General aspects

ESC CardioMed ◽  
2018 ◽  
pp. 2695-2699
Author(s):  
Lucia Mazzolai
Keyword(s):  
Weight Loss ◽  
Smoking Cessation ◽  
Risk Factor ◽  
Clinical History ◽  
Pharmacological Therapy ◽  
Risk Factor Management ◽  
Best Medical Therapy ◽  
General Aspects ◽  
Key Steps ◽  
Regular Physical Exercise

Thorough clinical history and physical examination are key steps in PADs management. Beyond the diagnosis of LEAD, ABI is also a strong marker for CV events. The management of PADs includes all interventions to address specific arterial symptoms as well as general CV risk prevention. Best medical therapy includes CV risk factor management, including optimal pharmacological therapy as well as non-pharmacological measures such as smoking cessation, healthy diet, weight loss and regular physical exercise.

General aspects

ESC CardioMed ◽  
2018 ◽  
pp. 2695-2699
Author(s):  
Lucia Mazzolai
Keyword(s):  
Weight Loss ◽  
Smoking Cessation ◽  
Risk Factor ◽  
Clinical History ◽  
Pharmacological Therapy ◽  
Risk Factor Management ◽  
Best Medical Therapy ◽  
General Aspects ◽  
Key Steps ◽  
Regular Physical Exercise

Thorough clinical history and physical examination are key steps in PADs management. Beyond the diagnosis of LEAD, ABI is also a strong marker for CV events. The management of PADs includes all interventions to address specific arterial symptoms as well as general CV risk prevention. Best medical therapy includes CV risk factor management, including optimal pharmacological therapy as well as non-pharmacological measures such as smoking cessation, healthy diet, weight loss and regular physical exercise.

Abstract P73: Social Support and Adherence to Cardiac Risk Factor Management Instructions during the First Year after Acute Myocardial Infarction

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Erica C Leifheit-Limson ◽  
Kimberly J Reid ◽  
Stanislav V Kasl ◽  
Haiqun Lin ◽  
Philip G Jones ◽  
...  
Keyword(s):  
Social Support ◽  
Risk Factor ◽  
Repeated Measures ◽  
Diabetes Management ◽  
A Priori ◽  
Clinical History ◽  
Poor Adherence ◽  
Cardiac Risk Factor ◽  
First Year ◽  
Risk Factor Management

Background: Adherence to risk factor management (RFM) instructions after AMI can promote recovery. The prognostic importance of social support for adherence is not well understood. We examined the relationship between baseline social support and post-AMI RFM adherence, and tested whether depression moderates this association. Methods: Using data from 2202 AMI patients enrolled in the 19-site PREMIER study, we longitudinally examined whether low baseline social support (index hospitalization; score <=18 on 5 items from ENRICHD Social Support Inventory) is associated with poor adherence to 13 RFM instructions (medication adherence, warfarin use, follow-up plan/appointments, whom to call, cholesterol monitoring and therapy, diabetes management, weight monitoring and loss, smoking cessation, diet, exercise, cardiac rehabilitation) within the first year of recovery. Patients were asked at 1, 6, and 12 months if they received any of the RFM instructions since their last interview. Poor adherence was defined a priori as adhering “very carefully” to less than 50% of the patient-appropriate instructions. Hierarchical repeated-measures Poisson regression evaluated the association between support and adherence, with adjustment for site, sociodemographics, clinical history and presentation, hospital and outpatient care, and depression. Whether depression (PHQ-9 score >=10) modified the association was evaluated by stratifying the risk-adjusted model by depression status and including a support*depression interaction term. Results: Patients with low social support had greater unadjusted risk of poor adherence than patients with high social support (RR 1.46, 95% CI 1.27-1.67). This association did not vary with time and remained significant after full risk adjustment (RR 1.24, 95% CI 1.05-1.47). In depression-stratified analyses, the risk-adjusted association of low support with poor adherence was significant among nondepressed (RR 1.44, 95% CI 1.26-1.66) but not depressed (RR 1.03, 95% CI 0.79-1.33) patients (p<0.001 for support*depression interaction). Conclusion: Good social support may improve adherence among nondepressed AMI patients, but more research is needed to understand the role of social support among depressed patients.

Risk factor management: antiatherogenic therapies

2009 ◽  
Vol 16 (2_suppl) ◽  
pp. S29-S36 ◽  
Author(s):  
Stephan Gielen ◽  
Marcus Sandri ◽  
Gerhard Schuler ◽  
Daniel Teupser
Keyword(s):  
Risk Factor ◽  
Physical Exercise ◽  
Lifestyle Changes ◽  
Lipid Lowering ◽  
Western World ◽  
Risk Factor Management ◽  
Risk Factor Modification ◽  
Target Values ◽  
Regular Physical Exercise ◽  
Factor Modification

Despite the advances in interventional techniques, the management of stable atherosclerosis remains the domain of optimal guideline-oriented therapy. Recent studies on the effects of aggressive lipid lowering on atheroma volume changes using intravascular ultrasound indicate that it is possible to achieve atherosclerosis regression by reaching low-density lipoprotein (LDL) levels less than 75 mg/dl. The pleiotropic anti-inflammatory effects of statins contribute to the reduction of cardiovascular (CV) event observed with aggressive lipid lowering. As a second important strategy to prevent disease progression, lifestyle changes with regular physical exercise are capable of halting the atherosclerotic process and reducing angina symptoms and CV events. Optimal medical therapy, a healthy lifestyle with regular physical exercise, and coronary interventions are not mutually exclusive treatment strategies. Over the last few decades, both have proved to be effective in significantly reducing the CV mortality in the Western world. However, risk factor modification contributed to at least half the effect in the reduction of CV mortality. This figure provides an estimate of what could be achieved if we were to take risk factor modification more seriously – especially in the acute care setting. The knowledge is there: today we have a better understanding on how to stop progression and even induce regression of atherosclerosis. Much research still needs to be done and will be done. In the meantime, however, our primary focus should lie in implementing what is already known. In addition, it is essential not just to treat CV risk factors, but also to treat them to achieve the target values as set by the guidelines of European Society of Cardiology.

scholarly journals Measurement of Markers of Tobacco Smoking in Patients with Coronary Heart Disease

1995 ◽  
Vol 32 (2) ◽  
pp. 201-207 ◽  
Author(s):  
G P R Archbold ◽  
Margaret E Cupples ◽  
Agnes McKnight ◽  
T Linton
Keyword(s):  
Coronary Heart Disease ◽  
Smoking Cessation ◽  
Risk Factor ◽  
Heart Disease ◽  
Tobacco Smoking ◽  
Biochemical Markers ◽  
Metabolite Concentration ◽  
Suitable Alternative ◽  
Risk Factor Management ◽  
History Of

591 patients with a history of coronary heart disease had one or more biochemical markers of tobacco smoking measured. 26% were self reported smokers and a further 4% were apparent ‘smoking deceivers’. The urinary nicotine metabolite concentration is an excellent marker for tobacco smoking; breath CO would be a suitable alternative for busy clinics. Half the patients were subjected to regular advice on risk factor management but there was no evidence that this contributed effectively to smoking cessation. Overall smoking cessation rate was poor.

scholarly journals Obesity and atrial fibrillation: making inroads through fat

2020 ◽  
Author(s):  
Saad Javed ◽  
Dhiraj Gupta ◽  
Gregory Y H Lip
Keyword(s):  
Atrial Fibrillation ◽  
Weight Loss ◽  
Risk Factor ◽  
Dietary Intervention ◽  
Outcome Data ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Risk Factor Management ◽  
Prevalence Of Obesity ◽  
Therapeutic Considerations

Abstract The global prevalence of obesity has reached epidemic proportions, paralleled by a rise in cases of atrial fibrillation (AF). Data from epidemiological cohorts support the role of obesity as an independent risk factor for AF. Increasing evidence indicates that obesity may contribute to the AF substrate through a number of pathways including by altering epicardial adipose tissue biology, inflammatory pathways, structural cardiac remodelling, and inducing atrial fibrosis. Due to changes in pharmacokinetics and pharmacodynamics, specific therapeutic considerations are required to guide management of patients with AF including anticoagulation and rhythm control. Also, weight loss in patients with AF has been associated with reduced progression from paroxysmal to persistent AF and indeed regression from persistent to proximal AF. However, the role of dietary intervention in AF control remains to be fully elucidated and hard prospective outcome data to support weight loss are required in AF to determine its role as part of a comprehensive risk factor management strategy for AF in obese patients.

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