scholarly journals Blended collaborative care in the secondary prevention of coronary heart disease improves risk factor control: Results of a randomised feasibility study

2019 ◽  
Vol 19 (2) ◽  
pp. 134-141 ◽  
Author(s):  
Lena Bosselmann ◽  
Stella V Fangauf ◽  
Birgit Herbeck Belnap ◽  
Mira-Lynn Chavanon ◽  
Jonas Nagel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Collaborative Care ◽  
Intervention Group ◽  
Psychosocial Risk ◽  
Control Group ◽  
Risk Factor Control ◽  
Care Intervention

Background: Risk factor control is essential in limiting the progression of coronary heart disease, but the necessary active patient involvement is often difficult to realise, especially in patients suffering psychosocial risk factors (e.g. distress). Blended collaborative care has been shown as an effective treatment addition, in which a (non-physician) care manager supports patients in implementing and sustaining lifestyle changes, follows-up on patients, and integrates care across providers, targeting both, somatic and psychosocial risk factors. Aims: The aim of this study was to test the feasibility, acceptance and effect of a six-month blended collaborative care intervention in Germany. Methods: For our randomised controlled pilot study with a crossover design we recruited coronary heart disease patients with ⩾1 insufficiently controlled cardiac risk factors and randomised them to either immediate blended collaborative care intervention (immediate intervention group, n=20) or waiting control (waiting control group, n=20). Results: Participation rate in the intervention phase was 67% ( n=40), and participants reported high satisfaction ( M=1.63, standard deviation=0.69; scale 1 (very high) to 5 (very low)). The number of risk factors decreased significantly from baseline to six months in the immediate intervention group ( t(60)=3.07, p=0.003), but not in the waiting control group t(60)=−0.29, p=0.77). Similarly, at the end of their intervention following the six-month waiting period, the waiting control group also showed a significant reduction of risk factors ( t(60)=3.88, p<0.001). Conclusion: This study shows that blended collaborative care can be a feasible, accepted and effective addition to standard medical care in the secondary prevention of coronary heart disease in the German healthcare system.

scholarly journals The Risk Factors of Coronary Heart Disease and its Relationship with Endothelial Nitric Oxide Synthase

2021 ◽  
Vol 9 (B) ◽  
pp. 451-456
Author(s):  
Eka Fithra Elfi ◽  
Eva Decroli ◽  
Ellyza Nasrul ◽  
Yanwirasti Yanwirasti ◽  
Eryati Darwin
Keyword(s):  
Nitric Oxide ◽  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Laboratory Finding ◽  
Control Group ◽  
Cardiology Department ◽  
History Of ◽  
Endothelial Nitric Oxide

BACKGROUND: Coronary heart disease (CHD) is the leading cause of death and start with injury to the endothelium of a coronary artery. The common feature of endothelial dysfunction is a decrease of nitric oxide (NO) bioavailability that regulated by endothelial NO synthase (eNOS) activity. AIM: The aim of our study was to study the relationship between risk factors of CHD patients with the level of eNOS. METHODS: Thirty-seven outpatients in cardiology department of the regional public hospital diagnosed as CHD were included in our study. Thirty healthy individuals were included as the control group. Risk factors of CHD were identified according to anamnesis and laboratory finding. eNOS was measured by ELISA methods. RESULTS: Endothelial NOS levels were significantly higher in the CHD when compared to the controls (p < 0.05). The most dominant risk factor for CHD is overweight, and followed by dyslipidemia, smoking, hypertension, history of CHD, and diabetes mellitus. eNOS in CHD patients who had one risk factor was 37.598 ± 0.1541 ng/ml, two risk factors 42.154 ± 22.329 ng/ml, three risk factors 25.329 ± 6.083 ng/ml, four risk factors 22.483 ± 4.022 ng/ml, and five risk factors 15.994 ± 4.774 ng/ml. There were significant differences in the average eNOS levels based on the number of risk factors (p < 0.05), and a tendency that more risk factors in CHD patients, the lower the average level of eNOS. CONCLUSION: In our study, eNOS levels showed highly significant relation with CHD and related to the number of risk factors those the CHD patients had.

Effects of Teaching Resourcefulness in Patients with Coronary Heart Disease

2021 ◽  
pp. 019394592110207
Author(s):  
Min Wen ◽  
Yaqin Liang ◽  
Qianqian Shen ◽  
Juping Yu ◽  
Pingping He ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Health Education ◽  
Controlled Trial ◽  
Coping Styles ◽  
Intervention Group ◽  
Control Group ◽  
Convenience Sample ◽  
Cluster Randomized ◽  
And Coping

This cluster randomized controlled trial aimed to investigate the effects of an intervention to teach resourcefulness on depression and coping style of patients with coronary heart disease (CHD). A convenience sample of 72 patients in community settings took part. Participants in the intervention group (n = 36) received an 8-week intervention based on the concept of resourcefulness, plus routine health education. Participants in the control group (n = 36) received routine health education only. After the intervention, participants in the intervention group had significantly higher scores on resourcefulness and coping styles, and lower scores on depression than those in the control group (both ps < .001). The findings suggest that a well-developed intervention to teach resourcefulness could help patients with CHD to be more resourceful, improve their level of depression, and choose more effective strategies to cope with stress.

Abstract P115: How Many Coronary Heart Disease Deaths In Poland In 2020 Might Be Prevented By Further Reductions In Population Risk Factor Levels?

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Piotr Bandosz ◽  
Maria Guzman-Castillo ◽  
Simon Capewell ◽  
Tomasz Zdrojewski ◽  
Julia Critchley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Smoking Prevalence ◽  
Mortality Rates ◽  
Mortality Reduction ◽  
Scenario Reduction ◽  
Saturated Fats ◽  
Changes In Risk

Background: Poland has experienced one of the most dramatic declines in coronary heart disease (CHD) mortality rates in recent decades. This decline reflects the use of evidence based treatments and, crucially, population wide changes in diet. Our aim is to explore the potential for further gains in Poland by achieving population wide reductions in smoking, dietary salt and saturated fat intake and physical inactivity levels. Methods: A validated and updated policy model was used to forecast potential decreases in CHD deaths by 2020 as consequence of lifestyle and dietary changes in the population. Data from the most recent Polish risk factor survey was used for the baseline (2011). We modeled two different policy scenarios regarding possible future changes in risk factors: A) conservative scenario: reduction of smoking prevalence and physically inactivity rates by 5% between 2011 and 2020, and reduction of dietary consumption of energy from saturated fats by 1% and of salt by 10%. B) ideal scenario: reduction of smoking and physically inactivity prevalence by 15%, and dietary reduction of energy from saturated fats by 3% and of salt by 30%. We also conducted extensive sensitivity analysis using different counterfactual scenarios of future mortality trends. Results: Baseline scenarios. By assuming continuing declines in mortality and no future improvements in risk factors the predicted number of CHD deaths in 2020 would be approximately 13,600 (9,838-18,184) while if mortality rates remain stable, the predicted number of deaths would approximate 22,200 (17,792-26,688). Conservative scenario. Assuming continuing declines in mortality, small changes in risk factors could result in approximately 1,500 (688-2,940) fewer deaths. This corresponds to a 11% mortality reduction. Under the ideal scenario, our model predicted some 4,600 (2,048-8,701) fewer deaths (a 34% mortality reduction). Reduction in smoking prevalence by 5% (conservative scenario) or 15% (ideal scenario) could result in mortality reductions of 4.5% and 13.8% respectively. Decreases in salt intake by 10% or 30% might reduce CHD deaths by 3.0% and 8.6% respectively. Replacing 1% or 3% of dietary saturated fats by poly-unsaturates could reduce CHD deaths by 2.6% or 7.7% Lowering the prevalence of physically inactive people by 5%-15% could decrease CHD deaths by 1.2%-3.7%. Conclusion: Small and eminently feasible population reductions in lifestyle related risk factors could substantially decrease future number of CHD deaths in Poland, thus consolidating the earlier gains.

scholarly journals Effect of a 36-month Pharmaceutical Care Program on the Coronary Heart Disease Risk in Elderly Diabetic and Hypertensive Patients

2011 ◽  
Vol 14 (2) ◽  
pp. 249 ◽  
Author(s):  
Paulo Roque Obreli Neto ◽  
Srecko Marusic ◽  
Divaldo Pereira De Lyra Júnior ◽  
Diogo Pilger ◽  
Joice Mara Cruciol-Souza ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Pharmaceutical Care ◽  
Coronary Heart Disease Risk ◽  
Disease Risk ◽  
Intervention Group ◽  
Care Program ◽  
Control Group ◽  
Hypertensive Patients ◽  
Heart Disease Risk

Purpose. To examine the effect of a pharmaceutical care program on the coronary heart disease risk in elderly diabetic and hypertensive patients. Methods. A total of 200 elderly (> 60 years) diabetic and/or hypertensive patients were recruited into a randomized, controlled, prospective clinical trial with a 36-month follow-up, developed in a public primary health care unit in a municipality in the Brazilian State of Sao Paulo. A range of clinical measurements were evaluated at the baseline and up to 36 months afterwards. The intervention group patients received pharmaceutical care from a clinical pharmacist, whereas the control group patients received their usual care from the medical and nursing staff. The Framingham scoring method was used to estimate changes in the 10-year coronary heart disease risk scores of all the patients. Results. A total of 194 patients completed the study. Significant reductions (p < 0.05) in the mean values (baseline vs. 36 months) for the systolic blood pressure [156.7mmHg vs 133.7mmHg; p

scholarly journals Analysis on the Expression and Prognostic Value of LncRNA FAF in Patients with Coronary Heart Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Hai Xu ◽  
Xiwen Zhang ◽  
Kun Yu ◽  
Gang Zhang ◽  
Yafei Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Poor Prognosis ◽  
Prognostic Value ◽  
High Sensitivity ◽  
Control Group ◽  
Coronary Lesion ◽  
Tnf Α ◽  
Factor Α

Objective. To investigate the expression and prognostic value of LncRNA FAF in patients with coronary heart disease. Patients and Methods. 97 patients with coronary heart disease who came to our hospital were selected as the research group (RG), and 97 healthy people who came to our hospital for physical examination during the same period were selected as the control group (CG). The serum LncRNA FAF, plasma homocysteine (HCY), lipoprotein A (Lp-a), serum tumor necrosis factor α (TNF-α), and high-sensitivity C-reactive protein (hsCRP) in the two groups of patients were detected, and their correlations were analyzed. Then, the predictive value and risk factors of FAF for poor prognosis of patients with coronary heart disease were analyzed. Results. The expression of LncRNA FAF in the serum of patients in the RG was significantly lower than that in the CG, and the expressions of HCY, Lp-a, TNF-α, and hsCRP were significantly higher than those in the CG (p <0.05). The AUC of FAF in the diagnosis of coronary heart disease was more than 0.9. FAF was negatively correlated with the coronary lesion vessels, HCY, Lp-a, TNF-α, and hsCRP expressions in patients with coronary heart disease ( p < 0.05 ). The ROC of FAF for predicting poor prognosis in patients with coronary heart disease was greater than 0.9. Low expression of FAF; high expressions of HCY, Lp-a, and hsCRP; and increase of coronary lesion vessels were independent risk factors for poor prognosis in patients with coronary heart disease. Conclusions. LncRNA FAF was lowly expressed in the serum of patients with coronary heart disease, and it was of high value in the diagnosis and prediction of poor prognosis of coronary heart disease. It was also an independent risk factor for poor prognosis of patients with coronary heart disease and may be a potential target for diagnosis and treatment of coronary heart disease.

Asymmetric and symmetric dimethylarginine in patients presenting with risk factors for coronary heart disease

Open Medicine ◽  
2012 ◽  
Vol 7 (5) ◽  
pp. 659-664
Author(s):  
Marina Ilic ◽  
Radmila Pavlovic ◽  
Gordana Lazarevic ◽  
Tatjana Cvetkovic ◽  
Gordana Kocic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Middle Aged ◽  
Control Groups ◽  
Symmetric Dimethylarginine ◽  
Patient Groups

AbstractThe aim of the present study was to investigate asymmetric (ADMA) and symmetric dimethylarginine (SDMA) production in patients presenting with one or more risk factor (RF) for coronary heart disease (CHD). Patients and methods: Overall, 113 participants were enrolled in the study, including 45 patients presenting with risk for CHD (27 male and 18 female; aged 55.9 ± 6.4 years), 30 sex and age-matched middle-aged healthy controls (16 male and 14 female; aged 56.3 ± 8.4 years), and 38 young healthy controls (38 male; aged 24.6 ± 3.9 years). Results: No significant differences for ADMA and SDMA were recorded between patients groups presenting with risk for CHD. However, ADMA and SDMA were significantly higher in all examined patient groups (≥3 and 1–2 RF, hypertensive and non-hypertensive, obese and non-obese, diabetics and non-diabetics) compared with both control groups (middle-aged and young controls) (p<0.001). ADMA significantly correlated with SDMA in ≥3 RF (p<0.05), hypertensive (p<0.05), non-obese (p<0.05), non-diabetics (p<0.01), as well in middle-aged (p<0.05) and young controls (p<0.001). Conclusion: Significantly higher ADMA and SDMA were found between patients presenting with risk for CHD (≥3 and 1–2 RF, hypertensive and nonhypertensive, obese and non-obese, diabetics and non-diabetics) and healthy, middle-aged and young controls. ADMA significantly correlated with SDMA in ≥3 RF, hypertensive, non-obese and non-diabetic patients, as well as in middle-aged and young controls.

Longitudinal Evolution of Risk of Coronary Heart Disease in Systemic Lupus Erythematosus

2012 ◽  
Vol 39 (5) ◽  
pp. 968-973 ◽  
Author(s):  
IGOR KARP ◽  
MICHAL ABRAHAMOWICZ ◽  
PAUL R. FORTIN ◽  
LOUISE PILOTE ◽  
CAROLYN NEVILLE ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Blood Glucose ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Chd Risk ◽  
Over Time

Objective.To produce evidence on the longitudinal evolution of risk factors for coronary heart disease (CHD) in patients with systemic lupus erythematosus (SLE).Methods.Based on data for 115 patients from the Montreal General Hospital Lupus Clinic (1971–2003) and for 4367 control subjects from the Framingham Offspring Study (1971–1994), we investigated the temporal evolution of total serum cholesterol, systolic blood pressure (SBP), body mass index (BMI), blood glucose, and estimated risk for CHD (reflecting the balance of changes in different risk factors). In analyses limited to patients with SLE, we assessed the effect of SLE duration on each risk factor, adjusting for age, calendar time, sex, baseline level of the risk factor, and medication use. Next, we assessed how the adjusted difference in the values of the risk factors between SLE and controls changes over time.Results.Among patients with SLE, longer disease duration was independently associated with higher SBP and blood glucose levels. Compared with controls, these patients appeared to have accelerated rates of increase in total cholesterol, blood glucose, and overall estimated CHD risk. The rate of increase in BMI was lower in patients with SLE than in controls.Conclusion.Elevated CHD risk in patients with SLE appears to be at least partially mediated by accelerated increases in some CHD risk factors, longitudinal trajectories of which increasingly diverge over time from those of population controls.

Sign in / Sign up

Export Citation Format

Share Document