RESUMEN
Background: In recent years, the integration of mobile health (m-Health) interventions has garnered increasing attention as a potential means to improve blood pressure (BP) management in adults. This updated systematic review with meta-analysis aimed to identify the effect of m-Health-based interventions on BP in adults and to evaluate the effect of m-Health on BP according to the characteristics of subjects, interventions, and countries. Methods: The search was carried out in PubMed, Embase, ResearchGate, and Cochrane databases in January 2022. Study selection and data extraction were performed by two independent reviewers. For analysis, random effects models were used with a confidence interval (CI) of 95% and p < 0.05. Results: Fifty studies were included in this review and in the meta-analysis. Interventions with m-Health reduced systolic BP in 3.5 mmHg (95% CI -4.3; -2.7; p < 0.001; I2 = 85.8%) and diastolic BP in 1.8 mmHg (95% CI -2.3; -1.4; p < 0.001; I2 = 78.9%) compared to usual care. The effects of m-Health interventions on BP were more evident in men and in older adults, in interventions lasting 6-8 weeks, with medication reminders, with the possibility of insertion of BP values (p < 0.05). Conclusion: The results of this study support the effectiveness of m-Health in reducing BP when compared to standard care. However, these effects are dependent on the characteristics of the subjects and interventions. Given the substantial heterogeneity among the results of this systematic review with meta-analysis, its interpretation should be cautious. Future research on this topic is warranted.
RESUMEN
BACKGROUND: Lifestyle and habits, cardiovascular risk factors (CRF), bone and mental health, dietary habits, physical activity, among others are developed in childhood and adolescence. Family environment has shown to play an important role in these outcomes. However, whether the parent-child relationship lifestyle habits and health parameters can be influenced by physical activity patterns still unclear. The objective of this study will be to monitor and investigate the associations between lifestyle habits between parents and their children longitudinally, as well as verify whether in more active parents, the possible associations with lifestyle habits are different from those of parents considered less active. METHODS: The sample will consist of parents (father, mother, or both) and their children /adolescents. The participants will be recruited through public call by flyers spread across all the regions of the city and also through social media. The health parameters will include cardiovascular (cardiac autonomic modulation, blood pressure and resting heart rate), bone mineral density, anthropometric indices, handgrip strength, mental health (quality of life, anxiety and depression symptoms and stress), self-reported morbidities and musculoskeletal pain. Lifestyle habits will include physical activity levels, sedentary behavior, sleep parameters, eating patterns, smoking and alcohol consumption. Sociodemographic variables of age, sex, ethnicity and socioeconomic status will be considered as covariates. The follow-up visits of data collection will be scheduled after a period of 12 months from the baseline assessment during every twelve months. DISCUSSION: The family environment has great potential to determine lifestyle habits in children and adolescents. Based on the results presented in the present study, we hope that health promotion actions can be better designed in the family environment.
RESUMEN
PURPOSE: The six-minute walk test (6MWT) is extensively employed to evaluate gait impairment in patients with symptomatic peripheral artery disease (PAD) and has been associated with different health outcomes. However, various approaches exist for calculating and interpreting the six-minute test in order to address the needs of patients more effectively. Therefore, we investigated how these different approaches correlate with functional capacity and cardiovascular health in patients with symptomatic PAD. METHODS: In total, 227 PAD patients [65.2% men and 67 (13) y.o.] were included in this cross-sectional study. The 6MWT was performed along a 30-meter corridor and the distance was expressed in three ways: absolute (described as the meters walked during the test), relativized (based on the results of the 6MWT in healthy individuals), and DW (multiplying the body weight in kilograms by the absolute distance in the 6MWT). A functional capacity z-score was calculated using the results of the handgrip strength test, 4-meter walking test, and sit-and-stand test. A cardiovascular parameter z-score was calculated with data on brachial and central blood pressure, the low-frequency component/high-frequency component ratio, and carotid-femoral pulse wave velocity. RESULTS: The absolute (b = 0.30, 95%CI: 18-0.43, R² = 0.11, p < 0.001) and DW (b = 0.40, 95%CI: 27-0.53, R² = 0.17, p < 0.001) measures were related to functional capacity, independently of sex, age, and the ankle-arm index of the patients. Neither absolute nor DW were related to cardiovascular health. The relativized measure was not associated with either functional capacity or cardiovascular health. CONCLUSION: In patients with symptomatic PAD, absolute and DW measures are related to functional capacity, but not cardiovascular function.
Asunto(s)
Enfermedad Arterial Periférica , Prueba de Paso , Caminata , Humanos , Enfermedad Arterial Periférica/fisiopatología , Masculino , Femenino , Estudios Transversales , Anciano , Caminata/fisiología , Peso Corporal , Análisis de la Onda del Pulso , Fuerza de la Mano/fisiología , Persona de Mediana Edad , Presión Sanguínea/fisiología , Índice Tobillo BraquialRESUMEN
The aims of the current study were to analyze the association between the barriers to and changes in physical activity levels and sedentary behavior, as well as to examine whether these barriers change over time in patients with peripheral artery disease. In this longitudinal study, we assessed 72 patients (68% men; 65.7 ± 9.2 years). Physical activity was measured over a 7-day period using an accelerometer, and data were collected on time spent in sedentary activities, low-light physical activities, and moderate-to-vigorous physical activities. Personal and environmental barriers to physical activity were collected using yes or no questions. Assessments were repeated in the same patients after 27 months (95% confidence interval [26, 28] months). Most barriers remained stable in these patients; however, those who reported lack of money experienced an increase in sedentary behavior (ß = 392.9 [159.7] min/week, p = .02) and a decrease in low-light physical activity (ß = -372.4 [140.1] min/week, p = .02). These findings suggest that patients with symptomatic peripheral artery disease typically exhibit stable barriers over time, and individuals reporting lack of money demonstrated a decrease in low-light physical activity and an increase in sedentary behavior after 27 months.
RESUMEN
INTRODUCTION: In peripheral artery disease (PAD) patients, the joint profile of low strength and cardiorespiratory fitness on movement behaviors, specifically physical activity levels and sedentary time, remains unclear. PURPOSE: To investigate the joint profiles between cardiorespiratory and neuromuscular fitness and daily physical activity among PAD patients. METHODS: Cross-sectional study in a sample of 155 PAD patients. We measured their physical activity level per week using accelerometers, assessed their muscle strength through a sit-to-stand test and cardiorespiratory fitness through a six-minute walk test. Patients were categorized into three groups: those with high strength and cardiorespiratory fitness (NC, n = 28), those with at least one component classified as low (1C, n = 88), and those with both components classified as low fitness (2C, n = 39). RESULTS: The patients in the 1C and 2C groups spent less time engaged in low-light and moderate activities compared to the NC group (low-light: NC: 2291 ± 680 minutes/week vs. 1C: 1826 ± 649 minutes/week vs. 2C: 1885 ± 651 minutes/week, p = .005; moderate: NC: 2617 ± 796 minutes/week vs. 1C: 2071 ± 767 minutes/week vs. 2C: 2092 ± 776 minutes/week, p = .005) and the patients in the 2C group spent less time engaged in vigorous activities compared to the NC and 1C groups (NC: 155 ± 148 minutes/week vs. 1C: 110 ± 110 minutes/week vs. 2C: 64 ± 70 minutes/week, p = .003). CONCLUSION: PAD patients with low strength and/or cardiorespiratory fitness are more likely to spend less time engaging in low-light and moderate physical activities and patients with low fitness in both components are more likely to spend less time engaging in vigorous physical activity.
Asunto(s)
Capacidad Cardiovascular , Enfermedad Arterial Periférica , Humanos , Estudios Transversales , Ejercicio Físico/fisiología , Fuerza Muscular/fisiología , Aptitud Física/fisiologíaRESUMEN
OBJECTIVE: This study analyzed the impact of sex on self-reported health and lifestyle parameters in peripheral artery disease patients at two periods of the COVID-19 pandemic. METHODS: In this longitudinal study, 99 patients with peripheral artery disease (53 men and 46 women) were evaluated during two periods of the COVID-19 pandemic ( i.e ., at onset: May to August 2020, and on follow-up: May to August 2021). Patients were interviewed via telephone, and information regarding lifestyle and health parameters was obtained. RESULTS: At the onset of the COVID-19 pandemic, health and habit parameters were similar between women and men, with 63.0% and 45.3% indicating frequent fatigue, 73.9% and 84.9% reporting increased sitting time, and 23.9% and 39.6% practicing physical activity, respectively. At follow-up, difficulties in physical mobility (women: from 26.1% to 73.9%, p<0.001; men: from 39.6% to 71.7%, p=0.001) and the frequency of hospitalization for reasons other than COVID-19 increased similarly in women and men (women: from 4.3% to 21.7%, p=0.013; men: from 9.4% to 24.5%, p=0.038). The other parameters were similar between the periods. CONCLUSION: Self-reported physical mobility difficulties and hospitalization frequency increased in women and men with peripheral artery disease. BACKGROUND: ⪠Sitting time increased in 73.9% of women and 84.9% of men at the onset of the pandemic. BACKGROUND: ⪠Physical activity was practiced by 23.9% of women and 39.6% of men at the onset of the pandemic. BACKGROUND: ⪠The prevalence of both women and men reporting physical mobility difficulties increased at follow-up. BACKGROUND: ⪠Hospitalization rates for reasons unrelated to COVID-19 have increased in both women and. BACKGROUND: While women experience more consequences related to peripheral artery disease than men, such as worse functional capacity and higher morbidity, there was a similar increase in physical mobility difficulty and frequency of hospitalization for reasons other than COVID-19 one year after the onset of the pandemic.
Asunto(s)
COVID-19 , Enfermedad Arterial Periférica , Masculino , Humanos , Femenino , Pandemias , Estudios Longitudinales , COVID-19/epidemiología , Enfermedad Arterial Periférica/epidemiología , Estilo de VidaAsunto(s)
Acoso Escolar , Víctimas de Crimen , Humanos , Adolescente , Ideación Suicida , Encuestas y Cuestionarios , Padres , DepresiónRESUMEN
ABSTRACT Objective: This study analyzed the impact of sex on self-reported health and lifestyle parameters in peripheral artery disease patients at two periods of the COVID-19 pandemic. Methods: In this longitudinal study, 99 patients with peripheral artery disease (53 men and 46 women) were evaluated during two periods of the COVID-19 pandemic ( i.e ., at onset: May to August 2020, and on follow-up: May to August 2021). Patients were interviewed via telephone, and information regarding lifestyle and health parameters was obtained. Results: At the onset of the COVID-19 pandemic, health and habit parameters were similar between women and men, with 63.0% and 45.3% indicating frequent fatigue, 73.9% and 84.9% reporting increased sitting time, and 23.9% and 39.6% practicing physical activity, respectively. At follow-up, difficulties in physical mobility (women: from 26.1% to 73.9%, p<0.001; men: from 39.6% to 71.7%, p=0.001) and the frequency of hospitalization for reasons other than COVID-19 increased similarly in women and men (women: from 4.3% to 21.7%, p=0.013; men: from 9.4% to 24.5%, p=0.038). The other parameters were similar between the periods. Conclusion: Self-reported physical mobility difficulties and hospitalization frequency increased in women and men with peripheral artery disease.
RESUMEN
BACKGROUND: Miyasato et al. show that peak oxygen consumption, walking economy, anaerobic threshold, and cardiovascular responses (heart rate, blood pressure, and rate pressure product) during walking were similar between men and women with peripheral artery disease and intermittent claudication. There were no differences in the physiological responses to walking between men and women with intermittent claudication. Sex per se is not a factor that demands changes in walking prescription for patients with intermittent claudication. OBJECTIVE: Peak oxygen consumption (VO2peak), anaerobic threshold, walking economy, and cardiovascular responses during walking are used to guide and monitor walking training in patients with peripheral artery disease and intermittent claudication. Women with peripheral artery disease and intermittent claudication present greater impairments than men, and evaluating training markers according to sex for decisions regarding walking prescription in this population is important. This study aimed to compare VO2peak, walking economy, anaerobic threshold, and cardiovascular responses during walking in men and women with peripheral artery disease and intermittent claudication. METHODS: Forty patients (20 men and 20 women with similar baseline characteristics) underwent a cardiopulmonary treadmill test (3.2km/h and 2% increase in slope every 2 minutes until maximal leg pain). The VO2 and rate-pressure product were assessed. Data from men and women were compared using t-tests. RESULTS: There were no significant differences between men and women (VO2peak: 15.0±4.8 versus 13.9±2.9mLâkg-1âmin-1, p=0.38; walking economy: 9.6±2.7 versus 8.4±1.6mLâkg-1âmin-1, p=0.09; anaerobic threshold: 10.5±3.2 versus 10.5±2.2mLâkg-1âmin-1, p=0.98; rate pressure product at 1st stage: 13,465± 2,910 versus 14,445±4,379bpmâmmHg, p=0.41; and rate pressure product at anaerobic threshold:13,673±3,100 versus 16,390±5,870bpmâmmHg, p=0.08 and rate pressure product at peak exercise: 21,253±6,141 versus 21,923±7,414bpmâmmHg, p=0.76, respectively). CONCLUSION: Men and women with peripheral artery disease and similar baseline characteristics presented similar responses to walking, suggesting that decisions regarding walking prescription and monitoring can be made regardless of sex in this specific population.
Asunto(s)
Claudicación Intermitente , Enfermedad Arterial Periférica , Caminata , Femenino , Humanos , Masculino , Prueba de Esfuerzo , Terapia por Ejercicio , Caminata/fisiologíaRESUMEN
INTRODUCTION: Peripheral artery disease (PAD) patients with claudication symptoms exhibit impaired functional capacity, which has been associated with disease severity, worse quality of life and higher risk of cardiovascular events. Different tests have been used to assess functional capacity in PAD patients. Therefore, understanding the characteristics, strengths and limitations of these tests are important to support the choice of tests to be used in clinical practice. AREAS COVERED: This review summarizes the main methods to assess functional capacity in PAD patients, discussing their psychometric properties, applications, and limitations. EXPERT OPINION: Robust evidence supports the use of treadmill and six-minute walk tests in PAD patients, as their results are associated with clinically meaningful outcomes, adequate psychometric properties and are sensitive to effects of interventions. On the other hand, other functional tests (Shuttle-walk test, outdoor walking capacity test, timed-up and go, four-meter walk test, heel-rise test, short physical performance battery and modified physical performance battery) are related to activities of daily living and do not require sophisticated equipment and can be easily used in clinical practice. However, these other tests still need evidence regarding their clinical relevance, reliability, and ability to detect long-term intervention changes, providing further investigation directions.
Asunto(s)
Actividades Cotidianas , Enfermedad Arterial Periférica , Humanos , Calidad de Vida , Reproducibilidad de los Resultados , Enfermedad Arterial Periférica/diagnóstico , Claudicación Intermitente/diagnóstico , Claudicación Intermitente/etiología , CaminataRESUMEN
BACKGROUND: Prolonged social isolation intended to mitigate the spread of Coronavirus 2019 (COVID-19), may potentially affect the physical activity level and health of patients with peripheral artery disease (PAD). OBJECTIVES: To analyze the impact of physical activity practice on longitudinal changes in self-reported health parameters during the COVID-19 pandemic in patients with PAD. DESIGN: Longitudinal study. SETTING: The database of studies developed by our group involving patients with PAD from public hospitals in São Paulo, Brazil. METHODS: In this longitudinal study, 99 patients with PAD were evaluated in two periods during the COVID-19 pandemic (i.e., May to August 2020 and May to August 2021). Patients were interviewed by telephone, and information was obtained regarding physical activity practice and self-reported health (i.e., current global, physical, and mental health). Patients were divided into two groups: the physically inactive group (patients who were or became physically inactive, n=76, 51.3% male, 67±10 years old, 8±7 years of disease duration) and the physically active group (patients who started or continued practicing physical activity, n=23, 65.2% male, 71±8years old, 7±6 years of disease). RESULTS: The physically inactive group more frequently self-reported their current health as poor (6.6 vs. 17.1%, P=0.045) and were more frequently hospitalized for reasons other than COVID-19 (6.6 vs. 27.6%, P=0.001) between the two periods evaluated during the COVID-19 pandemic. The physically active group self-reported lower declines in walking capacity (13.0 vs. 43.5%, P=0.022) between the two periods evaluated. We did not observe any differences in other parameters in either group between the two periods evaluated (p>0.05). CONCLUSIONS: The practice of physical activity during the COVID-19 pandemic can help maintain or mitigate the negative impacts on self-reported global and physical health parameters in patients with PAD.
Asunto(s)
COVID-19 , Enfermedad Arterial Periférica , Humanos , Masculino , Persona de Mediana Edad , Anciano , Femenino , Autoinforme , Estudios Longitudinales , Pandemias , Brasil/epidemiología , Ejercicio FísicoRESUMEN
Background: Erectile dysfunction (ED) is a multifactorial medical disorder often neglected in clinical practice between elderly men, defined as the inability to achieve and/or maintain a penile erection sufficient for satisfactory sexual intercourse and a common clinical entity among men and associated with impaired quality of life and cardiovascular diseases in elderly men. The aim of this study is to evaluate the association between ED and clinical, demographic and behavioral parameters in elderly men. Methods: A total of 2436 males aged 60 years and over who participated in the health screening between January 2008 and December 2018 were included in this study. Laboratory exams, clinical and behavior profiles were analyzed. Logistic regression models were used. Results: Men with ED were older (65.87±5.49 vs. 63.85±4.05 years old. p<0.001), higher prevalence of physical inactivity (23.8 vs. 19%, p = 0.039) and had a higher body mass index (BMI; 28.36±4.06 vs. 27.72±3.89 kg/m2. p<0.001) than men without ED. The multivariate model shown that hypertension (p = 0.001), diabetes mellitus (p<0.001), lower urinary tract symptoms (LUTS), depressive symptoms (p<0.001) and age (p<0.001), were strongly associated with ED. Conclusion: The main risk factors associated with ED in elderly men were hypertension, diabetes mellitus, LUTS, depressive symptoms and age.
Asunto(s)
Disfunción Eréctil , Hipertensión , Anciano , Masculino , Humanos , Persona de Mediana Edad , Disfunción Eréctil/epidemiología , Disfunción Eréctil/etiología , Estudios Transversales , Calidad de Vida , Brasil/epidemiología , Factores de Riesgo , Hipertensión/complicacionesRESUMEN
Introdução: Pacientes infectados com COVID-19 parecem manifestar evolução mais grave quando apresentam comorbidades, como a Diabetes Mellitus (DM). No entanto, dados da população brasileira ainda são pouco disponíveis. Objetivo: Analisar a associação entre DM e evolução para intubação e óbito em indivíduos internados com COVID-19. Metodologia: Estudo transversal, observacional, quantitativo com dados dos prontuários de 74 participantes adultos internados no Hospital Professora Lydia Storópoli, com diagnóstico de COVID-19. O Comitê de Ética em Pesquisa Humana aprovou este estudo e os participantes assinaram o termo de consentimento do estudo. Resultados: Dos 74 pacientes, 18 apresentavam DM, dos quais seis evoluíram para intubação e cinco evoluíram para óbito. Não houve associação significativa (p>0,05) entre DM e intubação e óbito. Conclusão: Na presente amostra a DM não foi associada com a evolução clínica para intubação e óbito.
Introduction: Patients infected with COVID-19 seem to manifest a more severe evolution when they have comorbidities, such as Diabetes Mellitus (DM). However, data on the Brazilian population are still scarcely available. Objective: To analyze the association between DM and evolution to intubation and death in individuals hospitalized with COVID-19. Methodology: Cross-sectional, observational, quantitative study with data from the medical records of 74 adult participants admitted to Professora Lydia Storópoli Hospital, diagnosed with COVID-19. The Human Research Ethics Committee approved this study, and participants signed the study consent form. Results: 74 patients with Covid-19, 18 had DM, of which six evolved to intubation, and five evolved to death. There was no significant association (p>0.05) between DM and intubation and death. Conclusion: In the present study, DM was not associated with clinical evolution to intubation and death.