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1.
Curr Probl Cardiol ; 46(4): 100737, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33412349

RESUMEN

BACKGROUND: The COVID-19 pandemic's mental health consequences remain unknown. AIM: To assess the mental health status of ambulatory cardiometabolic patients during COVID-19 pandemic lockdown in Spanish speaking Latin American countries. METHODS: Cardiometabolic patients without COVID-19 evidence in 13 Latin American countries answered a survey between June 15th and July 15th, 2020. The Diagnosis Manual of Mental Disorders fifth edition was used to identify the presence of major depressive symptoms. RESULTS: The sample included 4216 patients, 1590 (37.71%; IC95% 36.24-39.19) were considered suffering major depression. Female gender, consuming ≥5 medications day, physical activity <100 minutes weekly, low fruits and vegetables intake, poor treatment adherence, reduced food consumption were independently associated to the presence of major depressive symptoms. CONCLUSIONS: The CorCOVID Latam Psy study showed that one-third of the Latin American Spanish speaking population is suffering from major depressive symptoms during the COVID-19 outbreak.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Depresión/epidemiología , Trastorno Depresivo Mayor/epidemiología , Diabetes Mellitus/epidemiología , Síndrome Metabólico/epidemiología , Adulto , Anciano , Enfermedades Cardiovasculares/psicología , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/psicología , Depresión/psicología , Trastorno Depresivo Mayor/psicología , Diabetes Mellitus/psicología , Dieta/estadística & datos numéricos , Dislipidemias/epidemiología , Dislipidemias/psicología , Ingestión de Alimentos , Ejercicio Físico/psicología , Femenino , Frutas , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/psicología , Humanos , Hipertensión/epidemiología , Hipertensión/psicología , América Latina/epidemiología , Masculino , Salud Mental , Síndrome Metabólico/psicología , Persona de Mediana Edad , Factores Sexuales , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/psicología , Encuestas y Cuestionarios , Cumplimiento y Adherencia al Tratamiento/psicología , Cumplimiento y Adherencia al Tratamiento/estadística & datos numéricos , Verduras
2.
J Frailty Aging ; 10(1): 31-37, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33331619

RESUMEN

BACKGROUND: Given the important association between cardiovascular disease and cognitive decline, and their significant implications on frailty status, the contribution of neurocognitive frailty measure helping with the assessment of patient outcomes is dearly needed. OBJECTIVES: The present study examines the prognostic value of the Neurocognitive Frailty Index (NFI) in the elderly with cardiovascular disease. DESIGN: Secondary analysis of the Canadian Study of Health and Aging (CSHA) dataset was used for prediction of 5-year cognitive changes. SETTING: Community and institutional sample. PARTICIPANTS: Canadians aged 65 and over [Mean age: 80.4 years (SD=6.9; Range of 66-100)]. MEASUREMENT: Neurocognitive Frailty Index (NFI) and Modified Mini-Mental State (3MS) scores for cognitive functioning of all subjects at follow-up and mortality rate were measured. RESULTS: The NFI mean score was 9.63 (SD = 6.04) and ranged from 0 to 33. This study demonstrated that the NFI was significantly associated with cognitive changes for subjects with heart disease and this correlation was a stronger predictor than age. CONCLUSION: The clinical relevance of this study is that our result supports the prognostic utility of the NFI tool in treatment planning for those with modifiable cardiovascular disease risk factors in the development of dementia.


Asunto(s)
Envejecimiento/psicología , Enfermedades Cardiovasculares/mortalidad , Cognición/fisiología , Fragilidad/psicología , Evaluación Geriátrica/métodos , Anciano , Anciano de 80 o más Años , Canadá/epidemiología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/psicología , Envejecimiento Cognitivo , Análisis de Datos , Anciano Frágil/psicología , Humanos , Tasa de Supervivencia
3.
Curr Probl Cardiol ; 46(3): 100768, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33348221

RESUMEN

The exponential growth of commercial flights has resulted in an explosion of air travelers over the last few decades, including passengers with a wide range of cardiovascular conditions. Notwithstanding the ongoing COVID-19 pandemic that had set back the aviation industry for the next 1-2 years, air travel is expected to rebound fully by 2024. Guidelines and evidence-based recommendations for safe air travel in this group vary, and physicians often encounter situations where opinions and assessments on fitness for flights are sought. This article aims to provide an updated suite of recommendations for the aeromedical disposition of passenger with common cardiovascular conditions, such as ischemic heart disease, congestive heart failure, valvular heart disease, cardiomyopathies, and common arrhythmias.


Asunto(s)
Viaje en Avión/psicología , Enfermedades Cardiovasculares/epidemiología , Guías como Asunto/normas , Pandemias , Enfermedades Cardiovasculares/psicología , Comorbilidad , Humanos
4.
Health Qual Life Outcomes ; 18(1): 387, 2020 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-33317547

RESUMEN

BACKGROUND: Little is known about the impact of the global coronavirus disease-2019 (COVID-19) pandemic on patients with cardiovascular disease (CVD), the biggest global killer and major risk factor for severe COVID-19 infections. We aim to explore the indirect consequences of COVID-19 on health-related quality of life (HRQoL) of patients with CVD. METHODS: Eighty-one adult outpatients with CVD were assessed using the EQ-5D, a generic health status instrument with five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), before and during the pandemic. Changes in the EQ-5D dimensional responses were compared categorically as well as using the dimension-specific sum-score (range 1-3, with a higher score indicating worse health). The responses and sum-score were compared using the exact test of symmetry and the paired t-test, respectively. RESULTS: These patients [mean age (SD) 59.8 (10.5); 92.6% males; 56% New York Heart Association (NYHA) functional class I] had coronary artery disease (69%), heart failure (28%), or arrhythmias (15%). None experienced change in NYHA class between assessments. About 30% and 38% of patients reported problems with at least one of the EQ-5D dimensions pre-pandemic and during the pandemic, respectively. The highest increase in health problems was reported for anxiety/depression (12.5% pre-pandemic vs 23.5% during pandemic; p = 0.035) with mean domain-specific score from 1.12 (SD 0.33) to 1.25 (SD 0.46) (standardized effect size = 0.373, p = 0.012). There was no meaningful change in other dimensions as well as overall HRQoL. CONCLUSION: The COVID-19 pandemic is associated with a significant worsening of the mental health of patients with CVD.


Asunto(s)
/psicología , Enfermedades Cardiovasculares/psicología , Estado de Salud , Calidad de Vida , Actividades Cotidianas , Adulto , Anciano , Ansiedad/complicaciones , Grupo de Ascendencia Continental Asiática , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/etnología , Depresión/complicaciones , Femenino , Encuestas Epidemiológicas , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Dolor/etiología , Pandemias , Autocuidado , Singapur
5.
JAMA ; 324(23): 2396-2405, 2020 12 15.
Artículo en Inglés | MEDLINE | ID: mdl-33320224

RESUMEN

Importance: It is uncertain whether depressive symptoms are independently associated with subsequent risk of cardiovascular diseases (CVDs). Objective: To characterize the association between depressive symptoms and CVD incidence across the spectrum of lower mood. Design, Setting, and Participants: A pooled analysis of individual-participant data from the Emerging Risk Factors Collaboration (ERFC; 162 036 participants; 21 cohorts; baseline surveys, 1960-2008; latest follow-up, March 2020) and the UK Biobank (401 219 participants; baseline surveys, 2006-2010; latest follow-up, March 2020). Eligible participants had information about self-reported depressive symptoms and no CVD history at baseline. Exposures: Depressive symptoms were recorded using validated instruments. ERFC scores were harmonized across studies to a scale representative of the Center for Epidemiological Studies Depression (CES-D) scale (range, 0-60; ≥16 indicates possible depressive disorder). The UK Biobank recorded the 2-item Patient Health Questionnaire 2 (PHQ-2; range, 0-6; ≥3 indicates possible depressive disorder). Main Outcomes and Measures: Primary outcomes were incident fatal or nonfatal coronary heart disease (CHD), stroke, and CVD (composite of the 2). Hazard ratios (HRs) per 1-SD higher log CES-D or PHQ-2 adjusted for age, sex, smoking, and diabetes were reported. Results: Among 162 036 participants from the ERFC (73%, women; mean age at baseline, 63 years [SD, 9 years]), 5078 CHD and 3932 stroke events were recorded (median follow-up, 9.5 years). Associations with CHD, stroke, and CVD were log linear. The HR per 1-SD higher depression score for CHD was 1.07 (95% CI, 1.03-1.11); stroke, 1.05 (95% CI, 1.01-1.10); and CVD, 1.06 (95% CI, 1.04-1.08). The corresponding incidence rates per 10 000 person-years of follow-up in the highest vs the lowest quintile of CES-D score (geometric mean CES-D score, 19 vs 1) were 36.3 vs 29.0 for CHD events, 28.0 vs 24.7 for stroke events, and 62.8 vs 53.5 for CVD events. Among 401 219 participants from the UK Biobank (55% were women, mean age at baseline, 56 years [SD, 8 years]), 4607 CHD and 3253 stroke events were recorded (median follow-up, 8.1 years). The HR per 1-SD higher depression score for CHD was 1.11 (95% CI, 1.08-1.14); stroke, 1.10 (95% CI, 1.06-1.14); and CVD, 1.10 (95% CI, 1.08-1.13). The corresponding incidence rates per 10 000 person-years of follow-up among individuals with PHQ-2 scores of 4 or higher vs 0 were 20.9 vs 14.2 for CHD events, 15.3 vs 10.2 for stroke events, and 36.2 vs 24.5 for CVD events. The magnitude and statistical significance of the HRs were not materially changed after adjustment for additional risk factors. Conclusions and Relevance: In a pooled analysis of 563 255 participants in 22 cohorts, baseline depressive symptoms were associated with CVD incidence, including at symptom levels lower than the threshold indicative of a depressive disorder. However, the magnitude of associations was modest.


Asunto(s)
Enfermedades Cardiovasculares/psicología , Depresión/complicaciones , Anciano , Enfermedades Cardiovasculares/epidemiología , Estudios de Cohortes , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/psicología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Factores de Riesgo , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/psicología
6.
PLoS One ; 15(9): e0239533, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32966308

RESUMEN

BACKGROUND: Mindfulness-based programs hold promise for improving cardiovascular health (e.g. physical activity, diet, blood pressure). However, despite theoretical frameworks proposed, no studies have reported qualitative findings on how study participants themselves believe mindfulness-based programs improved their cardiovascular health. With an emphasis on in-depth, open-ended investigation, qualitative methods are well suited to explore the mechanisms underlying health outcomes. The objective of this qualitative study was to explore the mechanisms through which the mindfulness-based program, Mindfulness-Based Blood Pressure Reduction (MB-BP), may influence cardiovascular health. METHODS: This qualitative study was conducted as part of a Stage 1 single arm trial with one-year follow-up. The MB-BP curriculum was adapted from Mindfulness-Based Stress Reduction to direct participants' mindfulness skills towards modifiable determinants of blood pressure. Four focus group discussions were conducted (N = 19 participants), and seven additional participants were selected for in-depth interviews. Data analysis was conducted using the standard approach of thematic analysis. Following double-coding of audio-recorded transcripts, four members of the study team engaged in an iterative process of data analysis and interpretation. RESULTS: Participants identified self-awareness, attention control, and emotion regulation as key mechanisms that led to improvements in cardiovascular health. Within these broader themes, many participants detailed a process beginning with increased self-awareness to sustain attention and regulate emotions. Many also explained that the specific relationship between self-awareness and emotion regulation enabled them to respond more skillfully to stressors. In a secondary sub-theme, participants suggested that higher self-awareness helped them engage in positive health behaviors (e.g. healthier dietary choices). CONCLUSION: Qualitative analyses suggest that MB-BP mindfulness practices allowed participants to engage more effectively in self-regulation skills and behaviors lowering cardiovascular disease risk, which supports recent theory. Results are consistent with quantitative mechanistic findings showing emotion regulation, perceived stress, interoceptive awareness, and attention control are influenced by MB-BP.


Asunto(s)
Presión Sanguínea/fisiología , Hipertensión/terapia , Atención Plena/métodos , Adulto , Concienciación , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/psicología , Enfermedades Cardiovasculares/terapia , Curriculum , Emociones , Femenino , Grupos Focales , Conductas Relacionadas con la Salud , Humanos , Hipertensión/fisiopatología , Hipertensión/psicología , Masculino , Persona de Mediana Edad , Modelos Psicológicos , Autoimagen , Autocontrol
7.
PLoS One ; 15(9): e0239679, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32970741

RESUMEN

BACKGROUND: Undergo a health check for cardiovascular disease (CVD) is an important strategy to improve cardiovascular (CV) health. Men are reported to be less likely to undergo cardiovascular disease (CVD) health check than women. Gender difference could be one of the factors influencing health seeking behaviour of men and women. We aimed to identify gender differences in factors influencing the intention to undergo CVD health checks. METHODS: This was a cross-sectional survey using mall intercept interviews. Malaysians aged ≥30 years without known CVD were recruited. They were asked for their intention to undergo CVD health checks and associated factors. The factors included seven internal factors that were related to individuals' attitude, perception and preparedness for CVD health checks and two external factors that were related to external resources. Hierarchical ordinal regression analysis was used to evaluate the importance of the factors on intention to undergo CVD health checks, for men and women separately. RESULTS: 397 participants were recruited, 60% were women. For men, internal factors explained 31.6% of the variances in likeliness and 9.6% of the timeline to undergo CVD health checks, with 1.2% and 1.8% added respectively when external factors were sequentially included. For women, internal factors explained 18.9% and 22.1% of the variances, with 3.1% and 4.2% added with inclusion of the external factors. In men, perceived drawbacks of health checks was a significant negative factor associated with likeliness to undergo CVD health checks (coefficient = -1.093; 95%CI:-1.592 to -0.594), and timeline for checks (coefficient = -0.533; 95%CI:-0.975 to -0.091). In women, readiness to handle outcomes following health checks was significantly associated with likeliness to undergo the checks (coefficient = 0.575; 95%CI: 0.063 to 1.087), and timeline for checks (coefficient = 0.645; 95%CI: 0.162 to 1.128). Both external factors 1) influence by significant others (coefficient = 0.406; 95%CI: 0.013 to 0.800) and 2) external barriers (coefficient = -0.440; 95%CI:-0.869 to -0.011) were also significantly associated with likeliness to undergo CVD health checks in women. CONCLUSIONS: Both men and women were influenced by internal factors in their intention to undergo CVD health checks, and women were also influenced by external factors. Interventions to encourage CVD health checks need to focus on internal factors and be gender sensitive.


Asunto(s)
Enfermedades Cardiovasculares/psicología , Aceptación de la Atención de Salud , Adulto , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pacientes/estadística & datos numéricos , Factores Sexuales
9.
Niger J Clin Pract ; 23(9): 1305-1311, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32913172

RESUMEN

Objective: The aim of this study was to investigate the effects of the cardiology patients' illness perception on their medication adherence will guide in the development of training and consultancy strategies. Material and Method: The study was conducted with 110 patients who were followed up in the cardiology clinics of a university hospital. The study included patients over the age of 18 years, who agreed to participate in the study and were diagnosed with a cardiovascular disease at least six months before. The data were collected using a patient information form questioning the subjects such as the patients' age, gender, marital status and economic condition, the Illness Perception Questionnaire and the Morisky Medication Adherence Scale. Results: The results showed that 72.7% (n=80) of the group had forgotten to take their medicine, 38.2% (n=42) had a trouble remembering to take their medicine, 29.1% (n=32) stopped taking their medicine when they felt good and 32.7% (n=36) stopped taking their medicine because they sometimes felt bad after taking their medicine. It was determined that there was no statistically significant correlation between Morisky Medication Adherence Scale scores and Illness Perception Questionnaire subscale scores (P >0.05). It was determined that there was a statistically significant difference between the educational backgrounds, in terms of the personal control subscale mean scores (P=0.003; P<0.01). Conclusion: Patients try to explain their disease in the light of their personal experiences, knowledge, values, beliefs, and needs. Illness perception which is among the most important factors providing treatment adherence is an important factor affecting many areas from the person's psychological adaptation to the course of disease. Illness perception and treatment adherence are affected by educational level.


Asunto(s)
Enfermedades Cardiovasculares/terapia , Conocimientos, Actitudes y Práctica en Salud , Percepción , Cumplimiento y Adherencia al Tratamiento/estadística & datos numéricos , Adolescente , Adulto , Anciano , Actitud Frente a la Salud , Enfermedades Cardiovasculares/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Encuestas y Cuestionarios , Cumplimiento y Adherencia al Tratamiento/psicología , Adulto Joven
10.
PLoS One ; 15(8): e0237099, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32745147

RESUMEN

BACKGROUND: Caregivers experience high strain related to care giving. There is increasing interest in examining the caregiver burden of cardiac patients and studying the characteristics of caregivers. PURPOSE: To explore the correlation between quality of life cardiac patients and caregiver's burden. METHODS: A cross-sectional design using a convenience sample of caregivers and patients with cardiac conditions. Sociodemographic sheet, Dutch Objective Burden Inventory (DOBI), and Quality of Life (QLI-Cardiac 4). Linear regression was used to explore the predictors. RESULTS: 200 caregivers and 200 patients with cardiac diseases completed the study. The overall mean scores of both DOBI and QLI-4 indicated moderate results 1.51(SD 0.4), 19.8 (SD 4.7) respectively. Predictors of caregiver burden were young, less educated caregivers and high QoL of cardiac patients. CONCLUSION: Caregivers should receive more support and training from healthcare providers to develop their coping and resilience skills in a way that decreases their care burden and improves their quality of care and self-confidence.


Asunto(s)
Enfermedades Cardiovasculares/psicología , Cuidadores/psicología , Calidad de Vida , Adaptación Psicológica , Adulto , Anciano , Enfermedades Cardiovasculares/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos
11.
Health Qual Life Outcomes ; 18(1): 254, 2020 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-32727479

RESUMEN

BACKGROUND: Cardiovascular diseases (CVDs) have been the global health problems that cause a substantial burden for the patients and the society. Assessing the Quality of Life (QOL) of CVD patients is critical in the effectiveness evaluation of CVD treatments as well as in determining potential areas for enhancing health outcomes. Through the adoption of a combination of bibliometric approach and content analysis, publications trend and the common topics regarding interventions to improve QOL of CVD patients were searched and characterized to inform priority setting and policy development. METHODS: Bibliographic data of publications published from 1990 to 2018 on interventions to improve QOL of CVD patients were retrieved from Web of Science. Network graphs illustrating the terms co-occurrence clusters were created by VOSviewer software. Latent Dirichlet Allocation approach was adopted to classify papers into major research topics. RESULTS: A total of 6457 papers was analyzed. We found a substantial increase in the number of publications, citations, and the number of download times of papers in the last 5 years. There has been a rise in the number of papers related to intervention to increase quality of life among patients with CVD during 1990-2018. Conventional therapies (surgery and medication), and psychological, behavioral interventions were common research topics. Meanwhile, the number of papers evaluating economic effectiveness has not been as high as that of other topics. CONCLUSIONS: The research areas among the scientific studies emphasized the importance of interdisciplinary and inter-sectoral approaches in both evaluation and intervention. Future research should be a focus on economic evaluation of intervention as well as interventions to reduce mental issues among people with CVD.


Asunto(s)
Enfermedades Cardiovasculares/terapia , Publicaciones Periódicas como Asunto , Calidad de Vida , Bibliometría , Enfermedades Cardiovasculares/psicología , Salud Global , Humanos , Factor de Impacto de la Revista
12.
Health Qual Life Outcomes ; 18(1): 251, 2020 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-32718355

RESUMEN

OBJECTIVE: Identify the most recent utility value estimates for cardiovascular disease (CVD) via systematic literature review (SLR) and explore trends in utility elicitation methods in the last 6 years. METHODS: This SLR was updated on January 25, 2018, and identified studies reporting utilities for myocardial infarction (MI), stroke, angina, peripheral artery disease (PAD), and any-cause revascularization by searching Embase, PubMed, Health Technology Assessment Database, and grey literature. RESULTS: A total of 375 studies reported CVD utilities (pre-2013 vs post-2013: MI, 38 vs 32; stroke, 86 vs 113; stable angina, 8 vs 9; undefined/unstable angina, 23 vs 8; PAD, 29 vs 13; revascularization, 54 vs 40). Median average utilities for MI, stroke, and revascularization increased over time (pre-2013 vs post-2013: MI, 0.71 vs 0.79; stroke, 0.63 vs 0.64; revascularization, 0.76 vs 0.81); angina and PAD showed a decrease in median values over time (stable angina, 0.83 vs 0.72; undefined/unstable angina, 0.70 vs 0.69; PAD, 0.76 vs 0.71). The proportion of utility estimates from trials increased across health states (pre-2013 vs post-2013: 22.5% vs 37.2%), as did the proportion of trials using the EuroQol Five Dimensions Questionnaire (EQ-5D; pre-2013 vs post-2013: 73.8% vs 91.4%). Use of methods such as the standard gamble, time trade-off, and Health Utilities Index has declined. CONCLUSIONS: Health state utilities for cardiovascular health states have changed in the last 6 years, likely due to changes in the types of studies conducted, the patient populations evaluated, and possibly changing utility elicitation methods. The EQ-5D has been used more frequently.


Asunto(s)
Enfermedades Cardiovasculares/economía , Indicadores de Salud , Calidad de Vida , Enfermedades Cardiovasculares/psicología , Análisis Costo-Beneficio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Años de Vida Ajustados por Calidad de Vida , Encuestas y Cuestionarios/normas
13.
PLoS One ; 15(7): e0235274, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32628688

RESUMEN

The aim of this study is to explore participants' views and experiences of an eHealth phase 3 cardiac rehabilitation (CR) intervention: Physical Activity Towards Health (PATHway). Sixty participants took part in the PATHway intervention. Debriefs were conducted after the six-month intervention. All interviews were audio recorded and transcribed verbatim. Transcripts were analysed with Braun and Clarke's thematic analysis. Forty-four (71%) debriefs were conducted (n = 34 male, mean (SD) age 61 (10) years). Five key themes were identified: (1) Feedback on the components of the PATHway system, (2) Motivation, (3) Barriers to using PATHway, (4) Enablers to using PATHway, and (5) Post programme reflection. There were a number of subthemes within each theme, for example motivation explores participants motivation to take part in PATHway and participants motivation to sustain engagement with PATHway throughout the intervention period. Participant engagement with the components of the PATHway system was variable. Future research should focus on optimising participant familiarisation with eHealth systems and employ an iterative approach to development and evaluation.


Asunto(s)
Rehabilitación Cardiaca/psicología , Enfermedades Cardiovasculares/psicología , Ejercicio Físico/psicología , Telemedicina/métodos , Anciano , Rehabilitación Cardiaca/métodos , Convalecencia/psicología , Retroalimentación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Motivación/fisiología , Investigación Cualitativa , Encuestas y Cuestionarios
14.
Am J Physiol Heart Circ Physiol ; 319(2): H488-H506, 2020 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-32618516

RESUMEN

Although chronic stress is an important risk factor for cardiovascular diseases (CVD) onset, the underlying mechanisms driving such pathophysiological complications remain relatively unknown. Here, dysregulation of innate stress response systems and the effects of downstream mediators are strongly implicated, with the vascular endothelium emerging as a primary target of excessive glucocorticoid and catecholamine action. Therefore, this review article explores the development of stress-related endothelial dysfunction by focusing on the following: 1) assessing the phenomenon of stress and complexities surrounding this notion, 2) discussing mechanistic links between chronic stress and endothelial dysfunction, and 3) evaluating the utility of various preclinical models currently employed to study mechanisms underlying the onset of stress-mediated complications such as endothelial dysfunction. The data reveal that preclinical models play an important role in our efforts to gain an increased understanding of mechanisms underlying stress-mediated endothelial dysfunction. It is our understanding that this provides a good foundation going forward, and we propose that further efforts should be made to 1) more clearly define the concept of stress and 2) standardize protocols of animal models with specific guidelines to better indicate the mental complications that are simulated.


Asunto(s)
Enfermedades Cardiovasculares/etiología , Endotelio Vascular/fisiopatología , Estrés Psicológico/complicaciones , Animales , Enfermedades Cardiovasculares/metabolismo , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/psicología , Catecolaminas/metabolismo , Enfermedad Crónica , Modelos Animales de Enfermedad , Endotelio Vascular/metabolismo , Glucocorticoides/metabolismo , Humanos , Sistema Hipotálamo-Hipofisario/metabolismo , Sistema Hipotálamo-Hipofisario/fisiopatología , Factores de Riesgo , Transducción de Señal , Estrés Psicológico/metabolismo , Estrés Psicológico/fisiopatología , Estrés Psicológico/psicología
16.
Top Companion Anim Med ; 39: 100431, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32482290

RESUMEN

To evaluate the psychometric properties of the Spanish version of the "FETCH-Q™", 228 dogs with cardiovascular diseases were included. After forward and back translation of the original questionnaire, nonexperts, ethologists and veterinary colleagues evaluated the content's validity through feedback. For criteria validity, the total score was correlated with the heart disease/failure class. For construct validity, the overall quality of life of the dog and the results obtained in each question was correlated. The reliability of the questionnaire was assessed using the Cronbach's alpha coefficient. To evaluate the test-retest validity the intra-class correlation coefficient and Wilcoxon signed-rank test were used. A good agreement with the original questionnaire was evident. For construct validity, the questionnaire obtained r > 0.09 to < 0.82. The criterion validity was appropriate and the correlation was rho = 0.82, with an effect size of 0.55 (P < 0.05). Cronbach's alpha coefficient was (α = 0.89). The test-retest assessment revealed adequate repeatability (correlation coefficient = 0.87; P < .001). There was no difference in the owner responses to the questionnaire at baseline and 2 weeks later in dogs with stable cardiac disease (P > .05). This study supports the validity of psychometric properties of the Spanish version of the functional evaluation of cardiac health questionnaire "FETCHSV2-Q™" to assess Health-related Quality of Life in dogs with cardiovascular disease in clinical settings and research.


Asunto(s)
Enfermedades Cardiovasculares/veterinaria , Enfermedades de los Perros/psicología , Calidad de Vida , Encuestas y Cuestionarios , Animales , Enfermedades Cardiovasculares/psicología , Perros , Femenino , Humanos , Masculino , Propiedad , España , Traducciones
17.
Heart Lung Circ ; 29(7): 960-963, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32561126

RESUMEN

BACKGROUND: The coronavirus disease (COVID-19) pandemic has produced substantial health challenges from the perspective of both its direct health complications and the disruption to delivery of standard care for individuals with a range of acute and chronic health issues. In parallel, the widespread application of social isolation initiatives in most countries raises the potential for significant mental health consequences and psychosocial impacts. This has major implications for cardiovascular health care professionals and the management of their patients. CHALLENGES: The COVID-19 pandemic and associated physical isolation practices are likely to result in a range of mental health and psychosocial challenges. In addition to an increasing incidence of anxiety, depression, suicidal ideation and post-traumatic stress, the pandemic may also witness an increase in substance abuse, domestic violence and relationship discord. The consequences of these complications will be further magnified, when considering their potential effect on cardiovascular disease and its management. PURPOSE: This commentary aims to summarise some of the potential mental health and psychosocial challenges that may arise in the setting of the COVID-19 pandemic.


Asunto(s)
Enfermedades Cardiovasculares , Infecciones por Coronavirus/psicología , Salud Mental , Neumonía Viral/psicología , Psicología , Betacoronavirus , Enfermedades Cardiovasculares/psicología , Enfermedades Cardiovasculares/terapia , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Humanos , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control
18.
J R Soc Med ; 113(5): 185-192, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32407646

RESUMEN

To conduct a systematic review and develop a conceptual framework on the mechanisms linking loneliness, social isolation, health outcomes and mortality. Electronic databases were systematically searched (PubMed, MEDLINE, Scopus and EMBASE) from inception to October 2018 followed by manual searching to identify research on loneliness, social isolation and mortality in adults published in the English language. Articles were assessed for quality and synthesised into a conceptual framework using meta-ethnographical approaches. A total of 122 articles were included. These collated observational designs examining mediators and moderations of the association in addition to qualitative studies exploring potential mechanisms were included. A framework incorporating 18 discrete factors implicated in the association between loneliness, social isolation and mortality was developed. Factors were categorised into societal or individual, and sub-categorised into biological, behavioural and psychological. These findings emphasise the complex multidirectional relationship between loneliness, social isolation and mortality. Our conceptual framework may allow development of more holistic interventions, targeting many of the interdependent factors that contribute to poor outcomes for lonely and socially isolated people.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Causas de Muerte , Soledad/psicología , Aislamiento Social/psicología , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/psicología , Bases de Datos Factuales , Prestación de Atención de Salud , Femenino , Política de Salud , Humanos , Masculino , Formulación de Políticas , Psicología , Investigación Cualitativa , Medición de Riesgo , Análisis de Supervivencia , Reino Unido
19.
PLoS One ; 15(5): e0233703, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32469976

RESUMEN

BACKGROUND: Over a third of menopausal hormone therapy (HT) prescriptions in the US are written for women over age 60. Use of HT more than 5 years is associated with increased risk for cardiovascular disease; breast, ovarian, and endometrial cancers; thromboembolic stroke; gallbladder disease; dementia; and incontinence. OBJECTIVES: To explore older women's perceptions of the benefits and risks of long-term HT and examine factors influencing their decisions to use HT > 5 years despite medical risks. METHODS: A qualitative approach was selected to broadly explore thought processes and social phenomena underlying long-term users' decisions not to discontinue HT. Interviews were conducted with 30 women over age 60 reporting use of systemic HT more than 5 years recruited from an urban area in California and a small city in the Rocky Mountain region. Transcripts of interviews were analyzed using conventional grounded theory methods. RESULTS: Women reported using HT to preserve youthful physical and mental function and prevent disease. Gynecologists had reassured participants regarding risk, about which all 30 expressed little concern. Participants, rather than providers, were the principal drivers of long-term use. CONCLUSIONS: Participants perceived estrogen to have anti-aging efficacy, and using HT imparted a sense of control over various aspects of aging. Maintaining this sense of control was prioritized over potential risk from prolonged use. Our findings provide an additional perspective on previous work suggesting the pharmaceutical industry has leveraged older women's self-esteem, vanity, and fear of aging to sell hormones through marketing practices designed to shape the beliefs of both clinicians and patients. Efforts are needed to: 1) address misconceptions among patients and providers about medically supported uses and risks of prolonged HT, and 2) examine commercial influences, such as medical ghostwriting, that may lead to distorted views of HT efficacy and risk.


Asunto(s)
Envejecimiento/psicología , Terapia de Reemplazo de Estrógeno , Posmenopausia/fisiología , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/psicología , Cultura , Terapia de Reemplazo de Estrógeno/efectos adversos , Terapia de Reemplazo de Estrógeno/psicología , Femenino , Humanos , Persona de Mediana Edad
20.
J Med Internet Res ; 22(5): e14570, 2020 05 22.
Artículo en Inglés | MEDLINE | ID: mdl-32441658

RESUMEN

BACKGROUND: Behavior change methods involving new ambulatory technologies may improve lifestyle and cardiovascular disease outcomes. OBJECTIVE: This study aimed to provide proof-of-concept analyses of an intervention aiming to increase (1) behavioral flexibility, (2) lifestyle change, and (3) quality of life. The feasibility and patient acceptance of the intervention were also evaluated. METHODS: Patients with cardiovascular disease (N=149; mean age 63.57, SD 8.30 years; 50/149, 33.5% women) were recruited in the Do Cardiac Health Advanced New Generation Ecosystem (Do CHANGE) trial and randomized to the Do CHANGE intervention or care as usual (CAU). The intervention involved a 3-month behavioral program in combination with ecological momentary assessment and intervention technologies. RESULTS: The intervention was perceived to be feasible and useful. A significant increase in lifestyle scores over time was found for both groups (F2,146.6=9.99; P<.001), which was similar for CAU and the intervention group (F1,149.9=0.09; P=.77). Quality of life improved more in the intervention group (mean 1.11, SD 0.11) than CAU (mean -1.47, SD 0.11) immediately following the intervention (3 months), but this benefit was not sustained at the 6-month follow-up (interaction: P=.02). No significant treatment effects were observed for behavioral flexibility (F1,149.0=0.48; P=.07). CONCLUSIONS: The Do CHANGE 1 intervention was perceived as useful and easy to use. However, no long-term treatment effects were found on the outcome measures. More research is warranted to examine which components of behavioral interventions are effective in producing long-term behavior change. TRIAL REGISTRATION: ClinicalTrials.gov NCT02946281; https://www.clinicaltrials.gov/ct2/show/NCT02946281.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Estilo de Vida , Calidad de Vida/psicología , Telemedicina/métodos , Enfermedades Cardiovasculares/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad
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