Abstract 172: Baseline Physical Activity and Clinical Outcomes in Patients with Diabetes Mellitus and Stable Ischemic Heart Disease: Analysis From BARI-2D Trial.

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Lynda Otalvaro Orozco ◽  
Abdulla Damluji ◽  
Christopher Hawk ◽  
George Marzouka ◽  
Italo Novoa ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cox Regression ◽  
Activity Levels ◽  
Cox Regression Analysis ◽  
Strenuous Activity ◽  
All Cause Mortality ◽  
Strenuous Physical Activity ◽  
Sedentary Life ◽  
Sedentary Life Style ◽  
Baseline Physical Activity

Introduction: We aimed to evaluate the differences in clinical outcomes among patients with DM and coronary heart disease according to their baseline physical activity status. Methods: We evaluated 2,343 patients with CHD and DM who underwent either prompt revascularization (PR) and intensive medical therapy (IMT) or IMT alone in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial. Patients were categorized according to their baseline physical activity status to sedentary, mild physical activity or moderate/strenuous activity. Primary end points were all cause mortality. Cox Regression analysis was used to evaluate the effects of baseline physical activity on all-cause-mortality. Results: Of 2,343 patients, 858 (37%) were able to achieve moderate/strenuous physical activity prior to randomization. Patients with sedentary life style and mild physical activity at baseline had worse survival compared to those with higher activity levels (Figure). In a Cox regression analysis, in patients randomized to IMT alone, there were no differences in mortality across physical activity levels. In the PR arm, sedentary and mild physical activity carried high risk of mortality compared to strenuous activity levels. Furthermore, patients in the low physical activity categories carried an increased risk of death if they were randomized to the insulin sensitizing arm of the trial. Conclusions: In this study, patients with DM and CHD, moderate/strenuous physical activity at baseline had improved survival compared to mild physical activity or sedentary life-style.

Association of Different Physical Activity Domains on All-Cause Mortality in Adults Participating in Primary Care in the Brazilian National Health System: 4-Year Follow-up

2017 ◽  
Vol 14 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Bruna C. Turi ◽  
Jamile S. Codogno ◽  
Romulo A. Fernandes ◽  
Xuemei Sui ◽  
Carl J. Lavie ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Cox Regression ◽  
National Health System ◽  
Circulatory System ◽  
Cox Regression Analysis ◽  
Circulatory System Diseases ◽  
All Cause Mortality ◽  
Males And Females

Background:Evidence has shown that physical activity (PA) is associated with low mortality risk. However, data about reduced mortality due to PA are scarce in developing countries and the dose–response relationship between PA from different domains and all-cause mortality remains unclear. Thus, the aim of this study is to investigate the association of PA from different domains on all-cause mortality among Brazilian adults.Methods:679 males and females composed the study sample. Participants were divided into quartile groups according to PA from different domains (occupational, sports, and leisure-time). Medical records were used to identify the cause of the death. Cox regression analysis was performed to determine the independent associations of PA from different domains and all-cause mortality.Results:During the follow-up period, 59 participants died. The most prevalent cause of death was circulatory system diseases (n = 20; 33.9% [21.8%–45.9%]). Higher scores of occupational (HR= 0.45 [95% CI: 0.20–0.97]), sports (HR= 0.44 [95% CI: 0.20–0.95]) and overall PA (HR= 0.40 [95% CI: 0.17–0.90]) were associated with lower mortality, even after adjustment for confounders.Conclusions:The findings in this study showed the importance of being active in different domains to reduce mortality risk.

Cardiovascular or mortality risk of controlled hypertension and importance of physical activity

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318193
Author(s):  
Sehoon Park ◽  
Kyungdo Han ◽  
Soojin Lee ◽  
Yaerim Kim ◽  
Yeonhee Lee ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Cox Regression ◽  
Vigorous Physical Activity ◽  
Study Groups ◽  
Adverse Outcomes ◽  
Uncontrolled Hypertension ◽  
Cox Regression Analysis ◽  
Cerebrovascular Events ◽  
All Cause Mortality

ObjectiveTo investigate the risk of major adverse cardiac and cerebrovascular events (MACCEs) and all-cause death of patients with controlled hypertension and suggest the benefits of physical activity in their prognosis.MethodsPeople aged 40–69 years from the prospective UK Biobank cohort (UKB, n=220 026) and the retrospective Korean National Health Insurance Service cohort (KNHIS, n=3 593 202) were included in this observational cohort study, excluding those with previous cerebrocardiovascular diseases or hypertension without treatment. The study groups were stratified into normotension, controlled hypertension (patients with hypertension with systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg) and uncontrolled hypertension groups. The outcomes were MACCEs and all-cause mortality, analysed by Cox regression analysis.ResultsWe included 161 405/18 844/39 777 and 3 122 890/383 828/86 484 individuals with normotension/controlled hypertension/uncontrolled hypertension state from the UKB and KNHIS cohorts, respectively. The controlled hypertension group showed significantly higher risk of MACCEs (UKB: adjusted HR 1.73 (95% CI 1.55 to 1.92); KNHIS: 1.46 (95% CI 1.43 to 1.49)) and all-cause mortality (UKB: adjusted HR 1.28 (95% CI 1.18 to 1.39); KNHIS: 1.29 (95% CI 1.26 to 1.32)) than individuals with normotension. The controlled hypertension group not involved in any moderate or moderate-to-vigorous physical activity showed high risk of adverse outcomes, which was comparable with or even higher than the risk of patients with uncontrolled hypertension who were engaged in physical activity.ConclusionsControlled hypertension is associated with residual risks of adverse outcomes. Clinicians may encourage physical activity for patients with controlled hypertension, not being reassured by their achieved target blood pressure values.

scholarly journals Comparison of accelerometer-derived physical activity levels between individuals with and without cancer: a UK Biobank study

2019 ◽  
Vol 15 (33) ◽  
pp. 3763-3774 ◽  
Author(s):  
Laura McDonald ◽  
Mustafa Oguz ◽  
Robert Carroll ◽  
Pratik Thakkar ◽  
Fei Yang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cox Regression ◽  
Activity Levels ◽  
Uk Biobank ◽  
Cancer Group ◽  
All Cause Mortality ◽  
History Of ◽  
The Difference ◽  
The Uk ◽  
History Of Cancer

Aim: To identify the difference in physical activity (PA) levels between individuals with and without cancer, and to estimate all-cause mortality associated with this difference. Methods: Current cancer, cancer survivor and cancer-free groups were identified from the UK Biobank. We used multivariate and Cox regression to estimate PA differences and association of PA with all-cause mortality. Results: Compared with the cancer-free individuals, participants in the two cancer groups had fewer minutes in moderate-to-vigorous PA per day in adjusted analyses. The PA difference was associated with higher mortality in the current cancer group. Conclusion: Patients with a history of cancer were less active than those without cancer, and PA is associated with increased mortality. PA improvement strategies in cancer patients must be explored.

Moderate and vigorous physical activity levels are associated with circulating CD34+ progenitor cells which are predictive of all-cause and cardiovascular mortality

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Ross ◽  
D Muggeridge ◽  
J Dodd
Keyword(s):  
Physical Activity ◽  
Progenitor Cells ◽  
Cox Regression ◽  
Vigorous Physical Activity ◽  
Public Institution ◽  
Activity Levels ◽  
Inverse Association ◽  
Regression Analyses ◽  
All Cause Mortality ◽  
The Relationship

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Edinburgh Napier University Research Excellence Grant Background Circulating progenitor cells (CPCs) play an important role in vascular repair and may influence cardiovascular (CV) health and longevity. Physical activity is known to promote vascular health and may do so by modulating CPC counts. Purpose The primary aims of this study were to evaluate the association of CPCs with mortality and explore the association between physical activity (PA) and CPCs. Methods We studied 1,751 individuals from the Framingham Offspring cohort (66 ± 9 years, 54% female). CPCs (CD34+, CD34 + CD133+, CD34 + CD133 + KDR+) were measured from blood samples by flow cytometry. Multivariable cox regression analyses were performed to investigate the relationship of CPCs with future CV event, mortality, and all-cause mortality. Multivariate regression analyses were performed to determine the relationship between self-reported PA and CPC counts. Results Following adjustment for standard risk factors, there was an inverse association between CD34+ CPCs and all-cause mortality (hazard ratio (HR) per unit increase in CD34+, 0.79; 95% CI 0.64 – 0.98). CD34 + CD133+ CPCs were inversely associated with CV mortality (HR 0.63, 95% CI 0.44 – 0.91, P = 0.013). Associations of CD34+ and CD34 + CD133+ with mortality were strongest in participants with pre-existing CVD. PA was associated with CD34+ CPCs only in CVD participants. This relationship was maintained after adjustment for confounding variables. Conclusions Higher number of CD34+ and CD34+ CD133+ CPCs were inversely associated with all-cause and CV mortality. These associations were strongest in participants already diagnosed with CVD. PA is independently associated with CD34+ CPCs in individuals with CVD only, suggestive of greater benefit for this population group.

scholarly journals Joint association between accelerometry-measured daily combination of time spent in physical activity, sedentary behaviour and sleep and all-cause mortality: a pooled analysis of six prospective cohorts using compositional analysis

2021 ◽  
pp. bjsports-2020-102345
Author(s):  
Sebastien Chastin ◽  
Duncan McGregor ◽  
Javier Palarea-Albaladejo ◽  
Keith M Diaz ◽  
Maria Hagströmer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behaviour ◽  
Sedentary Time ◽  
Cox Regression ◽  
Vigorous Physical Activity ◽  
Pooled Analysis ◽  
Light Physical Activity ◽  
Cox Regression Analysis ◽  
All Cause Mortality ◽  
Prospective Cohorts

ObjectiveTo examine the joint associations of daily time spent in different intensities of physical activity, sedentary behaviour and sleep with all-cause mortality.MethodsFederated pooled analysis of six prospective cohorts with device-measured time spent in different intensities of physical activity, sedentary behaviour and sleep following a standardised compositional Cox regression analysis.Participants130 239 people from general population samples of adults (average age 54 years) from the UK, USA and Sweden.Main outcomeAll-cause mortality (follow-up 4.3–14.5 years).ResultsStudies using wrist and hip accelerometer provided statistically different results (I2=92.2%, Q-test p<0.001). There was no association between duration of sleep and all-cause mortality, HR=0.96 (95% CI 0.67 to 1.12). The proportion of time spent in moderate to vigorous physical activity was significantly associated with lower risk of all-cause mortality (HR=0.63 (95% CI 0.55 to 0.71) wrist; HR=0.93 (95% CI 0.87 to 0.98) hip). A significant association for the ratio of time spent in light physical activity and sedentary time was only found in hip accelerometer-based studies (HR=0.5, 95% CI 0.42 to 0.62). In studies based on hip accelerometer, the association between moderate to vigorous physical activity and mortality was modified by the balance of time spent in light physical activity and sedentary time.ConclusionThis federated analysis shows a joint dose–response association between the daily balance of time spent in physical activity of different intensities and sedentary behaviour with all-cause mortality, while sleep duration does not appear to be significant. The strongest association is with time spent in moderate to vigorous physical activity, but it is modified by the balance of time spent in light physical activity relative to sedentary behaviour.

Sex differences in transaortic flow rate and association with all-cause mortality in patients with severe aortic stenosis

2021 ◽  
Author(s):  
Sahrai Saeed ◽  
Anastasia Vamvakidou ◽  
Spyridon Zidros ◽  
George Papasozomenos ◽  
Vegard Lysne ◽  
...  
Keyword(s):  
Sex Differences ◽  
Aortic Stenosis ◽  
Flow Rate ◽  
Cox Regression ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Aims It is not known whether transaortic flow rate (FR) in aortic stenosis (AS) differs between men and women, and whether the commonly used cut-off of 200 mL/s is prognostic in females. We aimed to explore sex differences in the determinants of FR, and determine the best sex-specific cut-offs for prediction of all-cause mortality. Methods and results Between 2010 and 2017, a total of 1564 symptomatic patients (mean age 76 ± 13 years, 51% men) with severe AS were prospectively included. Mean follow-up was 35 ± 22 months. The prevalence of cardiovascular disease was significantly higher in men than women (63% vs. 42%, P &lt; 0.001). Men had higher left ventricular mass and lower left ventricular ejection fraction compared to women (both P &lt; 0.001). Men were more likely to undergo an aortic valve intervention (AVI) (54% vs. 45%, P = 0.001), while the death rates were similar (42.0% in men and 40.6% in women, P = 0.580). A total of 779 (49.8%) patients underwent an AVI in which 145 (18.6%) died. In a multivariate Cox regression analysis, each 10 mL/s decrease in FR was associated with a 7% increase in hazard ratio (HR) for all-cause mortality (HR 1.07; 95% CI 1.03–1.11, P &lt; 0.001). The best cut-off value of FR for prediction of all-cause mortality was 179 mL/s in women and 209 mL/s in men. Conclusion Transaortic FR was lower in women than men. In the group undergoing AVI, lower FR was associated with increased risk of all-cause mortality, and the optimal cut-off for prediction of all-cause mortality was lower in women than men.

scholarly journals Vascular and Cardiac Prognostic Determinants in Patients with Gynecological Cancers: A Six-Year Follow-up Study

2021 ◽  
Vol 11 (13) ◽  
pp. 6091
Author(s):  
Pietro Scicchitano ◽  
Marco Tucci ◽  
Gabriella Ricci ◽  
Michele Gesualdo ◽  
Santa Carbonara ◽  
...  
Keyword(s):  
Brachial Artery ◽  
Cox Regression ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Controlled Study ◽  
Gynecological Cancers ◽  
Roc Curve Analysis ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Background: The aim of this study was to assess the role of cardiac and vascular parameters as all-cause mortality determinants in patients suffering from gynecological cancers. Methods: This was an observational, prospective, non-randomized, and non-controlled study. Forty-seven consecutive patients (mean age: 58 ± 13 years) were enrolled after cancer staging. All patients underwent evaluation of vascular (common carotid intima-media thickness (mean C-IMT), flow-mediated dilation of the brachial artery (FMD), and antero-posterior diameter of the infrarenal abdominal aorta (APAO)) and cardiac function and morphology before cancer-related interventions. A 6-year follow-up was carried out to assess the overall survival of the whole population. Results: Twenty patients (42%) died by the time of the 6-year follow-up. The brachial artery FMD values were higher in the survivors than the non-survivors (9.71 ± 3.53% vs. 6.13 ± 2.62%, p < 0.001), as well as the LVEF (60.8 ± 3.0% vs. 57.8 ± 4.4%, p = 0.009). There were no differences in the mean C-IMT, APAO, and other echocardiographic parameters. ROC curve analysis identified a baseline LVEF < 57% and FMD value < 5.8% as the best cut-offs. Kaplan–Meier evaluation showed that the LVEF, tricuspid annular plane systolic excursion, and FMD were the best predictors of all-cause mortality, although only the LVEF and FMD were confirmed in multivariate Cox regression analysis. Conclusions: The LVEF and brachial artery FMD are independent prognostic determinants in patients with gynecological cancers.

scholarly journals Critical review of medovridhi (obesity) due to sedentary life style and junk food.

2019 ◽  
Vol 7 (02) ◽  
Author(s):  
Pasha Shaikh ◽  
Ramesh Bansode
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Body Fat ◽  
Sedentary Lifestyle ◽  
Junk Food ◽  
In Trans ◽  
Unhealthy Diet ◽  
Sedentary Life ◽  
Sedentary Life Style ◽  
Very High

Acharya sushruta said to be swastha whoes dosha,dhatu, agni, mala are in the state of in equilibrium along with mental, sensory and spiritual happiness. Medovridhi is a condition is of excess body fat for their height, medovridhi can affect any person from young children to older adults. there are many causes of medovridhi such as overeating, genetics, hormones, lack of physical activity, sedentary lifestyle, junk food etc.  Among them sedentary life-a kind of life which has less or no physical activity at all e.g. desk jobs, sleeping too much, sitting for long hours without reasons. Junk food like-like fried chicken, ice-cream, pizza, sandwiches, chips etc. is an unhealthy diet that is high in trans and saturated fats. In obesity (medovridhi) there is imbalance state of med dhatu which affect health of a person and prevalence rate of medovridhi is very high (16.6 in Maharashtra). Medovridhi is a burning issue for all the countries, it causes the number of health problems. Ayurvedic acharyas had mentioned the above condition and explained in detailed causes, sign, symptoms, and treatment.

Predictive Value of Atrial Electromechanical Delay on Long-Term Cardiovascular Outcomes in Hemodialysis Patients

2015 ◽  
Vol 42 (3) ◽  
pp. 239-249 ◽  
Author(s):  
Kultigin Turkmen ◽  
Levent Demirtas ◽  
Ergun Topal ◽  
Abduzhappar Gaipov ◽  
Ismail Kocyigit ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Total Cholesterol ◽  
Cox Regression ◽  
Healthy Individuals ◽  
Electromechanical Delay ◽  
Cox Regression Analysis ◽  
Atrial Electromechanical Delay ◽  
Kaplan Meier ◽  
All Cause Mortality ◽  
Spearman Test

Background: Atrial electromechanical delay (AEMD) times were considered independent predictors of cardiovascular morbidity among the general population. We aimed at evaluating AEMD times and other risk factors associated with 2-year combined cardiovascular (CV) events in HD patients. Material and Methods: Sixty hemodialysis (HD) and 44 healthy individuals were enrolled in this prospective study. Echocardiography was performed before the mid-week dialysis session for HD patients. Data were expressed as mean ± SD. Spearman test was used to assess linear associations. Survival was examined with the Kaplan-Meier method. Multivariate Cox regression analysis was used to determine the predictors of combined CV events in this cohort. Results: At the beginning of the study, left intra-atrial-AEMD times were significantly longer in HD patients compared to the left intra-atrial-AEMD times in healthy individuals. After 24 months, 41 patients were still on HD treatment and 19 (31.6%) had died. Serum triglyceride, total cholesterol and albumin were found to be higher and C-reactive protein (CRP) levels, left intra-atrial EMD time (LIAT) and interatrial EMD times were found to be lower in survived HD patients. With the cut-off median values of 3.5 g/dl for albumin, 0.87 mg/dl for CRP, 157 mg/dl for total cholesterol and 151 mg/dl for triglyceride, the Kaplan-Meier curves demonstrated significant differences in terms of all-cause mortality. We also demonstrated the Kaplan-Meier survival curves of HD patients according to tertile values of LIAT. Cox regression analysis revealed that increased CRP and higher LIAT were found to be independent predictors of combined CV events. Conclusions: Increased LIAT and inflammation were found to be closely associated with 2 years combined CV events and all-cause mortality in HD patients.

Abstract 6023: The Need for Blood Transfusion Is an Independent Predictor of Incident Cardiovascular Events and All-Cause Mortality among Patients Undergoing Percutaneous Coronary Intervention

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Jasper Jan Brugts ◽  
Nestor Mercado ◽  
Joachim Ix ◽  
Michael G Shlipak ◽  
Simon R Dixon ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Transfusion ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Independent Predictor ◽  
P Value ◽  
Transfusion Rate ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
All Cause Mortality

Periprocedural bleeding is one of the most frequent complications of percutaneours coronary interventions. We assessed the relation between blood transfusion and all-cause mortality or incident cardiovascular events (death, MI, stroke) among 6103 patients of the Evaluation of Oral Xemilofiban in Controlling Thrombotic Events (EXCITE)-trial. Subjects were followed for 7 months after enrollment for the occurrence of events. Multivariate Cox-regression analysis evaluated the independent association of blood transfusion with each outcome adjusted for age, gender, race, diabetes mellitus, hypertension, hypercholesterolemia, history of MI, PCI, CABG, heart failure, LVEF<30%, use of beta-blockers, statins, ACE-inhibitors, platelet inhibitors and allocation to treatment with xemolifiban. In addition, propensity score analyses were performed (ROC 0.80). Mean age was 59.2 years, 21.7% were female, and 18.9% had diabetes mellitus. Of the169 patients who received blood transfusion, 14 (8.3%) died and 42 (24.9%) experienced a CVD event. Of the 5934 patients without transfusion, 65 (1.1%) died (p-value: <0.001) and 555 (9,4%) experienced a CVD event (p-value: <0.001) In multivariate analysis, blood transfusion was associated with a 5.3 fold increased risk of mortality (HR 5.3; 95% CI 2.8 –10.2), and a 2.5 fold increased risk of incident CVD (HR 2.5; 95% CI 1.7–3.4.) Noteworthy, patients who were US citizens had a higher transfusion rate then non-US citizens (OR 1.45, 95%CI 1.02–2.06) The need of blood transfusion is a strong and independent predictor of all-cause mortality and incident CVD events among patients undergoing PCI.

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