scholarly journals Depressive disorder in the last phase of life in patients with cardiovascular disease, cancer, and COPD: data from a 20-year follow-up period in general practice

2013 ◽  
Vol 63 (610) ◽  
pp. e303-e308 ◽  
Author(s):  
Franca Warmenhoven ◽  
Hans Bor ◽  
Peter Lucassen ◽  
Kris Vissers ◽  
Chris van Weel ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
General Practice ◽  
Depressive Disorder

Utilisation of Medicare-funded schemes for people with cardiovascular disease

2017 ◽  
Vol 23 (5) ◽  
pp. 482 ◽  
Author(s):  
Julie Redfern ◽  
Karice Hyun ◽  
Emily Atkins ◽  
Clara Chow ◽  
Tom Briffa ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
General Practice ◽  
Data Extraction ◽  
Management Plan ◽  
Younger Age ◽  
Pressure Lowering ◽  
Medicare Benefit ◽  
The Mean ◽  
Gp Visits

The aim of this study is to investigate the utilisation of Medicare Benefit Scheme items for chronic disease in the management of cardiovascular disease (CVD) in general practice and to compare characteristics of CVD patients with and without a General Practice Management Plan (GPMP). Subgroup analysis of Treatment of Cardiovascular Risk using Electronic Decision Support (TORPEDO) baseline data was collected in a cohort comprising 6123 patients with CVD. The mean age (s.d.) was 71 (±13) years, 55% were male, 64% had a recorded diagnosis of coronary heart disease, 31% also had a diagnosis of diabetes and the mean number of general practice (GP) visits (s.d.) was 11 (±9) in 12 months. A total of 1955/6123 (32%) received a GPMP in the 12 months before data extraction; 1% received a Mental Health Plan. Factors associated with greater likelihood of receiving a GPMP were: younger age, had a diagnosis of diabetes, BMI > 30kgm–2, prescription of blood pressure-lowering therapy and more than ten general practice visits. Enhancing utilisation of existing schemes could augment systematic follow up and support of patients with CVD.

Integration of absolute cardiovascular disease risk assessment into routine blood cholesterol testing at pathology services

2020 ◽  
Vol 37 (5) ◽  
pp. 675-681 ◽  
Author(s):  
Niamh Chapman ◽  
Ricardo Fonseca ◽  
Leigh Murfett ◽  
Kevin Beazley ◽  
Rebekah E McWhirter ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Assessment ◽  
General Practice ◽  
Medical Practitioner ◽  
Blood Cholesterol ◽  
Cvd Risk ◽  
Usual Practice ◽  
Computer Based

Abstract Background Absolute cardiovascular disease (CVD) risk assessment is recommended for primary prevention of CVD, yet uptake in general practice is limited. Cholesterol requests at pathology services provide an opportunity to improve uptake by integrating absolute CVD risk assessment with this service. Objective This study aimed to assess the feasibility of such an additional service. Methods Two-hundred and ninety-nine patients (45–74 years) referred to pathology services for blood cholesterol had measurement of all variables required to determine absolute CVD risk according to Framingham calculator (blood pressure, age, sex, smoking and diabetes status via self-report). Data were recorded via computer-based application. The absolute risk score was communicated via the report sent to the referring medical practitioner as per usual practice. Evaluation questionnaires were completed immediately post visit and at 1-, 3- and 6-month follow-up via telephone (n = 262). Results Absolute CVD risk reports were issued for 90% of patients. Most patients (95%) reported that the length of time for the pathology service assessment was acceptable, and 91% that the self-directed computer-based application was easy to use. Seventy-eight per cent reported a preference for pathology services to conduct absolute CVD risk assessment. Only 2% preferred a medical practitioner. Of follow-up patients, 202 (75%) had a consultation with a medical practitioner, during which, aspects of CVD risk prevention were discussed (cholesterol and blood pressure 74% and 69% of the time, respectively). Conclusions Measurement of absolute CVD risk in pathology services is feasible, highly acceptable among middle-to-older adults and may increase uptake of guideline-directed care in general practice.

scholarly journals Incremental burden of comorbid major depressive disorder in patients with type 2 diabetes or cardiovascular disease: a retrospective claims analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne Kangethe ◽  
Debra F. Lawrence ◽  
Maëlys Touya ◽  
Lambros Chrones ◽  
Michael Polson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Major Depressive ◽  
Total Cost ◽  
Ed Visits ◽  
Baseline Characteristics

Abstract Background The estimated prevalence of comorbid major depressive disorder (. MDD) is 11% in patients with type 2 diabetes (T2D) and 15–20% in those with cardiovascular disease (CVD). Comorbid MDD continues to be a significant source of economic burden to the healthcare system. Methods We assessed the incremental healthcare burden of comorbid MDD in patients with T2D or CVD. This real-world, retrospective, administrative claims study analyzed commercially insured adults with T2D or CVD diagnosed on at least 2 separate claims within 12 months of each other (between January 1, 2011, and September 30, 2018). CVD included congestive heart failure, peripheral vascular disease, coronary heart disease, and cerebrovascular disease. The study compared patients with and without MDD with either T2D or CVD. Study assessments included all-cause healthcare resource utilization (proportion of patients with hospitalization, emergency department [ED] visits, and outpatient visits) and cost. Results Patients were matched by propensity score for demographics and baseline characteristics, resulting in similar baseline characteristics for the respective subcohorts. After matching, 22,892 patients with T2D (11,446 each with and without MDD) and 28,298 patients with CVD (14,149 each with and without MDD) were included. At follow-up, patients with T2D and MDD had significantly higher rates of hospitalization (26.1% vs 17.4%, P < 0.0001) and ED visits (55.3% vs 43.0%, P < 0.0001) than those observed in patients without MDD. The total cost for patients with T2D and MDD at follow-up was significantly higher than for those without MDD ($16,511 vs $11,550, P < 0.0001). Similarly, at follow-up, patients with CVD and MDD had significantly higher rates of hospitalization (45.4% vs 34.1%, P < 0.0001) and ED visits (66.5% vs 55.4%, P < 0.0001) than those observed in patients without MDD. Total cost at follow-up for patients with CVD and MDD was significantly higher than for those without MDD ($25,546 vs $18,041, P < 0.0001). Conclusions Patients with either T2D or CVD and comorbid MDD have higher total all-cause healthcare utilization and cost than similar patients without MDD. Study findings reinforce the need for appropriate management of MDD in patients with these comorbid diseases, which in turn may result in cost reductions for payers. Trial registration Not applicable.

Personality, Cardiovascular Disease, and Cancer:

2004 ◽  
Vol 12 (3) ◽  
pp. 102-115 ◽  
Author(s):  
Manfred Amelang ◽  
Petra Hasselbach ◽  
Til Stürmer
Keyword(s):  
Cardiovascular Disease ◽  
Behavioral Control ◽  
Smoking Behavior ◽  
Type A Behavior ◽  
Incremental Validity ◽  
Personality Factors ◽  
Emotional Lability ◽  
Prevalent Disease ◽  
Incident Cardiovascular Disease

Abstract. Ten years ago a sample of N = 5.133 male and female subjects (age 28-74) responded to questionnaires including scales for personality, life style, work stress as well as questions on prevalent disease. We now report on the follow-up regarding self-reported incidence of cardiovascular disease and cancer. During a mean follow-up of 10 years, 257 participants had died. Of those alive, N = 4.010 (82%) participated in the follow-up. Of these, 120 and 180 persons reported incident cardiovascular disease and cancer, respectively. The incidence of cardiovascular disease could be significantly predicted by the personality factors “Emotional Lability”, “Behavioral Control” and “Type-A-Behavior” as well as by the “Rationality/Antemotionality”-scale according to Grossarth-Maticek. After controlling for age, gender and smoking behavior only the significant effect of “Emotional Lability” remained and the predictors according to Grossarth-Maticek had no incremental validity. Cancer could not be predicted by any personality factors.

scholarly journals Skin autofluorescence predicts new cardiovascular disease and mortality in people with type 2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Henderikus E. Boersma ◽  
Robert P. van Waateringe ◽  
Melanie M. van der Klauw ◽  
Reindert Graaff ◽  
Andrew D. Paterson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Fasting Blood Glucose ◽  
Multivariable Analysis ◽  
Oral Glucose ◽  
Skin Autofluorescence ◽  
Z Score

Abstract Background Skin autofluorescence (SAF) is a non-invasive marker of tissue accumulation of advanced glycation endproducts (AGE). Recently, we demonstrated in the general population that elevated SAF levels predict the development of type 2 diabetes (T2D), cardiovascular disease (CVD) and mortality. We evaluated whether elevated SAF may predict the development of CVD and mortality in individuals with T2D. Methods We included 2349 people with T2D, available baseline SAF measurements (measured with the AGE reader) and follow-up data from the Lifelines Cohort Study. Of them, 2071 had no clinical CVD at baseline. 60% were already diagnosed with diabetes (median duration 5, IQR 2–9 years), while 40% were detected during the baseline examination by elevated fasting blood glucose ≥7.0 mmol/l) and/or HbA1c ≥6.5% (48 mmol/mol). Results Mean (±SD) age was 57 ± 12 yrs., BMI 30.2 ± 5.4 kg/m2. 11% of participants with known T2D were treated with diet, the others used oral glucose-lowering medication, with or without insulin; 6% was using insulin alone. Participants with known T2D had higher SAF than those with newly-detected T2D (SAF Z-score 0.56 ± 0.99 vs 0.34 ± 0.89 AU, p < 0.001), which reflects a longer duration of hyperglycaemia in the former group. Participants with existing CVD and T2D had the highest SAF Z-score: 0.78 ± 1.25 AU. During a median follow-up of 3.7 yrs., 195 (7.6%) developed an atherosclerotic CVD event, while 137 (5.4%) died. SAF was strongly associated with the combined outcome of a new CVD event or mortality (OR 2.59, 95% CI 2.10–3.20, p < 0.001), as well as incidence of CVD (OR 2.05, 95% CI 1.61–2.61, p < 0.001) and death (OR 2.98, 2.25–3.94, p < 0.001) as a single outcome. In multivariable analysis for the combined endpoint, SAF retained its significance when sex, systolic blood pressure, HbA1c, total cholesterol, eGFR, as well as antihypertensive and statin medication were included. In a similar multivariable model, SAF was independently associated with mortality as a single outcome, but not with incident CVD. Conclusions Measuring SAF can assist in prediction of incident cardiovascular disease and mortality in individuals with T2D. SAF showed a stronger association with future CVD events and mortality than cholesterol or blood pressure levels.

scholarly journals Longitudinal association between cardiovascular health and arterial stiffness in the Chinese adult population

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199888
Author(s):  
Yu Sang ◽  
Kaimin Mao ◽  
Ming Cao ◽  
Xiaofen Wu ◽  
Lei Ruan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Arterial Stiffness ◽  
Cardiovascular Health ◽  
Adult Population ◽  
Annual Change ◽  
Chinese Adult ◽  
Lower Baseline ◽  
Confounding Variables ◽  
Longitudinal Association

Objective Arterial stiffness may be an intermediary biological pathway involved in the association between cardiovascular health (CVH) and cardiovascular disease. We aimed to evaluate the effect of CVH on progression of brachial–ankle pulse wave velocity (baPWV) over approximately 4 years. Methods We included 1315 cardiovascular disease-free adults (49±12 years) who had two checkups from 2010 to 2019. CVH metrics (current smoking, body mass index, total cholesterol, blood pressure, and fasting plasma glucose) were assessed at baseline, and the number of ideal CVH metrics and CVH score were calculated. Additionally, baPWV was examined at baseline and follow-up. Results Median baPWV increased from 1340 cm/s to 1400 cm/s, with an average annual change in baPWV of 15 cm/s. More ideal CVH metrics and a higher CVH score were associated with lower baseline and follow-up baPWV, and the annual change in baPWV, even after adjustment for confounding variables. Associations between CVH parameters and baseline and follow-up baPWV remained robust in different sex and age subgroups, but they were only able to predict the annual change in baPWV in men and individuals older than 50 years. Conclusions Our findings highlight the benefit of a better baseline CVH profile for progression of arterial stiffness.

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