Abstract 1269 Physician Diagnosis of Overweight Predicts Weight Loss Attempts in Patients with Cardiovascular Disease and Central Obesity

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Siddharth Singh ◽  
Virend K Somers ◽  
Matthew M Clark ◽  
Donald D Hensrud ◽  
Kristin Vickers Douglas ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Weight Loss ◽  
Transtheoretical Model ◽  
Behavioral Change ◽  
Central Obesity ◽  
Sociodemographic Factors ◽  
Multivariate Models ◽  
Overweight Status ◽  
Nationally Representative ◽  
Artery Disease

Central obesity has been associated with adverse events in patients with cardiovascular disease (CVD). We undertook this study to evaluate predictors of overweight awareness, desire to lose weight and weight loss attempts in patients with CVD and central obesity. Association of physician-rendered diagnosis of overweight with weight loss attempts was also evaluated. Data from National Health and Nutrition Examination Survey (NHANES) 1999 –2004 were used. CVD was defined as self-referred history of coronary artery disease or stroke. Central obesity was determined based on a waist circumference > 102 cm in men and > 88 cm in women. Motivational factors considered as determinant for behavioral change that were evaluated included: participants’ awareness of their overweight status; desire to lose weight; any weight loss attempts in last year. We examined demographic, anthropometric and clinical determinants of each stage of change using multivariate models. Of the 1484 participants with CVD that were identified in NHANES, 824 had central obesity (56%). 76% of centrally obese participants were aware of their overweight status and 79% were desirous of losing weight. Despite this awareness and desire, only 41% of centrally obese had attempted weight loss in the last year. Only 61% reported that they had been informed that they were overweight by physicians. On multivariate analysis, after adjusting for sociodemographic factors and body mass index, physician rendered diagnosis of overweight was a significant predictor of weight loss attempts (OR=2.5, 95% CI 1.3– 4.9, p= 0.006). Awareness of one’s overweight status strongly predicted desire to lose weight in multivariate models (OR=107.6, 95 % CI 42.9 –270.0, p<.0001) and desire to lose weight was linked to recent attempts to lose weight (OR 10.4, 95 % CI 2.8– 39.2, p= 0.0005), confirming that the Transtheoretical Model of behavioral change applies to the study population. In a nationally representative sample of participants with CVD and central obesity, physician-rendered diagnosis of overweight emerged as an important predictor of weight loss attempts. Efforts to promote weight loss should focus on interventions based on Transtheoretical Model of behavioral change.

scholarly journals Physician diagnosis of overweight status predicts attempted and successful weight loss in patients with cardiovascular disease and central obesity

2010 ◽  
Vol 160 (5) ◽  
pp. 934-942 ◽  
Author(s):  
Siddharth Singh ◽  
Virend K. Somers ◽  
Matthew M. Clark ◽  
Kristin Vickers ◽  
Donald D. Hensrud ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Weight Loss ◽  
Central Obesity ◽  
Overweight Status ◽  
Successful Weight Loss ◽  
Physician Diagnosis

scholarly journals Trends of Substance Use among Individuals with Cardiovascular Disease in the United States, 2015–2019

2022 ◽  
Vol 19 (1) ◽  
pp. 577
Author(s):  
Yeonwoo Kim ◽  
Sehun Oh ◽  
Paul J. Fadel ◽  
Christopher P. Salas-Wright ◽  
Michael G. Vaughn
Keyword(s):  
Cardiovascular Disease ◽  
Substance Use ◽  
Risk Perceptions ◽  
The United States ◽  
Sociodemographic Factors ◽  
Cannabis Use ◽  
Early Screening ◽  
Nationally Representative ◽  
Adjusted Logistic Regression ◽  
Increasing Trends

Despite the adverse effects of substance use on health among individuals with preexisting cardiovascular disease (CVD), little is known about trends and correlates for substance use among individuals with CVD. We examined trends of use in tobacco, alcohol, and cannabis among US adults with heart disease. Using nationally representative data from the 2015–2019 National Survey on Drug Use and Health (N = 7339), we conducted survey-adjusted logistic regression analyses to test the significance of trends in substance use while controlling for sociodemographic factors and related correlates. Results showed that the prevalence of cannabis use among adults with a heart condition significantly increased. Notably, the prevalence of cannabis use increased by 91% among non-Hispanic Whites, while the increasing trends were not present among other racial/ethnic groups. Our results also showed that increase in cannabis use was associated with easier access, lower disapproval, and risk perceptions of cannabis. Special attention is needed to raise awareness of the risk associated with cannabis use among individuals with CVD and the implementation of an early screening and treatment strategy among those with CVD.

scholarly journals Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Tiffany M. Powell-Wiley ◽  
Paul Poirier ◽  
Lora E. Burke ◽  
Jean-Pierre Després ◽  
Penny Gordon-Larsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Weight Loss ◽  
Coronary Artery ◽  
Disease Risk ◽  
Artery Disease ◽  
The Impact

The global obesity epidemic is well established, with increases in obesity prevalence for most countries since the 1980s. Obesity contributes directly to incident cardiovascular risk factors, including dyslipidemia, type 2 diabetes, hypertension, and sleep disorders. Obesity also leads to the development of cardiovascular disease and cardiovascular disease mortality independently of other cardiovascular risk factors. More recent data highlight abdominal obesity, as determined by waist circumference, as a cardiovascular disease risk marker that is independent of body mass index. There have also been significant advances in imaging modalities for characterizing body composition, including visceral adiposity. Studies that quantify fat depots, including ectopic fat, support excess visceral adiposity as an independent indicator of poor cardiovascular outcomes. Lifestyle modification and subsequent weight loss improve both metabolic syndrome and associated systemic inflammation and endothelial dysfunction. However, clinical trials of medical weight loss have not demonstrated a reduction in coronary artery disease rates. In contrast, prospective studies comparing patients undergoing bariatric surgery with nonsurgical patients with obesity have shown reduced coronary artery disease risk with surgery. In this statement, we summarize the impact of obesity on the diagnosis, clinical management, and outcomes of atherosclerotic cardiovascular disease, heart failure, and arrhythmias, especially sudden cardiac death and atrial fibrillation. In particular, we examine the influence of obesity on noninvasive and invasive diagnostic procedures for coronary artery disease. Moreover, we review the impact of obesity on cardiac function and outcomes related to heart failure with reduced and preserved ejection fraction. Finally, we describe the effects of lifestyle and surgical weight loss interventions on outcomes related to coronary artery disease, heart failure, and atrial fibrillation.

Abstract 244: Sex-based Differences in Economic and Health-related Burden of Depression on Adults With Cardiovascular Disease

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Javier Valero-Elizondo ◽  
Joseph A Salami ◽  
Oluseye Ogunmoroti ◽  
Shozab Ali ◽  
Alejandro Arrieta ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Healthcare Costs ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditures ◽  
Medical Costs ◽  
Medical Expenditure ◽  
Study Population ◽  
Per Capita ◽  
Nationally Representative ◽  
Artery Disease

Background: Depression is commonly present in patients with cardiovascular disease (CVD). Among those with established CVD, depression is more common in women and associated with worse outcome. However, how depression affects overall health care expenditures, as well as whether depression among women has a greater impact on medical costs, has not been well studied, which is the aim of the present study. Methods: The 2012 Medical Expenditure Panel Survey was analyzed to explore this project. Variables of interest were defined as CVD (coronary artery disease, stroke, peripheral artery disease, dysrhythmias or heart failure) and depression diagnoses, ascertained by ICD-9-CM codes (410, 413, 433-437, 427-28, 440, 443, 447 and 296, 311, respectively). We restricted our study population to non-institutionalized adults ≥ 18 years of age. Two-part models were utilized to study cost data; a generalized linear model with gamma distribution and link log was used to assess the mean expenditure per capita for each sex/depression status. Results: 27,288 surveyed persons constituted our study population (mean age 67 ± 12.4, 46% female), translating to an approximate of 231 million people across the U.S. Overall, CVD was noted in 15.6 million, of which 18% were patients with depression (2.9 million). Of this nationally representative sample, those with CVD were 86% more likely to be diagnosed with depression (OR 1.86, 95% CI 1.51, 2.28, p<0.001) than Non-CVD. Additionally, among CVD individuals, females were 66% more likely be diagnosed with depression than males (OR 1.66, 95% CI 1.23, 2.23, p=0.001). CVD diagnosis was independently associated with higher healthcare costs among individuals with depression. Moreover, on adjusted analysis, females with depression were also associated with $4,380.14 higher medical costs than those without depression (Table 1). When comparing female vs. males with CVD and depression diagnoses, adjusted mean expenditure per capita was $14,162 (95% CI 10,211 - 18,112) and $11,325 (95% CI 7,769 - 14,881), respectively. Conclusion: CVD patients, especially women, were more likely to have depression, and had considerable higher medical expenditures. The results reinforce the paramount importance of assessing and managing depression among those with CVD to favorably impact healthcare costs.

scholarly journals Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity

2021 ◽  
Author(s):  
Mitch Wilson ◽  
Hailey Orgass ◽  
Jennifer Dearborn-Tomazos
Keyword(s):  
Weight Loss ◽  
Transtheoretical Model ◽  
Behavioral Change ◽  
Stage Of Change ◽  
Processes Of Change ◽  
Vascular Risk ◽  
Stroke Patients ◽  
Exclusion Criteria ◽  
Validated Questionnaire ◽  
Maintenance Stage

Background: Obesity is associated with an increased prevalence of vascular risk factors and incidence of stroke. As such weight loss is recommended for patients living with obesity in the secondary prevention of stroke. Few studies, however, have examined the stages and processes of change for weight loss in stroke patients living with obesity. Objective: To evaluate the stages and processes of change for weight loss in patients living with obesity who have had a recent stroke or TIA. Methods: Using a validated questionnaire, we assessed each patient’s stage of behavioral change according to the Transtheoretical Model (precontemplation, contemplation, preparation, action and maintenance). We also examined four processes of behavioral change, which quantify activities and experiences that patients undergo on the way to behavioral change: emotional re-evaluation (EMR), weight management action (WMA), weight consequence evaluation (WCE), and supporting relationships (SR). Processes scores were compared between patients in the action and maintenance stages and those in the precontemplation, contemplation and preparation stages. Results: Out of 49 patients who provided informed consent, 44 met the inclusion/exclusion criteria. Of these 44 patients, 6 (14%) were in the precontemplation stage of change, 7 (16%) were in contemplation, 2 (5%) were in preparation, 13 (30%) were in action, and 16 (36%) were in maintenance. Those in the action and maintenance stages accounted for the majority of participants (n=29, 66%). Patients in the action and maintenance stages (N=29) had higher EMR scores (mean 79, SD 13 vs mean 68, SD 19, t=2.0, p=0.03) and WMA scores (mean 69, SD 13 vs mean 59, SD 19, t=2.0, p=0.03) as compared to those in the precontemplation, contemplation and preparation stages (N=15). Conclusions: Our results suggest that without counseling or specific intervention, approximately two-thirds of stroke/TIA patients living with obesity are in the action or maintenance stage of behavior change with respect to weight loss and therefore more likely to succeed in intensive lifestyle-based interventions targeted towards weight loss. Patients who score higher in EMR and WMA are more likely to be in the action or maintenance stage of change.

scholarly journals Az együttműködés növelésének eszközei a testsúlykontrollban

2019 ◽  
Vol 160 (43) ◽  
pp. 1687-1697
Author(s):  
Edit Czeglédi
Keyword(s):  
Weight Loss ◽  
Transtheoretical Model ◽  
Behavioral Change ◽  
Weight Control ◽  
Health Risk Behaviors ◽  
Point Of View ◽  
Behavior Motivation ◽  
Health Related ◽  
Clinically Significant

Abstract: Long-term successful weight control poses a huge challenge to people who are overweight and treat them in the obesogenic environment. After reaching a clinically significant (5–10%) weight loss, the goal is to maintain the weight loss achieved. However, this requires virtually constant resistance to temptations and requires sustained effort in terms of dietary restriction and physical activity, which requires a strong motivational base. From the point of view of behavior, motivation is the probability that the patient starts, pursues, or persistently follows a strategy that triggers change, that is, in the case of obesity, is committed to health-related behaviors that support weight management and abandons health risk behaviors that hinders weight control efforts. The present study describes the transtheoretical model of behavioral change and provides examples of practical ways to increase motivation and adherence at all stages of behavioral change. All this can contribute to the work of primary care and outpatient care professionals in supporting weight loss patients with excess weight. Orv Hetil. 2019; 160(43): 1687–1697.

scholarly journals Examination of the Association between Insufficient Sleep and Cardiovascular Disease and Diabetes by Race/Ethnicity

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Abhishek Vishnu ◽  
Anoop Shankar ◽  
Sita Kalidindi
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Hispanic Americans ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Contemporary Sample ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Artery Disease ◽  
Multiethnic Sample

Background. We examined the association between insufficient rest/sleep and cardiovascular disease or diabetes mellitus separately among non-Hispanic whites, non-Hispanic blacks, Hispanic Americans, and other races in a contemporary sample of US adults.Methods. Multiethnic, nationally representative, cross-sectional survey (2008 BRFSS) participants who were >20 years of age (n=369, 217; 50% women). Self-reported insufficient rest/sleep in the previous month was categorized into: zero, 1–13, 14–29, and all 30 days. Outcomes were: (1) any CVD, (2) coronary artery disease (CHD), (3) stroke, and (4) diabetes mellitus.Results.Insufficient rest/sleep was found to be positively associated with (1) any CVD, (2) CHD, and (3) stroke among all race-ethnicities. In contrast, insufficient rest/sleep was positively associated with diabetes mellitus in all race-ethnicities except non-Hispanic blacks. The odds ratio of diabetes association with insufficient rest/sleep for all 30 days was 1.37 (1.26–1.48) among non-Hispanic whites, 1.11 (0.90–1.36) among non-Hispanic blacks, 1.88 (1.46–2.42) among Hispanic Americans, and 1.48 (1.10–2.00) among other race/ethnicities.Conclusion. In a multiethnic sample of US adults, perceived insufficient rest/sleep was associated with CVD, among all race-ethnicities. However, the association between insufficient rest/sleep and diabetes mellitus was present among all race-ethnicities except non-Hispanic blacks.

Stentul JJ ureteral - care este optiunea mai buna? New Considerations Regarding Chronic Kidney Disease, Cardiovascular Disease and Dyslipidemia in Diabetic Patients

2018 ◽  
Vol 69 (8) ◽  
pp. 2064-2066
Author(s):  
Mircea Munteanu ◽  
Adrian Apostol ◽  
Viviana Ivan
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Total Cholesterol ◽  
Total Cholesterol Level ◽  
Vascular Complications ◽  
Hdl Cholesterol ◽  
Controlled Study ◽  
Diabetic Patients ◽  
Artery Disease

The aim of the present study is to investigate the prevalance of chronic kidney disease (CKD), of cardiovascular disease (CVD) and dyslipidemia in patients with diabetes mellitus (DM). We conducted a prospective, controlled study involving 420 diabetic patients (120 T1DM, 300 T2DM) and investigate the following aspects: the presence of vascular complications (stroke, coronary artery disease, peripheral artery disease), lipid profile (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides), kidney function (glomerular filtration rate, albuminuria), blood pressure, HbA1C. The results that in diabetic patients with CKD there is an increased prevalence of CVD and of dislipidemia. Also we noticed a negative correlation between total cholesterol level and decease in eGFR in all patients, with or without CKD.

Statins and Inflammation in Cardiovascular Disease

2018 ◽  
Vol 23 (46) ◽  
pp. 7027-7039 ◽  
Author(s):  
Georgia Vogiatzi ◽  
Evangelos Oikonomou ◽  
Gerasimos Siasos ◽  
Sotiris Tsalamandris ◽  
Alexandros Briasoulis ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Lipid Lowering ◽  
Hmg Coa Reductase ◽  
Ample Evidence ◽  
Reductase Inhibitors ◽  
Immune System Activation ◽  
Hmg Coa Reductase Inhibitors ◽  
Anti Inflammatory ◽  
Artery Disease ◽  
Coa Reductase

Background: Chronic inflammation and immune system activation underlie a variety of seemingly unrelated cardiac conditions including not only atherosclerosis and the subsequent coronary artery disease but also peripheral artery disease, hypertension with target organ damage and heart failure. The beneficial effects of HMG-CoA reductase inhibitors or statins are mainly attributed to their ability to inhibit hepatic cholesterol biosynthesis. Beyond their lipid lowering activity, ample evidence exists in support of their potent anti-inflammatory properties which initiate from the inhibition of GTPase isoprenylation, activating a cataract of secondary pathways and extend to the inhibition and blocking of immune cell activation and interaction. </P><P> Objective: To summarize the anti-inflammatory mechanisms of statins in clinical and experimental settings in cardiovascular disease. </P><P> Methods: A systematic search of PubMed and the Cochrane Database was conducted in order to identify the majority of trials, studies, current guidelines and novel articles related to the subject. </P><P> Results: In vitro, statins have immuno-modulatory and anti-inflammatory effects, and they can exert antiatherosclerotic effects independently of their hypolipidemic actions. In addition, positive results have emerged from mechanistic and experimental studies on the active role of HMG-CoA reductase inhibitors in HF. By extrapolating those data in clinical setting, we further understand how HMG-CoA reductase inhibitors can beneficially affect not only systolic but also diastolic HF. </P><P> Conclusion: In this review article, we present the basic pathophysiologic data supporting the anti-inflammatory actions of statins in clinical and experimental settings and we link these mechanisms with confirmatory clinical data on the potent non lipid lowering effects of HMG-CoA reductase inhibitors.

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