent physician-scientist is a multifaceted process requiring a sustained commitment from the trainee, mentors, and institution. A cornerstone of this training process is a career development (K) award from the National Institutes of Health (NIH). These awards generally require 75% of the awardee’s professional effort devoted to research aims and diverse career development activities carried out in a mentored environment over a 5-year period. We report on recent success rates for obtaining NIH K awards, provide strategies for preparing a successful application and navigating the early career period for aspiring cardiovascular investigators, and offer cardiovascular division leadership perspectives regarding K awards in the current era. Our objective is to offer practical advice that will equip trainees considering an investigator path for success. PMID:26483107

National Institutes of Health Career Development Awards for Cardiovascular Physician-Scientists: Recent Trends and Strategies for Success.

PubMed

Lindman, Brian R; Tong, Carl W; Carlson, Drew E; Balke, C William; Jackson, Elizabeth A; Madhur, Meena S; Barac, Ana; Abdalla, Marwah; Brittain, Evan L; Desai, Nihar; Kates, Andrew M; Freeman, Andrew M; Mann, Douglas L

2015-10-20

Nurturing the development of cardiovascular physician-scientist investigators is critical for sustained progress in cardiovascular science and improving human health. The transition from an inexperienced trainee to an independent physician-scientist is a multifaceted process requiring a sustained commitment from the trainee, mentors, and institution. A cornerstone of this training process is a career development (K) award from the National Institutes of Health (NIH). These awards generally require 75% of the awardee's professional effort devoted to research aims and diverse career development activities carried out in a mentored environment over a 5-year period. We report on recent success rates for obtaining NIH K awards, provide strategies for preparing a successful application and navigating the early career period for aspiring cardiovascular investigators, and offer cardiovascular division leadership perspectives regarding K awards in the current era. Our objective is to offer practical advice that will equip trainees considering an investigator path for success. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Effect of unemployment on cardiovascular risk factors and mental health.

PubMed

Zagożdżon, P; Parszuto, J; Wrotkowska, M; Dydjow-Bendek, D

2014-09-01

Following the economic changes in Poland, increasing health discrepancies were observed during a period of 20 years, which may be partly attributable to the consequences of unemployment. To assess the association between unemployment, major cardiovascular risk factors and mental health. A cross-sectional study in which data were collected between 2009 and 2010 during preventive health examinations by an occupational medicine service in Gdansk, Poland. Data on blood pressure, resting heart rate, information about smoking habits, body mass index and history of use of mental health services were collected during these assessments. Multiple logistic regression was used during data analysis to adjust for age, gender, education and length of employment. Study participants comprised 3052 unemployed and 2059 employed individuals. After adjustment for age, gender, education and number of previous employments, the odds ratio (OR) for hypertension in relation to unemployment was 1.02 [95% confidence interval (95% CI) 0.84-1.23]. There was a statistically significant negative association between being overweight and unemployment (OR = 0.81, 95% CI: 0.66-0.99). Smoking was positively associated with unemployment after adjustment for age and sex (OR = 1.45, 95% CI: 1.25-1.67). There was a positive relationship between mental ill-health and unemployment among study participants (OR = 2.05, 95% CI: 0.91-4.65), but this was not statistically significant. The patterns of major cardiovascular risk factors differed between unemployed and employed individuals in Poland. Our observations suggest employment status is a predictor of specific disease risk profiles; consequently, specific preventive measures are needed in unemployed individuals. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Therapeutic adherence in users of a cardiovascular health program in primary care in Chile].

PubMed

Veliz-Rojas, Lizet; Mendoza-Parra, Sara; Barriga, Omar A

2015-01-01

To analyze therapeutic adherence in users of a cardiovascular health program in primary care in the community of San Pedro de la Paz in the region of Bío Bío, Chile. Cross-sectional and correlational study with a sample of 257 people aged 18-60 years. A questionnaire that included the Miller´s health behavior scale to measure adherence, and review of medical records was performed. Descriptive univariate and bivariate analyses supported in SPSS were performed. Of the total participants, 157 (61.1%) were women. The health behavior scale reflected non-adherence of participants, as only 4 (1.5%) indicated that they always followed the instructions provided by the health team. The subscale monitoring stress management had the highest average, indicating that in this aspect there was greater adherence of the participants. Associations between therapeutic adherence and doing paid work (p=0.025) and with participation in social activities (p=0.005) were found. Therapeutic adherence in users of the cardiovascular health program was low. It is important to develop strategies that favor therapeutic adherence from the perspective of equity and social determinants of health.

Population cardiovascular health and urban environments: the Heart Healthy Hoods exploratory study in Madrid, Spain.

PubMed

Bilal, Usama; Díez, Julia; Alfayate, Silvia; Gullón, Pedro; Del Cura, Isabel; Escobar, Francisco; Sandín, María; Franco, Manuel

2016-08-22

Our aim is to conduct an exploratory study to provide an in-depth characterization of a neighborhood's social and physical environment in relation to cardiovascular health. A mixed-methods approach was used to better understand the food, alcohol, tobacco and physical activity domains of the urban environment. We conducted this study in an area of 16,000 residents in Madrid (Spain). We obtained cardiovascular health and risk factors data from all residents aged 45 and above using Electronic Health Records from the Madrid Primary Health Care System. We used several quantitative audit tools to assess: the type and location of food outlets and healthy food availability; tobacco and alcohol points of sale; walkability of all streets and use of parks and public spaces. We also conducted 11 qualitative interviews with key informants to help understanding the relationships between urban environment and cardiovascular behaviors. We integrated quantitative and qualitative data following a mixed-methods merging approach. Electronic Health Records of the entire population of the area showed similar prevalence of risk factors compared to the rest of Madrid/Spain (prevalence of diabetes: 12 %, hypertension: 34 %, dyslipidemia: 32 %, smoking: 10 %, obesity: 20 %). The food environment was very dense, with many small stores (n = 44) and a large food market with 112 stalls. Residents highlighted the importance of these small stores for buying healthy foods. Alcohol and tobacco environments were also very dense (n = 91 and 64, respectively), dominated by bars and restaurants (n = 53) that also acted as food services. Neighbors emphasized the importance of drinking as a socialization mechanism. Public open spaces were mostly used by seniors that remarked the importance of accessibility to these spaces and the availability of destinations to walk to. This experience allowed testing and refining measurement tools, drawn from epidemiology, geography, sociology and

Sex inequalities in cardiovascular health: a cross-sectional study.

PubMed

Janković, Janko; Marinković, Jelena; Stojisavljević, Dragana; Erić, Miloš; Vasiljević, Nadja; Janković, Slavenka

2016-02-01

The aim of this study was to determine sex differences in the prevalence of cardiovascular health (CVH) metrics according to the CVH status. The cross-sectional, population-based study involved 2250 women and 1920 men aged ≥18 years that participated in the 2010 National Health Survey in the Republic of Srpska, Bosnia and Herzegovina. Prevalence of CVH behaviours (smoking, body mass index, physical activity, diet), CVH factors (cholesterol, fasting blood glucose and blood pressure, plus smoking) and ideal CVH were estimated according to the American Heart Association criteria for ideal, intermediate and poor levels. Association between sex and ideal CVH categories was analyzed with multivariable logistic regression analysis across three age stratums. A higher prevalence of ideal CVH metrics was seen in women for smoking status, body mass index, healthy diet score and blood pressure, and in men for physical activity and total cholesterol. Women from all age groups had better CVH behaviours (odds ratio [OR] = 1.40 for the youngest; OR = 2.05 for middle-aged; and OR = 2.03 for older-aged women), while only women from the youngest age group had better CVH factors (OR = 5.09). In line with this, ideal overall CVH prevailed in younger and middle-aged women in comparison to men of the same ages (OR = 3.01 and OR = 2.25, respectively), while disappeared in older ones. Significant differences in the prevalence of CVH metrics between men and women in the Republic of Srpska should be considered in cardiovascular disease prevention. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Affordability, accountability, and accessibility in health care reform: implications for cardiovascular and pulmonary rehabilitation.

PubMed

King, Marjorie L

2013-01-01

Because health care costs in the United States have been growing disproportionately compared to inflation for many years, without a clear connection to improved quality or increased access to care, employers and payers have begun to test new models of health care delivery and payment. These models are linked to the concepts of affordability, accountability, and accessibility and incorporate the premise that there must be shared responsibility for improving meaningful patient outcomes, with attention to the coordination of team-based and patient-centered care, and value for services purchased. This article explores emerging health care delivery and payment models, including expanded access to care related to the Affordable Care Act of 2010, patient-centered medical homes and neighborhoods, accountable and coordinated care organizations, and value-based purchasing and insurance design, with an emphasis on implications for cardiovascular and pulmonary rehabilitation programs and the American Association of Cardiovascular and Pulmonary Rehabilitation.

Using participatory research to challenge the status quo for women's cardiovascular health.

PubMed

Young, Lynne; Wharf Higgins, Joan

2010-12-01

Cardiovascular health research has been dominated by medical and patriarchal paradigms, minimizing a broader perspective of causes of disease. Socioeconomic status as a risk for cardiovascular disease is well established by research, yet these findings have had little influence. Participatory research (PR) that frames mixed method research has potential to bring contextualized clinically relevant findings into program planning and policy-making arenas toward developing meaningful health and social policies relevant to primary prevention. In this article we provide an overview of a PR program that included two quantitative and one qualitative studies and then we discuss lessons learned. The PR process we found was empowering for lone mothers, and transformative for lone mothers and researchers. Further, PR as an approach to research opened spaces in practice and policy-making arenas to raise upstream issues relevant to the health of low income lone mothers. We conclude that while PR is an effective approach to social determinants research, as a time-intensive endeavor, and one that does not easily align with research tradition, researchers must consider the strengths and drawbacks of PR when planning to implement such an approach. © 2010 Blackwell Publishing Ltd.

Effectiveness of a Walking Group Intervention to Promote Physical Activity and Cardiovascular Health in Predominantly Non-Hispanic Black and Hispanic Urban Neighborhoods: Findings from the Walk Your Heart to Health Intervention

ERIC Educational Resources Information Center

Schulz, Amy J.; Israel, Barbara A.; Mentz, Graciela B.; Bernal, Cristina; Caver, Deanna; DeMajo, Ricardo; Diaz, Gregoria; Gamboa, Cindy; Gaines, Causandra; Hoston, Bernadine; Opperman, Alisha; Reyes, Angela G.; Rowe, Zachary; Sand, Sharon L.; Woods, Sachiko

2015-01-01

Objectives: The purpose of this study was to evaluate the effectiveness of the "Walk Your Heart to Health" ("WYHH") intervention, one component of the multilevel Community Approaches to Cardiovascular Health: Pathways to Heart Health (CATCH:PATH) intervention designed to promote physical activity and reduce cardiovascular risk…

Neighborhood Environmental Health and Premature Death From Cardiovascular Disease

PubMed Central

Xu, Junjun; Rollins, Latrice; Baltrus, Peter; O’Connell, Laura Kathryn; Cooper, Dexter L.; Hopkins, Jammie; Botchwey, Nisha D.; Akintobi, Tabia Henry

2018-01-01

Introduction Cardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD. Methods We examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city. Results We found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality. Conclusion This study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes. PMID:29389312

A Mediterranean Diet to Improve Cardiovascular and Cognitive Health: Protocol for a Randomised Controlled Intervention Study.

PubMed

Wade, Alexandra T; Davis, Courtney R; Dyer, Kathryn A; Hodgson, Jonathan M; Woodman, Richard J; Keage, Hannah A D; Murphy, Karen J

2017-02-16

The Mediterranean diet has demonstrated efficacy for improving cardiovascular and cognitive health. However, a traditional Mediterranean diet delivers fewer serves of dairy and less dietary calcium than is currently recommended in Australia, which may limit long-term sustainability. The present study aims to evaluate whether a Mediterranean diet with adequate dairy and calcium can improve cardiovascular and cognitive function in an at-risk population, and thereby reduce risk of cardiovascular disease (CVD) and cognitive decline. A randomised, controlled, parallel, crossover design trial will compare a Mediterranean diet supplemented with dairy foods against a low-fat control diet. Forty participants with systolic blood pressure above 120 mmHg and at least two other risk factors of CVD will undertake each dietary intervention for eight weeks, with an eight-week washout period between interventions. Systolic blood pressure will be the primary measure of interest. Secondary outcomes will include measures of cardiometabolic health, dietary compliance, cognitive function, assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB), psychological well-being and dementia risk. This research will provide empirical evidence as to whether the Mediterranean diet can be modified to provide recommended dairy and calcium intakes while continuing to deliver positive effects for cardiovascular and cognitive health. The findings will hold relevance for the field of preventative healthcare and may contribute to revisions of national dietary guidelines.

A Mediterranean Diet to Improve Cardiovascular and Cognitive Health: Protocol for a Randomised Controlled Intervention Study

PubMed Central

Wade, Alexandra T.; Davis, Courtney R.; Dyer, Kathryn A.; Hodgson, Jonathan M.; Woodman, Richard J.; Keage, Hannah A. D.; Murphy, Karen J.

2017-01-01

The Mediterranean diet has demonstrated efficacy for improving cardiovascular and cognitive health. However, a traditional Mediterranean diet delivers fewer serves of dairy and less dietary calcium than is currently recommended in Australia, which may limit long-term sustainability. The present study aims to evaluate whether a Mediterranean diet with adequate dairy and calcium can improve cardiovascular and cognitive function in an at-risk population, and thereby reduce risk of cardiovascular disease (CVD) and cognitive decline. A randomised, controlled, parallel, crossover design trial will compare a Mediterranean diet supplemented with dairy foods against a low-fat control diet. Forty participants with systolic blood pressure above 120 mmHg and at least two other risk factors of CVD will undertake each dietary intervention for eight weeks, with an eight-week washout period between interventions. Systolic blood pressure will be the primary measure of interest. Secondary outcomes will include measures of cardiometabolic health, dietary compliance, cognitive function, assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB), psychological well-being and dementia risk. This research will provide empirical evidence as to whether the Mediterranean diet can be modified to provide recommended dairy and calcium intakes while continuing to deliver positive effects for cardiovascular and cognitive health. The findings will hold relevance for the field of preventative healthcare and may contribute to revisions of national dietary guidelines. PMID:28212320

Cardiovascular Disease Screening By Community Health Workers Can Be Cost-Effective In Low-Resource Countries.

PubMed

Gaziano, Thomas; Abrahams-Gessel, Shafika; Surka, Sam; Sy, Stephen; Pandya, Ankur; Denman, Catalina A; Mendoza, Carlos; Puoane, Thandi; Levitt, Naomi S

2015-09-01

In low-resource settings, a physician is not always available. We recently demonstrated that community health workers-instead of physicians or nurses-can efficiently screen adults for cardiovascular disease in South Africa, Mexico, and Guatemala. In this analysis we sought to determine the health and economic impacts of shifting this screening to community health workers equipped with either a paper-based or a mobile phone-based screening tool. We found that screening by community health workers was very cost-effective or even cost-saving in all three countries, compared to the usual clinic-based screening. The mobile application emerged as the most cost-effective strategy because it could save more lives than the paper tool at minimal extra cost. Our modeling indicated that screening by community health workers, combined with improved treatment rates, would increase the number of deaths averted from 15,000 to 110,000, compared to standard care. Policy makers should promote greater acceptance of community health workers by both national populations and health professionals and should increase their commitment to treating cardiovascular disease and making medications available. Project HOPE—The People-to-People Health Foundation, Inc.

Experiences of patients and healthcare professionals of NHS cardiovascular health checks: a qualitative study.

PubMed

Riley, R; Coghill, N; Montgomery, A; Feder, G; Horwood, J

2016-09-01

NHS Health Checks are a national cardiovascular risk assessment and management programme in England and Wales. We examined the experiences of patients attending and healthcare professionals (HCPs) conducting NHS Health Checks. Interviews were conducted with a purposive sample of 28 patients and 16 HCPs recruited from eight general practices across a range of socio-economic localities. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Patients were motivated to attend an NHS Health Check because of health beliefs, the perceived value of the programme, a family history of cardiovascular and other diseases and expectations of receiving a general health assessment. Some patients reported benefits including reassurance and reinforcement of healthy lifestyles. Others experienced confusion and frustration about how results and advice were communicated, some having a poor understanding of the implications of their results. HCPs raised concerns about the skill set of some staff to competently communicate risk and lifestyle information. To improve the satisfaction of patients attending and improve facilitation of lifestyle change, HCPs conducting the NHS Health Checks require sufficient training to equip them with appropriate skills and knowledge to deliver the service effectively. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

Duration of daily TV/screen watching with cardiovascular, respiratory, mental and psychiatric health: Scottish Health Survey, 2012-2013.

PubMed

Shiue, Ivy

2015-01-01

The link of duration of TV and/or screen watching and chronic health conditions by subtypes is unclear. Therefore, the relationship between TV and/or screen watching hours and cardiovascular, respiratory, mental and psychiatric health and well-being (happiness) was assessed in an independent population-based survey to identify correlations of various hours with health conditions. Data was retrieved from the Scottish Health Survey, 2012-2013. Information on demographics, lifestyle factors, self-reported health conditions and TV and/or screen watching duration in both Scottish adults and children was collected by annual household interviews. Chi-square test and survey weighted logistic and multi-nominal modelling were performed. 5527 (57.0%) Scottish adults aged 16-99 watched TV and/or screen daily for 3 + h on average. There was a trend toward more hypertension, angina, stroke, diabetes, chronic obstructive pulmonary disease and poor self-rated health and mental health. Reporting watching TV and/or screen for 4 + h, for 5 + h and for 8 + h was associated with higher rates of heart attack, heart murmur or other heart troubles and abnormal heart rhythms, respectively. 414 (20.7%) Scottish children aged 4-12 watched TV and/or screen for 3h or more. They tended to have poor self-rated health and life difficulties perceived as emotional and behavioural problems. There were associations between various hours of TV and/or screen watching (3+h) and poor health observed both in Scottish adults and children. Future educational and public health programmes minimising TV and/or screen watching in order to protect cardiovascular, respiratory, mental and psychiatric health might be considered. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Environmental Exposures and Cardiovascular Disease: A Challenge for Health and Development in Low- and Middle-Income Countries

PubMed Central

Burroughs Peña, Melissa S.; Rollins, Allman

2016-01-01

Summary Environmental exposures in low- and middle-income countries lie at the intersection of increased economic development and the rising public health burden of cardiovascular disease. Increasing evidence suggests an association of exposure to ambient air pollution, household air pollution from biomass fuel, lead, arsenic, and cadmium with multiple cardiovascular disease outcomes including hypertension, coronary heart disease, stroke, and cardiovascular mortality. While populations in low- and middle-income countries are disproportionately exposed to environmental pollution, the bulk of evidence that links these exposures to cardiovascular disease is derived from populations in high-income countries. More research is needed to further characterize the extent of environmental exposures and develop targeted interventions towards reducing cardiovascular disease in at-risk populations in low- and middle-income countries. PMID:27886791

The Motivations of Iranian Patients With Cardiovascular Disease to Seek Health Information: A Qualitative Study

PubMed Central

Gholami, Mohammad; Fallahi Khoshknab, Masoud; Khankeh, Hamid Reza; Ahmadi, Fazlollah; Maddah, Sadat Seyed Bagher; Mousavi Arfaa, Nazila

2016-01-01

Background Cardiovascular patients need information to preserve and promote their health, but not all of them have the necessary motivation to seek relevant health knowledge. Objectives The present study analyzed experiences of patients, family caregivers, and healthcare providers to explore the motivating factors that cause cardiovascular patients to seek important health information. Patients and Methods This study was conducted using a qualitative approach and conventional qualitative content analysis method. Thirty-six people, including 18 cardiovascular patients, 7 family caregivers, and 11 healthcare providers (from multidisciplinary backgrounds) participated in the study. The data were collected through semi-structured interviews and purposeful sampling and continued until data saturation. Data collection and analysis proceeded simultaneously and with constant comparison; this study was carried out from May 2012 to May 2013. Results During the analysis process, three main themes were extracted that characterized participants’ experiences, perceptions, and motivations to seek health information. The themes were “Optimizing quality of life, “Desire for personal rights to be respected,” and “Gaining confidence through consultation.” Conclusions Our findings showed that, through seeking information, patients try to achieve well-being and realize their personal rights as well as their right to security. They should also be encouraged to enhance their quality of life by using the Knowles’ learning theory to formulate their needs and learning priorities. PMID:27437128

Perceived Health Competence Predicts Health Behavior and Health-Related Quality of Life in Patients with Cardiovascular Disease

PubMed Central

Bachmann, Justin M.; Goggins, Kathryn M.; Nwosu, Samuel K.; Schildcrout, Jonathan S.; Kripalani, Sunil; Wallston, Kenneth A.

2017-01-01

Objective Evaluate the effect of perceived health competence, a patient’s belief in his or her ability to achieve health-related goals, on health behavior and health-related quality of life. Methods We analyzed 2063 patients hospitalized with acute coronary syndrome and/or congestive heart failure at a large academic hospital in the United States. Multivariable linear regression models investigated associations between the two-item perceived health competence scale (PHCS-2) and positive health behaviors such as medication adherence and exercise (Health Behavior Index) as well as health-related quality of life (5-item Patient Reported Outcome Information Measurement System Global Health Scale). Results After multivariable adjustment, perceived health competence was highly associated with health behaviors (p<0.001) and health-related quality of life (p<0.001). Low perceived health competence was associated with a decrease in health-related quality of life between hospitalization and 90 days after discharge (p<0.001). Conclusions Perceived health competence predicts health behavior and health-related quality of life in patients hospitalized with cardiovascular disease as well as change in health-related quality of life after discharge. Practice implications Patients with low perceived health competence may be at risk for a decline in health-related quality of life after hospitalization and thus a potential target for counseling and other behavioral interventions. PMID:27450479

Perceived health competence predicts health behavior and health-related quality of life in patients with cardiovascular disease.

PubMed

Bachmann, Justin M; Goggins, Kathryn M; Nwosu, Samuel K; Schildcrout, Jonathan S; Kripalani, Sunil; Wallston, Kenneth A

2016-12-01

Evaluate the effect of perceived health competence, a patient's belief in his or her ability to achieve health-related goals, on health behavior and health-related quality of life. We analyzed 2063 patients hospitalized with acute coronary syndrome and/or congestive heart failure at a large academic hospital in the United States. Multivariable linear regression models investigated associations between the two-item perceived health competence scale (PHCS-2) and positive health behaviors such as medication adherence and exercise (Health Behavior Index) as well as health-related quality of life (5-item Patient Reported Outcome Information Measurement System Global Health Scale). After multivariable adjustment, perceived health competence was highly associated with health behaviors (p<0.001) and health-related quality of life (p<0.001). Low perceived health competence was associated with a decrease in health-related quality of life between hospitalization and 90days after discharge (p<0.001). Perceived health competence predicts health behavior and health-related quality of life in patients hospitalized with cardiovascular disease as well as change in health-related quality of life after discharge. Patients with low perceived health competence may be at risk for a decline in health-related quality of life after hospitalization and thus a potential target for counseling and other behavioral interventions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Health-related shame: an affective determinant of health?

PubMed Central

Dolezal, Luna; Lyons, Barry

2017-01-01

Despite shame being recognised as a powerful force in the clinical encounter, it is underacknowledged, under-researched and undertheorised in the contexts of health and medicine. In this paper we make two claims. The first is that emotional or affective states, in particular shame, can have a significant impact on health, illness and health-related behaviours. We outline four possible processes through which this might occur: (1) acute shame avoidance behaviour; (2) chronic shame health-related behaviours; (3) stigma and social status threat and (4) biological mechanisms. Second, we postulate that shame's influence is so insidious, pervasive and pernicious, and so critical to clinical and political discourse around health, that it is imperative that its vital role in health, health-related behaviours and illness be recognised and assimilated into medical, social and political consciousness and practice. In essence, we argue that its impact is sufficiently powerful for it to be considered an affective determinant of health, and provide three justifications for this. We conclude with a proposal for a research agenda that aims to extend the state of knowledge of health-related shame. PMID:28596218

Cardiovascular disease among atomic bomb survivors.

PubMed

Ozasa, Kotaro; Takahashi, Ikuno; Grant, Eric J; Kodama, Kazunori

2017-10-01

The profile of cardiovascular disease in Japan has been different from that in Western countries. Hypertension was the major cause not only for hemorrhagic stroke but also for ischemic stroke and heart disease in the past, and the influence of hypertension has decreased with calendar years because of reduced salt intake and westernization of lifestyle, and also improved medical care. The health status of atomic bomb survivors has reflected this profile as well as radiation effects. It is also likely that this cohort has been affected by the difficult conditions experienced in the aftermath of the war and atomic bombings. In this article, we tried to make a consistent interpretation of epidemiological findings of atomic bomb radiation effects on cardiovascular disease. Among the atomic bomb survivors, radiation exposure was associated with some cardiovascular diseases that are often associated with hypertension, and dose response appeared to be primarily non-linear among those who were exposed at younger ages. These effects are thought to reflect the nature of whole body irradiation. But, some findings remain inconsistent, possibly because of possible misclassification in death certificate diagnoses in the Life Span Study as well as selected information from the Adult Health Study which was limited to participants, focused on specific outcomes, and gathered in selected periods of follow-up. Therefore, a comprehensive and balanced interpretation of the results from both groups is necessary.

Assessment of American Heart Association's Ideal Cardiovascular Health Metrics Among Employees of a Large Healthcare Organization: The Baptist Health South Florida Employee Study.

PubMed

Ogunmoroti, Oluseye; Younus, Adnan; Rouseff, Maribeth; Spatz, Erica S; Das, Sankalp; Parris, Don; Aneni, Ehimen; Holzwarth, Leah; Guzman, Henry; Tran, Thinh; Roberson, Lara; Ali, Shozab S; Agatston, Arthur; Maziak, Wasim; Feldman, Theodore; Veledar, Emir; Nasir, Khurram

2015-07-01

Healthcare organizations and their employees are critical role models for healthy living in their communities. The American Heart Association (AHA) 2020 impact goal provides a national framework that can be used to track the success of employee wellness programs with a focus on improving cardiovascular (CV) health. This study aimed to assess the CV health of the employees of Baptist Health South Florida (BHSF), a large nonprofit healthcare organization. HRAs and wellness examinations can be used to measure the cardiovascular health status of an employee population. The AHA's 7 CV health metrics (diet, physical activity, smoking, body mass index, blood pressure, total cholesterol, and blood glucose) categorized as ideal, intermediate, or poor were estimated among employees of BHSF participating voluntarily in an annual health risk assessment (HRA) and wellness fair. Age and gender differences were analyzed using χ(2) test. The sample consisted of 9364 employees who participated in the 2014 annual HRA and wellness fair (mean age [standard deviation], 43 [12] years, 74% women). Sixty (1%) individuals met the AHA's definition of ideal CV health. Women were more likely than men to meet the ideal criteria for more than 5 CV health metrics. The proportion of participants meeting the ideal criteria for more than 5 CV health metrics decreased with age. A combination of HRAs and wellness examinations can provide useful insights into the cardiovascular health status of an employee population. Future tracking of the CV health metrics will provide critical feedback on the impact of system wide wellness efforts as well as identifying proactive programs to assist in making substantial progress toward the AHA 2020 Impact Goal. © 2015 Wiley Periodicals, Inc.

Racism and cardiovascular disease: implications for nursing.

PubMed

Jackson, Jennifer; McGibbon, Elizabeth; Waldron, Ingrid

2013-01-01

The social determinants of health (SDH) are recognized as a prominent influence on health outcomes across the lifespan. Racism is identified as a key SDH. In this article, the authors describe the concept of racism as an SDH, its impact in discriminatory actions and inactions, and the implications for cardiovascular nurses. Although research in Canada on the links among racism, stress, and cardiovascular disease is limited, there is growing evidence about the stress of racism and its long-term impact on cardiovascular health. The authors discuss how cardiovascular nursing could be enhanced through an understanding of racism-related stress, and race-based differences in cardiovascular care. The authors conclude with strategies for action to address this nursing concern.

Screening for Cardiovascular Risk in Asymptomatic Users of the Primary Health Care Network in Lebanon, 2012–2013

PubMed Central

Adib, Salim M.; Hamadeh, Randa; Freidi, Alia; Ammar, Walid

2014-01-01

Introduction In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascular screening in the publicly subsidized Primary Health Care (PHC) Network. We present an epidemiological analysis of data produced during this pilot to justify the inclusion of this service in the package of essential services offered through PHC and to present a preliminary cardiovascular risk profile in an asymptomatic population. Methods A total of 4,205 participants (two-thirds of which were women) aged at least 40 years and reportedly free from diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD) were screened. The screening protocol used a questionnaire and direct measurements to assess 5 modifiable cardiovascular risk factors; total cardiovascular risk score was calculated according to a paper-based algorithm developed by the World Health Organization and the International Society of Hypertension. Results Approximately 25% of the sample displayed metabolic impairments (11% for impaired blood glucose metabolism and 17% for impaired systolic blood pressure), and 6.6% were classified at total cardiovascular risk of 10% or more. Just over one-quarter of the sample was obese, almost half had a substantially elevated waist circumference, and 41% were smokers. Men were significantly more likely to screen positive for metabolic impairment than women, and women were more likely to be obese. Conclusion The implementation of a multifactorial screening for CVD among asymptomatic subjects detected a substantial proportion of previously undiagnosed cases of high metabolic risk, people who could now be referred to optimal medical follow-up. PMID:25032835

Environmental Exposures and Cardiovascular Disease: A Challenge for Health and Development in Low- and Middle-Income Countries.

PubMed

Burroughs Peña, Melissa S; Rollins, Allman

2017-02-01

Environmental exposures in low- and middle-income countries lie at the intersection of increased economic development and the rising public health burden of cardiovascular disease. Increasing evidence suggests an association of exposure to ambient air pollution, household air pollution from biomass fuel, lead, arsenic, and cadmium with multiple cardiovascular disease outcomes, including hypertension, coronary heart disease, stroke, and cardiovascular mortality. Although populations in low- and middle-income countries are disproportionately exposed to environmental pollution, evidence linking these exposures to cardiovascular disease is derived from populations in high-income countries. More research is needed to further characterize the extent of environmental exposures. Copyright © 2016 Elsevier Inc. All rights reserved.

Predicting dementia in primary care patients with a cardiovascular health metric: a prospective population-based study.

PubMed

Hessler, Johannes Baltasar; Ander, Karl-Heinz; Brönner, Monika; Etgen, Thorleif; Förstl, Hans; Poppert, Holger; Sander, Dirk; Bickel, Horst

2016-07-26

Improving cardiovascular health possibly decreases the risk of dementia. Primary care practices offer a suitable setting for monitoring and controlling cardiovascular risk factors in the older population. The purpose of the study is to examine the association of a cardiovascular health metric including six behaviors and blood parameters with the risk of dementia in primary care patients. Participants (N = 3547) were insurants aged ≥55 of the largest German statutory health insurance company, who were enrolled in a six-year prospective population-based study. Smoking, physical activity, body mass index, blood pressure, total cholesterol, and fasting glucose were assessed by general practitioners at routine examinations. Using recommended cut-offs for each factor, the patients' cardiovascular health was classified as ideal, moderate, or poor. Behaviors and blood parameters sub-scores, as well as a total score, were calculated. Dementia diagnoses were retrieved from health insurance claims data. Results are presented as hazard ratios (HRs) and 95% confidence intervals (95% CIs). Over the course of the study 296 new cases of dementia occurred. Adjusted for age, sex, and education, current smoking (HR = 1.77, 95% CI 1.09-2.85), moderate (1.38, 1.05-1.81) or poor (1.81, 1.32-2.47) levels of physical activity, and poor fasting glucose levels (1.43, 1.02-2.02) were associated with an increased risk of dementia. Body mass index, blood pressure, and cholesterol were not associated with dementia. Separate summary scores for behaviors and blood values, as well as a total score showed no association with dementia. Sensitivity analyses with differently defined endpoints led to similar results. Due to complex relationships of body-mass index and blood pressure with dementia individual components cancelled each other out and rendered the sum-scores meaningless for the prediction of dementia.

The Relationship of Midlife Cardiovascular Health with Late Life Physical Performance: the ARIC Study

PubMed Central

Lirette, Seth T.; Lutsey, Pamela L.; Pompeii, Lisa A.; Gabriel, Kelley Pettee; Koton, Silvia; Steffen, Lyn M.; Griswold, Michael E.; Mosley, Thomas H.

2016-01-01

Objective To examine the association between midlife cardiovascular health and physical performance 25 years later. Design Cohort study measured cardiovascular health in mid-life and physical function 25 years later. Multinomial logistic and logistic regression were used, adjusted for demographics and clinical measures. Setting Four US communities: Forsyth County, NC; Washington County, MD; Minneapolis, MN; and Jackson, MS Participants Atherosclerosis Risk in Communities (ARIC) Study Measurements Cardiovascular health was measured using Life's Simple 7 (LS7) scores (0-14) and LS7 component categories (poor, intermediate, ideal) for each risk factor defined by the American Heart Association. The Short Physical Performance Battery (SPPB) quantified physical function as an ordinal (0-12) and categorical outcome: low (0-6), fair (7-9), good (10-12). Results Among 15,744 participants at baseline (mean age=54.2±5.8 years, 55% female, 27% black) the mean LS7 Score was 7.9±2.4, and 6,144 (39%) returned 25 years later for the fifth exam when the SPPB was administered. Good SPPB was observed in 3,288 of 5,916 who completed the SPPB (50%). Each 1-unit increase in LS7 score was associated with a 17% higher SPPB (1.17 95% confidence interval [CI]: 1.15-1.19) and a 29% greater chance of having good SPPB versus SPPB <10 in late life (RR=1.29, 95% CI: 1.25, 1.34). Ideal glucose (RR=2.53, 95% CI 2.24, 2.87), smoking (RR=1.97, 95% CI 1.81, 2.15), blood pressure (RR=1.70, 95% CI 1.54, 1.88), body mass index (RR=1.51, 95% CI 1.37, 1.66), and physical activity (RR=1.31, 95% CI 1.20, 1.43) showed the strongest associations, adjusting for other LS7 components. Conclusions Better cardiovascular health during mid-life may lead to improvements in physical functioning at older ages. PMID:28165626

[Sexual life in elderly patients with cardiovascular disease].

PubMed

Karpuz, Hakan

2017-09-01

Sexual activity is an important component of patient and partner quality of life for men and women with cardiovascular disease, including many elderly patients. Older adults desire sexual intimacy when there is a partner and a health status that allows sexual relationships. Older individuals desire to love and enjoy sexual activity in relation to personal circumstances, and when health status allows them to experience close relations, most often within marriage especially in our country. Normal changes occur in the phases of sexual cycle with aging, male erectile dysfunction and female sexual dysfunction increase with age. Elderly patients are often affected by multiple organic diseases which can interfere with sexual function especially cardiovascular disease. Treating those disorders or modifying lifestyle-related risk factors may help prevent sexual dysfunction in the elderly. Sexuality is important for older adults and physicians should give their patient's opportunity to voice their concerns with sexual function and offer them alternatives for evaluation and treatment. Asking about sexual health remains difficult or embarrassing for many physicians; in addition, many patients find it difficult to raise sexual issues with their doctor.

Alcohol Consumption, Diabetes Risk, and Cardiovascular Disease Within Diabetes.

PubMed

Polsky, Sarit; Akturk, Halis K

2017-11-04

The purpose of the study is to examine and summarize studies reporting on the epidemiology, the risk of developing diabetes, and the cardiovascular effects on individuals with diabetes of different levels of alcohol consumption. Men consume more alcohol than women in populations with and without diabetes. Light-to-moderate alcohol consumption decreases the incidence of diabetes in the majority of the studies, whereas heavy drinkers and binge drinkers are at increased risk for diabetes. Among people with diabetes, light-to-moderate alcohol consumption reduces risks of cardiovascular diseases and all-cause mortality. Alcohol consumption is less common among populations with diabetes compared to the general population. Moderate alcohol consumption reduces the risk of diabetes and, as in the general population, improves cardiovascular health in patients with diabetes. Type of alcoholic beverage, gender, and body mass index are factors that affect these outcomes.

Sleep restriction undermines cardiovascular adaptation during stress, contingent on emotional stability.

PubMed

Lü, Wei; Hughes, Brian M; Howard, Siobhán; James, Jack E

2018-02-01

Sleep loss is associated with increased cardiovascular disease, but physiological mechanisms accounting for this relationship are largely unknown. One possible mechanism is that sleep restriction exerts effects on cardiovascular stress responses, and that these effects vary between individuals. Emotional stability (ES) is a personality trait pertinent to sleep restriction and stress responding. However, no study to date has explored how ES and sleep-restriction interactively affect cardiovascular stress responses or processes of adaptation during stress. The present study sought to investigate the association between ES and impact of sleep restriction on cardiovascular function during stress, with particular regard to the trajectory of cardiovascular function change across time. Ninety female university students completed a laboratory vigilance stress task while undergoing continuous cardiovascular (SBP, DBP, HR, SV, CO, TPR) monitoring, after either a night of partial sleep restriction (40% of habitual sleep duration) or a full night's rest. Individuals high in ES showed stable and adaptive cardiovascular (SBP, SV, CO) responses throughout stress exposure, regardless of sleep. In contrast, individuals low in ES exhibited cardiovascular adaptation during stress exposure while rested, but disrupted adaption while sleep-restricted. These findings suggest that sleep-restriction undermines healthful cardiovascular adaptation to stress for individuals low in ES. Copyright © 2017 Elsevier B.V. All rights reserved.

Exploring cardiovascular health: the Healthy Life in Suriname (HELISUR) study. A protocol of a cross-sectional study.

PubMed

Diemer, Frederieke S; Aartman, Jet Q; Karamat, Fares A; Baldew, Sergio M; Jarbandhan, Ameerani V; van Montfrans, Gert A; Oehlers, Glenn P; Brewster, Lizzy M

2014-12-23

Obesity, hypertension and diabetes are on a dramatic rise in low-income and middle-income countries, and this foretells an overwhelming increase in chronic disease burden from cardiovascular disease. Therefore, rapid action should be taken through preventive population-based programmes. However, in these regions, data on the population distribution of cardiovascular risk factors, and of intermediate and final end points for cardiovascular disease are scarce. The Healthy Life in Suriname (HELISUR) study is a cardiovascular population study in Suriname, which is part of the Caribbean Community. The HELISUR study is dedicated to provide data on risk factors and prevalent cardiovascular disease in the multiethnic population, which is mainly of African and Asian descent. In a cross-sectional, observational population-based setting, a random representative sample of 1800 citizens aged between 18 and 70 years will be selected using a cluster household sampling method. Self-reported demographic, socioeconomic and (cardiovascular) health-related data will be collected. Physical examination will include the assessment of cardiovascular risk factors and prevalent cardiovascular disease. In addition, we will study cardiovascular haemodynamics non-invasively, as a novel intermediate outcome. Finally, fasting blood and overnight urine samples will be collected to monitor cardiometabolic risk factors. The main outcome will be descriptive in reporting the prevalence of risk factors and measures of (sub) clinical end organ damage, stratified for ethnicity and sex-age groups. Ethical approval has been obtained from the State Secretary of Health. Data analysis and manuscript submission are scheduled for 2016. Findings will be disseminated in peer-reviewed journals, and at national, regional and international scientific meetings. Importantly, data will be presented to Surinamese policymakers and healthcare workers, to develop preventive strategies to combat the rapid rise of

Ethnic Pride and Cardiovascular Health among Mexican American Adults along the U.S.-Mexico Border

ERIC Educational Resources Information Center

de Heer, Hendrik Dirk; Balcazar, Hector G; Lee Rosenthal, E.; Cardenas, Victor M; Schulz, Leslie O.

2011-01-01

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…

Does Commuting Affect Health?

PubMed

Künn-Nelen, Annemarie

2016-08-01

This paper analyzes the relation between commuting time and health in the UK. I focus on four different types of health outcomes: subjective health measures, objective health measures, health behavior, and healthcare utilization. Fixed effect models are estimated with British Household Panel Survey data. I find that whereas objective health and health behavior are barely affected by commuting time, subjective health measures are clearly lower for people who commute longer. A longer commuting time is, moreover, related to more visits to the general practitioner. Effects turn out to be more pronounced for women and for commuters driving a car. For women, commuting time is also negatively related to regular exercise and positively to calling in sick. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Characteristics of Smokers from a National Sample Who Engaged in Any Physical Activity: Implications for Cardiovascular Health Intervention

ERIC Educational Resources Information Center

Patterson, Freda; Lenhart, Clare M.

2016-01-01

Background: Tobacco is a major cause of cardiovascular disease, and current treatments lack long-term efficacy. Promoting physical activity may be a viable population-level approach to improving cardiovascular health among smokers. Purpose: To characterize smokers engaging in any physical activity based on demographics, quitting behaviors, health…

Dairy and cardiovascular health: Friend or foe?

PubMed Central

Markey, O; Vasilopoulou, D; Givens, D I; Lovegrove, J A

2014-01-01

Cardiovascular disease (CVD) prevalence at a global level is predicted to increase substantially over the next decade due to the increasing ageing population and incidence of obesity. Hence, there is an urgent requirement to focus on modifiable contributors to CVD risk, including a high dietary intake of saturated fatty acids (SFA). As an important source of SFA in the UK diet, milk and dairy products are often targeted for SFA reduction. The current paper acknowledges that milk is a complex food and that simply focusing on the link between SFA and CVD risk overlooks the other beneficial nutrients of dairy foods. The body of existing prospective evidence exploring the impact of milk and dairy consumption on risk factors for CVD is reviewed. The current paper highlights that high milk consumption may be beneficial to cardiovascular health, while illustrating that the evidence is less clear for cheese and butter intake. The option of manipulating the fatty acid profile of ruminant milk is discussed as a potential dietary strategy for lowering SFA intake at a population level. The review highlights that there is a necessity to perform more well-controlled human intervention-based research that provides a more holistic evaluation of fat-reduced and fat-modified dairy consumption on CVD risk factors including vascular function, arterial stiffness, postprandial lipaemia and markers of inflammation. Additionally, further research is required to investigate the impact of different dairy products and the effect of the specific food matrix on CVD development. PMID:25400508

Type D personality and health status in cardiovascular disease populations: a meta-analysis of prospective studies.

PubMed

Versteeg, Henneke; Spek, Viola; Pedersen, Susanne S; Denollet, Johan

2012-12-01

Knowledge of the factors associated with individual differences in patient-reported outcomes is essential to identify high-risk patients and improve secondary prevention. In this meta-analysis, we examined the association between Type D personality and the individual differences in patient-reported physical and mental health status among cardiovascular patients. 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. 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 status (Q = 12.78; p = 0.17; I(2 )= 29.59), but there was between those on mental health status (Q = 21.91; p = 0.003; I(2 )= 68.04). Subgroup analyses showed that the association between Type D and mental health status decreased yet remained significant when adjusting for baseline health status. Type D personality was shown to be an independent correlate of impaired patient-reported physical and mental health status in various cardiovascular patient groups. Clinicians should be aware of the association between chronic psychological distress and poor patient-reported outcomes.

An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy.

PubMed

Karwalajtys, Tina; Kaczorowski, Janusz

2010-01-01

Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.

Role of androgen excess on metabolic aberrations and cardiovascular risk in women with polycystic ovary syndrome.

PubMed

Christakou, Charikleia D; Diamanti-Kandarakis, Evanthia

2008-11-01

Polycystic ovary syndrome (PCOS) is associated with a clustering of metabolic and cardiovascular risk factors. Insulin resistance is implicated as the major player in the metabolic abnormalities and contributes to the increased cardiovascular risk associated with the syndrome. However, androgen excess appears to participate as an independent parameter, which further aggravates the cardiovascular and metabolic aberrations in affected women with PCOS. The resultant impact of hyperandrogenemia possibly acquires clinical significance for women's health in the context of PCOS, particularly since recent data support an increased incidence of coronary artery disease and of cardiovascular events directly related to androgen levels in women with the syndrome.

Remote health monitoring: predicting outcome success based on contextual features for cardiovascular disease.

PubMed

Alshurafa, Nabil; Eastwood, Jo-Ann; Pourhomayoun, Mohammad; Liu, Jason J; Sarrafzadeh, Majid

2014-01-01

Current studies have produced a plethora of remote health monitoring (RHM) systems designed to enhance the care of patients with chronic diseases. Many RHM systems are designed to improve patient risk factors for cardiovascular disease, including physiological parameters such as body mass index (BMI) and waist circumference, and lipid profiles such as low density lipoprotein (LDL) and high density lipoprotein (HDL). There are several patient characteristics that could be determining factors for a patient's RHM outcome success, but these characteristics have been largely unidentified. In this paper, we analyze results from an RHM system deployed in a six month Women's Heart Health study of 90 patients, and apply advanced feature selection and machine learning algorithms to identify patients' key baseline contextual features and build effective prediction models that help determine RHM outcome success. We introduce Wanda-CVD, a smartphone-based RHM system designed to help participants with cardiovascular disease risk factors by motivating participants through wireless coaching using feedback and prompts as social support. We analyze key contextual features that secure positive patient outcomes in both physiological parameters and lipid profiles. Results from the Women's Heart Health study show that health threat of heart disease, quality of life, family history, stress factors, social support, and anxiety at baseline all help predict patient RHM outcome success.

Do primary health care nurses address cardiovascular risk in diabetes patients?

PubMed

Daly, Barbara; Kenealy, Timothy; Arroll, Bruce; Sheridan, Nicolette; Scragg, Robert

2014-11-01

To identify factors associated with assessment and nursing management of blood pressure, smoking and other major cardiovascular risk factors by primary health care nurses in Auckland, New Zealand. Primary health care nurses (n = 287) were randomly sampled from the total (n=1091) identified throughout the Auckland region and completed a self-administered questionnaire (n = 284) and telephone interview. Nurses provided details for 86% (n =265) of all diabetes patients they consulted on a randomly selected day. The response rate for nurses was 86%. Of the patients sampled, 183 (69%) patients had their blood pressure measured, particularly if consulted by specialist (83%) and practice (77%) nurses compared with district (23%, p = 0.0003). After controlling for demographic variables, multivariate analyses showed patients consulted by nurses who had identified stroke as a major diabetes-related complication were more likely to have their blood pressure measured, and those consulted by district nurses less likely. Sixteen percent of patients were current smokers. Patients consulted by district nurses were more likely to smoke while, those >66 years less likely. Of those who wished to stop, only 50% were offered nicotine replacement therapy. Patients were significantly more likely to be advised on diet and physical activity if they had their blood pressure measured (p < 0.0001). Measurement of blood pressure and advice on diet or physical activity were not related to patient's cardiovascular risk profile and management of smoking cessation was far from ideal. Education of the community-based nursing workforce is essential to ensure cardiovascular risk management becomes integrated into diabetes management. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Valuing Quiet: An Economic Assessment of U.S. Environmental Noise as a Cardiovascular Health Hazard.

PubMed

Swinburn, Tracy K; Hammer, Monica S; Neitzel, Richard L

2015-09-01

Environmental noise pollution increases the risk for hearing loss, stress, sleep disruption, annoyance, and cardiovascular disease and has other adverse health impacts. Recent (2013) estimates suggest that more than 100 million Americans are exposed to unhealthy levels of noise. Given the pervasive nature and significant health effects of environmental noise pollution, the corresponding economic impacts may be substantial. This 2014 economic assessment developed a new approach to estimate the impact of environmental noise on the prevalence and cost of key components of hypertension and cardiovascular disease in the U.S. By placing environmental noise in context with comparable environmental pollutants, this approach can inform public health law, planning, and policy. The effects of hypothetical national-scale changes in environmental noise levels on the prevalence and corresponding costs of hypertension and coronary heart disease were estimated, with the caveat that the national-level U.S. noise data our exposure estimates were derived from are >30 years old. The analyses suggested that a 5-dB noise reduction scenario would reduce the prevalence of hypertension by 1.4% and coronary heart disease by 1.8%. The annual economic benefit was estimated at $3.9 billion. These findings suggest significant economic impacts from environmental noise-related cardiovascular disease. Given these initial findings, noise may deserve increased priority and research as an environmental health hazard. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Quantifying Socioeconomic and Lifestyle Related Health Risks: Burden of Cardiovascular Disease Among Indian Males

PubMed Central

Purohit, Neetu; Bhati, Divya K.; Gupta, Shiv D.; Kundu, Azad S.

2015-01-01

Background: Non-communicable diseases account for a significant disease burden in the South East Asia region. India is facing an increased incidence of lifestyle-related diseases, such as cardiovascular disease. Socioeconomic and lifestyle risk factors for cardiovascular disease (CVD) have been under investigated in India. This study was designed to explore risk factors contributing to the development of cardiovascular disease among Indian males. Methods: A population-based cross-sectional study was conducted among 2,235 males in the age group of 18–60 years across three states of India. A household survey was used to collect demographic and socioeconomic status information in addition to lifestyle-related attributes such as smoking, alcohol consumption, diet, and physical activity. Descriptive statistics and logistic regression were performed to identify the role of various factors that may be associated with the development of cardiovascular disease in this population. Results: The prevalence of cardiovascular disease among the male respondents contacted through a household survey was reported to be 9.8%. Logistic regression revealed that males with higher education and higher income were more likely to report CVD. With age as a strong predictor of CVD, the risk of CVD was found to be five times higher in the older age group. Current smokers were 1.3 times more likely to have CVD compared to those who never smoked. Those who were engaged in physical activity were less likely to have CVD; however, the adverse effects of smoking and excessive consumption of red meat showed a stronger association with CVD than the protective effects of physical activity. Conclusion: In developing countries, where the increase in earning capacity and change in lifestyle has been found to be accompanied by substantial risk of heart disease for males, public health measures like health promotion programs need to be implemented to decrease CVD burden. PMID:29138722

[Life style advice provided by primary health care to prevent cardiovascular diseases].

PubMed

Meland, E; Ellekjaer, H; Gjelsvik, B; Kimsås, A; Holmen, J; Hetlevik, I

2000-09-20

The Working Group on Hypertension of the Norwegian College of General Practitioners reports in this paper on the documentation on behavioural advice in the prevention of cardiovascular disease. Emphasis is given to hypertension. The recommendations are mainly based on updated metaanalyses and randomised controlled trials. Hypertension is treated to prevent cardiovascular disease; that is why we put emphasis on documentation with significant end points. The validity of the documentation for general practice is assessed. We have also assessed whether certain methods or theories for behavioural change could be helpful to the general practitioner. The value of advice against smoking, dietary advice (increased intake of grain products, vegetables, fruit, poultry and fish), and advice about exercise are well documented and applicable in general practice. Respect for the patient's autonomy and interest in the patients and their health-related habits seem to be important factors for improving doctor's chances of influencing patient behaviour. The value of life-style advice is well documented and should play an important role in clinical strategies to prevent cardiovascular disease in high-risk patients.

Plant protein and animal proteins: do they differentially affect cardiovascular disease risk?

PubMed

Richter, Chesney K; Skulas-Ray, Ann C; Champagne, Catherine M; Kris-Etherton, Penny M

2015-11-01

Proteins from plant-based compared with animal-based food sources may have different effects on cardiovascular disease (CVD) risk factors. Numerous epidemiologic and intervention studies have evaluated their respective health benefits; however, it is difficult to isolate the role of plant or animal protein on CVD risk. This review evaluates the current evidence from observational and intervention studies, focusing on the specific protein-providing foods and populations studied. Dietary protein is derived from many food sources, and each provides a different composite of nonprotein compounds that can also affect CVD risk factors. Increasing the consumption of protein-rich foods also typically results in lower intakes of other nutrients, which may simultaneously influence outcomes. Given these complexities, blanket statements about plant or animal protein may be too general, and greater consideration of the specific protein food sources and the background diet is required. The potential mechanisms responsible for any specific effects of plant and animal protein are similarly multifaceted and include the amino acid content of particular foods, contributions from other nonprotein compounds provided concomitantly by the whole food, and interactions with the gut microbiome. Evidence to date is inconclusive, and additional studies are needed to further advance our understanding of the complexity of plant protein vs. animal protein comparisons. Nonetheless, current evidence supports the idea that CVD risk can be reduced by a dietary pattern that provides more plant sources of protein compared with the typical American diet and also includes animal-based protein foods that are unprocessed and low in saturated fat. © 2015 American Society for Nutrition.

The influence of the human microbiome and probiotics on cardiovascular health

PubMed Central

Ettinger, Grace; MacDonald, Kyle; Reid, Gregor; Burton, Jeremy P

2014-01-01

Cardiovascular disease (CVD) is a major cause of death worldwide. Of the many etiological factors, microorganisms constitute one. From the local impact of the gut microbiota on energy metabolism and obesity, to the distal association of periodontal disease with coronary heart disease, microbes have a significant impact on cardiovascular health. In terms of the ability to modulate or influence the microbes, probiotic applications have been considered. These are live microorganisms which when administered in adequate amounts confer a benefit on the host. While a number of reports have established the beneficial abilities of certain probiotic bacterial strains to reduce cholesterol and hypertension, recent research suggests that their use could be more widely applied. This review presents an up-to-date summary of the known associations of the microbiome with CVD, and potential applications of probiotic therapy. PMID:25529048

The influence of the human microbiome and probiotics on cardiovascular health.

PubMed

Ettinger, Grace; MacDonald, Kyle; Reid, Gregor; Burton, Jeremy P

2014-01-01

Cardiovascular disease (CVD) is a major cause of death worldwide. Of the many etiological factors, microorganisms constitute one. From the local impact of the gut microbiota on energy metabolism and obesity, to the distal association of periodontal disease with coronary heart disease, microbes have a significant impact on cardiovascular health. In terms of the ability to modulate or influence the microbes, probiotic applications have been considered. These are live microorganisms which when administered in adequate amounts confer a benefit on the host. While a number of reports have established the beneficial abilities of certain probiotic bacterial strains to reduce cholesterol and hypertension, recent research suggests that their use could be more widely applied. This review presents an up-to-date summary of the known associations of the microbiome with CVD, and potential applications of probiotic therapy.

Use of Low-dose Aspirin as Secondary Prevention of Atherosclerotic Cardiovascular Disease Among US Adults (From the National Health Interview Survey, 2012)

PubMed Central

Fang, Jing; George, Mary G.; Gindi, Renee M.; Hong, Yuling; Yang, Quanhe; Ayala, Carma; Ward, Brian W.; Loustalot, Fleetwood

2015-01-01

Current guidelines recommend that adults with atherosclerotic cardiovascular disease take low-dose aspirin or other antiplatelet medications as secondary prevention of recurrent cardiovascular events. Yet, no national level assessment of low-dose aspirin use for secondary prevention of cardiovascular disease has been reported among a community-based population. Using data from the 2012 National Health Interview Survey, we assessed low-dose aspirin use among those with atherosclerotic cardiovascular disease. We estimated the prevalence ratios of low-dose aspirin use, adjusting for sociodemographic status, health insurance, and cardiovascular risk factors. Among those with atherosclerotic cardiovascular disease (n=3,068), 76% had been instructed to take aspirin, and 88% of those were following this advice. Of those not advised, 11% took aspirin on this own. Overall, 70% were taking aspirin (including those who followed their health care provider's advice and those who were not advised but took aspirin on their own). Logistic regression models showed that women, non-Hispanic blacks and Hispanics, those aged 40–64 years, with a high school education or with some college, or with fewer cardiovascular disease risk factors were less likely to take aspirin than men, non-Hispanic whites, those aged ≥65 years, with a college education or higher, or with all four selected cardiovascular disease risk factors, respectively. Additional analyses conducted among those with coronary heart disease only (n=2,007) showed similar patterns. In conclusion, use of low-dose aspirin for secondary prevention was 70%, with high reported adherence to health care providers' advice to take low-dose aspirin (88%), and significant variability within subgroups. PMID:25670639

Creating a Transdisciplinary Research Center to Reduce Cardiovascular Health Disparities in Baltimore, Maryland: Lessons Learned

PubMed Central

Boulware, L. Ebony; Miller, Edgar R.; Golden, Sherita Hill; Carson, Kathryn A.; Noronha, Gary; Huizinga, Mary Margaret; Roter, Debra L.; Yeh, Hsin-Chieh; Bone, Lee R.; Levine, David M.; Hill-Briggs, Felicia; Charleston, Jeanne; Kim, Miyong; Wang, Nae-Yuh; Aboumatar, Hanan; Halbert, Jennifer P.; Ephraim, Patti L.; Brancati, Frederick L.

2013-01-01

Cardiovascular disease (CVD) disparities continue to have a negative impact on African Americans in the United States, largely because of uncontrolled hypertension. Despite the availability of evidence-based interventions, their use has not been translated into clinical and public health practice. The Johns Hopkins Center to Eliminate Cardiovascular Health Disparities is a new transdisciplinary research program with a stated goal to lower the impact of CVD disparities on vulnerable populations in Baltimore, Maryland. By targeting multiple levels of influence on the core problem of disparities in Baltimore, the center leverages academic, community, and national partnerships and a novel structure to support 3 research studies and to train the next generation of CVD researchers. We also share the early lessons learned in the center’s design. PMID:24028238

Long-term indoor air conditioner filtration and cardiovascular health: A randomized crossover intervention study.

PubMed

Chuang, Hsiao-Chi; Ho, Kin-Fai; Lin, Lian-Yu; Chang, Ta-Yuan; Hong, Gui-Bing; Ma, Chi-Ming; Liu, I-Jung; Chuang, Kai-Jen

2017-09-01

The association of short-term air pollution filtration with cardiovascular health has been documented. However, the effect of long-term indoor air conditioner filtration on the association between air pollution and cardiovascular health is still unclear. We recruited 200 homemakers from Taipei and randomly assigned 100 of them to air filtration or control intervention; six home visits were conducted per year from 2013 to 2014. The participants under air filtration intervention during 2013 were reassigned to control intervention in 2014. The air pollution measurements consisted of particulate matter less than or equal to 2.5μm in diameter (PM 2.5 ) and total volatile organic compounds (VOCs); blood pressure was monitored for each participant during each visit. The following morning, blood samples were collected after air pollution monitoring. The blood samples were used to analyze biological markers, including high sensitivity-C-reactive protein (hs-CRP), 8-hydroxy-2'-deoxyguanosine (8-OHdG) and fibrinogen. Household information, including cleaning, cooking, and air conditioning, was collected by a questionnaire. Mixed-effects models were used to investigate the associations among air pollution measurements, blood pressure and biological markers. The results showed that increased levels of PM 2.5 and total VOCs were associated with increased hs-CRP, 8-OHdG and blood pressure. The health variables were higher among participants in the control intervention phase than among those in the air filtration intervention phase. We concluded that air pollution exposure was associated with systemic inflammation, oxidative stress and elevated blood pressure. The long-term filtration of air pollution with an air conditioner filter was associated with cardiovascular health of adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cardiovascular Risk among Older Women in a Havana Health Area.

PubMed

Armas, Nurys Bárbara; Hernández, Yesenia de la Caridad; Dueñas, Alfredo F; García, Reynaldo de la Noval; Castillo, Antonio

2008-04-01

Introduction Cardiovascular morbidity and mortality increase in women after menopause. Various scoring models assess qualitative risk of cardiovascular disease. The Framingham Heart Study global risk score is among the most widely used. Objective Determine level of coronary heart disease risk among women aged ≥60 years in a Havana health catchment area (geographic area whose residents are served by the M�rtires del Corynthia Polyclinic, in the Plaza de la Revoluci�n municipality of Havana). Methods A descriptive, cross-sectional study was conducted in 2006. Universe: all women (3,396) aged ≥60 years in the catchment area, attended at the primary care level by the Polyclinic and 42 neighborhood family doctor-and-nurse offices. Equal probability sample: 1,082 women meeting the inclusion criteria, chosen through single-stage cluster sampling considering a <10% error margin for estimates for this parameter, a 95% confidence interval (CI) and a design effect of 1.5. Absolute frequencies and percentages were calculated to summarize the qualitative data obtained. Results were presented as tables. Results The most common cardiovascular risk factors found in this study were: physical inactivity, 74.9%; hypertension (HTN), 70.6%; abdominal obesity, 53%; reported family history of coronary heart disease (CHD), 41.8%; diabetes mellitus (DM), 21.8%; and cigarette smoking, 17.2%. Scoring according to number of risk factors present in each individual, 79.3% of these women fell into the high- or moderate-risk categories. Conclusion The large number of women categorized as high- or moderate-risk for coronary heart disease in this population emphasizes the need for preventive actions aimed at reducing these figures. Cardiovascular diseases, vascular diseases, ischemic heart disease, coronary heart disease, postmenopause, woman, aged, risk factors, risk assessment, hypertension, high blood pressure, lifestyle, diabetes mellitus, obesity, abdominal adipose tissue, body mass

The Heart's Content : The Association between Positive Psychological Well-Being and Cardiovascular Health

ERIC Educational Resources Information Center

Boehm, Julia K.; Kubzansky, Laura D.

2012-01-01

This review investigates the association between positive psychological well-being (PPWB) and cardiovascular disease (CVD). We also consider the mechanisms by which PPWB may be linked with CVD, focusing on the health behaviors (e.g., smoking, alcohol consumption, physical activity, sleep quality and quantity, and food consumption) and biological…

Cardiovascular Disease Prevention and Health Promotion with the Transcendental Meditation Program and Maharishi Consciousness-Based Health Care

PubMed Central

Schneider, Robert H.; Walton, Kenneth G.; Salerno, John W.; Nidich, Sanford I.

2008-01-01

This article summarizes the background, rationale, and clinical research on a traditional system of natural health care that may be useful in the prevention of cardiovascular disease (CVD) and promotion of health. Results recently reported indude reductions in blood pressure, psychosocial stress, surrogate markers for atherosclerotic CVD, and mortality. The randomized clinical trials conducted so far have involved applications to both primary and secondary prevention as well as to health promotion more generally. The results support the applicability of this approach for reducing ethnic health disparities associated with environmental and psychosocial stress. Proposed mechanisms for the effects of this traditional system include enhanced resistance to physiological and psychological stress and improvements in homeostatic and self-repair processes. This system may offer clinical and cost effectiveness advantages for health care, particularly in preventive cardiology. PMID:16938913

Cardiovascular disease prevention and health promotion with the transcendental meditation program and Maharishi consciousness-based health care.

PubMed

Schneider, Robert H; Walton, Kenneth G; Salerno, John W; Nidich, Sanford I

2006-01-01

This article summarizes the background, rationale, and clinical research on a traditional system of natural health care that may be useful in the prevention of cardiovascular disease (CVD) and promotion of health. Results recently reported include reductions in blood pressure, psychosocial stress, surrogate markers for atherosclerotic CVD, and mortality. The randomized clinical trials conducted so far have involved applications to both primary and secondary prevention as well as to health promotion more generally. The results support the applicability of this approach for reducing ethnic health disparities associated with environmental and psychosocial stress. Proposed mechanisms for the effects of this traditional system include enhanced resistance to physiological and psychological stress and improvements in homeostatic and self-repair processes. This system may offer clinical and cost effectiveness advantages for health care, particularly in preventive cardiology.

Persistent subclinical hypothyroidism and cardiovascular risk in the elderly: the cardiovascular health study.

PubMed

Hyland, Kristen A; Arnold, Alice M; Lee, Jennifer S; Cappola, Anne R

2013-02-01

Use of a single set of thyroid function tests to define subclinical hypothyroidism may lead to misclassification over time and could influence findings from longitudinal studies. We assessed the risks of coronary heart disease (CHD), heart failure (HF), and cardiovascular (CV) death in older adults with persistent subclinical hypothyroidism. The study included 679 subclinically hypothyroid and 4184 euthyroid U.S. individuals at least 65 yr old enrolled in the Cardiovascular Health Study and not taking thyroid preparations. We measured the 10-yr risk of incident CHD, HF, and CV death from persistent subclinical hypothyroidism, overall and stratified by degree of TSH elevation (4.5-6.9, 7.0-9.9, and 10.0-19.9 mU/liter). There was no association between persistent subclinical hypothyroidism and incident CHD [hazard ratio (HR), 1.12; 95% confidence interval (CI), 0.93-1.36], HF (HR, 1.05; 95% CI, 0.97-1.27), or CV death (HR, 1.07; 95% CI, 0.87-1.31) in adjusted analyses in which subclinical hypothyroidism was modeled as a time-varying exposure using up to four serial thyroid function tests. When subclinical hypothyroidism was stratified by degree of TSH elevation, no significant associations were found in any stratum. Findings were similar in fixed exposure analyses in which only participants with testing 2 yr apart were considered, with no association between persistent or transient subclinical hypothyroidism and incident CHD, HF, or CV death. Our data do not support increased risk of CHD, HF, or CV death in older adults with persistent subclinical hypothyroidism.

A multifaceted strategy using mobile technology to assist rural primary healthcare doctors and frontline health workers in cardiovascular disease risk management: protocol for the SMARTHealth India cluster randomised controlled trial.

PubMed

Praveen, Devarsetty; Patel, Anushka; McMahon, Stephen; Prabhakaran, Dorairaj; Clifford, Gari D; Maulik, Pallab K; Joshi, Rohina; Jan, Stephen; Heritier, Stephane; Peiris, David

2013-11-25

Blood Pressure related disease affected 118 million people in India in the year 2000; this figure will double by 2025. Around one in four adults in rural India have hypertension, and of those, only a minority are accessing appropriate care. Health systems in India face substantial challenges to meet these gaps in care, and innovative solutions are needed. We hypothesise that a multifaceted intervention involving capacity strengthening of primary healthcare doctors and non-physician healthcare workers through use of a mobile device-based clinical decision support system will result in improved blood pressure control for individuals at high risk of a cardiovascular disease event when compared with usual healthcare. This intervention will be implemented as a stepped wedge, cluster randomised controlled trial in 18 primary health centres and 54 villages in rural Andhra Pradesh involving adults aged ≥40 years at high cardiovascular disease event risk (approximately 15,000 people). Cardiovascular disease event risk will be calculated based on World Health Organisation/International Society of Hypertension's region-specific risk charts. Cluster randomisation will occur at the level of the primary health centres. Outcome analyses will be conducted blinded to intervention allocation. The primary study outcome is the difference in the proportion of people meeting guideline-recommended blood pressure targets in the intervention period vs. the control period. Secondary outcomes include mean reduction in blood pressure levels; change in other cardiovascular disease risk factors, including body mass index, current smoking, reported healthy eating habits, and reported physical activity levels; self-reported use of blood pressure and other cardiovascular medicines; quality of life (using the EQ-5D); and cardiovascular disease events (using hospitalisation data). Trial outcomes will be accompanied by detailed process and economic evaluations. The findings are likely to inform

Affect-regulated exercise intensity: does training at an intensity that feels 'good' improve physical health?

PubMed

Parfitt, Gaynor; Alrumh, Amnah; Rowlands, Alex V

2012-11-01

Affect-regulated exercise to feel 'good' can be used to control exercise intensity amongst both active and sedentary individuals and should support exercise adherence. It is not known, however, whether affect-regulated exercise training can lead to physical health gains. The aim of this study was to examine if affect-regulated exercise to feel 'good' leads to improved fitness over the course of an 8-week training programme. A repeated measures design (pretest-posttest) with independent groups (training and control). 20 sedentary females completed a submaximal graded exercise test and were then allocated to either a training group or control group. The training group completed two supervised sessions and one unsupervised session per week for 8 weeks. Exercise intensity was affect-regulated to feel 'good'. Following the 8 weeks of training, both groups completed a second submaximal graded exercise test. Repeated measures analyses of variance indicated a significant increase in the time to reach ventilatory threshold in the training group (318 ± 23.7s) compared to control (248 ± 16.9s). Overall compliance to training was high (>92%). Participants in the training group exercised at intensities that would be classified as being in the lower range of the recommended guidelines (≈ 50% V˙O(2) max) for cardiovascular health. Affect-regulated exercise to feel 'good' can be used in a training programme to regulate exercise intensity. This approach led to a 19% increase in time to reach ventilatory threshold, which is indicative of improved fitness. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Apical Periodontitis - Is It Accountable for Cardiovascular Diseases?

PubMed Central

Chaman, Chandrakar

2016-01-01

The aim of this review was to assess the relationship between apical periodontitis and cardiovascular diseases and the predictive factors regarding this association. Cross sectional and observational studies have been included, which are mostly retrospective. A comprehensive search was performed in the Systematic Electronic Databases, PUBMED and MEDLINE from 1919 till September 2014. Articles were also hand searched. From 86 studies identified, all were read and 58 articles which were relevant were included in the text. Some articles were excluded because they were pertaining to periodontology and other systemic disorders. Some were solely animal studies and were thus excluded. Our results suggest an independent association between cardiovascular diseases and apical periodontitis. A causal relationship could not be established since weak parameters of risk have been assessed in the studies, population taken is difficult to compare and other confounding factors have not been ruled out. Only a more focused and better instituted scientific research can determine this association. Establishing a cause and effect relationship between apical periodontitis and cardiovascular diseases can affect the course of treatment of cardiovascular diseases. It is not only of interest from the scientific point of view but also from public health perspective. PMID:27656588

Playing it safe: exercise and cardiovascular health.

PubMed

Dhutia, Harshil; Sharma, Sanjay

2015-10-01

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.

Women's Initiative for Nonsmoking-VII: evaluation of health service utilization and costs among women smokers with cardiovascular disease.

PubMed

Froelicher, Erika Sivarajan; Sohn, Min; Max, Wendy; Bacchetti, Peter

2004-01-01

The Women's Initiative for Nonsmoking (WINS), a randomized clinical trial of a smoking cessation intervention for women with cardiovascular disease, permitted an assessment of the types and costs of health services women used during the 30 months after their hospitalization with cardiovascular disease. A prospective design nested within WINS was used for this study. A structured telephone interview guide included questions about medical services and 15 categories of prevention services, including cardiac rehabilitation at 6, 12, 24, and 30 months. Costs were estimated from state and national databases. The 277 women studied had a mean age of 60.7 +/- 10 years. They had smoked approximately 40 +/- 11.4 years. More than 50% of the women had one or more risk factors for cardiovascular disease. During the first 6 months after the index hospitalization, 94% had a physician visit, 39% had an emergency-room visit, and 36% had a hospital admission. Prevention services used were home healthcare by nurse or home health aide (26%), a cardiac rehabilitation program, including Multifit and Heart Smart (19%), and physical therapy (14%). Usage decreased over the 30 months. For the women who used any service, the mean total monthly cost per woman was 913 dollars +/- 1204 dollars. This is the first report on health service use by women smokers with cardiovascular disease. Data collection using a telephone interview guide proved feasible for evaluating health service use. The greatest costs resulted from hospital admissions and physician and emergency-room visits. Considering the high prevalence of risk factors in this cohort, secondary prevention services were severely underutilized. By increasing referrals to such services, physicians and nurses might influence women to reduce their risk for subsequent cardiovascular disease.

Alcohol, red wine and cardiovascular disease.

PubMed

Wollin, S D; Jones, P J

2001-05-01

The objective of this article is to review the existing literature concerning the effects and mechanisms of action of red wine consumption vs. other alcoholic beverages on the risk of cardiovascular disease (CVD). Of particular interest is the form and quantity of alcohol consumed. This relationship between alcohol consumption and mortality is well supported by epidemiologic studies, which have suggested that different forms of alcohol alter the relative risk values for mortality from CVD. Although not without exception, current evidence from epidemiologic and experimental studies suggests a protective effect against the development of CVD with moderate consumption of red wine. The exact nature of the protective effect remains to be established. However, mechanisms including LDL oxidation and alterations in hemostatic variables are being increasingly recognized as contributory. Key components of red wine thought to be responsible for the protective effects include phenolic compounds and alcohol content. Despite the research presented, some questions relating to the current recommendations regarding moderate alcohol consumption and cardiovascular health remain. However, collectively, the literature aids in understanding some of the ways in which alcoholic beverages and their components affect the health of our population.

Positive affect moderates the effect of negative affect on cardiovascular disease-related hospitalizations and all-cause mortality after cardiac rehabilitation.

PubMed

Meyer, Fiorenza Angela; von Känel, Roland; Saner, Hugo; Schmid, Jean-Paul; Stauber, Stefanie

2015-10-01

Little is known as to whether negative emotions adversely impact the prognosis of patients who undergo cardiac rehabilitation. We prospectively investigated the predictive value of state negative affect (NA) assessed at discharge from cardiac rehabilitation for prognosis and the moderating role of positive affect (PA) on the effect of NA on outcomes. A total of 564 cardiac patients (62.49 ± 11.51) completed a comprehensive three-month outpatient cardiac rehabilitation program, filling in the Global Mood Scale (GMS) at discharge. The combined endpoint was cardiovascular disease (CVD)-related hospitalizations plus all-cause mortality at follow-up. Cox regression models estimated the predictive value of NA, as well as the moderating influence of PA on outcomes. Survival models were adjusted for sociodemographic factors, traditional cardiovascular risk factors, and severity of disease. During a mean follow-up period of 3.4 years, 71 patients were hospitalized for a CVD-related event and 15 patients died. NA score (range 0-20) was a significant and independent predictor (hazard ratio (HR) 1.091, 95% confidence interval (CI) 1.012-1.175; p = 0.023) with a three-point higher level in NA increasing the relative risk by 9.1%. Furthermore, PA interacted significantly with NA (p < 0.001). The relative risk of poor prognosis with NA was increased in patients with low PA (p = 0.012) but remained unchanged in combination with high PA (p = 0.12). The combination of NA with low PA was particularly predictive of poor prognosis. Whether reduction of NA and increase of PA, particularly in those with high NA, improves outcome needs to be tested. © The European Society of Cardiology 2014.

Unmet Needs for Cardiovascular Care in Indonesia

PubMed Central

Maharani, Asri; Tampubolon, Gindo

2014-01-01

Background In the past twenty years the heaviest burden of cardiovascular diseases has begun to shift from developed to developing countries. However, little is known about the real needs for cardiovascular care in these countries and how well those needs are being met. This study aims to investigate the prevalence and determinants of unmet needs for cardiovascular care based on objective assessment. Methods and Findings Multilevel analysis is used to analyse the determinants of met needs and multilevel multiple imputation is applied to manage missing data. The 2008 Indonesian Family Life Survey (IFLS4) survey is the source of the household data used in this study, while district data is sourced from the Ministry of Health and Ministry of Finance. The data shows that nearly 70% of respondents with moderate to high cardiovascular risk failed to receive cardiovascular care. Higher income, possession of health insurance and residence in urban areas are significantly associated with met needs for cardiovascular care, while health facility density and physician density show no association with them. Conclusions The prevalence of unmet needs for cardiovascular care is considerable in Indonesia. Inequality persists as a factor in meeting needs for cardiovascular care as the needs of people with higher incomes and those living in urban areas are more likely to be met. Alleviation of poverty, provision of health care insurance for the poor, and improvement in the quality of healthcare providers are recommended in order to meet this ever-increasing need. PMID:25148389

Relationships Between Glycemic Control and Cardiovascular Fitness.

PubMed

Moxley, Elizabeth W; Smith, Donald; Quinn, Lauretta; Park, Chang

2018-07-01

Diabetes is a serious health problem affecting approximately 29.1 million individuals in the United States. Another 86 million have prediabetes. The development and implementation of lifestyle modifications such as physical activity for these persons are among the most effective methods for prevention and treatment. The aim of this study was to examine relationships between glycemic control (HbA1c) and cardiovascular fitness (peak maximal oxygen uptake [VO 2 peak] and ventilatory threshold [VT]) in overweight/obese subjects with and without type 2 diabetes (T2DM). In addition, the influences of body mass index (BMI) and insulin sensitivity (homeostasis model assessment [HOMA %S]) on the relationship between glycemic control and cardiovascular fitness were explored. Data were abstracted from a completed study that included 51 overweight or obese subjects with T2DM ( n = 18), impaired glucose tolerance ( n = 8), or normal glucose tolerance ( n = 25). Relationships between glycemic control (HbA1c) and cardiovascular fitness (VO 2 peak and VT) were determined using correlational analysis and multiple linear regression analyses. A statistically significant relationship was observed between HbA1c and cardiovascular fitness. However, BMI and HOMA %S did not influence the relationship between glycemic control and cardiovascular fitness. HbA1c contributes to VO 2 peak and VT in obese and overweight subjects across glucose tolerance categories. Significant results were achieved despite the fact that there was a limited range of HbA1c based on the study inclusion criteria. This finding suggests that even a mild decrease in glycemic control can negatively influence cardiovascular fitness.

Health monitoring of Japanese payload specialist: Autonomic nervous and cardiovascular responses under reduced gravity condition (L-0)

NASA Technical Reports Server (NTRS)

Sekiguchi, Chiharu

1993-01-01

In addition to health monitoring of the Japanese Payload Specialists (PS) during the flight, this investigation also focuses on the changes of cardiovascular hemodynamics during flight which will be conducted under the science collaboration with the Lower Body Negative Pressure (LBNP) Experiment of NASA. For the Japanese, this is an opportunity to examine firsthand the effects of microgravity of human physiology. We are particularly interested in the adaption process and how it relates to space motion sickness and cardiovascular deconditioning. By comparing data from our own experiment to data collected by others, we hope to understand the processes involved and find ways to avoid these problems for future Japanese astronauts onboard Space Station Freedom and other Japanese space ventures. The primary objective of this experiment is to monitor the health condition of Japanese Payload Specialists to maintain a good health status during and after space flight. The second purpose is to investigate the autonomic nervous system's response to space motion sickness. To achieve this, the function of the autonomic nervous system will be monitored using non-invasive techniques. Data obtained will be employed to evaluate the role of autonomic nervous system in space motion sickness and to predict susceptibility to space motion sickness. The third objective is evaluation of the adaption process of the cardiovascular system to microgravity. By observation of the hemodynamics using an echocardiogram we will gain insight on cardiovascular deconditioning. The last objective is to create a data base for use in the health care of Japanese astronauts by obtaining control data in experiment L-O in the SL-J mission.

Dietary potassium intake and renal handling, and their impact on the cardiovascular health of normotensive afro-caribbeans.

PubMed

Cohall, D H; Scantlebury-Manning, T; Rafie, C; James, S; Hall, K

2014-01-01

Recent nutritional profiles of dietary intake have indicated a shift from the ancient diet to the Western diet. The ancient diet provided a high potassium and low sodium intake, which in turn leads to sodium conservation and potassium excretion. This change in the dietary intake is expected to affect potassium and sodium handling in the kidneys. Numerous studies have been done to emphasize the importance of sodium handling by the kidneys and its impact on cardiovascular health. This study will investigate potassium intake and handling, and its impact on the cardiovascular health of a sample of normotensive Afro-Caribbeans by the possible modulation of the renin angiotensin aldosterone system (RAAS). A sample of 51 normotensive Afro-Caribbean participants was recruited for the study. Participants were observed over a two-day period in which they were given a 24-hour ambulatory blood pressure monitor and a container to collect blood pressure data and a 24-hour urine sample. Anthropometric measurements were noted. Urinary electrolytes and supine plasma renin activity (PRA) were determined from the 24-hour urine collection and a blood sample. Dietary potassium intake was estimated based on dietary intake observations and calculated based on the urinary potassium excretion. SPSS version 19 was used to analyse the data to make inferences. The daily potassium intake was observed to be 2.95 g/day and measured intake from the urinary potassium was between 4.95 and 7.32 g/day. Urinary potassium excretion was 3.66 (± 1.40) g/day. The urinary potassium excretion in the Afro-Caribbean sample in Barbados was higher than the other population samples. The averaged PRA of the participants (supine) was 0.778 (± 1.072) ng/mL/hour. The averaged nocturnal systolic blood pressure dip of the participants was 5.97 (± 4.324) %. There was no significant correlation between urinary potassium excretion, blood pressure, nocturnal systolic blood pressure dip and PRA. The Afro

Effectiveness of exercise intervention and health promotion on cardiovascular risk factors in middle-aged men: a protocol of a randomized controlled trial

PubMed Central

2013-01-01

Background Although cardiovascular disease has decreased, there is still potential for prevention as obesity and diabetes increase. Exercise has a positive effect on many cardiovascular risk factors, and it can significantly reduce the components of metabolic syndrome. The main challenge with exercise in primary care is how to succeed in motivating the patients at risk to change and increase their exercise habits. The objective of this study is to modify the cardiovascular risk in middle-aged men, either through a health promotion intervention alone or combined with an exercise intervention. Methods/design During a two-year period we recruit 300 men aged from 35 to 45 years with elevated cardiovascular risk (> two traditional risk factors). The men are randomized into three arms: 1) a health promotion intervention alone, 2) both health promotion and exercise intervention, or 3) control with usual community care and delayed health promotion (these men receive the intervention after one year). The main outcome measures will be the existence of metabolic syndrome and physical activity frequency (times per week). The participants are assessed at baseline, and at 3, 6, and 12 months. The follow-up of the study will last 12 months. Discussion This pragmatic trial in primary health care aimed to assess the effect of a health promotion programme with or without exercise intervention on cardiovascular risk and physical activity in middle-aged men. The results of this study may help to plan the primary care interventions to further reduce cardiovascular mortality. The study was registered at the Controlled Trials ( http://www.controlled-trials.com). Trial number: ISRCTN80672011. The study received ethics approval from the Coordinating Ethics Committee at Helsinki University Hospital on 8 June 2009 (ref: 4/13/03/00/09). PMID:23398957

Effectiveness of exercise intervention and health promotion on cardiovascular risk factors in middle-aged men: a protocol of a randomized controlled trial.

PubMed

From, Svetlana; Liira, Helena; Leppävuori, Jenni; Remes-Lyly, Taina; Tikkanen, Heikki; Pitkälä, Kaisu

2013-02-11

Although cardiovascular disease has decreased, there is still potential for prevention as obesity and diabetes increase. Exercise has a positive effect on many cardiovascular risk factors, and it can significantly reduce the components of metabolic syndrome. The main challenge with exercise in primary care is how to succeed in motivating the patients at risk to change and increase their exercise habits. The objective of this study is to modify the cardiovascular risk in middle-aged men, either through a health promotion intervention alone or combined with an exercise intervention. During a two-year period we recruit 300 men aged from 35 to 45 years with elevated cardiovascular risk (> two traditional risk factors). The men are randomized into three arms: 1) a health promotion intervention alone, 2) both health promotion and exercise intervention, or 3) control with usual community care and delayed health promotion (these men receive the intervention after one year). The main outcome measures will be the existence of metabolic syndrome and physical activity frequency (times per week). The participants are assessed at baseline, and at 3, 6, and 12 months. The follow-up of the study will last 12 months. This pragmatic trial in primary health care aimed to assess the effect of a health promotion programme with or without exercise intervention on cardiovascular risk and physical activity in middle-aged men. The results of this study may help to plan the primary care interventions to further reduce cardiovascular mortality.The study was registered at the Controlled Trials ( http://www.controlled-trials.com). ISRCTN80672011. The study received ethics approval from the Coordinating Ethics Committee at Helsinki University Hospital on 8 June 2009 (ref: 4/13/03/00/09).

Impact of cardiovascular risk factors on medical expenditure: evidence from epidemiological studies analysing data on health checkups and medical insurance.

PubMed

Nakamura, Koshi

2014-01-01

Concerns have increasingly been raised about the medical economic burden in Japan, of which approximately 20% is attributable to cardiovascular disease, including coronary heart disease and stroke. Because the management of risk factors is essential for the prevention of cardiovascular disease, it is important to understand the relationship between cardiovascular risk factors and medical expenditure in the Japanese population. However, only a few Japanese epidemiological studies analysing data on health checkups and medical insurance have provided evidence on this topic. Patients with cardiovascular risk factors, including obesity, hypertension, and diabetes, may incur medical expenditures through treatment of the risk factors themselves and through procedures for associated diseases that usually require hospitalization and sometimes result in death. Untreated risk factors may cause medical expenditure surges, mainly due to long-term hospitalization, more often than risk factors preventively treated by medication. On an individual patient level, medical expenditures increase with the number of concomitant cardiovascular risk factors. For single risk factors, personal medical expenditure may increase with the severity of that factor. However, on a population level, the medical economic burden attributable to cardiovascular risk factors results largely from a single, particularly prevalent risk factor, especially from mildly-to-moderately abnormal levels of the factor. Therefore, cardiovascular risk factors require management on the basis of both a cost-effective strategy of treating high-risk patients and a population strategy for reducing both the ill health and medical economic burdens that result from cardiovascular disease.

Jumping the gun: the problematic discourse on socioeconomic status and cardiovascular health in India.

PubMed

Subramanian, S V; Corsi, Daniel J; Subramanyam, Malavika A; Smith, George Davey

2013-10-01

There has been an increased focus on non-communicable diseases (NCDs) in India, especially on cardiovascular diseases and associated risk factors. In this essay, we scrutinize the prevailing narrative that cardiovascular risk factors (CVRF) and cardiovascular disease (CVD) are no longer confined to the economically advantaged groups but are an increasing burden among the poor in India. We conducted a comprehensive review of studies reporting the association between socioeconomic status (SES) and CVRF, CVD, and CVD-related mortality in India. With the exception of smoking and low fruit and vegetable intake, the studies clearly suggest that CVRF/CVD is more prevalent among high SES groups in India than among the low SES groups. Although CVD-related mortality rates appear to be higher among the lower SES groups, the proportion of deaths from CVD-related causes was found to be greatest among higher SES groups. The studies on SES and CVRF/CVD also reveal a substantial discrepancy between the data presented and the authors' interpretations and conclusions, along with an unsubstantiated claim that a reversal in the positive SES-CVRF/CVD association has occurred or is occurring in India. We conclude our essay by emphasizing the need to prioritize public health policies that are focused on the health concerns of the majority of the Indian population. Resource allocation in the context of efforts to make health care in India free and universal should reflect the proportional burden of disease on different population groups if it is not to entrench inequity.

Positive affect and psychosocial processes related to health.

PubMed

Steptoe, Andrew; O'Donnell, Katie; Marmot, Michael; Wardle, Jane

2008-05-01

Positive affect is associated with longevity and favourable physiological function. We tested the hypothesis that positive affect is related to health-protective psychosocial characteristics independently of negative affect and socio-economic status. Both positive and negative affect were measured by aggregating momentary samples collected repeatedly over 1 day, and health-related psychosocial factors were assessed by questionnaire in a sample of 716 men and women aged 58-72 years. Positive affect was associated with greater social connectedness, emotional and practical support, optimism and adaptive coping responses, and lower depression, independently of age, gender, household income, paid employment, smoking status, and negative affect. Negative affect was independently associated with negative relationships, greater exposure to chronic stress, depressed mood, pessimism, and avoidant coping. Positive affect may be beneficial for health outcomes in part because it is a component of a profile of protective psychosocial characteristics.

Big heart data: advancing health informatics through data sharing in cardiovascular imaging.

PubMed

Suinesiaputra, Avan; Medrano-Gracia, Pau; Cowan, Brett R; Young, Alistair A

2015-07-01

The burden of heart disease is rapidly worsening due to the increasing prevalence of obesity and diabetes. Data sharing and open database resources for heart health informatics are important for advancing our understanding of cardiovascular function, disease progression and therapeutics. Data sharing enables valuable information, often obtained at considerable expense and effort, to be reused beyond the specific objectives of the original study. Many government funding agencies and journal publishers are requiring data reuse, and are providing mechanisms for data curation and archival. Tools and infrastructure are available to archive anonymous data from a wide range of studies, from descriptive epidemiological data to gigabytes of imaging data. Meta-analyses can be performed to combine raw data from disparate studies to obtain unique comparisons or to enhance statistical power. Open benchmark datasets are invaluable for validating data analysis algorithms and objectively comparing results. This review provides a rationale for increased data sharing and surveys recent progress in the cardiovascular domain. We also highlight the potential of recent large cardiovascular epidemiological studies enabling collaborative efforts to facilitate data sharing, algorithms benchmarking, disease modeling and statistical atlases.

Impact of a Population Health Management Intervention on Disparities in Cardiovascular Disease Control.

PubMed

James, Aisha; Berkowitz, Seth A; Ashburner, Jeffrey M; Chang, Yuchiao; Horn, Daniel M; O'Keefe, Sandra M; Atlas, Steven J

2018-04-01

Healthcare systems use population health management programs to improve the quality of cardiovascular disease care. Adding a dedicated population health coordinator (PHC) who identifies and reaches out to patients not meeting cardiovascular care goals to these programs may help reduce disparities in cardiovascular care. To determine whether a program that used PHCs decreased racial/ethnic disparities in LDL cholesterol and blood pressure (BP) control. Retrospective difference-in-difference analysis. Twelve thousdand five hundred fifty-five primary care patients with cardiovascular disease (cohort for LDL analysis) and 41,183 with hypertension (cohort for BP analysis). From July 1, 2014-December 31, 2014, 18 practices used an information technology (IT) system to identify patients not meeting LDL and BP goals; 8 practices also received a PHC. We examined whether having the PHC plus IT system, compared with having the IT system alone, decreased racial/ethnic disparities, using difference-in-difference analysis of data collected before and after program implementation. Meeting guideline concordant LDL and BP goals. At baseline, there were racial/ethnic disparities in meeting LDL (p = 0.007) and BP (p = 0.0003) goals. Comparing practices with and without a PHC, and accounting for pre-intervention LDL control, non-Hispanic white patients in PHC practices had improved odds of LDL control (OR 1.20 95% CI 1.09-1.32) compared with those in non-PHC practices. Non-Hispanic black (OR 1.15 95% CI 0.80-1.65) and Hispanic (OR 1.29 95% CI 0.66-2.53) patients saw similar, but non-significant, improvements in LDL control. For BP control, non-Hispanic white patients in PHC practices (versus non-PHC) improved (OR 1.13 95% CI 1.05-1.22). Non-Hispanic black patients (OR 1.17 95% CI 0.94-1.45) saw similar, but non-statistically significant, improvements in BP control, but Hispanic (OR 0.90 95% CI 0.59-1.36) patients did not. Interaction testing confirmed that disparities did not

The mechanisms of air pollution and particulate matter in cardiovascular diseases.

PubMed

Fiordelisi, Antonella; Piscitelli, Prisco; Trimarco, Bruno; Coscioni, Enrico; Iaccarino, Guido; Sorriento, Daniela

2017-05-01

Clinical and epidemiological studies demonstrate that short- and long-term exposure to air pollution increases mortality due to respiratory and cardiovascular diseases. Given the increased industrialization and the increased sources of pollutants (i.e., cars exhaust emissions, cigarette smoke, industry emissions, burning of fossil fuels, incineration of garbage), air pollution has become a key public health issue to solve. Among pollutants, the particulate matter (PM) is a mixture of solid and liquid particles which differently affects human health depending on their size (i.e., PM 10 with a diameter <10 μm reach the lung and PM 2.5 with a diameter <2.5 μm penetrate deeper into the lung). In particular, the acute exposure to PM 10 and PM 2.5 increases the rate of cardiovascular deaths. Thus, appropriate interventions to reduce air pollution may promote great benefits to public health by reducing the risk of cardiovascular diseases. Several biological mechanisms have been identified to date which could be responsible for PM-dependent adverse cardiovascular outcomes. Indeed, the exposure to PM 10 and PM 2.5 induces sustained oxidative stress and inflammation. PM 2.5 is also able to increase autonomic nervous system activation. Some potential therapeutic approaches have been tested both in pre-clinical and clinical studies, based on the intake of antioxidants from dietary or by pharmacological administration. Studies are still in progress to increase the knowledge of PM activation of intracellular pathways and propose new strategies of intervention.

Regional variations in ambulatory care and incidence of cardiovascular events

PubMed Central

Tu, Jack V.; Chu, Anna; Maclagan, Laura; Austin, Peter C.; Johnston, Sharon; Ko, Dennis T.; Cheung, Ingrid; Atzema, Clare L.; Booth, Gillian L.; Bhatia, R. Sacha; Lee, Douglas S.; Jackevicius, Cynthia A.; Kapral, Moira K.; Tu, Karen; Wijeysundera, Harindra C.; Alter, David A.; Udell, Jacob A.; Manuel, Douglas G.; Mondal, Prosanta; Hogg, William

2017-01-01

BACKGROUND: Variations in the prevalence of traditional cardiac risk factors only partially account for geographic variations in the incidence of cardiovascular disease. We examined the extent to which preventive ambulatory health care services contribute to geographic variations in cardiovascular event rates. METHODS: We conducted a cohort study involving 5.5 million patients aged 40 to 79 years in Ontario, Canada, with no hospital stays for cardiovascular disease as of January 2008, through linkage of multiple population-based health databases. The primary outcome was the occurrence of a major cardiovascular event (myocardial infarction, stroke or cardiovascular-related death) over the following 5 years. We compared patient demographics, cardiac risk factors and ambulatory health care services across the province’s 14 health service regions, known as Local Health Integration Networks (LHINs), and evaluated the contribution of these variables to regional variations in cardiovascular event rates. RESULTS: Cardiovascular event rates across LHINs varied from 3.2 to 5.7 events per 1000 person-years. Compared with residents of high-rate LHINs, those of low-rate health regions received physician services more often (e.g., 4.2 v. 3.5 mean annual family physician visits, p value for LHIN-level trend = 0.01) and were screened for risk factors more often. Low-rate LHINs were also more likely to achieve treatment targets for hypercholes-terolemia (51.8% v. 49.6% of patients, p = 0.03) and controlled hypertension (67.4% v. 53.3%, p = 0.04). Differences in patient and health system factors accounted for 74.5% of the variation in events between LHINs, of which 15.5% was attributable to health system factors alone. INTERPRETATION: Preventive ambulatory health care services were provided more frequently in health regions with lower cardiovascular event rates. Health system interventions to improve equitable access to preventive care might improve cardiovascular outcomes. PMID

Does the Perception that Stress Affects Health Matter? The Association with Health and Mortality

PubMed Central

Keller, Abiola; Litzelman, Kristin; Wisk, Lauren E.; Maddox, Torsheika; Cheng, Erika Rose; Creswell, Paul D.; Witt, Whitney P.

2012-01-01

Objective This study sought to examine the relationship among the amount of stress, the perception that stress affects health, and health and mortality outcomes in a nationally-representative sample of U.S. adults. Methods Data from the 1998 National Health Interview Survey were linked to prospective National Death Index mortality data through 2006. Separate logistic regression models were used to examine the factors associated with current health status and psychological distress. Cox proportional hazard models were used to determine the impact of perceiving that stress affects health on all-cause mortality. Each model specifically examined the interaction between the amount of stress and the perception that stress affects health, controlling for sociodemographic, health behavior, and access to healthcare factors. Results 33.7% of nearly 186 million (n=28,753) U.S. adults perceived that stress affected their health a lot or to some extent. Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes. The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death (HR = 1.43, 95% CI [1.20, 1.71]). Conclusions High amounts of stress and the perception that stress impacts health are each associated with poor health and mental health. Individuals who perceived that stress affects their health and reported a large amount of stress had an increased risk of premature death. PMID:22201278

A Systematic Review of Cardiovascular Disease in Sexual Minorities

PubMed Central

Brody, Abraham; Luscombe, Rachel E.; Primiano, Jillian E.; Marusca, Peter; Sitts, Edward M.; Chyun, Deborah

2017-01-01

Background: Mental health and HIV disparities are well documented among sexual minorities, but there is a dearth of research on other chronic conditions. Cardiovascular disease remains the leading cause of death worldwide. Although sexual minorities have high rates of several modifiable risk factors for cardiovascular disease (including stress, tobacco use, and alcohol consumption), there is a paucity of research in this area. Objectives: In this systematic review, we synthesized and critiqued the existing evidence on cardiovascular disease among sexual minority adults. Search Methods: We conducted a thorough literature search of 6 electronic databases for studies published between January 1985 and December 2015 that compared cardiovascular disease risk or prevalence between sexual minority and heterosexual adults. Selection Criteria: We included peer-reviewed English-language studies that compared cardiovascular disease risk or diagnoses between sexual minority and heterosexual individuals older than 18 years. We excluded reviews, case studies, and gray literature. A total of 31 studies met inclusion criteria. Data Collection and Analysis: At least 2 authors independently abstracted data from each study. We performed quality assessment of retrieved studies using the Crowe Critical Appraisal Tool. Main Results: Sexual minority women exhibited greater cardiovascular disease risk related to tobacco use, alcohol consumption, illicit drug use, poor mental health, and body mass index, whereas sexual minority men experienced excess risk related to tobacco use, illicit drug use, and poor mental health. We identified several limitations in the extant literature. The majority of included studies were cross-sectional analyses that used self-reported measures of cardiovascular disease. Even though we observed elevated cardiovascular disease risk, we found few differences in cardiovascular disease diagnoses (including hypertension, diabetes, and high cholesterol). Overall, 23

Simulating the Impact of Improved Cardiovascular Risk Interventions on Clinical and Economic Outcomes in Russia

PubMed Central

Shum, Kenny; Alperin, Peter; Shalnova, Svetlana; Boytsov, Sergey; Kontsevaya, Anna; Vigdorchik, Alexey; Guetz, Adam; Eriksson, Jennifer; Hughes, David

2014-01-01

Objectives Russia faces a high burden of cardiovascular disease. Prevalence of all cardiovascular risk factors, especially hypertension, is high. Elevated blood pressure is generally poorly controlled and medication usage is suboptimal. With a disease-model simulation, we forecast how various treatment programs aimed at increasing blood pressure control would affect cardiovascular outcomes. In addition, we investigated what additional benefit adding lipid control and smoking cessation to blood pressure control would generate in terms of reduced cardiovascular events. Finally, we estimated the direct health care costs saved by treating fewer cardiovascular events. Methods The Archimedes Model, a detailed computer model of human physiology, disease progression, and health care delivery was adapted to the Russian setting. Intervention scenarios of achieving systolic blood pressure control rates (defined as systolic blood pressure <140 mmHg) of 40% and 60% were simulated by modifying adherence rates of an antihypertensive medication combination and compared with current care (23.9% blood pressure control rate). Outcomes of major adverse cardiovascular events; cerebrovascular event (stroke), myocardial infarction, and cardiovascular death over a 10-year time horizon were reported. Direct health care costs of strokes and myocardial infarctions were derived from official Russian statistics and tariff lists. Results To achieve systolic blood pressure control rates of 40% and 60%, adherence rates to the antihypertensive treatment program were 29.4% and 65.9%. Cardiovascular death relative risk reductions were 13.2%, and 29.6%, respectively. For the current estimated 43,855,000-person Russian hypertensive population, each control-rate scenario resulted in an absolute reduction of 1.0 million and 2.4 million cardiovascular deaths, and a reduction of 1.2 million and 2.7 million stroke/myocardial infarction diagnoses, respectively. Averted direct costs from current care levels

Handgrip Strength and Ideal Cardiovascular Health among Colombian Children and Adolescents.

PubMed

Ramírez-Vélez, Robinson; Tordecilla-Sanders, Alejandra; Correa-Bautista, Jorge Enrique; Peterson, Mark D; Garcia-Hermoso, Antonio

2016-12-01

To evaluate the association between handgrip strength and ideal cardiovascular health (CVH) in Colombian children and adolescents. During the 2014-2015 school years, we examined a cross-sectional component of the FUPRECOL (Association for Muscular Strength with Early Manifestation of Cardiovascular Disease Risk Factors among Colombian Children and Adolescents) study. Participants included 1199 (n = 627 boys) youths from Bogota (Colombia). Handgrip strength was measured with a standard adjustable hand held dynamometer and expressed relative to body mass (handgrip/body mass) and as absolute values in kilograms. Ideal CVH, as defined by the American Heart Association, was determined as meeting ideal levels of the following components: 4 behaviors (smoking status, body mass index, cardiorespiratory fitness, and diet) and 3 factors (total cholesterol, blood pressure, and glucose). Higher levels of handgrip strength (both absolute and relative values) were associated with a higher frequency of ideal CVH metrics in both sexes (P for trend ≤ .001). Also, higher levels of handgrip strength were associated with a greater number of ideal health behaviors (P for trend < .001 in both boys and girls), and with a higher number of ideal health factors in boys (P for trend < .001). Finally, levels of handgrip strength were similar between ideal versus nonideal glucose or total cholesterol groups in girls. Handgrip strength was strongly associated with ideal CVH in Colombian children and adolescents, and thus supports the relevance of early targeted interventions to promote strength adaptation and preservation as part of primordial prevention. Copyright © 2016 Elsevier Inc. All rights reserved.

The women's heart health programme: a pilot trial of sex-specific cardiovascular management.

PubMed

Low, Ting Ting; Chan, Siew Pang; Wai, Shin Hnin; Ang, Zhou; Kyu, Kyu; Lee, Kim Yee; Ching, Anne; Comer, Sarah; Tan, Naomi Qiu Pin; Thong, Elizabeth Grace Hui En; Nang, Tracy; Dutta, Mohan; Lam, Carolyn S P

2018-04-16

There is increasing knowledge of sex-specific differences in cardiovascular disease and recognition of sex disparities in management. In our study, we investigated whether a cardiovascular programme tailored to the specific needs of women could lead to improved outcomes. We randomised 100 female patients to receive cardiology follow-up with the conventional sex-neutral cardiac programme (control), or the sex-tailored Women's Heart Health Programme (intervention). The intervention group was managed by an all-women multidisciplinary team and received culture-centred health intervention workshops, designed through in-depth interviews with the participants. The primary outcome was cardiovascular risk factor improvement at 1 year. Secondary outcomes include cardiovascular event rates, quality of life scores, and self-reported improvement in knowledge, attitudes, intentions and practices. Generalised structural equation model analysis was used to determine if the intervention group had better outcomes at alpha level 0.1. The mean age was 67.3 ± 12.7 years, with an ethnic distribution of 70% Chinese, 18% Malays, and 12% Indians. The majority of these patients had no formal or primary level of education (63%), and were mostly unemployed (78%). Patients in intervention group had better control of diabetes mellitus (lower HbA1c of 0.63% [CI 0.21-1.04], p = 0.015) and lower body-mass-index (0.74 kg/m 2 [CI 0.02-1.46], p = 0.092) at 1 year, but there was no significant difference in blood pressure or lipid control. Overall, there was a trend towards better risk factor control, 31.6% of intervention group versus 26.5% of control group achieved improvement in at least 1 CV risk factor control to target range. There was no significant difference in incidence of cardiovascular events, quality of life, or domains in knowledge, attitudes, intention and practices. This pilot study is the first of its kind evaluating a new model of care for women with heart disease

Does the perception that stress affects health matter? The association with health and mortality.

PubMed

Keller, Abiola; Litzelman, Kristin; Wisk, Lauren E; Maddox, Torsheika; Cheng, Erika Rose; Creswell, Paul D; Witt, Whitney P

2012-09-01

This study sought to examine the relationship among the amount of stress, the perception that stress affects health, and health and mortality outcomes in a nationally representative sample of U.S. adults. Data from the 1998 National Health Interview Survey were linked to prospective National Death Index mortality data through 2006. Separate logistic regression models were used to examine the factors associated with current health status and psychological distress. Cox proportional hazard models were used to determine the impact of perceiving that stress affects health on all-cause mortality. Each model specifically examined the interaction between the amount of stress and the perception that stress affects health, controlling for sociodemographic, health behavior, and access to health care factors. 33.7% of nearly 186 million (unweighted n = 28,753) U.S. adults perceived that stress affected their health a lot or to some extent. Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes. The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death (HR = 1.43, 95% CI [1.2, 1.7]). High amounts of stress and the perception that stress impacts health are each associated with poor health and mental health. Individuals who perceived that stress affects their health and reported a large amount of stress had an increased risk of premature death. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Persistent Subclinical Hypothyroidism and Cardiovascular Risk in the Elderly: The Cardiovascular Health Study

PubMed Central

Hyland, Kristen A.; Arnold, Alice M.; Lee, Jennifer S.

2013-01-01

Context: Use of a single set of thyroid function tests to define subclinical hypothyroidism may lead to misclassification over time and could influence findings from longitudinal studies. Objective: We assessed the risks of coronary heart disease (CHD), heart failure (HF), and cardiovascular (CV) death in older adults with persistent subclinical hypothyroidism. Design, Setting, and Participants: The study included 679 subclinically hypothyroid and 4184 euthyroid U.S. individuals at least 65 yr old enrolled in the Cardiovascular Health Study and not taking thyroid preparations. Main Outcome Measure: We measured the 10-yr risk of incident CHD, HF, and CV death from persistent subclinical hypothyroidism, overall and stratified by degree of TSH elevation (4.5–6.9, 7.0–9.9, and 10.0–19.9 mU/liter). Results: There was no association between persistent subclinical hypothyroidism and incident CHD [hazard ratio (HR), 1.12; 95% confidence interval (CI), 0.93–1.36], HF (HR, 1.05; 95% CI, 0.97–1.27), or CV death (HR, 1.07; 95% CI, 0.87–1.31) in adjusted analyses in which subclinical hypothyroidism was modeled as a time-varying exposure using up to four serial thyroid function tests. When subclinical hypothyroidism was stratified by degree of TSH elevation, no significant associations were found in any stratum. Findings were similar in fixed exposure analyses in which only participants with testing 2 yr apart were considered, with no association between persistent or transient subclinical hypothyroidism and incident CHD, HF, or CV death. Conclusions: Our data do not support increased risk of CHD, HF, or CV death in older adults with persistent subclinical hypothyroidism. PMID:23162099

Effects of bioactive constituents in functional cocoa products on cardiovascular health in humans.

PubMed

Sarriá, Beatriz; Martínez-López, Sara; Sierra-Cinos, José Luis; Garcia-Diz, Luis; Goya, Luis; Mateos, Raquel; Bravo, Laura

2015-05-01

Cocoa manufacturers are producing novel products increasing polyphenols, methylxanthines or dietary fibre to improve purported health benefits. We attempt to explain the contribution of cocoa bioactive compounds to cardiovascular effects observed in previous studies, placing particular emphasis on methylxanthines. We focused on a soluble cocoa product rich in dietary fibre (DFCP) and a product rich in polyphenols (PPCP). Effects of regularly consuming DFCP (providing daily 10.17 g, 43.8 mg and 168.6 mg of total-dietary-fibre, flavanols and methylxanthines, respectively) as well as PPCP (providing daily 3.74 g, 45.3 mg and 109.8 mg of total-dietary-fibre, flavanols and methylxanthines, respectively) on cardiovascular health were assessed in two controlled, cross-over studies in free-living normocholesterolemic and moderately hypercholesterolemic subjects. Both products increased HDL-cholesterol concentrations, whereas only DFCP decreased glucose and IL-1β levels in all subjects. Flavanols appeared to be responsible for the increase in HDL-cholesterol, whereas insoluble-dietary-fibre and theobromine in DFCP were associated with the hypoglycemic and anti-inflammatory effects observed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Positive affective processes underlie positive health behaviour change.

PubMed

Van Cappellen, Patty; Rice, Elise L; Catalino, Lahnna I; Fredrickson, Barbara L

2018-01-01

Positive health behaviours such as physical activity can prevent or reverse many chronic conditions, yet a majority of people fall short of leading a healthy lifestyle. Recent discoveries in affective science point to promising approaches to circumvent barriers to lifestyle change. Here, we present a new theoretical framework that integrates scientific knowledge about positive affect with that on implicit processes. The upward spiral theory of lifestyle change explains how positive affect can facilitate long-term adherence to positive health behaviours. The inner loop of this spiral model identifies nonconscious motives as a central mechanism of behavioural maintenance. Positive affect experienced during health behaviours increases incentive salience for cues associated with those behaviours, which in turn, implicitly guides attention and the everyday decisions to repeat those behaviours. The outer loop represents the evidence-backed claim, based on Fredrickson's broaden-and-build theory, that positive affect builds a suite of endogenous resources, which may in turn amplify the positive affect experienced during positive health behaviours and strengthen the nonconscious motives. We offer published and preliminary evidence in favour of the theory, contrast it to other dominant theories of health behaviour change, and highlight attendant implications for interventions that merit testing.

Cardiovascular dysfunction in obesity and new diagnostic imaging techniques: the role of noninvasive image methods.

PubMed

Barbosa, José Augusto A; Rodrigues, Alexandre B; Mota, Cleonice Carvalho C; Barbosa, Márcia M; Simões e Silva, Ana C

2011-01-01

Obesity is a major public health problem affecting adults and children in both developed and developing countries. This condition often leads to metabolic syndrome, which increases the risk of cardiovascular disease. A large number of studies have been carried out to understand the pathogenesis of cardiovascular dysfunction in obese patients. Endothelial dysfunction plays a key role in the progression of atherosclerosis and the development of coronary artery disease, hypertension and congestive heart failure. Noninvasive methods in the field of cardiovascular imaging, such as measuring intima-media thickness, flow-mediated dilatation, tissue Doppler, and strain, and strain rate, constitute new tools for the early detection of cardiac and vascular dysfunction. These techniques will certainly enable a better evaluation of initial cardiovascular injury and allow the correct, timely management of obese patients. The present review summarizes the main aspects of cardiovascular dysfunction in obesity and discusses the application of recent noninvasive imaging methods for the early detection of cardiovascular alterations.

Favorable Cardiovascular Health, Compression of Morbidity, and Healthcare Costs: Forty-Year Follow-Up of the CHA Study (Chicago Heart Association Detection Project in Industry).

PubMed

Allen, Norrina B; Zhao, Lihui; Liu, Lei; Daviglus, Martha; Liu, Kiang; Fries, James; Shih, Ya-Chen Tina; Garside, Daniel; Vu, Thanh-Huyen; Stamler, Jeremiah; Lloyd-Jones, Donald M

2017-05-02

We examined the association of cardiovascular health at younger ages with the proportion of life lived free of morbidity, the cumulative burden of morbidity, and average healthcare costs at older ages. The CHA study (Chicago Heart Association Detection Project in Industry) is a longitudinal cohort of employed men and women 18 to 74 years of age at baseline examination in 1967 to 1973. Baseline measurements included blood pressure, cholesterol, diabetes mellitus, body mass index, and smoking. Individuals were classified into 1 of 4 strata of cardiovascular health: favorable levels of all factors, 0 factors high but ≥1 elevated risk factors, 1 high risk factor, and ≥2 high risk factors. Linked Medicare and National Death Index data from 1984 to 2010 were used to determine morbidity in older age. An individual's all-cause morbidity score and cardiovascular morbidity score were calculated from International Classification of Disease, Ninth Revision codes for each year of follow-up. We included 25 804 participants who became ≥65 years of age by 2010, representing 65% of all original CHA participants (43% female; 90% white; mean age, 44 years at baseline); 6% had favorable levels of all factors, 19% had ≥1 risk factors at elevated levels, 40% had 1 high risk factor, and 35% had ≥2 high risk factors. Favorable cardiovascular health at younger ages extended survival by almost 4 years and postponed the onset of all-cause and cardiovascular morbidity by 4.5 and 7 years, respectively, resulting in compression of morbidity in both absolute and relative terms. This translated to lower cumulative and annual healthcare costs for those in favorable cardiovascular health ( P <0.001) during Medicare eligibility. Individuals in favorable cardiovascular health in early middle age live a longer, healthier life free of all types of morbidity. These findings provide strong support for prevention efforts earlier in life aimed at preserving cardiovascular health and reducing

The Future Role of the United States in Global Health: Emphasis on Cardiovascular Disease.

PubMed

Fuster, Valentin; Frazer, Jendayi; Snair, Megan; Vedanthan, Rajesh; Dzau, Victor

2017-12-26

U.S. global health investment has focused on detection, treatment, and eradication of infectious diseases such as tuberculosis, malaria, and human immunodeficiency virus/acquired immunodeficiency syndrome, with significant results. Although efforts should be maintained and expanded to provide ongoing therapy for chronic infectious disease, there is a pressing need to meet the challenge of noncommunicable diseases, which constitute the highest burden of diseases globally. A Committee of the National Academies of Sciences, Engineering, and Medicine has made 14 recommendations that require ongoing commitments to eradication of infectious disease and increase the emphasis on chronic diseases such as cardiovascular disease. These include improving early detection and treatment, mitigating disease risk factors, shifting global health infrastructure to include management of cardiovascular disease, developing global partners and private-public ventures to meet infrastructure and funding challenges, streamlining medical product development and supply, increasing research and development capacity, and addressing gaps in global political and institutional leadership to meet the shifting challenge. Copyright © 2017. Published by Elsevier Inc.

Gut Microbiota in Cardiovascular Health and Disease

PubMed Central

Tang, W.H. Wilson; Kitai, Takeshi; Hazen, Stanley L

2017-01-01

Significant interest in recent years has focused on gut microbiota-host interaction because accumulating evidence has revealed that intestinal microbiota play an important role in human health and disease, including cardiovascular diseases. Changes in the composition of gut microbiota associated with disease, referred to as dysbiosis, have been linked to pathologies such as atherosclerosis, hypertension, heart failure, chronic kidney disease, obesity and type 2 diabetes mellitus. In addition to alterations in gut microbiota composition, the metabolic potential of gut microbiota has been identified as a contributing factor in the development of diseases. Recent studies revealed that gut microbiota can elicit a variety of effects on the host. Indeed, the gut microbiome functions like an endocrine organ, generating bioactive metabolites, that can impact host physiology. Microbiota interact with the host through a number of pathways, including the trimethylamine (TMA)/ trimethylamine N-oxide (TMAO) pathway, short-chain fatty acids pathway, and primary and secondary bile acids pathways. In addition to these “metabolism dependent” pathways, metabolism independent processes are suggested to also potentially contribute to CVD pathogenesis. For example, heart failure associated splanchnic circulation congestion, bowel wall edema and impaired intestinal barrier function are thought to result in bacterial translocation, the presence of bacterial products in the systemic circulation and heightened inflammatory state. These are believed to also contribute to further progression of heart failure and atherosclerosis. The purpose of the current review is to highlight the complex interplay between microbiota, their metabolites and the development and progression of cardiovascular diseases. We will also discuss the roles of gut microbiota in normal physiology and the potential of modulating intestinal microbial inhabitants as novel therapeutic targets. PMID:28360349

Depressive symptoms, physical inactivity and risk of cardiovascular mortality in older adults: the Cardiovascular Health Study

PubMed Central

Win, Sithu; Parakh, Kapil; Eze-Nliam, Chete M; Gottdiener, John S; Kop, Willem J

2011-01-01

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-reported depressive symptoms (10-item Center for Epidemiological Studies Depression Scale) were assessed annually and self-reported physical activity was assessed at baseline and at 3 and 7 years. To estimate how much of the increased risk of cardiovascular mortality associated with depressive symptoms was due to physical inactivity, Cox regression with time-varying covariates was used to determine the percentage change in the log HR of depressive symptoms for cardiovascular mortality after adding physical activity variables. Results At baseline, 20% of participants scored above the cut-off for depressive symptoms. There were 2915 deaths (49.8%), of which 1176 (20.1%) were from cardiovascular causes. Depressive symptoms and physical inactivity each independently increased the risk of cardiovascular mortality and were strongly associated with each other (all p<0.001). Individuals with both depressive symptoms and physical inactivity had greater cardiovascular mortality than those with either individually (p<0.001, log rank test). Physical inactivity reduced the log HR of depressive symptoms for cardiovascular mortality by 26% after adjustment. This was similar for persons with (25%) and without (23%) established coronary heart disease. Conclusions Physical inactivity accounted for a significant proportion of the risk of cardiovascular mortality due to depressive symptoms in older adults, regardless of coronary heart disease status. PMID:21339320

Cardiovascular Update: Risk, Guidelines, and Recommendations.

PubMed

Pearson, Tamera

2015-09-01

This article provides an update of the current status of cardiovascular disease (CVD) in the United States, including a brief review of the underlying pathophysiology and epidemiology. This article presents a discussion of the latest American Heart Association guidelines that introduce the concept of promoting ideal cardiovascular health, defined by seven identified metrics. Specific CVD risk factors and utilization of the 10-year CVD event prediction calculator are discussed. In addition, current management recommendations of health-related conditions that increase risk for CVD, such as hypertension and hypercholesterolemia, are provided. Finally, a discussion of detailed evidence-based lifestyle recommendations to promote cardiovascular health and reduce CVD risks concludes the update. © 2015 The Author(s).

Cardiovascular Ultrasound of Neonatal Long Evans Rats ...

EPA Pesticide Factsheets

This abstract describes the use of a relatively new technology, cardiovascular ultrasound (echocardiography) for evaluating developmental toxicity affecting heart development. The abstract describes the effects of two known cardiac teratogens, trichloroacetic acid and dimethadione, and their effects as determined by echocardiography. This abstract describes the use and development of a relatively new technology, cardiovascular ultrasound (echocardiography) for evaluating developmental toxicity affecting heart development.

Health-related quality of life evaluated by the eight-item short form after cardiovascular surgery.

PubMed

Kato, Takayoshi; Tomita, Shinji; Handa, Nobuhiro; Ueno, Yo-ichiro

2010-12-01

Owing to advances in cardiovascular surgery, patients with cardiovascular disease require improvement of health-related quality of life (QOL) than before. We measured the QOL of patients undergoing cardiovascular surgery using the eight-item Short Form (SF-8) and assessed its usefulness. This was a prospective repeated-measures observational study. The SF-8 questionnaire was completed through interviews with 117 consecutive adult patients undergoing cardiovascular surgery at a single center (Nagara Medical Center, Japan) from April 2006 to March 2008. The SF-8 was evaluated before surgery and at 7 days, 1 month, and 6 months after surgery. The physical and mental scores over time were assessed. Regarding physical status, compared with the normal population, the patients' scores were worse preoperatively and had deteriorated 7 days postoperatively; they gradually got closer to preoperative status a month after the procedure. At 6 months after surgery, all physical scores were higher than before surgery. The mental scores, including a mental component summary score, were inferior to those of the normal population until 1 month postoperatively, and they reached those of the normal population at 6 months. The SF-8 changed with the postoperative time course. It was a useful tool for analyzing the physical and mental QOL of patients who underwent cardiovascular surgery.

Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III).

PubMed

Vanhees, L; Rauch, B; Piepoli, M; van Buuren, F; Takken, T; Börjesson, M; Bjarnason-Wehrens, B; Doherty, P; Dugmore, D; Halle, M

2012-12-01

The beneficial effect of exercise training and exercise-based cardiac rehabilitation on symptom-free exercise capacity,cardiovascular and skeletal muscle function, quality of life, general healthy lifestyle, and reduction of depressive symptoms and psychosocial stress is nowadays well recognized. However, it remains largely obscure, which characteristics of physical activity (PA) and exercise training--frequency, intensity, time (duration), type (mode), and volume (dose: intensity x duration) of exercise--are the most effective. The present paper, therefore, will deal with these exercise characteristics in the management of individuals with cardiovascular disease, i.e. coronary artery disease and chronic heart failure patients, but also in patients with congenital or valvular heart disease. Based on the current literature, and if sufficient evidence is available, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding frequency, intensity, time and type of PA, and safety aspects during exercise inpatients with cardiovascular disease. This paper is the third in a series of three papers, all devoted to the same theme: the importance of the exercise characteristics in the management of cardiovascular health. Part I is directed to the general population and Part II to individuals with cardiovascular risk factors. In general, PA recommendations and exercise training programmes for patients with coronary artery disease or chronic heart failure need to be tailored to the individual's exercise capacity and risk profile, with the aim to reach and maintain the individually highest fitness level possible and to perform endurance exercise training 30–60 min daily (3–5 days per week) in combination with resistance training 2–3 times a week. Because of the frequently reported dose–response relationship between training effect and exercise intensity, one should seek sufficiently high training intensities

Quality of life and self-care in elderly patients with cardiovascular diseases: The effect of a Traditional Chinese Medicine health educational intervention.

PubMed

Sun, Yi-Qin; Jiang, An-Li; Chen, San-Mei; Li, Hui; Xing, Hai-Yan; Wang, Fang

2017-12-01

To explore the effects of a Traditional Chinese Medicine health educational intervention on the quality of life and self-care agency of elderly patients living with chronic cardiovascular disease. Cardiovascular disease is a leading cause of morbidity and mortality worldwide. The secondary prevention and treatment for chronic cardiovascular disease emphasize the importance of lifestyle modification. However, behavior-changing is difficult and individual choices are influenced by broader environmental factors. The lifestyle intervention for the purpose of self-care enhancing should be considered the driving force from the cultural element. The study was conducted from April 2014 to October 2014. Ninety-eight community dwelling individuals with chronic cardiovascular disease were recruited from Shaoxing and randomized. 48 participants were in the intervention group with a 6-month Traditional Chinese Medicine health education and 50 participants were in the control group with routine care. The main measurements included health-related quality of life and self-care agency, which was assessed by the Short Form-36 Chinese version and the Exercise of Self-Care Agency Scale respectively, and were measured at the baseline and post intervention (6months after baseline). After 6months of intervention, the quality of life and self-care agency in the intervention group were significantly improved. The traditional Chinese medicine health education is an effective method for promoting quality of life and self-care agency in cardiovascular disease patients. It could be applied as adjunctive care for cardiovascular disease patients self-care supporting. Copyright © 2017 Elsevier Inc. All rights reserved.

Anabolic steroids and cardiovascular risk.

PubMed

Angell, Peter; Chester, Neil; Green, Danny; Somauroo, John; Whyte, Greg; George, Keith

2012-02-01

Recent reports from needle exchange programmes and other public health initiatives have suggested growing use of anabolic steroids (AS) in the UK and other countries. Data indicate that AS use is not confined to body-builders or high-level sportsmen. Use has spread to professionals working in emergency services, casual fitness enthusiasts and subelite sportsmen and women. Although the precise health consequences of AS use is largely undefined, AS use represents a growing public health concern. Data regarding the consequences of AS use on cardiovascular health are limited to case studies and a modest number of small cohort studies. Numerous case studies have linked AS use with a variety of cardiovascular disease (CVD) events or endpoints, including myocardial infarction, stroke and death. Large-scale epidemiological studies to support these links are absent. Consequently, the impact of AS use upon known CVD risk factors has been studied in relatively small, case-series studies. Data relating AS use to elevated blood pressure, altered lipid profiles and ECG abnormalities have been reported, but are often limited in scope, and other studies have often produced equivocal outcomes. The use of AS has been linked to the appearance of concentric left ventricular hypertrophy as well as endothelial dysfunction but the data again remains controversial. The mechanisms responsible for the negative effect of AS on cardiovascular health are poorly understood, especially in humans. Possibilities include direct effects on myocytes and endothelial cells, reduced intracellular Ca2+ levels, increased release of apoptogenic factors, as well as increased collagen crosslinks between myocytes. New data relating AS use to cardiovascular health risks are emerging, as novel technologies are developed (especially in non-invasive imaging) that can assess physiological structure and function. Continued efforts to fully document the cardiovascular health consequences of AS use is important to

Plant Protein and Animal Proteins: Do They Differentially Affect Cardiovascular Disease Risk?12

PubMed Central

Richter, Chesney K; Skulas-Ray, Ann C; Champagne, Catherine M; Kris-Etherton, Penny M

2015-01-01

Proteins from plant-based compared with animal-based food sources may have different effects on cardiovascular disease (CVD) risk factors. Numerous epidemiologic and intervention studies have evaluated their respective health benefits; however, it is difficult to isolate the role of plant or animal protein on CVD risk. This review evaluates the current evidence from observational and intervention studies, focusing on the specific protein-providing foods and populations studied. Dietary protein is derived from many food sources, and each provides a different composite of nonprotein compounds that can also affect CVD risk factors. Increasing the consumption of protein-rich foods also typically results in lower intakes of other nutrients, which may simultaneously influence outcomes. Given these complexities, blanket statements about plant or animal protein may be too general, and greater consideration of the specific protein food sources and the background diet is required. The potential mechanisms responsible for any specific effects of plant and animal protein are similarly multifaceted and include the amino acid content of particular foods, contributions from other nonprotein compounds provided concomitantly by the whole food, and interactions with the gut microbiome. Evidence to date is inconclusive, and additional studies are needed to further advance our understanding of the complexity of plant protein vs. animal protein comparisons. Nonetheless, current evidence supports the idea that CVD risk can be reduced by a dietary pattern that provides more plant sources of protein compared with the typical American diet and also includes animal-based protein foods that are unprocessed and low in saturated fat. PMID:26567196

Cardiovascular Disease Risk Perception and Knowledge: A Comparison of Hispanic and White College Students in a Hispanic-Serving Institution

ERIC Educational Resources Information Center

McMahan, Shari; Cathorall, Michelle; Romero, Devan R.

2007-01-01

There are clear health conditions that disproportionately affect the Hispanic population. One hundred twenty-four (45%) Hispanic and 153 (55%) White college students completed a questionnaire on cardiovascular disease (CVD) awareness, knowledge, and perceptions of risk. Results indicated that Hispanic students rated themselves as poorer in health,…

Internet Searches for Affect-Related Terms: An Indicator of Subjective Well-Being and Predictor of Health Outcomes across US States and Metro Areas.

PubMed

Ford, Michael T; Jebb, Andrew T; Tay, Louis; Diener, Ed

2018-03-01

The present study explored the potential for internet search data to serve as indicators of subjective well-being (SWB) and predictors of health at the state and metro area levels. We propose that searches for positive and negative affect-related terms represent information-seeking behavior of individuals who are experiencing emotions and seeking information about them. Data on the frequency of Google searches for 15 affect terms were collected from Google's Trends website (trends.google.com). These were paired with data on health, self-reported emotions, psychological well-being, personality, and Twitter postings at the state and metro area levels. Several internet search scores correlated with indicators of cardiovascular health and depression. Some search term scores also correlated strongly with self-reported emotions, well-being metrics, neuroticism, per capita income, and Twitter postings at the state or metro area level. Multiple regression analyses suggest that affect searches predict depression rates at the metro area level beyond the effects of income and other well-being measures. The results highlight the promise and challenges of using internet search data at the aggregate level for physical and mental health assessment and surveillance. © 2018 The International Association of Applied Psychology.

Cardiovascular health promotion and consumers with mental illness in Australia.

PubMed

Happell, Brenda; Platania-Phung, Chris

2015-04-01

People with serious mental illness (SMI) have increased risk of cardiovascular disease and premature death, yet research on nurse-provided health promotion in mental health services remains under-developed. This paper informs efforts to improve the nursing role in physical health of consumers with SMI by establishing what nurse perceptions and background influence their care. Members of the Australian College of Mental Health Nursing were invited to participate in an online survey on their views on physical health care in mental health services. Survey questions included: (a) nurse-consumer collaboration in preventative care and (b) sub-sections of the Robson and Haddad Physical Health Attitude Scale to measure nurse perceived barriers to encouraging lifestyle change of consumers with SMI and frequency of nurse physical healthcare practices. Structural equation modelling was applied to investigate antecedents to physical health care, as well as relationships between antecedents. A national sample of 643 nurses reported regular engagement in health promotion (e.g. advice on diet). There was statistical support for a model depicting perceived consumer-nurse collaboration as a dual-determinant of nurse perceived barriers and self-reported health promotion to consumers with SMI. Perceived barriers to consumer lifestyle change did not predict health promotion. The effects of nurse-consumer collaboration were significant, but small. Perceived consumer-nurse collaboration in preventative care may positively influence the amount of health promotion by nurses in mental health. Perceived barriers to consumer adherence with a healthy lifestyle did not have an impact on nurse-delivered health promotion.

Could cut-price cardiovascular procedures in India help Europe's hard-pressed health-care systems?

PubMed

2011-05-01

Until recently, travelling to India for a cardiovascular procedure was unheard of, but huge improvements in the quality of medical care available in the subcontinent, and its relative cheapness, have fostered the growth of 'medical tourism' and could impact on health care in Europe, reports Barry Shurlock, PhD.

Tocotrienols and cardiovascular health.

PubMed

Prasad, Kailash

2011-01-01

This review emphasizes the effects of tocotrienols on the risk factors for atherosclerosis, plaque instability and thrombogenesis, and compares these effects with tocopherol. Tocotrienols reduce serum lipids and raise serum HDL-C. Alpha-tocopherol, on the other hand, has no effect on serum lipids. Tocotrienols have greater antioxidant activity than tocopherols. Both reduce the serum levels of C-reactive protein (CRP) and advanced glycation end products, and expression of cell adhesion molecules. The CRP-lowering effects of tocotrienols are greater than tocopherol. Tocotrienols reduce inflammatory mediators, δ-tocotrienol being more potent, followed by γ- and α-tocotrienol. Tocotrienols are antithrombotic and suppress the expression of matrix metalloproteinases. They suppress, regress and slow the progression of atherosclerosis, while tocopherol only suppresses, and has no effect on regression and slowing of progression of atherosclerosis. Tocotrienol reduces risk factors for destabilization of atherosclerotic plaques. There are no firm data to suggest that tocotrienols are effective in reducing the risk of cardiac events in established ischemic heart disease. Alpha-tocopherol is effective in primary prevention of coronary artery disease (CAD), but has no conclusive evidence that it has beneficial effects in patients with established ischemic heart disease. Tocotrienols are effective in reducing ischemia-reperfusion cardiac injury in experimental animals and has the potential to be used in patients undergoing angioplasty, stent implantation and aorto-coronary bypass surgery. In conclusion, experimental data suggest that tocotrienols have a potential for cardiovascular health, but long-term randomized clinical trials are needed to establish their efficacy in primary and secondary prevention of CAD.

Cardiovascular disease risk factors and the perception of general health among male law enforcement officers: encouraging behavioral change.

PubMed

Ramey, Sandra L

2003-05-01

The relationship among cardiovascular disease (CVD) morbidity, risk factors (including stress), and the perception of health among male law enforcement officers (LEOs) compared to men in the general population were examined in this study. Self reported prevalence of CVD and CVD risk factors among currently employed male LEOs from nine states (n = 2,818) were compared to those of other men in the same states (n = 9,650 for CVD risk factors, n = 3,147 for CVD prevalence). Perceived stress in LEOs was assessed to determine if it affected the relationship between CVD prevalence and CVD risk factors. Cross tabulated simple percentages showed CVD was less prevalent in the LEO group than among the general population. The best predictor variables for CVD were perceived stress, time in the profession, and hypertension. The LEO group had greater prevalence of hypercholesterolemia, overweight, and tobacco use than the general population. However, a greater percentage of LEOs perceived their health as "good to excellent" compared to men in the general population. Using multivariate analysis of variance (MANOVA) it was determined that perceived stress was associated with CVD in the LEO group and three CVD risk factors (i.e., cholesterol, hypertension, physical activity) were significantly affected by perceived stress. Among susceptible officers, stress may contribute to CVD development as well as potentiate several CVD risk factors. However, an apparent lack of association exists between perception of general health and CVD risk in LEOs.

Positive affect, negative affect, stress, and social support as mediators of the forgiveness-health relationship.

PubMed

Green, Michelle; Decourville, Nancy; Sadava, Stanley

2012-01-01

Structural equation modeling was used to test a model in which positive affect, negative affect, perceived stress, and social support were hypothesized to mediate the relationship between forgiveness and mental and physical health. Six hundred and twenty-three undergraduates completed a battery of self-report measures. Results of the analyses indicated that the forgiveness-health relation was mediated by positive affect, negative affect, stress, and the interrelationship between negative affect and stress. There was limited support for social support and the interrelationship between positive affect and social support as mediators. The results suggested that the relationship between forgiveness and health is mediated rather than direct. Implications and directions for future research are discussed.

Cardiovascular reactivity, stress, and physical activity

PubMed Central

Huang, Chun-Jung; Webb, Heather E.; Zourdos, Michael C.; Acevedo, Edmund O.

2013-01-01

Psychological stress has been proposed as a major contributor to the progression of cardiovascular disease (CVD). Acute mental stress can activate the sympathetic-adrenal-medullary (SAM) axis, eliciting the release of catecholamines (NE and EPI) resulting in the elevation of heart rate (HR) and blood pressure (BP). Combined stress (psychological and physical) can exacerbate these cardiovascular responses, which may partially contribute to the elevated risk of CVD and increased proportionate mortality risks experienced by some occupations (e.g., firefighting and law enforcement). Studies have supported the benefits of physical activity on physiological and psychological health, including the cardiovascular response to acute stress. Aerobically trained individuals exhibit lower sympathetic nervous system (e.g., HR) reactivity and enhanced cardiovascular efficiency (e.g., lower vascular reactivity and decreased recovery time) in response to physical and/or psychological stress. In addition, resistance training has been demonstrated to attenuate cardiovascular responses and improve mental health. This review will examine stress-induced cardiovascular reactivity and plausible explanations for how exercise training and physical fitness (aerobic and resistance exercise) can attenuate cardiovascular responses to stress. This enhanced functionality may facilitate a reduction in the incidence of stroke and myocardial infarction. Finally, this review will also address the interaction of obesity and physical activity on cardiovascular reactivity and CVD. PMID:24223557