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1.
Scand J Med Sci Sports ; 31(2): 265-294, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33098219

RESUMO

Improving cardiorespiratory fitness (CRFit) in cancer patients is crucial to increase survivorship, promote health, and improve quality of life. High-intensity training (HIT) has the potential to increase CRFit, perhaps better than other exercise modalities, but the extant evidence has yet to be fully explored. This systematic review and meta-analysis aimed to evaluate the effects of HIT on CRFit in cancer patients and survivors and to identify the optimal characteristics of the interventions (eg, cancer type, intervention timing, exercise modality, intervention's duration, and the number of minutes of high-intensity exercise in each session). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A total of 31 articles (2515 participants) were included in the systematic review and 25 in the meta-analyses. CRFit significantly improved with HIT in comparison with a control group (P < .00001, SMD = 0.44 and a 95% confidence interval from 0.25 to 0.64). The results obtained in the sub-analysis were statistically significant except the comparison with the active group CRFit (P = .13). The results showed that higher effects could be achieved in: patients starting to exercise before treatment, interventions longer than eight weeks, programs including exclusively cardiovascular training and with a high-intensity part of session duration of at least 20 minutes.


Assuntos
Sobreviventes de Câncer , Aptidão Cardiorrespiratória , Neoplasias/reabilitação , Condicionamento Físico Humano/métodos , Adulto , Idoso , Viés , Intervalos de Confiança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Treinamento Resistido , Fatores de Tempo
2.
Movimento (Porto Alegre) ; 25(1): e25028, jan.- dez. 2019. Tabelas
Artigo em Espanhol | LILACS | ID: biblio-1048073

RESUMO

El objetivo del presente estudio fue analizar el efecto de un programa de enseñanza comprensiva, basado en el cuestionamiento, sobre la toma de decisiones en las habilidades del pase y del lanzamiento, en una unidad didáctica de baloncesto en Educación Primaria. Participaron 37 alumnos de 6º de Primaria con edades comprendidas entre los 11 y 12 años. La variable independiente fue el programa de intervención, basado en el modelo Teaching Games for Understanding (TGfU). La variable de toma de decisiones fue evaluada a través de la observación sistemática. Los resultados obtenidos mostraron que, tras la intervención, los alumnos que recibieron el cuestionamiento durante el desarrollo de las actividades formativas mejoraron su toma de decisiones en comparación con los alumnos que no lo recibieron. Estos resultados manifiestan la necesidad de incluir este modelo pedagógico en las programaciones docentes en los niveles superiores de la etapa de Primaria


O principal objetivo do estudo foi analisar o efeito de um programa de ensino centrado na compreensão, baseado no questionamento, na tomada de decisões nas ações de passe e do lançamento, numa unidade didática de basquetebol no ensino fundamental. Participaram 37 alunos com idades compreendidas entre 11 e 12 anos. A variável independente foi o programa de intervenção baseado no modelo Teaching Games for Understanding (TGfU). A variável dependente de tomada de decisão foi avaliada através da observação sistemática. Os resultados mostraram que, após a intervenção, os alunos que receberam o questionamento durante o desenvolvimento das atividades de treino melhoraram sua tomada de decisão em relação aos alunos que não o receberam. Esses resultados mostram a necessidade de incluir esse modelo pedagógico nos programas de ensino nos níveis superiores do ensino fundamental


The main purpose of this study was to analyze the effect of a comprehensive questioning-based teaching program about decision-making on passing and throwing abilities in a Primary Education teaching unit focused on basketball. Thirty-seven students aged 11-12 participated in the study. The independent variable was the intervention program based on the Teaching Games for Understanding (TGfU). The decision-making variable was assessed by systematic observation. The results obtained showed that, after the intervention, the students who received the questioning when developing training activities improved their decision-making compared to those who did not. These results show the need to include this pedagogical model in teaching programs at the higher levels of Primary Education


Assuntos
Humanos , Masculino , Feminino , Basquetebol , Tomada de Decisões , Educação , Ensino Fundamental e Médio , Metodologia como Assunto
3.
PeerJ ; 7: e7392, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31423354

RESUMO

BACKGROUND: This study has analyzed the impact of applying a decision training program, in which video-feedback and questioning were used, on the development of decision-making, skill execution and procedural knowledge in basketball players. METHODS: Participants were eleven male players aged between 12 and 13 years old (M age = 12.75, SD age = .65), who were assigned to an experimental or control group within a pre-test/intervention test/retention test quasi-experimental design. The decision training program was applied over 11 weeks. Throughout this intervention, players had to analyze the causes and reasons for the decision made, using video feedback and questioning to this end. Decision-making and skill execution variables were analyzed using the French & Thomas (1987) observation instrument, while a validated questionnaire was used to assess procedural knowledge in basketball. RESULTS: The results reported that sport expertise improved in players from the experimental group, who had significantly higher intervention test scores for successful decisions and skill executions when compared to players in the control group. In the intra-group analysis, the experimental group significantly improved in the intervention test compared to the pre-test, in terms of some of the variables of decision-making, skill execution and procedural knowledge. DISCUSSION: These results reinforce the idea of including cognitive tools in training, such as video-feedback and questioning, to improve sport expertise in players' formative stages, and presumably to improve their performance whilst maintaining decision training throughout time.

6.
Univ. psychol ; 16(4): 303-317, oct.-dic. 2017. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-963323

RESUMO

Resumen La etapa universitaria supone un momento sensible respecto a la realización de práctica de actividad física (AF), especialmente en las mujeres. El objetivo principal de este estudio fue identificar la prevalencia de barreras de práctica de AF, y analizar las posibles diferencias en función del género y el cumplimiento de las recomendaciones de práctica de AF para adultos, establecidas por la Organización Mundial de la Salud (2010). Participaron 901 estudiantes universitarios (M = 22.59; DT = 3.59) que cumplimentaron el IPAQ-SF y la Escala de Percepción de Barreras. Entre los resultados destaca que las barreras relativas a la falta de tiempo obtuvieron los valores más altos entre la población universitaria. El MANOVA realizado mostró que los estudiantes que no cumplían las recomendaciones de práctica de AF percibían valores superiores en la mayoría de barreras de práctica de AF que aquellos estudiantes que sí cumplían las recomendaciones. De igual modo, las mujeres que cumplían las recomendaciones de AF presentaron valores superiores en todas las barreras analizadas, que los hombres que cumplían dichas recomendaciones. En esta misma línea, las mujeres que no cumplían las recomendaciones de AF presentaron valores superiores en las barreras referentes al tiempo y a la capacidad de disfrute que los hombres que no cumplían dichas recomendaciones. A raíz de la alta prevalencia de percepción de barreras, especialmente en las mujeres, se destaca la importancia de desarrollar programas de intervención y políticas que puedan suponer una mayor adherencia a la práctica de AF, asentando unos hábitos más activos en la población universitaria.


Abstract University stage is a sensitive moment about doing physical activity (PA), especially in women. The main objective of this study was to identify the barriers to PA in university students and analyze possible differences in gender and compliance with PA guidelines established in adults by World Health Organization (2010). 901 students (M = 22.59; SD = 3.59) completed the IPAQ-SF and the Scale of Perceived Barriers. Among the results, the barriers related to lack of time obtained the highest values among the university population. The MANOVA showed that students who failing to meet PA guidelines perceived higher values ​​in most analyzed barriers than the students who meet PA guidelines. Likewise, women who met the PA guidelines presented higher values in all the barriers analyzed than the men who met the PA guidelines. In addition, women who failing to meet PA guidelines presented higher values in the barriers related to time and disliking of PA than the men who failing to meet PA guidelines. In summary, this study showed a high prevalencia of barriers in university students, especially in women. The results highlight the importance of developing health policies and PA interventions targeting university students.


Assuntos
Exercício Físico/psicologia , Saúde/classificação , Estilo de Vida
7.
Semergen ; 43(4): 295-311, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-28532894

RESUMO

The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than <10 years of evolution, without other risk factors or complications, or type 1 diabetes of short evolution without complications. The decision to start pharmacological treatment of arterial hypertension will depend on the blood pressure level and the cardiovascular risk, taking into account the lesion of target organs. The guidelines don't recommend antiplatelet drugs in primary prevention because of the increased bleeding risk. The low adherence to the medication requires simplified therapeutic regimes and to identify and combat its causes. The guidelines highlight the responsibility of health professionals to take an active role in advocating evidence-based interventions at the population level, and propose effective interventions, at individual and population level, to promote a healthy diet, the practice of physical activity, the cessation of smoking and the protection against alcohol abuse.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Estilo de Vida , Guias de Prática Clínica como Assunto , Doenças Cardiovasculares/etiologia , Europa (Continente) , Pessoal de Saúde/organização & administração , Humanos , Adesão à Medicação , Prevenção Primária/métodos , Papel Profissional , Fatores de Risco , Espanha
8.
Gac Sanit ; 31(3): 255-268, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-28292529

RESUMO

The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than <10 years of evolution, without other risk factors or complications, or type 1 diabetes of short evolution without complications. The decision to start pharmacological treatment of arterial hypertension will depend on the blood pressure level and the cardiovascular risk, taking into account the lesion of target organs. The guidelines don't recommend antiplatelet drugs in primary prevention because of the increased bleeding risk. The low adherence to the medication requires simplified therapeutic regimes and to identify and combat its causes. The guidelines highlight the responsibility of health professionals to take an active role in advocating evidence-based interventions at the population level, and propose effective interventions, at individual and population level, to promote a healthy diet, the practice of physical activity, the cessation of smoking and the protection against alcohol abuse.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Estilo de Vida , Guias de Prática Clínica como Assunto , Medição de Risco , Fatores Etários , Biomarcadores/análise , Doenças Cardiovasculares/epidemiologia , Europa (Continente) , Feminino , Promoção da Saúde , Humanos , Masculino , Programas de Rastreamento , Cooperação do Paciente , Papel do Médico , Fatores de Risco , Espanha
9.
Rev Esp Salud Publica ; 90: e1-e24, 2016 Nov 24.
Artigo em Espanhol | MEDLINE | ID: mdl-27880755

RESUMO

The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than 10 years of evolution, without other risk factors or complications, or type 1 diabetes of short evolution without complications. The decision to start pharmacological treatment of arterial hypertension will depend on the blood pressure level and the cardiovascular risk, taking into account the lesion of target organs. The guidelines don't recommend antiplatelet drugs in primary prevention because of the increased bleeding risk. The low adherence to the medication requires simplified therapeutic regimes and to identify and combat its causes. The guidelines highlight the responsibility of health professionals to take an active role in advocating evidence-based interventions at the population level, and propose effective interventions, at individual and population level, to promote a healthy diet, the practice of physical activity, the cessation of smoking and the protection against alcohol abuse.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Terapia Combinada , Europa (Continente) , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Medição de Risco , Fatores de Risco , Espanha
10.
Hipertens Riesgo Vasc ; 32(2): 83-91, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-26179969

RESUMO

The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention.


Assuntos
Dislipidemias/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Cardiologia , Doenças Cardiovasculares/tratamento farmacológico , LDL-Colesterol , Gerenciamento Clínico , Humanos , Fatores de Risco , Estados Unidos
11.
Rev Esp Salud Publica ; 89(1): 15-26, 2015.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-25946582

RESUMO

The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention.


Assuntos
Dislipidemias/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Guias de Prática Clínica como Assunto , Biomarcadores/sangue , LDL-Colesterol/sangue , Dislipidemias/sangue , Medicina Baseada em Evidências , Humanos , Prevenção Primária/normas , Medição de Risco , Fatores de Risco , Espanha , Estados Unidos
12.
Clin Investig Arterioscler ; 27(1): 36-44, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-25444651

RESUMO

The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention. Full English text available from:www.revespcardiol.org/en.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Dislipidemias/tratamento farmacológico , Guias de Prática Clínica como Assunto , LDL-Colesterol/sangue , Dislipidemias/complicações , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Adesão à Medicação , Sociedades Médicas , Espanha , Estados Unidos
13.
Semergen ; 41(3): 149-57, 2015 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-25450438

RESUMO

The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Dislipidemias/terapia , Guias de Prática Clínica como Assunto , Doenças Cardiovasculares/etiologia , Dislipidemias/complicações , Europa (Continente) , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipolipemiantes/administração & dosagem , Hipolipemiantes/uso terapêutico , Prevenção Primária/métodos , Comportamento de Redução do Risco , Sociedades Médicas , Espanha , Estados Unidos
14.
Rev Esp Cardiol (Engl Ed) ; 67(11): 913-9, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25443815

RESUMO

The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention.


Assuntos
Cardiologia/normas , Doenças Cardiovasculares/prevenção & controle , Dislipidemias/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Guias de Prática Clínica como Assunto , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sociedades Médicas , Espanha
16.
Rev Esp Salud Publica ; 87(2): 103-20, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23775101

RESUMO

Based on the two main frameworks for evaluating scientific evidence--SEC and GRADE--European cardiovascular prevention guidelines recommend interventions across all life stages using a combination of population-based and high-risk strategies with diet as the cornerstone of prevention. The evaluation of cardiovascular risk (CVR) incorporates HDL levels and psychosocial factors, a very high risk category, and the concept of age-risk. They also recommend cognitive-behavioural methods (e.g., motivational interviewing, psychological interventions, led by health professionals and with the participation of the patient's family, to counterbalance psychosocial stress and reduce CVR through the institution of positive habits such as a healthy diet, physical activity, smoking cessation, and adherence to treatment. Additionally, public health interventions--such as smoking ban in public areas or the elimination of trans fatty acids from the food chain--are also essential. Other innovations include abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure (BP) within the 130-139/80-85 mmHg range in diabetic patients and individuals with high CVR. Finally, due to the significant impact on patient progress and medical costs, special emphasis is given to the low therapeutic adherence levels observed. In sum, improving cardiovascular prevention requires a true partnership among the political class, public administrations, scientific and professional associations, health foundations, consumer associations, patients and their families. Such partnership would promote population-based and individual strategies by taking advantage of the broad spectrum of scientific evidence available, from clinical trials to observational studies and mathematical models to evaluate population-based interventions, including cost-effectiveness analyses.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Guias de Prática Clínica como Assunto , Prevenção Primária/normas , Adulto , Doenças Cardiovasculares/psicologia , Dieta/economia , Humanos , Saúde Pública , Fatores de Risco , Abandono do Hábito de Fumar , Espanha
17.
Clin Investig Arterioscler ; 25(3): 127-39, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23726872

RESUMO

Based on the two main frameworks for evaluating scientific evidence (SEC and GRADE) European cardiovascular prevention guidelines recommend interventions across all life stages using a combination of population-based and high-risk strategies with diet as the cornerstone of prevention. The evaluation of cardiovascular risk (CVR) incorporates HDL levels and psychosocial factors, a very high risk category, and the concept of age-risk. They also recommend cognitive-behavioural methods (e.g., motivational interviewing, psychological interventions) led by health professionals and with the participation of the patient's family, to counterbalance psychosocial stress and reduce CVR through the institution of positive habits such as a healthy diet, physical activity, smoking cessation, and adherence to treatment. Additionally, public health interventions - such as smoking ban in public areas or the elimination of trans fatty acids from the food chain - are also essential. Other innovations include abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure within the 130-139/80-85mmHg range in diabetic patients and individuals with high CVR. Finally, due to the significant impact on patient progress and medical costs, special emphasis is given to the low therapeutic adherence levels observed. In sum, improving cardiovascular prevention requires a true partnership among the political class, public administrations, scientific and professional associations, health foundations, consumer associations, patients and their families. Such partnership would promote population-based and individual strategies by taking advantage of the broad spectrum of scientific evidence available, from clinical trials to observational studies and mathematical models to evaluate population-based interventions, including cost-effectiveness analyses.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Guias de Prática Clínica como Assunto , Prevenção Primária/métodos , Fatores Etários , Análise Custo-Benefício , Europa (Continente) , Humanos , Modelos Teóricos , Fatores de Risco , Abandono do Hábito de Fumar , Espanha
18.
Rev Esp Cardiol ; 64(10): 876-82, 2011 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-21821340

RESUMO

INTRODUCTION AND OBJECTIVES: The ENRICA study aims to assess the frequency and distribution of the main components of the natural history of cardiovascular disease in Spain, including food consumption and other behavioral risk factors, biological risk factors, early damage of target organs, and diagnosed morbidity. METHODS: A cross-sectional survey of 11,991 individuals representative of the non-institutionalized population aged 18 years and older in Spain was conducted from June 2008 to October 2010. Data collection comprised 3 sequential stages: a) computer-assisted telephone interview to obtain information on lifestyle, knowledge and attitudes about cardiovascular disease risk factors, and the signs and symptoms of heart attack and stroke, subjective health, and morbidity; b) first home visit, to collect blood and urine samples for analysis by a central laboratory, and c) second home visit, to measure anthropometric variables and blood pressure and to administer a computer-assisted dietary history; data on functional limitations are also collected from participants aged 65 years and older. DISCUSSION: The ENRICA study has shown the feasibility of a large home-based health interview and examination survey in Spain. It will provide valuable information to support and evaluate national strategies against cardiovascular disease and other chronic diseases in Spain. Moreover, a 3-year prospective follow-up of the study participants, including a new physical exam, is planned to start in the second semester of 2011 and will update lifestyle information and biological variables. (ClinicalTrials.gov number, NCT01133093).


Assuntos
Doenças Cardiovasculares/epidemiologia , Estado Nutricional , Adolescente , Adulto , Idoso , Antropometria , Estudos Transversais , Interpretação Estatística de Dados , Dieta , Ingestão de Alimentos , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Projetos de Pesquisa , Risco , Fatores de Risco , Espanha/epidemiologia , Telefone , Adulto Jovem
19.
Med Clin (Barc) ; 137(1): 30.e1-30.e13, 2011 Jun 11.
Artigo em Espanhol | MEDLINE | ID: mdl-21511309

RESUMO

In Spain, where cardiovascular disease (CVD) is the leading cause of death, hypercholesterolemia, one of the most prevalent risk factors in adults, is poorly controlled. Dyslipidemia should not be approached in isolation, but in the context of overall cardiovascular risk (CVR). Measurement of CVR facilitates decision making, but should not be the only tool nor should it take the place of clinical judgment, given the limitations of the available calculation methods. This document, prepared by the Interdisciplinary Spanish Committee on Cardiovascular Prevention, at the proposal of the Spanish Society of Arteriosclerosis, reviews the cardiovascular prevention activities of the regional health authorities, scientific societies and medical professionals. An initiation of a national strategy on cardiovascular prevention is proposed based on lifestyle modification (healthy diet, physical activity and smoking cessation) through actions in different settings. At the population level, regulation of food advertising, elimination of trans fats and reduction of added sugar are feasible and cost-effective interventions to help control dyslipidemias and reduce CVR. In the health setting, it is proposed to facilitate the application of guidelines, improve training for medical professionals, and include CVR assessment among the quality indicators. Scientific societies should collaborate with the health authorities and contribute to the generation and transmission of knowledge. Finally, it is in the hands of professionals to apply the concept of CVR, promote healthy lifestyles, and make efficient use of available pharmacological treatments.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Dislipidemias/terapia , Doenças Cardiovasculares/etiologia , Dislipidemias/complicações , Feminino , Humanos , Masculino , Espanha
20.
Med Clin (Barc) ; 136(3): 97-102, 2011 Feb 12.
Artigo em Espanhol | MEDLINE | ID: mdl-20980030

RESUMO

BACKGROUND AND OBJECTIVE: This study estimates smoking-attributable mortality in Spain in 2006. POPULATION AND METHOD: Source data included 1) smoking prevalence in Spain; 2) deaths occurred in Spain; and 3) relative risks of mortality by tobacco-caused diseases drawn from the Cancer Prevention Study II. All data corresponded to individuals aged 35 years and older. RESULTS: In 2006, 53,155 smoking-attributable deaths were estimated (14.7% of all deaths occurred in individuals≥35 years; 25.1% in men and 3.4% in women). Almost 90% (47,174) of these attributable deaths corresponded to men, and 11.3% (5,981) to women. The most frequent attributable deaths were: cancer (24,058), specially lung cancer (16,482), cardiovascular disease (17,560), specially ischemic heart disease (6,263) and stroke (4,283), and respiratory disease (11,537), specially chronic obstructive lung disease (9,886). Since 2001, a decrease in smoking-attributable mortality was observed in men and an increase in women. CONCLUSIONS: About one out of 7 deaths occurring annually in individuals≥35 years in Spain is attributable to smoking (one in 4 in men and one in 29 in women). Despite a decreasing trend in the number of smoking-attributable deaths over time (except in women, where they increase), the toll of estimated attributable deaths is still very high.


Assuntos
Fumar/mortalidade , Feminino , Humanos , Masculino , Espanha
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