scholarly journals Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liina Kask-Flight ◽  
Koray Durak ◽  
Kadri Suija ◽  
Anneli Rätsep ◽  
Ruth Kalda

Abstract Background Coronary heart disease (CHD) mortality among young men is very high and the prevention methods usable in family practice (FP) settings are limited (1,2). The objectives of this study were to investigate the cardiovascular risk profile among young males (18–50) visiting their family doctor (FD) and to find out if using an interactive computer-based decision aid (DA) has advantages in reducing cardiovascular risk factors compared to usual counselling at the FD’s office. Methods The study was a cluster-randomized controlled trial including hypertensive male patients aged 18–50 recruited by their FD in 2015–2016. Patients with cardiovascular complications were not included. FDs were randomly divided into intervention groups (n = 9) and control groups (n = 11). Altogether, FDs recruited 130 patients, 77 into the intervention group (IG) and 53 into the control group (CG). IG patients were counselled about cardiovascular risk factors using a computer-based DA. CG patients received usual counselling by their FD. Data was collected with questionnaires, clinical examinations and laboratory analyses at the baseline and at the follow-up visit three months later. We compared the cardiovascular risk factors of the IG and CG patients. Results Baseline characteristics of the IG and CG patients were comparable. Of the whole study group, 51.5% (n = 67) of the patients had hypertension grade 1, 45.4% (n = 59) had grade 2 and 3.1% (n = 4) had grade 3. Twenty-seven per cent (n = 21) of the IG and 42% (n = 22) of the CG patients were smokers. We found that shared decision making with the DA was more effective in smoking reduction compared to usual FD counselling: 21 smoking patients in the IG reduced the number of cigarettes per day which is significantly more than the 22 smoking patients in the CG (− 3.82 ± 1.32 (SE Mean) versus + 2.32 ± 1.29; p = 0.001). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and the number of cigarettes per day, all showed a statistically significant reduction among patients who were using the DA. Male patients with hypertension grade 2 had a significantly greater reduction in their SBP (− 6.003 ± 2.59 (SE Mean) versus + 1.86 ± 2.58; p = 0.038) grade 1. Reduction of DBP, cigarettes per day and CVD risk in general were nearly significant in the IG whereas the CG showed an increase in all of these parameters. Conclusion Using interactive DAs at FD’s offices for counselling of young hypertensive male patients is one possibility to help patients understand their risk factors and make changes in their treatment choices. DAs can be more effective in achieving behavioural changes like reducing smoking or blood pressure compared to normal counselling.

2020 ◽  
Vol 16 ◽  
Author(s):  
Rahil Taheri ◽  
Shahram Molavynejad ◽  
Parvin Abedi ◽  
Elham Rajaei ◽  
Mohammad Hosein Haghighizadeh

Aim: The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis. Method: In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after intervention. Data was analyzed using SPSS software and appropriate statistical tests. Results: The mean of total cholesterol (p <0.001), triglycerides (p = 0.004), LDL (p <0.001), systolic blood pressure (p = 0.001), diastolic blood pressure (p = 0.003), FBS and BMI (p <0.001) were decreased significantly in the intervention group after education compared the control group. Conclusion: Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Keren Cohen-Hagai ◽  
Feda Fanadka ◽  
Tania Grumberg ◽  
Guy Topaz ◽  
Naomi Nacasch ◽  
...  

Abstract Background and Aims Brain atrophy (BA) is a common finding in neuroimaging of hemodialysis (HD) patients, representing a parenchymal cerebral damage. Likely contributing factors to BA are age, chronic hypertension, diabetes mellitus and other cardiovascular risk factors of atherosclerosis that are also common among HD patients. BA may also occur due to focal ischemia and hypoperfusion during HD. However, data on optimal blood pressure (BP) in these patients are limited. The goal of this study was to determine whether the prevalence and severity of BA would be higher among HD patients with lower BP. Method A blinded neuroradiologist graded BA of all HD patients who underwent brain non-contrast computerized tomography (CT) from 2015 to 2017 in our institution. Age-and sex-matched patients with normal kidney function who underwent brain CT during the same period and technique served as the control group Results A total of 280 patients were included in this retrospective study, with average BP of 140/70 mmHg among HD patients and 142/75 mmHg in the control group. BA was more common in dialysis patients and its severity increased with age and traditional cardiovascular risk factors. We observed a significant negative correlation between diastolic BP (DBP) at dialysis initiation and BA. Average DBP decreased with increasing severity of BA. These findings were observed in both HD and non-CKD patients. Conclusion Brain atrophy was associated with lower DBP, which may induce cerebral hypoperfusion and ischemia. This finding should discourage over-treatment of hypertension in hemodialysis patients.


Hypertension ◽  
2006 ◽  
Vol 47 (3) ◽  
pp. 396-402 ◽  
Author(s):  
Arnljot Flaa ◽  
Håvard H. Mundal ◽  
Ivar Eide ◽  
Sverre Kjeldsen ◽  
Morten Rostrup

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1758 ◽  
Author(s):  
Irene A. Garcia-Yu ◽  
Luis Garcia-Ortiz ◽  
Manuel A. Gomez-Marcos ◽  
Emiliano Rodriguez-Sanchez ◽  
Cristina Agudo-Conde ◽  
...  

This study aimed to evaluate the effects of the intake of 10 g of cocoa-rich chocolate on blood pressure, other cardiovascular risk factors, and vascular structure and function in postmenopausal women. A total of 140 postmenopausal women participated in this randomized and controlled parallel clinical trial. For six months, the intervention group (IG; n = 73) consumed daily 10 g of chocolate (99% cocoa) added to their usual food intake, whereas the control group (CG; n = 67) did not receive any intervention. Blood pressure, pulse pressure (PP), cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), augmentation index, and laboratory variables were measured at baseline and six months. ANCOVA analyses adjusted for baseline values revealed no significant differences for systolic blood pressure (−1.45 mm Hg; 95% confidence interval (CI): −4.79, 1.88; p = 0.391) or baPWV (0.18 m/s; 95% CI: −0.14, 0.50; p = 0.263) between groups. A decrease in PP was observed in the IG compared to the CG (−2.05 mm Hg; 95% CI: −4.08, −0.02; p = 0.048). The rest of the vascular structure and function parameters and other measured variables remained unchanged. The daily intake of 10 g of cocoa-rich chocolate seems to provide little improvement to cardiovascular health, but neither does it cause any adverse effects on the parameters evaluated in postmenopausal women in the long term.


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.


2014 ◽  
pp. 77-86
Author(s):  
Anh Tien Hoang ◽  
Thi Y Nhi Nguyen ◽  
Luu Trinh Nguyen ◽  
Thi Hong Diep Phan ◽  
Huu Cat Nguyen ◽  
...  

Background : Sleep Apnea Syndrome (SAS) is a cause of hypertension, increasingcardiovascular risk and cardiovascular disease such as stroke, coronary artery disease, myocardial infarction, arrhythmias, heart failure, increasing the risk of death in patients with heart disease, independent of other causative factors. So far, in Vietnam there are very few studies on Obstructive Sleep Apnea Syndrome (OSAS) and cardiovascular risk factors . Self-making SASD07 is trustly for detecting OSAS with statistical significiant in comparision with StarDustII (gold criteria). Subjects and Methods: Cross sectional study, comparision with control group: 136 peoples (68 in disease group and 68 in control group). Patients were parallelly measured with StarDustII and SASD07 to detect OSAS and find the corellation with cardiovascular risk factors. Results: There is a positive correlation between SBP with the severity of OSAS (r = 0.459, p < 0.001), positive correlation between DBP with the severity of OSAS (r = 0.352, p < 0.003). No statistically significant differences between severe OSAS and fasting blood glucose, cholesterol, HDL Cholesterol, Non - HDL Cholesterol, LDL Cholesterol and TG median (p > 0.05). There is a positive correlation between AHI and neck circumference (r = 0.511, p < 0.001), waist circumference (r = 0.585, p < 0.001), BMI (r = 0.380, p < 0.01). SASD07 diagnostic value of detecting OSAS compared with StarDustII have Kappa = 0.72, (standard error 0.06, p <0.001). Conclusion: The risk factors related to OSAS in our study is neck circumference, waist circumference, systolic blood pressure, diastolic blood pressure. SASD07 have a good value in diagnosing of OSAS compared with polysomnography StarDustII. Key words: Sleep Apnea Syndrome, cardiovascular risk factor, SASD07.


2017 ◽  
Vol 54 (1) ◽  
pp. 137-140
Author(s):  
Ana Minodora Grozdan ◽  
Oana Paduraru ◽  
Rodica Ghiuru ◽  
Costinela Georgescu ◽  
Letitia Duceac

The aim of this study was to determine the incidence of hypoandrogenenic to male patients with S.Met., in the context of cardiovascular risk factors. It performed description of a correlation with diagnostic components of S.Met., and specifying an interrelated male hypogonadism with each of the major cardiovascular risk factors.


2010 ◽  
Vol 50 (4) ◽  
pp. 220
Author(s):  
Nadia Dwi Insani ◽  
Sukman Tulus Putra ◽  
Agus Firmansyah

Background Cardiovascular diseases remain the leading cause of death worldwide. Atherosclerotic process increases rapidly during adolescence. Physical activity is considered important in this period to modify cardiovascular risk factors, thus preventing disease in the future.Objective To determine whether different physical activity status in adolescence can influence body mass index (BMBMI), waist-to-hip ratio, blood pressure (BP), and blood lipid profile.Methods This was a cross-sectional descriptive study, conducted from December 2009 to January 2010. Adolescents who fulfilled the study criteria were classified into high and low physical activity category. Further examination including body mass index, waist-to-hip ratio, blood pressure, and blood lipid profile were performed.Results Adolescents with high physical activity had higher, but statistically insignificant, BMBMI compared to adolescents in the P=0.493] and significantly lower waist-to-hip ratio [0.80 (range 0.73-0.9) vs.. 0.82 (range 0.7-0.9), P=0.019]. Difference in BP was not statistically significant between both groups [diastolic BP (70 (range 60-90) mmHg vs. 70 (range 60-90) mmHg, P=0.148; systolic BP 100 (range 90-130) mmHg vs. 100 (range 90-140) mmHg, P=0.228)]. Blood lipid examination in the high activity group showed significantly higher HDL cholesterol and lower triglyceride compared to the low activity group [HDL 59.8 (SD 11.8) mg/dL vs. 54.7 (SD 8.9) mg/dL; p=0.044; triglyceride: 60 (range 32-203) mmHg vs. 82 (range 37-198) mmHg, P=0.014]. Total and LDL cholesterol [total cholesterol 169.8 (SD 28.6) mmHg vs. 181.2 (SD 30.8) mmHg, P=0.107; LDL 103.6 (SD 26.8) mmHg vs. 114.1 (SD 27.3) mmHg, P=0.100] were lower in the high activity group but not statistically different in both groups.Conclusions Adolescents with high physical activity show less cardiovascular risk factors compared to those in the low physical activity group.


BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jessica Gong ◽  
Katie Harris ◽  
Sanne A. E. Peters ◽  
Mark Woodward

Abstract Background Sex differences in major cardiovascular risk factors for incident (fatal or non-fatal) all-cause dementia were assessed in the UK Biobank. The effects of these risk factors on all-cause dementia were explored by age and socioeconomic status (SES). Methods Cox proportional hazards models were used to estimate hazard ratios (HRs) and women-to-men ratio of HRs (RHR) with 95% confidence intervals (CIs) for systolic blood pressure (SBP) and diastolic blood pressure (DBP), smoking, diabetes, adiposity, stroke, SES and lipids with dementia. Poisson regression was used to estimate the sex-specific incidence rate of dementia for these risk factors. Results 502,226 individuals in midlife (54.4% women, mean age 56.5 years) with no prevalent dementia were included in the analyses. Over 11.8 years (median), 4068 participants (45.9% women) developed dementia. The crude incidence rates were 5.88 [95% CI 5.62–6.16] for women and 8.42 [8.07–8.78] for men, per 10,000 person-years. Sex was associated with the risk of dementia, where the risk was lower in women than men (HR = 0.83 [0.77–0.89]). Current smoking, diabetes, high adiposity, prior stroke and low SES were associated with a greater risk of dementia, similarly in women and men. The relationship between blood pressure (BP) and dementia was U-shaped in men but had a dose-response relationship in women: the HR for SBP per 20 mmHg was 1.08 [1.02–1.13] in women and 0.98 [0.93–1.03] in men. This sex difference was not affected by the use of antihypertensive medication at baseline. The sex difference in the effect of raised BP was consistent for dementia subtypes (vascular dementia and Alzheimer’s disease). Conclusions Several mid-life cardiovascular risk factors were associated with dementia similarly in women and men, but not raised BP. Future bespoke BP-lowering trials are necessary to understand its role in restricting cognitive decline and to clarify any sex difference.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
H Bergum ◽  
I Sandven ◽  
TO Klemsdal

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Norwegian health department Background The evidence of the long-term effects of multiple lifestyle intervention on cardiovascular risk is uncertain. We aimed to summarize the evidence from randomized clinical trials examining the efficacy of lifestyle intervention on major cardiovascular risk factors in subjects at high cardiovascular risk. Methods  Eligible trials investigated the impact of lifestyle intervention versus usual care with minimum 24 months follow-up, reporting more than one major cardiovascular risk factor. A literature search updated April 15, 2020 identified 12 eligible studies. The results from individual trials were combined using fixed and random effect models, using the standardized mean difference (SMD) to estimate effect sizes. Small-study effect was evaluated, and heterogeneity between studies examined by subgroup and meta-regression analyses considering patient- and study-level variables. Results  Small-study effect was not identified. Lifestyle intervention reduced systolic blood pressure modestly with an estimated SMD of -0.13, 95% confidence interval (CI): -0.21 to -0.04, with moderate heterogeneity (I² = 59%), corresponding to a mean difference of approximately 2 mmHg (MD = -1.86, 95% CI: -3.14 to -0.57, p = 0.0046). This effect disappeared in the subgroup of trials judged at low risk of bias (SMD = 0.02, 95% CI: -0.08 to 0.11). For the outcome total cholesterol SMD was -0.06, 95% CI: -0.13 to 0.00, with no heterogeneity (I² = 0%), indicating no effect of the intervention. Conclusion  Lifestyle intervention resulted in only a modest effect on systolic blood pressure and no effect on total cholesterol after 24 months. Further lifestyle trials should consider the challenge of maintaining larger long-term benefits to ensure impact on cardiovascular outcomes.


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