scholarly journals Fasting, non-fasting and postprandial triglycerides for screening cardiometabolic risk

2021 ◽  
Vol 10 ◽  
Author(s):  
Bryant H. Keirns ◽  
Christina M. Sciarrillo ◽  
Nicholas A. Koemel ◽  
Sam R. Emerson
Keyword(s):  
Cardiovascular Disease ◽  
At Risk ◽  
Early Detection ◽  
Cardiometabolic Risk ◽  
Distinct Advantage ◽  
Cvd Risk ◽  
Postprandial Triglycerides

Abstract Fasting triacylglycerols have long been associated with cardiovascular disease (CVD) and other cardiometabolic conditions. Evidence suggests that non-fasting triglycerides (i.e. measured within 8 h of eating) better predict CVD than fasting triglycerides, which has led several organisations to recommend non-fasting lipid panels as the new clinical standard. However, unstandardised assessment protocols associated with non-fasting triglyceride measurement may lead to misclassification, with at-risk individuals being overlooked. A third type of triglyceride assessment, postprandial testing, is more controlled, yet historically has been difficult to implement due to the time and effort required to execute it. Here, we review differences in assessment, the underlying physiology and the pathophysiological relevance of elevated fasting, non-fasting and postprandial triglycerides. We also present data suggesting that there may be a distinct advantage of postprandial triglycerides, even over non-fasting triglycerides, for early detection of CVD risk and offer suggestions to make postprandial protocols more clinically feasible.

scholarly journals Feasibility of cardiovascular risk screening in Portuguese community pharmacies

2021 ◽  
Vol 19 (2) ◽  
pp. 2255
Author(s):  
Anabela Fonseca ◽  
Tacio Lima ◽  
Margarida Castelo-Branco ◽  
Isabel Vitória Figueiredo
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Early Detection ◽  
Community Pharmacists ◽  
Physical Parameters ◽  
Community Pharmacies ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Risk Screening ◽  
Screening Programs

Background: Cardiovascular disease (CVD) remains the leading cause of human mortality. As highly accessible and qualified health professionals, community pharmacists can be included in the early detection of patients at risk for CVD by implementing CVD screening programs. Objective: To assess the feasibility of CVD risk screening services in Portuguese community pharmacies from the evaluation of customers acceptability. Methods: A cross-sectional study was conducted in a community pharmacy in Portugal. The purpose of entering the pharmacy was recorded for all customers. Afterwards, the customers were invited to be interviewed by the pharmacist, who registered their willingness to participate and collected the participants’ data and biochemical and physical parameters to assess their CV risk by applying the Systematic COronary Risk Evaluation (SCORE) model. For the participants who were not eligible for the SCORE-based risk assessment, the pharmacist considered the major modifiable CVD risk factors - hypertension, dyslipidemia, smoking habits, obesity, impaired fasting glucose and sedentary behavior - according to the ESC guidelines. Results: Picking up medication was the most prevalent reason 69.8% (n=1,600) for entering the pharmacy, and among the contacted customers, 56.4% (n=621) agreed to have their CVD risk assessed. Of the 588 participants, 56.6% (n=333) were already on CV pharmacotherapy and were therefore not eligible for screening. Of the 43.4% (n=255) CV pharmacotherapy-naïve participants, 94.9% (n=242) were screened with at least one CVD risk factor; 52.9% (n=135) were not eligible for the SCORE assessment, of which 92.6% (n=125) presented CVD risk factors. Of the 120 SCORE eligible participants, 80.0% (n=96) were at least at moderate risk of CVD. Conclusions: We determined the feasibility of CVD risk screening in Portuguese community pharmacies, as we found high customer acceptability, noted the reasons for nonattendance, and found a high prevalence of CVD risk factors in at-risk patients. This is an opportunity for Portuguese community pharmacists to take a leading role in the early detection of CVD.

scholarly journals Key Potentials of mHealth for Community-Based Early Detection of Cardiovascular Disease During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Kemal Nazarudin Siregar ◽  
Rico Kurniawan ◽  
Ryza Jazid BaharuddinNur ◽  
Dion Zein Nuridzin ◽  
Yolanda Handayani ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Early Detection ◽  
Communicable Disease ◽  
Age Groups ◽  
The Elderly ◽  
Cvd Risk ◽  
Community Based ◽  
Detection Mechanism ◽  
Control Programs ◽  
Personalized Health

Abstract Background The epidemiological transition from infectious to non-communicable disease (NCD) is characterized by an increasing incidence of cardiovascular disease (CVD). The Coronavirus Disease 2019 (COVID-19) pandemic has led to a significant decline in NCD screening and treatment activities in health centers. This study aims to revive and expand the coverage of NCD control programs, from the elderly to productive age groups, through the use of mHealth for the early detection of CVD, which is also provides health promotion media that is easily accessible. Methods This research is an operational study to develop a community-based early detection mechanism for CVD using mHealth during the COVID-19 pandemic in the Babakan Madang sub-district, Bogor district. Results The use of the mHealth application supported by community participation is proven to be able to reach the productive age population significantly (87.1%) in the Babakan Madang sub-district. The mHealth application simplifies CVD risk predictions so that it can be used by the public during the COVID-19 pandemic. Conclusion This application is also very well accepted by the community and is able to provide personalized health promotions.

Influence of different training methods on cardiovascular disease risk markers after cessation of anabolic steroids abuse in bodybuilders at risk

2021 ◽  
pp. 1-12
Author(s):  
S.M.S. Hashemi ◽  
H. Arazi
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
At Risk ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Training Methods ◽  
Risk Markers ◽  
Cvd Risk ◽  
Training Groups ◽  
Significant Difference

Evidence suggests that anabolic-androgenic steroid (AAS) abuse induces adverse effects on cardiovascular disease (CVD). However, it is unclear whether different training methods are effective in reducing these consequences. This study aims to compare the effects of aerobic training (AT), resistance training (RT), and combined training (CT) on CVD risk markers in professional bodybuilders at risk after cessation of AAS abuse. Forty bodybuilders were randomly assigned to one of four groups: control (n=10), AT (n=10), RT (RT, n=10), and CT (n=10) groups. Before and after eight weeks of training, the high sensitivity C-reactive protein (hs-CRP), haematocrit (HCT), homocysteine (HCY), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and blood pressure (BP) were measured. Significant decreases within groups in HCY and CRP were observed (P<0.05). However, decreases were greater in training groups, and there was a significant difference between control and training groups (P<0.05). Increase in NT-proBNP, and decreases in systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels were significant only in training groups (P<0.005). The increase of NT-proBNP was significant in the CT when compared to the RT (P<0.05). The present study found that discontinuing AAS consumption can improve some CVD risk markers in professional bodybuilders, but this effect could be improved if various modalities of training were performed. Accompanying AT with RT was also discovered to have a greater impact on some markers (including NT-proBNP).

The Associations Between Cardiovascular Risk Factors, Physical Activity, and Arterial Stiffness in Youth

2013 ◽  
Vol 10 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Darolyn J. Walker ◽  
Andrea MacIntosh ◽  
Anita Kozyrskyj ◽  
Allan Becker ◽  
Jon McGavock
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Risk Factor ◽  
Arterial Stiffness ◽  
Cardiometabolic Risk ◽  
Vigorous Physical Activity ◽  
Cardiometabolic Risk Factor ◽  
Cvd Risk

Background:The primary aim of this population-based study was to determine if arterial stiffness is associated with cardiovascular disease (CVD) risk factor clustering and physical activity in youth 12−14 years old. We hypothesized that arterial stiffness would be positively associated with CVD risk factor clustering and negatively associated with physical activity in a dose-response manner in this cohort of youth.Methods:This was a cross sectional study of 485 youth recruited from the 1995 Manitoba birth cohort. The primary outcome, arterial stiffness, was assessed noninvasively using conventional pulse wave analysis and velocity. The primary exposure variables included 1) a measure of cardiometabolic risk, defined as a composite of novel and traditional risk factors for cardiovascular disease and type 2 diabetes and 2) self-reported physical activity.Results:Neither cardiometabolic risk factor clustering, nor physical activity were associated with either measure of arterial stiffness in this cohort of youth 12−14 years. Cardiometabolic risk decreased with increasing levels of vigorous physical activity, (P < .05) and increased with increasing body mass index.Conclusions:Cardiometabolic risk factor clustering and physical activity are not associated with arterial stiffness in youth 12−14 years of age. Increased vigorous physical activity is associated with reduced cardiometabolic risk in youth independent of body mass index.

The EXPERT tool: how to make exercise prescription easy

2020 ◽  
pp. 177-186
Author(s):  
Dominique Hansen ◽  
Karin Coninx
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
At Risk ◽  
Clinical Practice ◽  
Exercise Training ◽  
Exercise Prescription ◽  
Potential Method ◽  
Everyday Practice ◽  
Cvd Risk ◽  
Exercise Guidelines

Exercise training (ET) is a cornerstone of the multidisciplinary rehabilitation of patients with and at risk of cardiovascular disease (CVD). However, evidence indicates that clinicians experience difficulties in prescribing exercise for patients with different CVDs and risk factors (RFs). Different exercise intensities, duration, volume, frequency, and type will lead to different changes in CVD RFs. The Exercise Prescription in Everyday Practice & Rehabilitative Training (EXPERT) tool has been developed to overcome this limitation. It is a potential method for encouraging standardization of exercise prescription in CVD (risk) and enhancing the implementation of integrated exercise guidelines into clinical practice. The aim of this chapter is to guide clinicians on how to use the EXPERT tool to optimize their exercise prescription (skills).

scholarly journals Development of a Psychosocial Intervention to Promote Treatment Adherence in Patients with Bipolar Disorder at Risk of Cardiovascular Disease

2021 ◽  
Vol 10 (24) ◽  
pp. 5890
Author(s):  
Sandra I. Ralat ◽  
Giselle Alicea-Cuprill ◽  
Yashira Arroyo ◽  
William Otero
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
At Risk ◽  
Bipolar Disorder ◽  
Psychosocial Intervention ◽  
Effect Sizes ◽  
Type I ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Adherence To Medication

Nonadherence to treatment is a serious concern that affects the successful management of bipolar disorder (BD) patients. The aim of this study was to pilot test a psychosocial intervention (previously developed by this team) intended to increase adherence to medication and health behaviors targeting cardiovascular disease (CVD) risk factors in BD patients. An open, single-group design was used to assess the feasibility and acceptability of the intervention. The participants had BD, type I/II or unspecified, and CVD risk factors. Baseline demographic measures were taken. We also obtained preliminary effect sizes related to pre-post changes on measures of self-reported adherence to psychiatric medication, depressive and manic symptoms, and pharmacy records. At baseline, 29% of the participants reported recent adherence to psychiatric medications. A total of 71% of the participants completed the intervention. Pre-post improvements by medium and large effect sizes (Cohen’s d = 0.52–0.92) were seen in medication adherence, attitudes toward medication, and mania symptoms. The participants reported high levels of satisfaction with the intervention. A culturally sensitive psychosocial intervention for Puerto Rican BD patients who are at risk of CVD was found to be feasible and acceptable. Improvements in the key outcomes were seen in this small, preliminary study. Further research is needed with a larger sample size.

Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA

2017 ◽  
Vol 72 (3) ◽  
pp. 193-201 ◽  
Author(s):  
Emily M D’Agostino ◽  
Hersila H Patel ◽  
Eric Hansen ◽  
M Sunil Mathew ◽  
Maria Nardi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
At Risk ◽  
Risk Profile ◽  
At Risk Youth ◽  
High Poverty ◽  
Cvd Risk ◽  
Poverty Areas ◽  
Programme Participation ◽  
Very High

BackgroundThe WHO calls for affordable population-based prevention strategies for reducing the global burden of cardiovascular disease (CVD) on morbidity and mortality; however, effective, sustainable and accessible community-based approaches for CVD prevention in at-risk youth have yet to be identified. We examined the effects of implementing a daily park-based afterschool fitness programme on youth CVD risk profiles over 5 years and across area poverty subgroups.MethodsThe study included 2264 youth (mean age 9.4 years, 54% male, 50% Hispanic, 47% non-Hispanic black, 70% high/very high area poverty) in Miami, Florida, USA. We used three-level repeated measures mixed models to determine the longitudinal effects of programme participation on modifiable CVD outcomes (2010–2016).ResultsDuration of programme participation was significantly associated with CVD risk profile improvements, including body mass index (BMI) z-score, diastolic/systolic blood pressure, skinfold thicknesses, waist–hip ratio, sit-ups, push-ups, Progressive Aerobic Cardiovascular Endurance Run (PACER) score, 400 m run time, probability of developing systolic/diastolic hypertension and overweight/obesity in high/very high poverty neighbourhoods (P<0.001). Diastolic blood pressure decreased 3.4 percentile points (95% CI −5.85 to −0.85), 8.1 percentile points (95% CI –11.98 to −4.26), 6.1 percentile points (95% CI −11.49 to −0.66), 7.6 percentile points (95% CI −15.33 to –0.15) and 11.4 percentile points (95% CI −25.32 to 2.61) for 1–5 years, respectively, in high/very high poverty areas. In contrast, significant improvements were found only for PACER score and waist–hip ratio in low/mid poverty areas.ConclusionThis analysis presents compelling evidence demonstrating that park-based afterschool programmes can successfully maintain or improve at-risk youth CVD profiles over multiple years.

scholarly journals Potentials of community-based early detection of cardiovascular disease risk during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kemal Nazarudin Siregar ◽  
Rico Kurniawan ◽  
Ryza Jazid BaharuddinNur ◽  
Dion Zein Nuridzin ◽  
Yolanda Handayani ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Early Detection ◽  
Health Workers ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Screening Tools ◽  
Cvd Risk ◽  
Community Based ◽  
Community Activities ◽  
Community Acceptance

Abstract Background The Coronavirus Disease 2019 (COVID-19) pandemic has led to a significant decline in Non Communicable Diseases (NCD) screening and early detection activities, especially Cardiovascular Disease (CVD). This study aims to assess the potential of community-based self-screening of CVD risk through the mhealth application. Methods This is operational research by actively involving the community to carry out self-screening through the mHealth application. Community health workers were recruited as facilitators who encourage the community to carry out self-screening. To evaluate the potential of community-based self-screening of CVD risk, we use several indicators: responses rate, level of CVD risk, and community acceptance. Results Of the 846 individuals reached by the cadres, 53% or 442 individuals carried out self-screening. Based on the results of self-screening of CVD risk, it is known that around 21.3% are at high risk of developing CVD in the next 10 years. The results of the evaluation of semi-structured questions showed that about 48% of the people had positive impressions, 22% assessed that this self-screening could increase awareness and was informative, 3% suggested improvements to self-screening tools. Conclusion Cadres play an important role in reaching and facilitating the community in their environment to remain aware of their health conditions by conducting self-screening of CVD risk. The availability of the mHealth application that the public can easily access can simplify CVD risk prediction and expand screening coverage, especially during the COVID-19 pandemic, where there are social restrictions policies and community activities.

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