RESUMO
PURPOSE: Guidelines for the prevention and treatment of cardiovascular disease (CVD) have recently changed. Goals of these guidelines have shifted to the promotion of health and control of risk rather than solely on treatment of CVD. This article summarizes the six new cardiovascular screening, prevention, and treatment guidelines for use in practice. DATA SOURCES: Published and peer-reviewed guidelines published jointly and in collaboration with the National Heart Lung and Blood Institute by the American Heart Association and the American College of Cardiology constitute the evidence base for this article. CONCLUSIONS: The potential for making lifestyle changes a way of life instead of a diet or program is an important point to make in clinical visits. If nurse practitioners (NPs) could promote a way-of-life lifestyle change to individuals in America, even change at a modest level, we could improve the health of the nation. IMPLICATIONS FOR PRACTICE: NPs need to be aware of new guidelines and best practices to improve the cardiovascular health of their patients. We summarized these new guidelines into an easy-to-interpret format for use in practice.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/terapia , Prática Clínica Baseada em Evidências/métodos , Profissionais de Enfermagem/educação , Prática Clínica Baseada em Evidências/normas , Guias como Assunto , Humanos , Hipercolesterolemia/enfermagem , Hipercolesterolemia/terapia , Hipertensão/enfermagem , Hipertensão/terapia , Estilo de Vida , Sobrepeso/enfermagem , Sobrepeso/terapia , Medição de Risco/métodos , Estados UnidosRESUMO
This descriptive study examined relationships among disordered sleep and cognitive and functional status in nursing home residents (N = 90). Baseline data were used from a randomized controlled clinical trial that took place in three nursing homes. The sample included individuals age 55 and older with disordered sleep and cognitive impairment. We measured nighttime sleep with attended polysomnography and cognitive status with the Mini-Mental State Examination and assessed two indicators of functional status: level of assistance required and gait speed. Decreased total sleep time (TST), fewer respiratory awakenings, and higher oxygen saturation (SaO(2)) nadir were associated with better cognitive and functional status. After controlling for the effect of cognitive status, the association between decreased TST and better gait speed remained significant. Although correlation does not establish causation, these findings suggest that interventions to decrease nighttime respiratory awakenings and maintain SaO(2) have the potential to support cognitive and functional status in nursing home residents.