scholarly journals The effects of a web-based educational intervention on total exercise amount, and self- efficacy for exercise in soon-to-be-aged adults with coronary heart disease (Preprint)

2018 ◽  
Author(s):  
Eliza Mi-Ling Wong ◽  
Doris Y.P. Leung
Keyword(s):  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Physical Exercise ◽  
Educational Intervention ◽  
Self Efficacy ◽  
Intervention Group ◽  
Risk Factor Profile ◽  
Chd Risk ◽  
The Web

BACKGROUND Coronary heart disease (CHD) is the leading cause of death globally, and e-health educational programmes have proven to be an effective support for patients. Considering the advantages of such programmes, as well as the growing number of soon-to-be aged patients with CHD, a study was conducted. OBJECTIVE It aims to investigate the effectiveness of a home-based interactive e-health educational intervention (eHEI) for patients with CHD in terms of improvements in their total amount of physical exercise, self-efficacy for exercise, and CHD risk factor profile. METHODS A prospective randomized controlled trial (RCT). The study was conducted in two government cardiac clinics in Hong Kong. Using a block randomization method, 441 eligible CHD clients were randomly assigned to either the control or intervention group. All of the participants received standard care, which consisted of regular follow-ups with a doctor and medical prescriptions related to their CHD, while the intervention group received in addition the e-HEI, which consisted of a 20-minute individual educational session on the use of the web link. The web link contains general health information related to CHD and an individual member area with records of health measures and physical exercise data for six months. Data were collected at baseline, and at three-month and six-month intervals at the cardiac clinic. The primary outcome was the total amount of physical exercise, measured by the Godin–Shephard Leisure-Time Physical Activity Questionnaire. The secondary outcomes were total exercise time, self-efficacy for exercise, and CHD risk profile (body weight, blood pressure, lipids profile). The data were analyzed using a generalized estimating equations model. RESULTS Patients in the intervention group who received the e-HEI intervention reported a statistically higher amount of physical exercise (P=0.02) over a three-month period. There were no statistical differences between the groups in their self-efficacy for exercise and CHD risk factor profile. The results indicated that the e-HEI intervention was feasible and safe to use by the participants in terms of supporting their exercise maintenance, and improving their exercise and health records. CONCLUSIONS The study demonstrated the effectiveness of the e-HEI intervention in meeting the challenge of boosting the amount of physical exercise that CHD patients engaged in over three months. The evidence may benefit healthcare professionals involved in efforts to devise strategic plans on how to apply e-health education and provide continual support to promote exercise initiation and maintenance among Chinese CHD patients in the community. CLINICALTRIAL Registered at Clinicaltrials.gov. (NCT02350192 ).

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.

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.

scholarly journals Candidate Gene Genotypes, Along with Conventional Risk Factor Assessment, Improve Estimation of Coronary Heart Disease Risk in Healthy UK Men

2007 ◽  
Vol 53 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Steve E Humphries ◽  
Jackie A Cooper ◽  
Philippa J Talmud ◽  
George J Miller
Keyword(s):  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Disease Risk ◽  
Uncoupling Protein ◽  
False Positive Rate ◽  
Conventional Risk Factor ◽  
Risk Estimates ◽  
Chd Risk ◽  
Genotype Information

Abstract Background: One of the aims of cardiovascular genetics is to test the efficacy of the use of genetic information to predict cardiovascular risk. We therefore investigated whether inclusion of a set of common variants in candidate genes along with conventional risk factor (CRF) assessment enhanced coronary heart disease (CHD)-risk algorithms. Methods: We followed middle-aged men in the prospective Northwick Park Heart Study II (NPHSII) for 10.8 years and analyzed complete trait and genotype information available on 2057 men (183 CHD events). Results: Of the 12 genes previously associated with CHD risk, in stepwise multivariate risk analysis, uncoupling protein 2 (UCP2; P = 0.0001), apolipoprotein E (APOE; P = 0.0003), lipoprotein lipase (LPL; P = 0.007), and apolipoprotein AIV (APOA4; P = 0.04) remained in the model. Their combined area under the ROC curve (AROC) was 0.62 (0.58–0.66) [12.6% detection rate for a 5% false positive rate (DR5)]. The AROC for the CRFs age, triglyceride, cholesterol, systolic blood pressure, and smoking was 0.66 (0.61–0.70) (DR5 = 14.2%). Combining CRFs and genotypes significantly improved discrimination (P = 0.001). Inclusion of previously demonstrated interactions of smoking with LPL, interleukin-6 (IL6), and platelet/endothelial cell adhesion molecule (PECAM1) genotypes increased the AROC to 0.72 (0.68–0.76) for a DR5 of 19.1% (P = 0.01 vs CRF combined with genotypes). Conclusions: For a modest panel of selected genotypes, CHD-risk estimates incorporating CRFs and genotype–risk factor interactions were more effective than risk estimates that used CRFs alone.

Coronary Heart Disease (CHD) Risk Factor Knowledge in a Rural Population

2008 ◽  
Vol 17 ◽  
pp. S205
Author(s):  
Heather Pascoe ◽  
John Kotroulas ◽  
Alan Soward
Keyword(s):  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Rural Population ◽  
Chd Risk

Abstract P204: Coronary Heart Disease Risk Factors and Perceived Risk among Overweight and Obese Adults

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Christopher C Imes ◽  
Meghan Mattos ◽  
Yaguang Zheng ◽  
Lei Ye ◽  
Edvin Music ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Weight Loss ◽  
Risk Factor ◽  
Heart Disease ◽  
Perceived Risk ◽  
Pearson Correlation ◽  
Obese Adults ◽  
Chd Risk ◽  
Chd Risk Factors

Background: Obesity is a known risk factor for coronary heart disease (CHD) and plays a role in other CHD risk factors including dyslipidemia, hypertension, and type 2 diabetes mellitus. With nearly two-thirds of the adult US population being overweight and obese, it is important to know how these individuals perceive their CHD risk. Objective: The purpose of this study was to examine the associations between self-reported CHD risk factors and perceived CHD risk among overweight and obese adults. Methods: Demographic data, CHD risk factors, and perceived lifetime CHD risk were collected via electronic surveys using REDCap, an Internet-based data capture tool, of overweight and obese adults enrolled in a Weight Loss Research Registry. CHD risk factors were assessed using an investigator-developed survey of self-reported diagnoses of hyperlipidemia, hypertension, and diabetes, family history of CHD, and current smoking status. A risk factor ranking was assigned to each participant ranging from 0 to 5, with one point given for each of the aforementioned risk factors. Perceived lifetime CHD risk was assessed using a visual analogue scale with a range of 0 (No Risk) to 100 (High Risk). Linear regression and Pearson Correlation were used to analyze the data. Results: The response rate was 44.7% (N = 151) from 338 eligible adults. Respondents were mostly female (91%), White (81.5%), 51.3±10.4 years old with 16.2±2.9 years of education, 65.6% had annual household incomes ≥ $50,000. Males reported a higher perceived risk compared to females (77.6±18.0 vs. 64.9 ±21.5, p=.03). There was no difference in perceived risk based on age, race, education, or income. The prevalence of reported risk factors in the sample was as follows: 49.6% (n=75) had at least one first degree-relative with CHD, 32.5% (n=49) had hypertension, 31.8% (n=48) had hyperlipidemia, 3.9% (n=6) had diabetes and 3.3% (n=5) reported currently smoking. Perceived CHD risk was associated with the number of CHD risk factors (p<.001). The mean perceived risk increased incrementally as the number of risk factors increased: 56.5±24.8 for 0 risk factors (n=46), 65.1±17.6 for 1 risk factor (n=53), 74.3±18.4 for 2 risk factors (n=30), 77.0±17.3 for 3 risk factors (n=19), and 79.7±20.5 for respondents (n=3) with 4 risk factors. No respondent reported 5 risk factors. Conclusions: In this sample, the number of self-reported CHD risk factor was associated with perceived CHD risk (r= .353, p<.001). Male respondents had a higher perceived risk compared to females (77.6±18.0 vs. 64.9±21.5); however, the percent of males in the Registry was significantly lower than females (9% vs. 91%) This might suggest that males may require a higher perceived risk before enrolling in a Registry for weight loss studies. For these respondents, awareness of CHD risk factors and their health implications could be a motivator for enrollment in the Registry.

P02.227 Comparison of the coronary heart disease risk factor profile of risperidone vs olanzapine treated patients

2000 ◽  
Vol 15 (S2) ◽  
pp. 382s-382s
Author(s):  
R.H. Bouchard ◽  
J. Villeneuve ◽  
N. Alméras ◽  
I. Simoneau ◽  
M.F. Demers ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Coronary Heart Disease Risk ◽  
Disease Risk ◽  
Disease Risk Factor ◽  
Risk Factor Profile ◽  
Heart Disease Risk

scholarly journals Associations between Coronary Heart Disease and Individual Components of the Metabolic Syndrome according to Glucose Tolerance Status

2012 ◽  
Vol 40 (3) ◽  
pp. 934-942 ◽  
Author(s):  
X Gong ◽  
X Pan ◽  
X Chen ◽  
C Hong ◽  
J Hong ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Glucose Tolerance ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Postprandial Blood Glucose ◽  
The Metabolic Syndrome ◽  
Chd Risk

OBJECTIVE: To assess whether the contributions of individual metabolic syndrome components to coronary heart disease (CHD) risk vary in patients with different glucose tolerance. METHODS: A total of 1619 patients were included in this cross-sectional study. CHD, metabolic syndrome and glucose tolerance were assessed using coronary angiography, anthropometric and biochemical parameters, and an oral glucose tolerance test, respectively. Associations between CHD and components of metabolic syndrome were determined using logistic regression analysis. RESULTS: Low high-density lipoprotein-cholesterol (HDL-C) was the only CHD risk factor in patients with both CHD and metabolic syndrome who had normal glucose tolerance, after adjustments for age, smoking and low-density lipoprotein-cholesterol (LDL-C) concentration. In patients with CHD plus metabolic syndrome and prediabetes, the most important risk factor was hypertension; additional risk factors were high postprandial blood glucose (PBG) and low HDL-C. In patients with CHD plus metabolic syndrome and diabetes, high PBG was the strongest risk factor, followed by hypertension, high FBG and high waist circumference. CONCLUSIONS: Individual components of metabolic syndrome contributed variously to CHD across different glucose tolerance statuses.

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