scholarly journals UK cardiac rehabilitation fit for purpose? A community-based observational cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037980
Author(s):  
Saïd Ibeggazene ◽  
Chelsea Moore ◽  
Costas Tsakirides ◽  
Michelle Swainson ◽  
Theocharis Ispoglou ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Heart Rate ◽  
Cohort Study ◽  
Arterial Stiffness ◽  
Observational Cohort Study ◽  
Habitual Physical Activity ◽  
Community Based ◽  
Observational Cohort ◽  
Exercise Dose

ObjectivesThis study aimed to characterise the exercise performed in UK cardiac rehabilitation (CR) and explore relationships between exercise dose and changes in physiological variables.DesignObservational cohort study.SettingOutpatient community-based CR in Leeds, UK. Rehabilitation sessions were provided twice per week for 6 weeks.ParticipantsSixty patients (45 male/15 female 33–86 years) were recruited following referral to local outpatient CR.Outcome measuresThe primary outcome was heart rate achieved during exercise sessions. Secondary outcomes were measured before and after CR and included incremental shuttle walk test (ISWT) distance and speed, blood pressure, brachial artery flow-mediated dilatation, carotid arterial stiffness and accelerometer-derived habitual physical activity behaviours.ResultsThe mean % of heart rate reserve patients exercised at was low and variable at the start of CR (42%±16 %) and did not progress by the middle (48%±17 %) or end (48%±16 %) of the programme. ISWT performance increased following CR (440±150 m vs 633±217 m, p<0.001); however, blood pressure, body weight, endothelial function, arterial stiffness and habitual physical activity behaviours were unchanged following 6 weeks of CR (p>0.05).ConclusionPatients in a UK CR cohort exercise at intensities that are variable but generally low. The exercise dose achieved using this CR format appears inadequate to impact markers of health. Attending CR had no effect on physical activity behaviours. Strategies to increase the dose of exercise patients achieve during CR and influence habitual physical activity behaviours may enhance the effectiveness of UK CR.

scholarly journals Equivalency between the shock index and subtracting the systolic blood pressure from the heart rate: an observational cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yohei Kamikawa ◽  
Hiroyuki Hayashi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cohort Study ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Correlation Coefficient ◽  
Observational Cohort Study ◽  
Regression Equation ◽  
Shock Index ◽  
Observational Cohort

Abstract Background Although the shock index is known to predict mortality and other severe outcomes, deriving it requires complex calculations. Subtracting the systolic blood pressure from the heart rate may produce a simple shock index that would be a clinically useful substitute for the shock index. In this study, we investigated whether the simple shock index was equivalent to the shock index. Methods This observational cohort study was conducted at 2 tertiary care hospitals. Patients who were transported by ambulance were recruited for this study and were excluded if they were aged < 15 years, had experienced prehospital cardiopulmonary arrest, or had undergone inter-hospital transfer. Pearson’s product-moment correlation coefficient and regression equation were calculated, and two one-sided tests were performed to examine their equivalency. Results Among 5429 eligible patients, the correlation coefficient between the shock index and simple shock index was extremely high (0.917, 95% confidence interval 0.912 to 0.921, P < .001). The regression equation was estimated as sSI = 258.55 log SI. The two one-sided tests revealed a very strong equivalency between the shock index and the index estimated by the above equation using the simple shock index (mean difference was 0.004, 90% confidence interval 0.003 to 0.005). Conclusion The simple shock index strongly correlated with the shock index.

scholarly journals Equivalency between the shock index and subtracting the systolic blood pressure from the heart rate: An observational cohort study

2020 ◽  
Author(s):  
Yohei Kamikawa ◽  
Hiroyuki Hayashi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cohort Study ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Correlation Coefficient ◽  
Observational Cohort Study ◽  
Regression Equation ◽  
Shock Index ◽  
Observational Cohort

Abstract Background: Although the shock index is known to predict mortality and other severe outcomes, deriving it requires complex calculations. Subtracting the systolic blood pressure from the heart rate may produce a simple shock index that would be a clinically useful substitute for the shock index. In this study, we investigated whether the simple shock index was equivalent to the shock index.Methods: This observational cohort study was conducted at 2 tertiary care hospitals. Patients who were transported by ambulance were recruited for this study and were excluded if they were aged < 15 years, had experienced prehospital cardiopulmonary arrest, or had undergone inter-hospital transfer. Pearson’s product-moment correlation coefficient and regression equation were calculated, and two one-sided tests were performed to examine their equivalency.Results: Among 5,429 eligible patients, the correlation coefficient between the shock index and simple shock index was extremely high (0.917, 95% confidence interval 0.912 to 0.921, P < .001). The regression equation was estimated as sSI = 258.55 log SI. The two one-sided tests revealed a very strong equivalency between the shock index and the index estimated by the above equation using the simple shock index (mean difference was 0.004, 90% confidence interval 0.003 to 0.005).Conclusion: The simple shock index strongly correlated with the shock index.

scholarly journals Effects of Two Community-Based Exercise Programs on Adherence, Cardiometabolic Markers, and Body Composition in Older People with Cardiovascular Risk Factors: A Prospective Observational Cohort Study

2020 ◽  
Vol 10 (4) ◽  
pp. 176
Author(s):  
Esther García-Sánchez ◽  
Jacobo Á. Rubio-Arias ◽  
Vicente Ávila-Gandía ◽  
F. Javier López-Román ◽  
Juan F. Menarguez-Puche
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cohort Study ◽  
Physical Exercise ◽  
Exercise Program ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Community Based ◽  
Observational Cohort ◽  
Observation Period

Cardiovascular disease is one of the leading causes of death globally, and cardiovascular risk factors (CRFs) are major behavioral risk factors. Therefore, community-based programs are being designed based on the prescription of physical exercise from primary care centers to improve people’s health through changes in lifestyle. The objective was to compare the effects of two types of community exercise on adherence, lipid profile, body composition and blood pressure. A prospective observational cohort study was designed with two cohorts of study depending on the duration and type of physical exercise program performed. Fifty-one participants (82.4% women) with CRF completed the observation period in which they carried out a short-term, non-individualized exercise program (3 months), and 42 participants (71.4% women) with CRF completed the observation period in which they conducted a long-term, individualized exercise program (6 months). The results suggest that participants who carried out the longer program with an individualized progression produced greater adherence to physical exercise and a decrease in diastolic blood pressure. In addition, LDL and insulin levels decreased in both groups. Therefore, our results suggest that a longer duration and individualized evolution of the loads of a community exercise program lead to higher levels of physical activity (PA) and improvements diastolic blood pressure.

scholarly journals Equivalency Between the Shock Index and Subtracting the Systolic Blood Pressure From the Heart Rate: An Observational Cohort Study

2020 ◽  
Author(s):  
Yohei Kamikawa ◽  
Hiroyuki Hayashi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cohort Study ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Correlation Coefficient ◽  
Observational Cohort Study ◽  
Regression Equation ◽  
Shock Index ◽  
Observational Cohort

Abstract Background: Although the shock index is known to predict mortality and other severe outcomes, deriving it requires complex calculations. Subtracting the systolic blood pressure from the heart rate may produce a simple shock index that would be a clinically useful substitute for the shock index. In this study, we investigated whether the simple shock index was equivalent to the shock index.Methods: This observational cohort study was conducted at 2 tertiary care hospitals. Patients who were transported by ambulance were recruited for this study and were excluded if they were aged <15 years, had experienced prehospital cardiopulmonary arrest, or had undergone inter-hospital transfer. Pearson’s product-moment correlation coefficient and regression equation were calculated, and two one-sided tests were performed to examine their equivalency. Results: Among 5,429 eligible patients, the correlation coefficient between the shock index and simple shock index was extremely high (0.917, 95% confidence interval 0.912 to 0.921, P <.001). The regression equation was estimated as sSI = 258.55 log SI. The two one-sided tests revealed a very strong equivalency between the shock index and the index estimated by the above equation using the simple shock index (mean difference was 0.004, 90% confidence interval 0.003 to 0.005). Conclusion: The simple shock index strongly correlated with the shock index.

scholarly journals Association between Objectively Measured Physical Activity and Arterial Stiffness in Children with Congenital Heart Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3266
Author(s):  
Laura Willinger ◽  
Leon Brudy ◽  
Renate Oberhoffer-Fritz ◽  
Peter Ewert ◽  
Jan Müller
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Heart Rate ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Arterial Stiffness ◽  
Systolic Blood Pressure ◽  
Congenital Heart ◽  
Z Score ◽  
Objectively Measured

Background: The association between physical activity (PA) and arterial stiffness is particularly important in children with congenital heart disease (CHD) who are at risk for arterial stiffening. The aim of this study was to examine the association between objectively measured PA and arterial stiffness in children and adolescents with CHD. Methods: In 387 children and adolescents with various CHD (12.2 ± 3.3 years; 162 girls) moderate-to-vigorous PA (MVPA) was assessed with the “Garmin vivofit jr.” for 7 consecutive days. Arterial stiffness parameters including pulse wave velocity (PWV) and central systolic blood pressure (cSBP) were non-invasively assessed by oscillometric measurement via Mobil-O-Graph®. Results: MVPA was not associated with PWV (ß = −0.025, p = 0.446) and cSBP (ß = −0.020, p = 0.552) in children with CHD after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents. Children with CHD were remarkably active with 80% of the study population reaching the WHO recommendation of average 60 min of MVPA per day. Arterial stiffness did not differ between low-active and high-active CHD group after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents (PWV: F = 0.530, p = 0.467; cSBP: F = 0.843, p = 0.359). Conclusion: In this active cohort, no association between PA and arterial stiffness was found. Longer exposure to the respective risk factors of physical inactivity might be necessary to determine an impact of PA on the vascular system.

Diurnal blood pressure variation in adults after abdominal surgery–An observational cohort study

2022 ◽  
Vol 77 ◽  
pp. 110633
Author(s):  
Barak Cohen ◽  
Eva Rivas ◽  
Xuan Pu ◽  
Kamal Maheshwari ◽  
Jorge A. Araujo-Duran ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Abdominal Surgery ◽  
Observational Cohort Study ◽  
Pressure Variation ◽  
Blood Pressure Variation ◽  
Observational Cohort
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