scholarly journals A nurse-led intervention to promote physical activity in sedentary older adults with cardiovascular risk factors: a randomized clinical trial (STEP-IT-UP study)

2020 ◽  
Vol 19 (7) ◽  
pp. 638-645 ◽  
Author(s):  
Magdalena Chudowolska-Kiełkowska ◽  
Łukasz A Małek

Background Regular physical activity should constitute the essence of treatment in patients with cardiovascular risk factors. We sought to determine the benefits of nurse-led intervention to promote physical activity in sedentary older adults in a primary care setting. Methods A group of 199 sedentary older adults (mean age 62.7±6.9, 34.2% male) with at least one more cardiovascular risk factor were randomized 1:1 to receive a nurse-led tutorial on lifestyle modification, including pedometer hand-out – with a daily goal of at least 7000 steps – and supporting phone calls (study group), or without a goal or calls (control group). Body weight (BW), resting heart rate, systolic and diastolic blood pressure (SBP/DBP), total cholesterol (TC) and glucose were assessed at baseline and after 3 months. Results Subjects in the study group ( n = 86) achieved higher daily step count in comparison to the control group ( n = 78), 10,648±3098 vs. 3589±2000, p < 0.0001. The study group presented an improvement in all analysed parameters but glucose, including BW (−2.5±1.9 kg), SBP and DBP (−7.9±7.6 mmHg and −6.2±6.5 mmHg) and TC (−14.7±30.4 mg%), all p < 0.0001. In the control group, all parameters increased or remained unchanged. An inverse correlation between the daily step count and delta of the analysed parameters ( r = −0.26 to −0.72, p < 0.001) was found. Conclusion Nurse-led intervention with pedometer, goal setting and supporting phone calls is an effective way to promote physical activity in sedentary older adults and leads to improvement of cardiovascular risk factors within 3 months.

2021 ◽  
Vol 10 (4) ◽  
pp. 579
Author(s):  
Deborah Talamonti ◽  
Thomas Vincent ◽  
Sarah Fraser ◽  
Anil Nigam ◽  
Frédéric Lesage ◽  
...  

Cardiovascular fitness is linked to better executive functions, preserved gait speed, and efficient cortical activity. Older adults with cardiovascular risk factors (CVRFs) typically show poor cognitive performance, low physical fitness, and altered brain functioning compared with healthy individuals. In the current study, the impact of regular physical activity on cognition, locomotion, and brain functions was explored in a cohort of older adults with low or high CVRFs. Cortical activation of the frontal areas was investigated using functional Near-Infrared Spectroscopy (fNIRS) at baseline, at 6 months and at 12 months. Evoked cortical response and behavioral performance were assessed using the dual-task walking paradigm, consisting of three conditions: single cognitive task (2-back task), single walking task (walking), and dual-task (2-back whilst walking). Results show greater task-related cortical response at baseline in individuals with high CVRFs compared to those with low CVRFs. Moreover, participants with high CVRFs benefitted the most from participating in regular physical activity, as their cortical response decreased at the 12-month follow-up and became comparable to that of participants with low CVRFs. These changes were observed in conjunction with improved cognitive performance and stable gait speed throughout the 12-month period in both groups. Our findings provide evidence that participation in regular physical activity may be especially beneficial in individuals with CVRFs by promoting brain and cognitive health, thus potentially contributing to prevention of cognitive decline. Future research may explore whether such effects are maintained in the long-term in order to design ad-hoc interventions in this specific population.


2021 ◽  
Vol 40 (2) ◽  
pp. 49-54
Author(s):  
Al’farabi S. Izmuhanov ◽  
Aleksandr V. Gordienko

AIM: Myocardial rupture currently remains in most cases a fatal complication of myocardial infarction. OBJECTIVE: To study the features of the structure of cardiovascular risk factors in men under 60 years old with complicated myocardial infarction to improve prevention. MATERIALS AND METHODS: The study included men 1960 years old with type I myocardial infarction. The patients were divided into two groups age-comparable: I studied, with myocardial rupture seven patients; II control, without breaks 558 patients. A comparative analysis of the frequency of observation of the main and additional factors of cardiovascular risk in the selected groups was performed. RESULTS OF THE STUDY: In the patients of the study group, frequent (four or more times a year) colds were observed more often than in the control group (42.9 and 14.8%, respectively; p = 0.04), the internal organs foci of infections (85.7 and 40.3%; p = 0.049), bypass surgery (57.1 and 10.2%; p 0.0001) and continuous cardiac pacing (28.6 and 0.5%; p 0.0001) in medical history. The presence of arterial hypertension (28.5 and 67.6%; p = 0.03) and foci of oral cavity infections (0 and 20.3%; p = 0.049) reduced the risk of myocardial rupture. In the study group, the levels of total cholesterol (4.3 0.3 and 5.8 1.2 mmol/l); p = 0.02), low-density lipoproteins (2.7 0.1 and 4.2 1.2 mmol/l); p = 0.04) and triglycerides (0.7 0.1 and 2.6 1.8 mmol/l); p = 0.008) were lower than in the control. CONCLUSION: Combinations of these cardiovascular risk factors indicate an increased risk of myocardial rupture. It is advisable to use them for predictive modeling of this event and the formation of risk groups for the purpose of timely prevention, (bibliography: 18 refs.).


Author(s):  
Gordienko A.V. ◽  
Balabanov A.S. ◽  
Biyaliev E.K.

Relevance. Mortality in cardiogenic shock remains high. Aim. To evaluate the structure of cardiovascular risk factors features in men under 50 years old with myocardial infarction complicated by cardiogenic shock, in order to improve the prevention of this complication. Material and methods. The study included men 19-50 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - the study group, with cardiogenic shock - seven patients; II - control, without it - 202 patients. A comparative analysis of the of cardiovascular risk factors structure in the selected groups and a risk analysis (ANOVA) of the development of cardiogenic shock were performed. Results. In the study group, the predominance of renal dysfunction (100 and 10.3%, respectively; p=0.004), alcohol abuse (71.4 and 35.2%; p=0.049), the presence of atrial fibrillation (57.1 and 5,0%; p˂0.0001), urolithiasis 28.6 and 6.4%; p=0.001), cholelithiasis 14.3 and 5.5%; p=0.001 and gout 14.3 and 0.5%; p=0.001) in history. In the control group, a history of unstable angina pectoris was more often recorded (0 and 38.1%; p=0.04). When assessing the risks, in addition to those listed, smoking 20 cigarettes per day, a decrease in lipid metabolism indicators (very low density lipoproteins 0.36 mmol/l, low density 2.7 mmol/l, cholesterol˂3,8 mmol/l, triglycerides 1.2 mmol/l, cholesterol/high density lipoproteins˂4.63), creatinine≥140 μmol/l in combination with overweight (≥96.0 kg and Quetelet index ≥31,0 kg/m2) and age (≥48 years). Conclusions. The listed factors can be used in the formation of high-risk groups for observation and timely implementation of the necessary treatment as well as for prognostic modeling of cardiogenic shock.


2019 ◽  
Vol 32 ◽  
Author(s):  
Ana Esther Pereira de Oliveira ◽  
Thatiane Lopes Valentim Di Paschoale Ostolin ◽  
Wesley de Oliveira Vieira ◽  
Rodolfo Leite Arantes ◽  
Antônio Ricardo de Toledo Gagliardi ◽  
...  

Abstract Introduction: Sedentary behavior (SB) has been described as an independent risk factor for health, regardless of the recommended amount of moderate-to-vigorous physical activity (MVPA). However, SB and MVPA as predictors of falls have been poorly investigated. Objective: To compare the associations between SB and MVPA and the occurrence of falls in middle-aged and older adults. Method: The participants wore a triaxial accelerometer over the dominant hip for seven days to measure SB and MVPA. The occurrence of falls and cardiovascular risk factors were assessed by self-report. Isokinetic peak torque (PT) of knee extension, peak oxygen uptake (V’O2) in a ramp treadmill protocol, and lean (LBM) body mass and body fat (BFM) (bioelectrical impedance) were also assessed. The critical roles of SB and MVPA on the occurrence of falls were compared by multiple logistic regression adjusted for age, sex, cardiovascular risk factors, LBM, peak V’O2, and PT of knee extension. Results: 379 participants were evaluated, aged 40-80 years. Forty-eight participants reported at least one fall in the previous 12 months (14.5%). Fallers presented lower SB and higher MVPA. They were predominantly women and older adults with lower physical fitness. After multivariate analysis, MVPA, but not SB, was selected as an independent predictor of falls, increasing the odds ratio of having a fall (1.184, 95% confidence interval, 1.016 - 1.378). Conclusion: Episodes of falls in predominantly middle-aged and women subjects were associated with a higher amount of MVPA, not the opposite, indicating an adverse effect of MVPA in these subjects.


Author(s):  
Gordienko A.V. ◽  
Reiza V.A. ◽  
Izmuhanov A.S. ◽  
Golikov A.V.

Relevance. The cardiovascular risk factors structure features in myocardial infarction, complicated by urinary disorders, in young and middle-aged men have been insufficiently studied. Aim. To evaluate the cardiovascular risk factors structure features in men under 60 years old with myocardial infarction, complicated by urinary disorders, to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 15 patients; II - control, without it - 496 patients. A comparative analysis of the main and additional cardiovascular risk factors frequency, analysis of their influence on the risk of urinary disorders in myocardial infarction (ANOVA) were performed. Results. The study group differed from the control group in the greater frequency of coronary artery bypass surgery (in the study group: 31.8%; in the control group: 8.4%; p = 0.0002), pacing (9.1 and 0.5%; respectively); p < 0.0001), history of atrial fibrillation and/or flutter (27.3 and 9.2%; p = 0.005), chronic cerebrovascular insufficiency (77.3 and 51.3%; p = 0,02), alcohol abuse (63.6 and 25.2%; p < 0.0001), frequent (four or more per year) colds (27.3 and 12.6%; p = 0,04), cardiac arrhythmias and conduction disturbances in the onset of coronary artery disease (61.9 and 24.9%; p = 0.0007), smoking for 20 years or more (36.4 and 16.8%; p = 0.003) , chronic kidney disease (46.7 and 16.2%; p = 0.02), chronic foci of internal organs infections (77.3 and 39.4%; p = 0.002), urine (27.3 and 8.6%; p = 0.006) and gallstone diseases (13.6 and 5.4%; p = 0.006). These indicators were the markers of the urinary disorders development in myocardial infarction. Conclusions. Men under 60 years old with urinary disorders in myocardial infarction are characterized by smoking, metabolic disorders, chronic kidney disease, heart rhythm and conduction disorders, alcohol abuse, frequent colds and chronic foci of internal organ infections. The data listed above should be used in the formation of high-risk groups for the development of urinary disorders, as well as for prognostic modeling.


Author(s):  
Epifanov S.Y. ◽  
Tupitsyn V.V. ◽  
Baltabaeva A.M.

Relevance. Recurrent ischemic damages negatively affect the prognosis of myocardial infarction. Aim. To evaluate the peculiarities of cardiovascular risk factors in men younger than 60 years old with myocardial infarction and recurrent ischemic damages to improve prevention, and outcomes. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent ischemic damages - 95 patients; II - con-trol, without it - 470 patients. A comparative analysis of the frequency of observation of the main and additional car-diovascular risk factors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hypodynamia (94.7 and 77.7%, respectively; p ˂ 0.05), smoking (86.3 and 72.6%; p ˂ 0.05), myocardial infarction (56.8 and 40.3%; p ˂ 0.05), unstable angina (57.9 and 46.3%; p ˂ 0.05), coronary artery bypass surgery (17.9 and 9, 3%; p ˂ 0.05) in the pa-tient’s medical a history, stress (53.7 and 36.9%; p ˂ 0.05) and changes in meteorological factors (26.4 and 23.0%; p ˂ 0.05) as causes of myocardial infarction , winter (37.9 and 28.1%; p ˂ 0.05) and autumn (28.4 and 18.3%; p ˂ 0.05) periods and impaired renal function (29.2 and 12.1% ; p ˂ 0.05). Conclusions. The use of these factors in prognostic modeling of recurring ischemic damages risk in case of myocardi-al infarction in men under 60 years old, as well as in creating high-risk groups for their development to monitor and conduct preventive measures, will improve the outcome of such patients.


Author(s):  
Premalatha Paulsamy ◽  
Kalaiselvi Periannan ◽  
Vigneshwaran Easwaran ◽  
Noohu Abdulla Khan ◽  
Vani Manoharan ◽  
...  

There are evidences of shared biological mechanisms between obesity and hypertension during childhood in the adulthood, and loads of research literatures have proven that, it will cost the economies and health of nations profoundly if neglected. The Prevention and early diagnosis of cardiovascular risk factors such as overweight and hypertension is an essential strategy for control, effective treatment and prevention of its&rsquo; complications. The aim of the study is to assess the effect of school based Exercise and Life style Motivation Intervention (SEAL-MI) on adolescent's cardiovascular risk factors and academic performance. An experimental study was conducted among 1005 adolescents - 520 and 485 adolescents were randomly selected for control and study group, respectively. Demographic details and the data related to dietary habits, physical activity and sleep quality were collected by a structured interview questionnaire. The study group adolescents were given the SEAL-MI for six months which includes a school based rope exercise for 45 minutes per day for 5 days a week and a motivation intervention related to dietary habits, physical activity and sleep. Post-test 1 and 2 were done after 3 and 6 months of intervention. The prevalence of overweight among adolescents was 28.73% and prehypertension was 9.26%. Among overweight adolescents, the prevalence of prehypertension was found to be very high (32.25%). In post intervention, there was a significant reduction in weight, BP (p=0.000) and improvement in dietary habits, physical activity, sleep (p=0.000) and academic performance. A significant positive correlation was found between BMI and SBP (p=0.000) and BMI and academic performance (p=0.003). The linear regression analyses revealed that the gender (&szlig;: 0.47, 95% CI: 0.39, 0.81), age (&szlig;: 0.39, 95% CI: 0.17, 0.46), family income (&szlig;: 0.2, 95% CI: 0.41, 0.5), residence (&szlig;: 0.19, 95% CI: 0.01, 0.27) and type of family (&szlig;: 0.25, 95% CI: 0.39, 0.02) had the strongest correlate with the BMI of the adolescents. Also, Mother&rsquo;s education Mother&rsquo;s education (&szlig;: 0.35, 95% CI: 0.18, 0.59) had the strongest correlate with the SBP of the adolescents. In contrast, the DBP was negatively persuaded by age (&szlig;: -0.36, 95% CI: 1.54, 0.29) and gender (&szlig;: -0.26, 95% CI: 1.34, 0.12) of the adolescents. Regular practice of rope exercise and lifestyle modification such as diet, physical activity and sleep quality among adolescents prevent and control childhood CVD risk factors like overweight, hypertension. The SEAL-MI may lead to age appropriate development of adolescents and improves their academic performance and quality of life. Giving importance to the adolescents from urban habitat, from affluent nuclear family and catching them young will bring significant change in the disease burden.


1994 ◽  
Vol 72 (01) ◽  
pp. 058-064 ◽  
Author(s):  
Goya Wannamethee ◽  
A Gerald Shaper

SummaryThe relationship between haematocrit and cardiovascular risk factors, particularly blood pressure and blood lipids, has been examined in detail in a large prospective study of 7735 middle-aged men drawn from general practices in 24 British towns. The analyses are restricted to the 5494 men free of any evidence of ischaemic heart disease at screening.Smoking, body mass index, physical activity, alcohol intake and lung function (FEV1) were factors strongly associated with haematocrit levels independent of each other. Age showed a significant but small independent association with haematocrit. Non-manual workers had slightly higher haematocrit levels than manual workers; this difference increased considerably and became significant after adjustment for the other risk factors. Diabetics showed significantly lower levels of haematocrit than non-diabetics. In the univariate analysis, haematocrit was significantly associated with total serum protein (r = 0*18), cholesterol (r = 0.16), triglyceride (r = 0.15), diastolic blood pressure (r = 0.17) and heart rate (r = 0.14); all at p <0.0001. A weaker but significant association was seen with systolic blood pressure (r = 0.09, p <0.001). These relationships remained significant even after adjustment for age, smoking, body mass index, physical activity, alcohol intake, lung function, presence of diabetes, social class and for each of the other biological variables; the relationship with systolic blood pressure was considerably weakened. No association was seen with blood glucose and HDL-cholesterol. This study has shown significant associations between several lifestyle characteristics and the haematocrit and supports the findings of a significant relationship between the haematocrit and blood lipids and blood pressure. It emphasises the role of the haematocrit in assessing the risk of ischaemic heart disease and stroke in individuals, and the need to take haematocrit levels into account in determining the importance of other cardiovascular risk factors.


Author(s):  
Tupitsyn V.V. ◽  
Bataev Kh.M. ◽  
Men’shikova A.N. ◽  
Godina Z.N.

Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.


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