P2507Role of “Walk with a doc” program practice in total risk approach to prevention of cardiovascular disease in RF

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O L Bockeria ◽  
Z Kudzoeva ◽  
S G Khugaev

Abstract Background It is known that life-style related factors are the main risk factors for CVD morbidity and mortality. In countries with economies in transition (such as Russia) many efforts were aimed at CVD diagnostic and treatment procedures improvement, but lack of primary prevention strategies is observed in general population. CVD morbidity and mortality could be prevented through population based strategies. Purpose To evaluate the feasibility and potency of implementing “Walk with a doc” program practice using newly-developed “Cardiac numbers Diary” for estimation of the individual risk on making decision about whether to initiate specific preventive action to reduce CVD morbidity. Methods The program has successfully started in Moscow, RF in July 2012 as a Russian branch of the global “Walk with a doc” activity. As of January 2019 there are 1576 participants in the database. Special “Cardiac numbers Diary” was developed and includes special charts to allow the introduction of the total risk stratification approach for management of CVD. The charts use a modelling approach with age, sex, physical activity, smoking, blood pressure, body weight, blood glucose and cholesterol. With support of center specialists the weekly events are carried out in different open space grounds and include the assessment of the above risk factors, life style modifying counseling including lectures and 35–40 minutes' walk at the moderate pace. 150 participants participated in more than 20 walks mean age 58,2 years old (±17,1) were assessed in this prospective study. They were assessed for risk factors modifying in 6 months follow-up period. At the moment of inclusion 37.5% participants had arterial hypertension, 12.1% were smokers, 20.2% were overweight. The official Walk-with-a-doc movement is registered in RF. Special Web site provides information on future events, physician team, life-style, diet, physical activity recommendations, photo materials and etc. Results After 6 month of regular walking the number of hypertensive participants decreased to 20.2%. 9.4% of all participants were able to lose weight by 1–6 kg, and 33.3% quit smoking. 75% of people who walked noticed an increase in the level of physical activity. 17.3% of them underwent inpatient treatment using high-tech medical care. Ther were no major events in the above cohort of patients. Conclusions “Walk with a doc” program practice using newly-developed individual “Cardiac numbers Diary” for a predicted individual risk with regular professional counseling can be a useful guide for making clinical decisions on the intensity of preventive interventions to reduce cardiovascular risk factors in general population. Acknowledgement/Funding None

2020 ◽  
Vol 65 (6) ◽  
pp. 911-921 ◽  
Author(s):  
Sophie Gottschalk ◽  
Hans-Helmut König ◽  
Christian Brettschneider

Abstract Objectives This study aimed to compare informal caregivers/dementia caregivers to non-caregivers regarding alcohol consumption, smoking behavior, obesity, and insufficient physical activity and to identify caregiving-related factors (caregiving intensity, length of caregiving, relationship to the care recipient, and type of caregiving task) which are associated with behavioral risk factors in caregivers/dementia caregivers. Methods Using cross-sectional data from the Behavioral Risk Factor Surveillance System, we performed the statistical analyses applying logistic regression models and accounted for confounding using the entropy balancing approach. Results For caregivers (n = 12,044), the odds of overweight/obesity and smoking were higher (OR = 1.14/1.34, p < 0.05) and the odds of binge drinking and insufficient physical activity were lower (OR = 0.86/0.83, p < 0.05) than for non-caregivers (n = 45,925). For dementia caregivers, results point in the same direction. Caregiving-related variables tend to influence the likelihood of behavioral risk factors, but depending on the kind of factor considered, in different directions. Conclusions Being a caregiver is associated with risky and health-promoting behavior. However, the effects are relatively low. Future studies should study potential pathways between caregiving characteristics, psychological impacts of caregiving, health behavior, and mental or physical health.


2013 ◽  
Vol 16 (5) ◽  
pp. 987-995 ◽  
Author(s):  
W. Wolfgang Fleischhacker ◽  
Cynthia O. Siu ◽  
Robert Bodén ◽  
Elizabeth Pappadopulos ◽  
Onur N. Karayal ◽  
...  

Abstract Available data on antipsychotic-induced metabolic risks are often constrained by potential confounding effects due to prior antipsychotic treatment. In this study, we assessed the baseline prevalence of metabolic abnormalities and changes following treatment with five commonly-used antipsychotic drugs (haloperidol, amisulpride, olanzapine, quetiapine or ziprasidone) in first-episode, partially antipsychotic-naive patients with schizophrenia in the European first-episode schizophrenia trial (EUFEST). Overall baseline prevalence of metabolic syndrome (MetS) was 6.0%, with similar rates observed in the antipsychotic-naive patients (5.7%, 9/157) and in the other patients with only a brief prior exposure to antipsychotics (6.1%, 20/326). These results are consistent with the MetS prevalence rate estimated in a general population of similar age. Examination of individual risk factors showed 58.5% of subjects had one or more elevated metabolic risks at baseline: 28.5% demonstrated suboptimal HDL; 24.2% hypertension; 17.7% hypertriglyceridemia; 8.2% abdominal obesity; 7.3% hyperglycaemia. Increase in body weight (kg/month) occurred in patients treated with haloperidol (0.62 s.e. 0.11), amisulpride (0.76 s.e. 0.08), olanzapine (0.98 s.e. 0.07) and quetiapine (0.58 s.e. 0.09), which was significantly greater than that in the ziprasidone group (0.18 s.e. 0.10). The incidence rate of new diabetes cases over a 52-wk follow-up period was 0.82% (4/488). More patients experienced worsening rather than improvement of hypertriglyceridemia or hyperglycaemia in all treatment groups. Our findings suggest that in first-episode, partially antipsychotic-naive patients, the baseline prevalence rate of MetS appears to be no higher than that in the general population, but serious underlying individual risk factors nevertheless existed.


2017 ◽  
Vol 25 (5) ◽  
pp. 543-550 ◽  
Author(s):  
Tarun K Mittal ◽  
Christine L Cleghorn ◽  
Janet E Cade ◽  
Suzanne Barr ◽  
Tim Grove ◽  
...  

Background A high prevalence of stress-related disorders is well known among healthcare professionals. We set out to assess the prevalence of cardiovascular risk factors and compliance with national dietary and physical activity recommendations in NHS staff in the UK with comparison between clinical and non-clinical staff, and national surveys. Design A multi-centre cross-sectional study. Methods A web-based questionnaire was developed to include anonymised data on demographics, job role, cardiovascular risk factors and diseases, dietary habits, physical activity and barriers towards healthy lifestyle. This was distributed to staff in four NHS hospitals via emails. Results A total of 1158 staff completed the survey (response rate 13%) with equal distribution between the clinical and non-clinical groups. Most staff were aged 26–60 years and 79% were women. Half of the staff were either overweight or obese (51%) with no difference between the groups ( P = 0.176), but there was a lower prevalence of cardiovascular risk factors compared to the general population. The survey revealed a low compliance (17%) with the recommended intake of five-a-day portions of fruit and vegetables, and that of moderate or vigorous physical activity (56%), with no difference between the clinical and non-clinical staff ( P = 0.6). However, more clinical staff were exceeding the alcohol recommendations ( P = 0.02). Lack of fitness facilities and managerial support, coupled with long working hours, were the main reported barriers to a healthy lifestyle. Conclusions In this survey of UK NHS staff, half were found to be overweight or obese with a lower prevalence of cardiovascular risk factors compared to the general population. There was a low compliance with the five-a-day fruit and vegetables recommendation and physical activity guidelines, with no difference between the clinical and non-clinical staff.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Vandal ◽  
M Garant ◽  
B Cossette ◽  
L Pinsonneault

Abstract Background Multiple individual risk factors for morbidity and mortality during heat waves have previously been identified. Based on these, five categories of area-level indicators are used in Quebec, Canada, to identify geographical regions with presumed increased vulnerability: economic, social and biological vulnerability, housing characteristics and urban environment. However, we do not know which indicators correlate with an increase in morbidity and mortality during heat waves. This study evaluated, among 13 different area-level vulnerability factors from these five categories, which ones predict an effect modification of hot temperatures on morbidity and mortality. Methods For 2008 to 2018, we first explored the association between average daily temperature and four daily health indicators for the Eastern Townships region in Quebec: all-cause ambulance transports, all-cause emergency department (ED) visits, all-cause mortality and heat-related hospitalizations. We then used Poisson regression linear mixed models to investigate effect modification from the 13 area-level risk factors. Results Three vulnerability factors significantly caused positive effect modification between temperature and daily all-cause ambulance counts: the chronic diseases index, the percentage of people aged 65 years or older and the percentage of people aged 65 or older and living alone. For heat-related hospitalizations, four factors caused positive effect modification: the same three as for ambulance counts, plus the proportion of people that spend 30% or more household income on rent. For the ED-temperature association, only the percentage of people with low income caused positive effect modification. There was no significant association between temperature and daily mortality. Conclusions This study will help public health officials target preventive interventions to areas with the vulnerability factors that most strongly predict heat-related morbidity. Key messages Some, but not all, individual risk factors are useful at the area-level to predict areas with the strongest increases in morbidity associated with hot temperatures. The chronic diseases index and the percentage of people 65 and older living alone both accentuated the association between hot temperatures and ambulance transports or hospitalizations.


2016 ◽  
Vol 68 (1) ◽  
Author(s):  
Ricarda Marinigh ◽  
Paolo M. Fioretti ◽  
Rosa Pecoraro ◽  
Claudio Fresco ◽  
Silvio Brusaferro

Background and aims: Percutaneous coronary intervention (PCI) is the most frequently used revascularization approach, often repeatedly applied. The quest for the ultimate revascularization procedure however may capture cardiologist’s attention and lead them to minimize the issue of secondary prevention in their patients. Aims of this study were to assess: 1. The individual risk factor profile, 2. The relation between the risk factors correction and the number of hospital admissions for elective procedures, 3. The appropriateness of medical treatment in patients admitted for elective coronary invasive procedures (diagnostic and interventional). 4. The patients knowledge of threshold values for cardiovascular risk factors. Patients and Methods: 100 patients (71% males, mean age 68 years) consecutively admitted for elective coronary angiography or PCI. They underwent a classical risk factors assessment and were divided in three groups according to the number of admissions for coronary angiography and in two groups according to the number of PCIs. Results: Fifty-seven % of patients had been previously admitted for invasive examination at least three times and 58% had already been treated with at least one PCI. Seventyone % were treated with beta-blockers but only 25% of them received a dosage found effective in RCTs (randomized clinical trials). Sixty % were treated with ACE-inhibitors and 83% received the dosage found effective in RCTs. Fifty-two % were treated with statins and 95% received a dosage found effective in RCTs. Nine % were still active smokers. Fourtynine % had a LDL cholesterol level above 100 mg/dL. The percentage of patients not on target was unrelated to the number of hospital admissions for invasive procedures. Conclusions: Modern cardiology is quickly embracing high tech procedures and trials results but often fails to spend enough time teaching how to control risk factors according to the recommendations of the evidence-based guidelines, even independently of the number of hospitalizations for invasive cardiovascular procedures.


Author(s):  
Vesna Maksimovic ◽  
Biljana Jakovljevic

Abstract The SCORE model was calibrated according to mortality statistics for each European country. If it is used for the population aged 40-65, it will predict the possibility of fatal cardiovascular consequences that will appear after 10 years. The aim of this study was to investigate individual risk factors for cardiovascular complications in the adult population in the city of Belgrade. The study was designed as a cross-sectional study. Using Heart Score tool for determining of the total risk of CVD, could be projected to the age of 60, which may be of particular importance for guiding young adults, aged 20 to 30, with low absolute risk but already with an unhealthy risk profile, which will lead to a much higher risk as they age. In our study, predominately were present female participants without hypertension, then male and were dominate frequent non-smokers compared with smokers in male and female. Furthermore, in study population were more present smokers with longer duration of smoking (>10 years). After calculated Heart Score, we can see that 25.6% of respondents have a high risk of cardiovascular event, of which 19.6% high risk, 4.4% very high risk, and 1.6% extremely high risk of developing some an adverse fatal cardiovascular event. The present risk factors and high mortality and morbidity from cardiovascular disease indicate the need for taking preventive measures already in children, with the parallel implementation of population strategies and high risk.


2021 ◽  
Vol 8 ◽  
Author(s):  
Valentina Bracun ◽  
Navin Suthahar ◽  
Canxia Shi ◽  
Sanne de Wit ◽  
Wouter C. Meijers ◽  
...  

Introduction: Several lines of evidence reveal that cardiovascular disease (CVD) and cancer share similar common pathological milieus. The prevalence of the two diseases is growing as the population ages and the burden of shared risk factors increases. In this respect, we hypothesise that tumour biomarkers can be potential predictors of CVD outcomes in the general population.Methods: We measured six tumour biomarkers (AFP, CA125, CA15-3, CA19-9, CEA and CYFRA 21-1) and determined their predictive value for CVD in the Prevention of Renal and Vascular End-stage Disease (PREVEND) study. A total of 8,592 subjects were enrolled in the study.Results: The levels of CEA significantly predicted CV morbidity and mortality, with hazard ratios (HRs) of HR 1.28 (95% CI 1.08–1.53), respectively. Two biomarkers (CA15-3 and CEA) showed statistical significance in predicting all-cause mortality, with HRs 1.58 (95% CI 1.18–2.12) and HR 1.60 (95% CI 1.30–1.96), when adjusted for shared risk factors and prevalent CVD. Furthermore, biomarkers seem to be sex specific. CYFRA 21-1 presented as an independent predictor of CV morbidity and mortality in female, but not in male gender, with HR 1.82 (95% CI 1.40–2.35). When it comes to all-cause mortality, both CYFRA and CEA show statistical significance in male gender, with HR 1.64 (95% CI 1.28–3.12) and HR 1.55 (95% CI 1.18–2.02), while only CEA showed statistical significance in female gender, with HR 1.64 (95% CI 1.20–2.24). Lastly, CA15-3 and CEA strongly predicted CV mortality with HR 3.01 (95% CI 1.70–5.32) and HR 1.82 (95% CI 1.30–2.56). On another hand, CA 15-3 also presented as an independent predictor of heart failure (HF) with HR 1.67 (95% CI 1.15–2.42).Conclusion: Several tumour biomarkers demonstrated independent prognostic value for CV events and all-cause mortality in a large cohort from the general population. These findings support the notion that CVD and cancer are associated with similar pathological milieus.


2012 ◽  
Vol 03 (01) ◽  
pp. 28-35 ◽  
Author(s):  
Aliasgar V Moiyadi ◽  
Prakash M Shetty

ABSTRACT Background: Perioperative outcomes following surgery for brain tumors are an important indicator of the safety as well as efficacy of surgical intervention. Perioperative morbidity not only has implications on direct patient care, but also serves as an indicator of the quality of care provided, and enables objective documentation, for comparision in various clinical trials. We document our experience at a tertiary care referral, a dedicated neuro-oncology center in India. Materials and Methods: One hundred and ninety-six patients undergoing various surgeries for intra-axial brain tumors were analyzed. Routine microsurgical techniques and uniform antibiotic policy were used. Navigation/ intraoperative electrophysiological monitoring was not available. The endpoints assessed included immediate postoperative neurological status, neurological outcome at discharge, regional complications, systemic complications, overall morbidity, and mortality. Various risk factors assessed included clinico-epidemiological factors, tumor-related factors, and surgery-related factors. Univariate and multivariate analysis were performed. Results: Median age was 38 years. 72% had tumors larger than 4 cm. Neurological morbidity, and regional and systemic complications occurred in 16.8, 17.3, and 10.7%, respectively. Overall, major morbidity occurred in 18% and perioperative mortality rate was 3.6%. Although a few of the known risk factors were found to be significant on univariate analysis, none achieved significance on multivariate analysis. Conclusions: Our patients were younger and had larger tumors than are generally reported. Despite the unavailability of advanced intraoperative aids we could achieve acceptable levels of morbidity and mortality. Objective recording of perioperative events is crucial to document outcomes after surgery for brain tumors.


Author(s):  
Tormod Brenn

The 738 oldest men who participated in the first survey of the population-based Tromsø Study (Tromsø 1) in Norway in 1974 have now had the chance to reach the age of 90 years. The men were also invited to subsequent surveys (Tromsø 2–7, 1979–2016) and have been followed up for all-cause deaths. This study sought to investigate what could be learned from how these men have fared. The men were born in 1925–1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, and 10.8 for never, former, and current smokers, respectively. Significant effects on survival were also found for physical inactivity, low income, being unmarried, high blood pressure, and high cholesterol. For men with 0–4 of these risk factors, the percentages reaching 90 years were 33.3, 24.9, 12.4, 14.4, and 1.5, respectively. Quitting smoking and increasing physical activity before 55 years of age improved survival significantly. Men should refrain from smoking and increase their physical activity, especially those with low income, those who are unmarried, and those with high blood pressure and high cholesterol.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Samaneh Akbarpour ◽  
Davood Khalili ◽  
Hojjat Zeraati ◽  
Mohammad Ali Mansournia ◽  
Azra Ramezankhani ◽  
...  

Abstract We aimed to evaluate the relationship between different lifestyle patterns and blood pressure. This study is based on the national survey of the risk factors for non-communicable diseases in Iran in 2012. A total of 8244 people aged 25–70 years old have been enrolled in the survey. Clustering on the individual data of lifestyle factors (nutrition, physical activity, and smoking) were carried out using self-organizing neural network method. Multivariable regression models were used to determine the relationship between blood pressure and the clusters. This study revealed seven lifestyle clusters in the national survey. The first cluster had a healthier lifestyle (15%), and the rest of the clusters had at least one or more lifestyle-related risk factors. Among all the clusters, people in two clusters, i.e. one characterized by consumption of sugar-sweetened beverages, salt, and fast foods, and the other one characterized by physical inactivity, were more exposed to the risk of hypertension (odds ratios of 1.44 and 1.12, respectively). People in another cluster who were 100% smokers and had a very high level of work-related physical activity were about 30% less likely to experience elevated blood pressure. Although a lifestyle with cigarette smoking was associated with a reduction in blood pressure, this might be due to other related factors, such as work-related physical activity, which lower blood pressure. Of course, this hypothesis still needs to be further studied in the future.


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